This article explores the compatibility of traditional Chinese medicine for external treatment of ulcers from the perspec-tive of"the principle of internal and external treatment"in Rhymed Discourse on External Remedies.First,it discusses the clinical un-derstanding of chronic skin ulcers,and then it explains the connotation of"the principle of internal and external treatment",which has the characteristics of theoretical homology,syndrome differentiation and treatment,and focusing on the property and taste of the medi-cine first.Finally,based on"the principle of internal and external treatment",it discusses the compatibility ideas of Chinese medicine for external treatment of ulcers,and specifically analyzes the compatibility ideas of property and taste and monarch,minister,assistant and envoy,so as to provide some reference for the external treatment and compatibility of Chinese medicine for chronic skin ulcers,and also hopes to provide some directions for the research and development of external traditional Chinese patent medicines and simple prep-arations.

Objective:To explore the relationship between childhood obesity, gut microbiota, and short chain fatty acids(SCFAs) based on 16S rRNA sequencing.Methods:A total of 162 obese children admitted to our hospital and 162 age-matched healthy children with normal body weight from the same period were selected as the control group. Baseline data were collected. Gut microbiota composition and abundance were analyzed using 16S rRNA sequencing, and fecal SCFA levels were measured by gas chromatography-mass spectrometry. Then, multiple linear regression, multivariable logistic regression, Spearman correlation, and restricted cubic spline models were applied to explore the relationships among baseline data, childhood obesity, gut microbiota, and their metabolites. Results:The α diversity(ACE, Chao1, Shannon index) of intestinal flora in the obese group was significantly lower than that in the control group( P<0.05). The abundance of Firmicutes, Actinobacteria, Acinetobacter, Ruminococcus, Clostridium, and Prevotella increased significantly, while the abundance of Bacteroidetes, Bifidobacterium, Akkermansia, Coprococcus, Streptobacter, and Eubacterium decreased significantly( P<0.05). The levels of butyrate, propionate, acetate, and total SCFAs in the obese group decreased significantly( P<0.05). Multivariate linear regression analysis showed that parental obesity and snack consumption frequency were positively related to the abundance of Firmicutes and Actinobacteria in children′s gut, but negatively related to the abundance of Proteobacteria. As for Bacteroidetes, butyrate and propionate levels, they were negatively linked to exercise time, eating rate, and birth weight, and also positively related to Firmicutes. The results of correlation analysis showed that Firmicutes, Actinobacteria, Anaerostipes, Acinetobacter, Ruminococcus, Clostridium, and Prevotella were significantly positively correlated with childhood obesity, while Bacteroidetes, Bifidobacterium, Akkermansia, butyrate, propionate, acetate, and total SCFAs were significantly negatively correlated with childhood obesity. Nonlinear analysis showed that butyrate, propionate, acetate, and Firmicutes/ Bacteroidetes were nonlinearly correlated with the occurrence of obesity( P<0.05). Conclusion:Childhood obesity is closely related to reduced gut microbiota diversity, altered abundances of specific microbial taxa, and reduced levels of SCFA. Modulating gut microbiota may provide novel microbial targets for obesity prevention and treatment.

This article explores the compatibility of traditional Chinese medicine for external treatment of ulcers from the perspec-tive of"the principle of internal and external treatment"in Rhymed Discourse on External Remedies.First,it discusses the clinical un-derstanding of chronic skin ulcers,and then it explains the connotation of"the principle of internal and external treatment",which has the characteristics of theoretical homology,syndrome differentiation and treatment,and focusing on the property and taste of the medi-cine first.Finally,based on"the principle of internal and external treatment",it discusses the compatibility ideas of Chinese medicine for external treatment of ulcers,and specifically analyzes the compatibility ideas of property and taste and monarch,minister,assistant and envoy,so as to provide some reference for the external treatment and compatibility of Chinese medicine for chronic skin ulcers,and also hopes to provide some directions for the research and development of external traditional Chinese patent medicines and simple prep-arations.

Objective:To explore the relationship between childhood obesity, gut microbiota, and short chain fatty acids(SCFAs) based on 16S rRNA sequencing.Methods:A total of 162 obese children admitted to our hospital and 162 age-matched healthy children with normal body weight from the same period were selected as the control group. Baseline data were collected. Gut microbiota composition and abundance were analyzed using 16S rRNA sequencing, and fecal SCFA levels were measured by gas chromatography-mass spectrometry. Then, multiple linear regression, multivariable logistic regression, Spearman correlation, and restricted cubic spline models were applied to explore the relationships among baseline data, childhood obesity, gut microbiota, and their metabolites. Results:The α diversity(ACE, Chao1, Shannon index) of intestinal flora in the obese group was significantly lower than that in the control group( P<0.05). The abundance of Firmicutes, Actinobacteria, Acinetobacter, Ruminococcus, Clostridium, and Prevotella increased significantly, while the abundance of Bacteroidetes, Bifidobacterium, Akkermansia, Coprococcus, Streptobacter, and Eubacterium decreased significantly( P<0.05). The levels of butyrate, propionate, acetate, and total SCFAs in the obese group decreased significantly( P<0.05). Multivariate linear regression analysis showed that parental obesity and snack consumption frequency were positively related to the abundance of Firmicutes and Actinobacteria in children′s gut, but negatively related to the abundance of Proteobacteria. As for Bacteroidetes, butyrate and propionate levels, they were negatively linked to exercise time, eating rate, and birth weight, and also positively related to Firmicutes. The results of correlation analysis showed that Firmicutes, Actinobacteria, Anaerostipes, Acinetobacter, Ruminococcus, Clostridium, and Prevotella were significantly positively correlated with childhood obesity, while Bacteroidetes, Bifidobacterium, Akkermansia, butyrate, propionate, acetate, and total SCFAs were significantly negatively correlated with childhood obesity. Nonlinear analysis showed that butyrate, propionate, acetate, and Firmicutes/ Bacteroidetes were nonlinearly correlated with the occurrence of obesity( P<0.05). Conclusion:Childhood obesity is closely related to reduced gut microbiota diversity, altered abundances of specific microbial taxa, and reduced levels of SCFA. Modulating gut microbiota may provide novel microbial targets for obesity prevention and treatment.

This paper reviews the limitations of current infectious disease surveillance and early warning system in China, analyzes the concepts and countermeasures of the establishment of an intelligent early warning platform of infectious diseases based on multi-point trigger mechanism and multi-channel surveillance mechanism and proposes the realization routes for the purpose of facilitating capacity building and improvement of surveillance and early warning of infectious diseases in China.

Objective: To summarize the measures and experience of treatment in mass extremely severe burn patients. Methods: The clinical data and treatment of 8 extremely severe burn patients in August 2 Kunshan factory aluminum dust explosion accident who were admitted in the 100th Hospital of PLA on August 2nd, 2014, were retrospectively analyzed. There were 4 males and 4 females, aging 22-45 (34±7) years, with total burn area of 55%-98% [(89±15)%] total body surface area (TBSA) and full-thickness burn area of 45%-97% [(80±21)%] TBSA. All the 8 patients were accompanied with severe shock, inhalation injury, and blast injury. According to the requirements of former PLA General Logistics Department and Nanjing Military Command, a treatment team was set up including a special medical unit and a special care unit, with Chai Jiake from the First Affiliated Hospital of PLA General Hospital as the team leader, Zheng Qingyi from the 175th Hospital of PLA (the Affiliated Dongnan Hospital of Xiamen University) as the deputy leader, the 100th Hospital of PLA as the treatment base, and burn care, respiratory, nephrology, nursing specialists from the First Affiliated Hospital of PLA General Hospital, and the burn care experts and nursing staff from the 180th Hospital of PLA, 118th Hospital of PLA, 98th Hospital of PLA, and 175th Hospital of PLA, and nurses from the 85th Hospital of PLA, 455th Hospital of PLA, 101th Hospital of PLA, 113th Hospital of PLA as team members. Treatment strategies were adopted as unified coordination by the superior, unified responsibility of team leader, division of labor and cooperation between team members, and multidisciplinary cooperation led by department of burns. With exception of one patient who received deep vein catheterization before admission, the other 7 patients were treated with deep vein catheterization 0.5 to 3.0 hours after admission to correct hypovolemic shock as soon as possible. Eight patients received tracheotomy, and 7 patients were treated with mechanical ventilation by ventilator in protective ventilation strategy with low tide volume and low volume pressure to assist breathing. Fiberoptic bronchoscopy was done one to three times for all the 8 patients to confirm airway injuries and healing status. Escharectomy and Meek dermatoplasty in the extremities of all the 8 patients were performed 3 to 6 days after injury for the first time. Escharectomy, microskin grafting, and covering of large pieces of allogeneic skin on the trunks of 4 patients were performed 11 to 16 days after injury for the second time. The broad-spectrum antibiotics were uniformly used at first time of anti-infective therapy, and then the antibiotics species were adjusted in time. The balance of internal environment was maintained and the visceral functions were protected. One special care unit was on responsibility of only one patient. Psychological intervention was performed on admission. The rehabilitative treatment was started at early stage and in company with the whole treatment. Results: Acute renal injury occurred in 5 patients within 36 hours after injury and their renal function was restored to normal 4 days after injury due to active adjustment of fluid resuscitation program. No pulmonary complications, such as severe pulmonary infection and ventilator-associated pneumonia, occurred in the survived patients. One of the 8 patients died, and the other 7 patients were cured successfully. The wounds were basically healed in 2 patients in 26 or 27 days by 2 or 3 times of operation, and in 5 patients by 4 or 5 times of operation. The basic wound healing time was 26-64 (48±15) days for all the 7 patients. Conclusions Treatment strategies of unified coordination by the superior, unified responsibility of team leader, division of labor and cooperation between team members, and multidisciplinary cooperation led by department of burns are the bases to successful treatment. Correcting shock as soon as possible is the prerequisite and closing wound as soon as possible is the key to successful treatment. Comprehensive treatment measures, such as maintaining and regulating the function of viscera, improving the body immunity, and preventing and treating the complications, are the important components to successful treatment. It is emphasized that in the treatment of mass extremely severe burn patients, specialist burn treatment should always be in the dominant position, and other related disciplines may play a part in auxiliary function.

Objective To share the experience of the patent application,authorization,and transfer in a hospital in last five years,this study aims to improve the patent application and authorization in hospitals.Methods Using data from China Patent Infonet and State Intellectual Property Office of People's Republic of China,we searched the patent application and authorization during Jan.2012 to Dec.2016,and included those that patentee was our hospital or the employee of our hospital.Results The number of patent applications was 215,including 151 service intention-creation applications,and 64 non-service intention-creation applications.Patent application and authorization in our hospital have been increasing year by year,covering internal medicine,surgery,obstetrics and gynecology,pediatrics and so forth.Conclusions We accumulated some experience in patent application,authorization and transfer which provide reference for further,more comprehensive and integrated,patent management system.

Objective To evaluate the efficacy of patients with stage T2 bladder cancer who underwent combined treatment of bladder-preserving surgery and adjuvant intra-arterial chemotherapy.Methods The survival data of bladder cancer paients from January 2000 to December 2014 with stage T2N0M0 were retrospectively analyzed.Thirty-five patients of cT2N0M0 receive combined treatment of bladder-preserving surgery and adjuvant intra-arterial chemotherapy(group A),and 80 patients of pT2N0M0 underwent radical cystectomy (RC) (group B).The pathological diagnosis of all patients was urothelial carcinoma.In group A,there were 33(94.2％) males and 2 (5.8％) females;20 (57.1％) tumor size less than 3 cm and 15 (42.9％) larger than 3 cm;24 (68.6％) with single tumor and 11 (31.4％) with multiple tumors;11 (31.4％) patients with primary tumors and 24 (68.6％) recurrent tumors.In group B,there were 71 (88.7％) males and 9 (11.3％) females;35 (43.8％) tumor size less than 3 cm and 45(56.2％) larger than 3 cm;44 (55.0％) with single tumors and 36 (45.0％) with multiple tumors;22(27.5％) patients with primary tumors and 58 (72.5％) recurrent tumors.Results Groups A and B consisted of 35 and 80 patients and median follow-up time was 68 (13-157)and 67 (4-198)months,respectively.There was no significantly statistical difference in disease-specific survival (DSS) between the two groups(P =0.888),76.5％ for group A and 60.6％ for group B respectively.In group A,26 (74.3％) patients achieved complete response (CR) to intra-arterial chemotherapy.Additionally,amounts of 21 (60.0％) patients preserve their functional bladder successfully and their median follow-up time was 69 (13-134)months.8 patients receive delayed radical cystectomy when suffered tumor recurrence and none of them had lymph node metastases.Of those pathological stage was presented as stage T2 5 cases,T3 2 cases and T4 1 case.Importantly,the 8 patients who receive delayed RC did not confer worse DSS when compared with those underwent immediate RC in group B (P =0.809).Cox proportional hazards model showed that tumor number and CR to intra-arterial chemotherapy was independent prognostic factor for disease-free survival (HR =0.238,P =0.007) and DSS(HR =0.085,P =0.004) respectively.During the period of intra-arterial chemotherapy,we did not observe hematological toxicity of grade Ⅳ and the hematological toxicity of grade Ⅰ-Ⅲ was 9 (25.7％),6 (17.1％) and 4 (11.4％).Conclusions For patients with T2N0M0,combined treatment of bladder-preserving surgery and adjuvant intra-arterial chemotherapy could be a therapy with long-term survival outcome and safety.The therapy could be offered as alternative treatment option for patients who were unsuitable for receiving RC.

OBJECTIVETo explore the diagnosis, treatment and prognosis of testicular benign tumors in children.

METHODSThe clinical data of 37 boys (aged between 3 months to 12 years) with testicular tumors treated in our center between August 2000 and August 2013 were retrospectively analyzed. The median age was 14 months and 21 boys were less than 2 years old. The tumors were on the left side in 18 cases, on the right side in 15 cases, and on both sides in 4 cases (adrenal residue testis tumor). Thirty-five patients presented with painless scrotal mass; in the other two cases, testicular residue tumor was found in routine medical examination in one case and testicular mature teratoma was found due to perineal pain in the other; both of the boys underwent ultrasound or CT examination. Thirty-three boys had tumor marker detection. Of the 37 boys with benign testicular tumors, 25 underwent radical inguinal orchiectomy and 12 had testis-sparing surgery.

RESULTSThe boys were followed up for 3-107 months (median 46 months). No patients were found to have tumor recurrence, metastasis or such complications as testicular atrophy; 3 boys had natural fertility later in adutthood.

CONCLUSIONSA high proportion of testicular tumors in children are benign. Preoperative ultrasound or CT combined with detection of tumor markers such as serum AFP can be important in the diagnosis of pediatric testicular tumors, for which testis-sparing surgery should be considered.

Biomarkers, Tumor ; Child ; Child, Preschool ; Humans ; Infant ; Male ; Neoplasm Metastasis ; Neoplasm Recurrence, Local ; Orchiectomy ; Retrospective Studies ; Teratoma ; diagnosis ; pathology ; therapy ; Testicular Neoplasms ; diagnosis ; pathology ; therapy

OBJECTIVETo analyze the viral etiologies of hospitalized pneumonia patients aged less than five years in six provinces during 2009-2012, and to describe the seasonality of the detected viral etiologies.

METHODSEight hospitals were selected in six provinces from a national acute respiratory infection surveillance network. Demographic information, clinical history and physical examination, and laboratory testing results of the enrolled hospitalized patients aged less than five years with pneumonia, including respiratory syncytial virus (RSV), human influenza virus, adenoviruses (ADV), human parainfluenza virus (PIV), human metapneumovirus (hMPV), human coronavirus (hCoV)and human bocavirus (hBoV) were analyzed. The viral etiology spectrum of the enrolled patients was analyzed by age-group, year, and seasonality of the detected viral etiologies were described.

RESULTS4 508 hospitalized children less than five years old, with pneumonia from 8 hospitals were included, and 2 688 (59.6%) patients were positive for at least one viral etiology. The most frequent detected virus was RSV (21.3%), followed by PIV (7.1%) and influenza (5.2%), hBoV (3.8%), ADV(3.6%) and hMPV(2.6%). The lowest positive rates in hCoV(1.1%). RSV, influenza, PIV, hBoV and hMPV all showed the nature of seasonality.

CONCLUSIONRSV was a most common viral etiology in the hospitalized young children less than 5 years of age with pneumonia. Prevention measures should be conducted to decrease its severe impact to the young infants and children in China.

Child, Hospitalized ; statistics & numerical data ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Infant ; Male ; Pneumonia, Viral ; epidemiology ; virology