The comparison between traditional Chinese medicine Jinzhen oral liquid (JZOL) and Western medicine in treating children with acute bronchitis (AB) showed encouraging outcomes. This trial evaluated the efficacy and safety of the JZOL for improving cough and expectoration in children with AB. 480 children were randomly assigned to take JZOL or ambroxol hydrochloride and clenbuterol hydrochloride oral solution for 7 days. The primary outcome was time-to-cough resolution. The median time-to-cough resolution in both groups was 5.0 days and the antitussive onset median time was only 1 day. This randomized controlled trial showed that JZOL was not inferior to cough suppressant and phlegm resolving western medicine in treating cough and sputum and could comprehensively treat respiratory and systemic discomfort symptoms. Combined with clinical trials, the mechanism of JZOL against AB was uncovered by network target analysis, it was found that the pathways in TRP channels like IL-1β/IL1R/TRPV1/TRPA1, NGF/TrkA/TRPV1/TRPA1, and PGE2/EP/PKA/TRPV1/TRPA1 might play important roles. Animal experiments further confirmed that inflammation and the immune regulatory effect of JZOL in the treatment of AB were of vital importance and TRP channels were the key mechanism of action.

OBJECTIVE To evaluate the quality of guidelines/consensus on therapeutic drug monitoring （TDM） of anti-tumor necrosis factor-α （TNF-α） in patients with inflammatory bowel disease （IBD） in China and globally. METHODS PubMed， Embase， CNKI， Wanfang data， VIP， and release websites of guidelines/consensus in China and globally were searched to collect guidelines/expert consensus on TDM with anti-TNF-α for IBD patients. The search period was from database establishment to June 2023. After two investigators independently screened the literature and extracted the data， the methodological quality of the included guidelines/consensuses was evaluated using the Appraisal of Guidelines for Research and Evaluation Ⅱ. The main recommendations of the included guidelines/consensuses were summarized. RESULTS A total of 9 articles were included， 3 were guidelines and 6 were expert consensus. The standardized percentages of the 9 guidelines/consensus in the 6 dimensions （scope and aims， participants， rigor of formulation， clarity of expression， application， and editorial independence） were 90.43%， 41.98%， 52.55%， 85.49%， 19.00%， and 76.85%， respectively. Eight guidelines/consensus had a recommendation of grade B and one consensus of grade C. The main recommendations involve TDM application scenarios， threshold ranges， strategy adjustments， detection methods， and interpretation of results. Most guidelines/consensus recommend passive TDM for non-responders. It is recommended to set the TDM concentration range according to the expected treatment results and make strategy adjustments in combination with the disease condition and TDM results. Additionally， the same test method is recommended for the same patient. Some guidelines/consensus hold that no differences were noted in the interpretation of results between biosimilar and original drug. CONCLUSIONS The overall quality of the included guidelines/consensus was fair， with relatively consistent recommendation. Clinicians need to understand the characteristics and limitations of TDM with this class of drugs， and interpret and apply results of TDM in combination with specific clinical treatment goals.

Purpose To investigate the expression and sig-nificance of CH25H and STAT3 in follicular lymphoma(FL).Methods Differentially expressed genes in FL and normal lymph node tissues from the GEO were screened.Paraffin sam-ples from 54 cases of FL and 20 cases of reactive proliferative lymph node tissue were collected.Immunohistochemical methods were used to detect the expression of CH25H and STAT3 in par-affin samples,and their relationship with the clinical and patho-logical characteristics of FL was analyzed.Results The expres-sion of CH25H mRNA in FL was significantly higher than that in normal lymph node tissue(P＜0.01).The expression level of CH25H mRNA in FL was linearly correlated with STAT3(P＜0.01).The high expression rate of CH25H in FL was 48.1％,which significantly higher than that in reactive proliferative lymph node tissue(15.0％,P＜0.05).The high expression rate of STAT3 was 59.3％,which significantly higher than that of reactive proliferative lymph node tissue(25.0％,P＜0.05).The expression level of CH25H protein was significantly correla-ted with the pathological grading and clinical Ann Arbor staging of FL(all P＜0.05).CH25H expression was higher in FL with high Ki67 expression(≥30％),while it was lower in FL with low Ki67 expression,and the difference was significant(P＜0.05).There was no significant correlation between CH25H and patient age,gender,presence or absence of B symptoms,ex-pression of CD10,BCL6,BCL2,FLIPI-1 score,lymphocyte count,and monocyte count(all P＞0.05).The expression lev-el of STAT3 protein was significantly correlated with the patho-logical grading,clinical Ann Arbor staging,and FLIPI-1 score of FL(all P＜0.05).STAT3 expression was higher in FL with high Ki67 expression(≥30％),while it was lower in FL with low Ki67 expression,and the difference was significant(P＜0.05).STAT3 was not significantly correlated with patient age,gender,presence or absence of B symptoms,expression of CD10,BCL6,BCL2,lymphocyte count,and monocyte count(all P＞0.05).The expression levels of CH25H and STAT3 in FL were positively correlated(r=0.573,P＜0.001).Conclu-sion The expression levels of CH25H and STAT3 proteins in FL are significantly increased,which can serve as potential mo-lecular markers for pathological diagnosis,grading,and progno-sis evaluation of FL.Abnormal expression of CH25H and STAT3 may jointly participate in the occurrence and progression of FL.

Purpose To investigate the expression and sig-nificance of CH25H and STAT3 in follicular lymphoma(FL).Methods Differentially expressed genes in FL and normal lymph node tissues from the GEO were screened.Paraffin sam-ples from 54 cases of FL and 20 cases of reactive proliferative lymph node tissue were collected.Immunohistochemical methods were used to detect the expression of CH25H and STAT3 in par-affin samples,and their relationship with the clinical and patho-logical characteristics of FL was analyzed.Results The expres-sion of CH25H mRNA in FL was significantly higher than that in normal lymph node tissue(P＜0.01).The expression level of CH25H mRNA in FL was linearly correlated with STAT3(P＜0.01).The high expression rate of CH25H in FL was 48.1％,which significantly higher than that in reactive proliferative lymph node tissue(15.0％,P＜0.05).The high expression rate of STAT3 was 59.3％,which significantly higher than that of reactive proliferative lymph node tissue(25.0％,P＜0.05).The expression level of CH25H protein was significantly correla-ted with the pathological grading and clinical Ann Arbor staging of FL(all P＜0.05).CH25H expression was higher in FL with high Ki67 expression(≥30％),while it was lower in FL with low Ki67 expression,and the difference was significant(P＜0.05).There was no significant correlation between CH25H and patient age,gender,presence or absence of B symptoms,ex-pression of CD10,BCL6,BCL2,FLIPI-1 score,lymphocyte count,and monocyte count(all P＞0.05).The expression lev-el of STAT3 protein was significantly correlated with the patho-logical grading,clinical Ann Arbor staging,and FLIPI-1 score of FL(all P＜0.05).STAT3 expression was higher in FL with high Ki67 expression(≥30％),while it was lower in FL with low Ki67 expression,and the difference was significant(P＜0.05).STAT3 was not significantly correlated with patient age,gender,presence or absence of B symptoms,expression of CD10,BCL6,BCL2,lymphocyte count,and monocyte count(all P＞0.05).The expression levels of CH25H and STAT3 in FL were positively correlated(r=0.573,P＜0.001).Conclu-sion The expression levels of CH25H and STAT3 proteins in FL are significantly increased,which can serve as potential mo-lecular markers for pathological diagnosis,grading,and progno-sis evaluation of FL.Abnormal expression of CH25H and STAT3 may jointly participate in the occurrence and progression of FL.

Objective:To analyze the relationship of fractional exhaled nitric oxide(FeNO)levels with eosinophils(EOS), C-reactive protein(CRP), procalcitonin(PCT)levels in elderly patients with asthma-chronic obstructive pulmonary disease overlap(ACO).Methods:A retrospective study was conducted.According to the inclusion criteria, 60 elderly patients with ACO admitted in Fujian Geriatric Hospital from May 2016 to May 2019 were enrolled in the ACO group.During the same period, 60 patients with bronchial asthma were included in the asthma group, 60 patients with chronic obstructive pulmonary disease(COPD)were recruited in the COPD group, and 60 people taking health examination were included in the health group.Levels of FeNO, EOS, CRP and PCT were detected and compared between the groups.Correlations of FeNO levels with EOS and inflammatory factors were analyzed by the Spearman correlation.Results:The group with asthma alone showed the highest levels of FeNO, followed by the ACO group, the COPD group and the healthy group( F=970.235, P=0.000). The ACO group had the highest levels of EOS, CRP and PCT, followed by the COPD group, the asthma group and the healthy group( F=103.74, 76.648 and 57.042, P=0.000). Spearman bivariate correlation analysis showed that FeNO levels were positively correlated with levels of EOS, CRP and PCT in the asthma, COPD and ACO groups(the asthma group: r=0.646, 0.326 and 0.497, P=0.000, 0.014 and 0.000; the COPD group: r=0.398, 0.613 and 0.432, P=0.009, 0.000 and 0.001 the ACO group: r=0.654, 0.573 and 0.516, P=0.000, 0.000 and 0.000). Conclusions:High levels of FeNO are found in elderly patients with ACO.Levels of FeNO are positively correlated with EOS, CRP and PCT levels in peripheral blood, and can be used as a sensitive index for airway hyperinflammatory responses.

Objective:To optimize the water extraction and alcohol precipitation technology of Xuanfei Zhike granule .Methods:Orthogonal test was used to investigate the effects of adding water , decocting time and boiling time on the water extraction , and the effects of relative density , alcohol precipitation concentration and alcohol precipitation time on the alcohol precipitation technology by taking comprehensive score including the amount of hesperidin , the amount of tectoridin and the yield of dry cream as the indices .Re-sults:The preferred water extraction technology was as follows: added 10 times water and extracted 1.5 h firstly, and then added 8 times water and extracted twice with 0.5 h for each.The preferred alcohol precipitation technology was as follows:concentrated the wa-ter extraction to a relative density of 1.05 (measured at 60℃), slowly added 95％ethanol to 80％alcohol solution and stored 18 h at low temperature .Conclusion:The optimal water extraction and alcohol precipitation technology is stable and feasible , which can pro-vide reference for the standardized production of Xuanfei Zhike granule .

Objective To explore the correlation between volumetric capnography(VCap)and traditional pulmonary function in chronic obstructive pulmonary disease(COPD),so as to assess whether VCap can be used as alternative indicators for the evaluation of COPD severity when some of the elderly COPD patients do not accomplish the traditional pulmonary function tests.Methods 960 patients admitted to Fujian Geriatric Hospital from June 2008 to June 2015 and undergoing pulmonary function tests were included in the study.They were divided into 2 groups of the COPD group(640 cases)and the control group(320 cases).The pulmonary function of COPD group was divided into 4 subgroups(Ⅰ~Ⅳ).All persons received tests of traditional pulmonary function and VCap.The correlations between VCap and traditional pulmonary function indexes and between VCap and COPD severity were observed.Results The differences in Vm25-50/VT,Vm50-75/VT,dC/dV3,SR23 of VCap between the 4 subgroups(COPDⅠ~COPDⅣ)and control group were statistically significant(all P<0.05),while the difference in dC/dV2 of VCap between the 4 subgroups(COPDⅠ~COPDⅣ)and control group was not statistically significant(t=-0.22,-0.43,0.26 and 0.64,all P>0.05).The difference in CO2 max between the COPD Ⅲ group(severe or more severe group)and control group was statistically significant(t=6.91 and 4.65,all P<0.05).The difference in VD-B/VT and VD-F/VT of VCap between the COPD(Ⅱ~Ⅳ)group(from moderate to very severe group)and control group were statistically significant(all P<0.05).CO2 max,VD-B/VT,VD-F/VT,Vm25-50/VT,Vm50-75/VT,dC/dV3,SR23 of VCap showed correlation with traditional pulmonary function.The correlation between dC/dV3 and the seven traditional pulmonary function indexes seen above was statistically significant(|r|>0.555,P<0.05).The specificity of Vm25-50/VT of VCap for the diagnosis of COPD was best,but its sensitivity was poor than other indexes of VCap.The indexes with both high sensitivity and high specificity were Vm50-75/VT and dC/dV3.Conclusions When the patients with COPD manifest the mild airflow limited,Vm25-50/VT,Vm50-75/VT,dC/dV3 and SR23 of VCap are gradually increased with abnormal VCap figures when the illness progressed.The CO2max of VCap might be one of the indexes for assessing the severity of severe or more severe COPD.

Objective:To study the effect of atractylodes lactideⅠ,Ⅱand Ⅲ on the expression of cytokines by inducing M1 type macrophage model. Methods:Apoptotic macrophages were induced by sodium thioglycolate, and then the rat peritoneal inflammatory macrophages were purified by a differential adherence method. The expression of macrophage marker antigen (ED1) was identified by flow cytometry macrophages. Tumor necrosis factor ( TNF-α) , proinflammatory cytokines ( IL-1β) and interleukin-6 ( IL-6 ) were measured by ELISA in vitro. The levels of expression of arginase 1, inducible nitric oxide synthase (iNOS), inflammatory cytokines (IL-1β) chemokine (CCL22) and transforming growth factor (TGF-β) in inflammatory macrophages were determined by RT-PCR. Results:As for the purification of cultured rat inflammatory macrophage expressing ED1, atractylenolideⅠand Ⅲ could reduce the ex-pression levels of iNOS and IL-1βand increase the expression levels of arginase1 CCL22 and TGF-β. The release of inflammatory fac-tor IL-1β decreased, and the release levels of TGF-β and chemokines CCL22 were promoted(P<0. 05). Atropine lactoneⅠ and Ⅲ had significant inhibitory effects on TNF-α, IL-1β and IL-6 in macrophages(P<0. 05). Conclusion: Atractylodes lactone Ⅰand Ⅲ with anti-inflammatory activity can promote the expression of cytokines in inflammatory macrophages, while the change induced by at-ractylaxanthin Ⅱ is not obvious.

Objective To investigate the prognostic value of regulatory B cells (Bregs) in patients with acute pancreatitis .Methods Flow cytometry analysis was performed to detected the percentages of CD19+IL-10+and CD19+CD24hiCD27hi Bregs in peripheral blood samples collected from patients with acute pancreatitis (36 cases with mild acute pancreatitis and 15 cases with severe acute pancreatitis ) as well as the surface costimulatory molecules including CD80 and CD86 on CD19+CD24hiCD27hi Bregs.Their correlations with lymphocytes and C-reactive protein ( CRP) were further analyzed .Results The numbers of lympho-cytes, CD19+lymphocytes, CD19+IL-10+and CD19+CD24hi CD27hi Bregs in peripheral blood samples col-lected from patients with severe and mild acute pancreatitis as well as the mean fluorescence intensities ( MFI) of CD80 and CD86 were significantly lower than those from healthy subjects .Compared with patients with mild acute pancreatitis , the numbers of lymphocytes and CD 19+lymphocytes , the absolute numbers of CD19+IL-10+and CD19+CD24hiCD27hi Bregs as well as the mean fluorescence intensities (MFI) of CD80 and CD86 in patients with severe acute pancreatitis were significantly decreased .The percentages of CD19+IL-10+and CD19+CD24hiCD27hi Bregs in patients with mild acute pancreatitis were significantly increased af-ter an initial drop , but in patients with severe acute pancreatitis those values were continuously decreased along with the disease progression .The percentage of CD19+IL-10+Bregs was positively correlated with the percentage of CD19+CD24hiCD27hi Bregs and the absolute number of CD19+lymphocytes, but was negatively correlated with CRP .Conclusion The abnormal number and function of CD 19+IL-10+and CD19+CD24 hi CD27hi Bregs might be one of the important reasons causing immune dysfunction in patients with acute pan -creatitis.

Objective To investigate the prognostic value of CD 4+CD25+/high CD127 low/-and CD14+HLA-DRlow/-for evaluating the severity of acute pancreatitis .Methods The percentages of CD4+CD25+/highCD127low/-and CD14+HLA-DRlow/-and the CD64 index were measured by flow cytometry in pa-tients with acute pancreatitis ( including 43 cases of mild acute pancreatitis and 24 cases of severe acute pan-creatitis).Moreover, the levels of C-reactive protein (CRP), acute physiology and chronic health evaluationⅡ( APACHEⅡ) score and CT severity index ( CTSI ) were detected for a correlation analysis .Results The percentages of CD4+CD25+/highCD127low/-and CD14+HLA-DRlow/-and the CD64 index in patients with severe and mild acute pancreatitis were significantly higher than those in healthy subjects .Patients with se-vere acute pancreatitis showed higher percentages of CD 14+HLA-DRlow/-than patients with mild acute pan-creatitis.With the disease progression, the CD64 index and the levels of CD4+CD25+/highCD127low/-, CD14+HLA-DRlow/-and CRP were significantly dropped after an initial increase in patients with mild acute pancrea -titis, while these indexes were continuously elevated in patients with severe acute pancreatitis .The percent-age of CD14+HLA-DRlow/-was positively correlated with CD64 index, CRP level, APACHEⅡ score and CTSI.Conclusion CD14+HLA-DRlow/-level was closely related to the severity of acute pancreatitis , which could be used as immune parameter for the estimation of the clinical severity of acute pancreatitis .