Allergic rhinitis is a common allergic disease in children.Its pathogenesis is complex and it is difficult to achieve radi-cal cure or effective and stable long-term treatment goals.Chinese medicine has obvious advantages in preventing and treating allergic rhinitis in children due to its wide range of targets,long-lasting effects and few adverse reactions.This paper proposes that the onset of allergic rhinitis is mostly caused by the dysfunction of the lung,spleen and kidney,the external wind triggering the latent wind,and the combination of the two winds.A staged prevention and treatment strategy of Chinese medicine should be adopted,which includes dispersing external wind,suppressing latent wind,and promoting lung-qi and clearing nasal orifice during the attack period to treat its symptoms,and preventing external wind,calming down latent wind,and regulating and tonifying the lung,spleen,and kidney during the remission period to treat its root cause;meanwhile,attention should be paid to avoiding the adverse effects of congenital endowment factors and the induction of acquired environmental factors,strengthening the body's health to protect against the evil wind,preventing the transformation of existing diseases and the recurrence of allergic rhinitis in children at all stages.

Objective:To describe the characteristics, etiology and patterns of outpatients and inpatients patients with moderate or severe valvular heart disease (VHD).Methods:This is a cross-sectional study. Outpatients and inpatients with moderate or severe VHD who underwent transthoracic echocardiography for first examination from 1 st January 2001 to 1 st January 2020 in Southwest Hospital, Army Medical University were enrolled. Data were collected from medical records and big data platform of Southwest Hospital. Characteristics of age and gender, etiology and types of VHD were descriptively analysed. Results:A total of 68 354 patients with moderate or severe VHD were enrolled. The age was 63 (50, 72) years. And 35 706 (52.24%) patients were female. (1) Age characteristics: There was similar age trend between male and female patients with moderate or severe VHD. The number of patients increased firstly and then decreased and reached its peak in the age group of 65-69 years old. The peak age of mitral stenosis patients was 45-49 years, which was earlier than that of whole patients with moderate or severe VHD. The median age of patients with bicuspid aortic valve was 42 years. (2) Gender characteristics: The proportion of tricuspid regurgitation, pulmonary regurgitation, mitral regurgitation, mitral stenosis and valve surgery in female patients with moderate or severe VHD were higher than those in male patients. The proportion of aortic regurgitation, aortic stenosis and bicuspid aortic valve in male patients with moderate or severe VHD were significantly higher than those in female patients (all P<0.05). (3) Etiology: The proportion of rheumatic VHD was 13.07% (8 934/68 354), which was higher than that of degenerative VHD (0.67% (458/68 354)). (4) Types of VHD: Tricuspid regurgitation made contribution to the largest proportion with 60.72% (41 503/68 354), followed by mitral regurgitation, aortic regurgitation, mitral stenosis, pulmonary regurgitation and aortic stenosis. Conclusions:There are certain regional characteristics in the prevalence of moderate or severe VHD in southwest China, suggesting different attention should be paid on the whole process of refined management of moderate or severe VHD.

With the advancement of comprehensive treatment and minimally invasive technology, patients with originally unresectable gallbladder cancer are expected to undergo surgical treatment after transformational therapy, which can achieve the effect of increasing R0 resection rate and improving long-term prognosis. Conversion therapy as a new option for patients with gallbladder cancer who are difficult to undergo radical surgery is still subject to much debate. Patients with locally progressive gallbladder cancer at the initial diagnosis may be the target population for conversion therapy. Gemcitabine+ cisplatin is still used as the standard first-line chemotherapy regimen. The use of multiple chemotherapeutic agents in combination also shows new vitality. High-throughput sequencing and the use of precision targeting drugs will become new trends in the future. The use of immune drugs is still needed. And the use of immunotherapy drugs is still in demand. High-throughput sequencing and the use of precision-targeted drugs will become a new trend in the future, the use of immunologic drugs still needs more evidence-based medical support, and the use of post-translational minimally invasive techniques may bring benefits to patients.

As the largest cancer in the world, breast cancer has both benefits and risks from its diversified treatments. Shared decision-making can respect the patient's right to information and autonomy, consider their preferences and value orientations, and help patients obtain the most suitable treatment plan, it also can reduce their decision-making difficulties and improve their disease knowledge awareness and decision-making satisfaction. This paper reviews the definition of shared decision-making, the influencing factors, steps, tools and clinical effects of shared decision-making in the treatment decision-making of breast cancer patients, in order to provide reference for the research of shared decision-making in breast cancer patients in China.

Objective:To investigate the effect of Stigma Maydis Palysaccharide(SMPS)on ATP synthesis in kidney mitochondria of D-galactose-induced aging mice, and to clarify its possible mechanism.Methods:The aging mouse model was established by subcutaneous injection of D-galactose solution in the back of the neck.The 48 SPF male mice were randomly divided into normal control group(control group), D-galactose model group(D-Gal group), SMPS low-dose group and SMPS high-dose group(n=12 for each). The control group was subcutaneously injected with 150 mg/kg normal saline on the back of the neck every day, while the other three groups were subcutaneously injected with 150 mg/kg of D-gal solution on the back of the neck every day.SMPS-L and-H dose groups were given 30 mg/kg and 60 mg/kg of SMPS solution by gavage at the same day of D-Gal injection.The control group and D-GAL group were given the same volume of normal saline daily by gavage for 42 days.Blood samples were collected from the eyeball under general anesthesia after 42 days of intervention for the detection of serum levels of superoxide dismutase(SOD), glutathione peroxidase(GSH-Px)and MDA.After harvesting the kidney tissue, various tests were used to detect ATP content, the mRNA expression levels and protein expression levels in kidney.Luciferase assay was used to detect ATP content in renal tissue.Real-time fluorescent quantitative PCR was used to detect the mRNA expression levels of succinate dehydrogenase(SDH)of complex Ⅱ, cytochrome C reductase(Cycs)of complex Ⅲ, complex Ⅳ(COXⅣ)and ATP5b in ATP synthase in mitochondrial oxidative respiratory chain.Western blot was used to detect the expression levels of mitochondrial fusion protein 2(MFN2), dynamin-related protein1(DRP1)and mitochondrial autophagy related protein P62 in renal tissues of each group.Results:Compared with control group, the activities of serum of SOD(116.53±10.01)U/mg and GSH-Px(127.58±8.74)μmol/L were significantly decreased in D-GAL group(both P< 0.01), and serum MDA content(15.42±0.91)μmol/L increased significantly in D-GAL group( P<0.01). Compared with D-GAL group, the activities of SOD(152.80±9.29)U/mg and GSH-Px(274.07±10.73)μmol/L were significantly increased in SMPS intervention group( P< 0.01), while the MDA content(8.10±0.66)μmol/L decreased significantly in SMPS intervention group( P< 0.01). Compared with control group, the content of ATP(178±4)10 -4 μmol in D-gal group was significantly decreased( P<0.01), the mRNA expression levels of SDH, Cycs and COXⅣ were not significantly changed in D-gal group, and the mRNA expression level of ATP5b(0.67±0.01)was down-regulated in D-gal group( P<0.01), the expression of MFN2 protein(0.29±0.02)was significantly decreased in D-gal group( P<0.01), and the expression of DRP1 and P62 protein(0.31±0.02 and 0.21±0.01)was significantly increased in D-gal group(both P<0.01). Compared with the D-gal group, the ATP content(193±1)10 -4 μmol in the kidney tissue of the mice was significantly increased in SMPS intervention group( P< 0.01), and the ATP5b mRNA expression and MFN2 protein expression(0.87±0.05 and 0.71±0.08)were significantly increased in SMPS intervention group(both P< 0.01), DRP1 and P62 protein expressions(0.20±0.01 and 0.10±0.01)were significantly down-regulated in in SMPS intervention group(both P< 0.01). Conclusions:SMPS can improve the mitochondrial dynamic homeostasis disorder in aging mice by increasing the activity of antioxidant enzymes, up-regulating the expression of ATP5b mRNA and MFN2 protein, down-regulating the expression of DRP1 and P62 protein, and promoting the generation of mitochondrial ATP in D-gal-induced aging mice kidney tissue.

Objective To investigate the modification effect of atmospheric temperature on outpatient visits caused by O₃ in Linzhi City. Methods The daily outpatient data, the daily O₃ concentration and daily meteorological data (including daily average temperature, average relative humidity, etc.) in Linzhi City from 2018 to 2019 were collected. The distributed lag non-liner-model (DLNM) was used to quantitatively evaluate the impact of O₃ in different temperature layers on the risk of outpatient visits. Results At low temperature layers, the cumulative relative risk (CRR) of total outpatient visits and non-injury outpatient visits increased by 53.8%（4.2% -126.9%) and 59.1%（5.8% -139.2%）for every 10 μg/m³ increase of O₃ concentration, respectively. The subgroup analysis showed that for every 10 μg/m³ increase of O₃ concentration at low temperature, the CRR of patients with circulatory diseases, men, women, and people being <14 years old and 14-65 years old increased by 152.1% (15.1% - 451.9%), 58.3% (2.1%-145.5%), 49.2% (3.0% -116.1%), 39.6% (2.5% - 90.3%), and 61% (0.8%-157.1%), respectively. Conclusion The average temperature may have a modifying effect on the outpatient visits caused by O₃ in Linzhi City. In general, the cumulative risk increases as the temperature decreases.

Pharmacy active consultation refers to the spontaneous activity that clinical pharmacists take the initiative to go to clinical departments to help doctors solve problems related to drug use in clinical practice ，put forward drug treatment suggestions or provide pharmaceutical services ，and form medical documents . The difference between pharmacy active consultation and pharmacy consultation is that the latter is generally proposed by the clinician ，who sends a consultation invitation to the pharmacy department in the hospital information system ，and the clinical pharmacist will go to the consultation after receiving it ，while the former is a pharmaceutical service mode that the clinical pharmacist takes the initiative to carry out in the clinical department . On the basis of routine pharmacy active consultation ，clinical pharmacists in our hospital also further carried out a special active consultation mode （including prompt special active consultation for patients with multidrug resistance bacteria positive ，active monitoring and intervention for patients with drug -induced liver injury ），and patient pharmaceutical supervision in the form of return visit of pharmacy active consultation . Pharmacy active consultation and its special active consultation possess the characteristics of initiative ， early and extensive coverage ，as a supplement to resident clinical pharmacy services . Pharmacy active consultation could help the pharmacy department to improve service efficiency ，provide a new perspective for medical institutions to carry out efficient pharmaceutical services ，and supply new ideas for the reform of pharmaceutical services in China .

Objective:To investigate the effects of maternal subclinical hypothyroidism (SCH) on preschoolers′ behavioral problems.Methods:Based on the Ma′ anshan Birth Cohort, pregnant women who had their first antenatal checkup in Maternal and Child Health Center in Ma′ anshan were recruited from May 2013 to September 2014. Data on demographic, obstetric information, and maternal exposure were collected. Women′s fasting venous blood in the first, second, and third trimesters of pregnancy was collected. The levels of thyroid hormones [thyrotropin (TSH), free thyroxine (FT 4)] and thyroid autoantibodies [thyroid peroxidase antibody (TPOAb), thyroglobulin antibody (TgAb)] in maternal blood were retrospectively detected by electrochemiluminescence immunoassay. Preschoolers′ behavioral problems were assessed by Achenbach Child Behavior Checklist (CBCL/1.5-5). Poisson regression models were adopted to examine the effect of maternal SCH on preschoolers′ internalizing and externalizing problems and the critical period. Results:In this study, the reference of maternal thyroid indexes was established (between 2.5 th and 97.5 th percentile). The reference of TSH in the first, second, and third trimester of pregnancy was 0.04-4.90 μIU/mL, 0.75-6.08 μIU/mL, and 0.58-5.59 μIU/mL respectively; and the reference of FT 4 was 13.19-23.27 pmol/L, 9.14-15.32 pmol/L, and 9.53-17.45 pmol/L respectively. In the first, second, and third trimester of pregnancy, the prevalence of SCH was found to be 2.0% (25/1 224), 1.6% (19/1 218), and 1.7% (21/1 220), respectively. After adjusting for confounding factors, maternal SCH in the first trimester was associated with the risk of anxiety and depression in preschool children ( OR=3.06, 95% CI 1.05-8.98). Maternal SCH in the second trimester was found to be associated with the risk of overreaction in preschool children ( OR=2.65, 95% CI 1.13-6.21). Conclusions:The establishment of thyroid hormones reference range for pregnant women in Ma′ anshan area is beneficial to the screening, diagnosis, and treatment of thyroid diseases during pregnancy in this area. Maternal SCH during pregnancy is associated with increased risk of behavioral problems in preschool children. In the first trimester, maternal SCH was associated with preschoolers′ anxiety and depression, and in the second trimester, maternal SCH was associated with preschoolers′ emotional reactivity.

Zinc oxide quantum dots (ZnO QDs) were synthesized by gel-sol method and employed as the transdermal aloesin (Alo) carriers. ZnO QDs were surface-functionalized with amino using aminopropyltriethoxysilane (APTES). Alo was covalently bonded on the surface of ZnO QDs via N,N'-carbonyldiimidazole to obtain Alo NPs, which were characterized by transmission electron microscope (TEM), dynamic light scattering (DLS), Fourier transform infrared spectroscopy (FTIR) and thermal gravimetric analyzer (TGA). TEM images showed that ZnO QDs were analogously sphere and monodisperse with a reasonably narrow size distribution, of which was around 4 nm. The size of Alo NPs increased to around 8 nm due to the surface modification. The intense bands at around 3 400 cm and 1 200 cm in the FTIR spectrum of Alo NPs from the vibration of -OH indicated the linkage of Alo on the surface of ZnO QDs. The results of TGA analysis showed that the mass ratio of ZnO QDs and Alo were 39.27% and 35.14%, respectively. The penetration of Alo NPs was much higher than raw Alo according to the passive penetration experiments with Franz-type diffusion cells instrument using full-thickness cavy skin, which manifested the improvement of the penetration for Alo delivered by ZnO QDs. The pH-controlled drug release behavior was investigated. At pH 7.4, only a small amount of Alo (1.45% ± 0.21%) had been released after 2 h. In contrast, as incubation at pH 5.0 of which pH was similar to endosomal environment, Alo was released very fast (87.63% ± 0.46% in 2 h) from Alo NPs, confirming that Alo NPs could response to the pH and realize the intracellular drug release. The inhibitory effect of Alo NPs on tyrosinase was in a dose dependent manner. When the concentration of Alo NPs was 12.5 μg/mL, the inhibition rate was up to 40.32% ± 1.57%. All the results show that the Alo NPs hold a great potential in transdermal tyrosinase inhibition.
Administration, Cutaneous ; Animals ; Chromones ; administration & dosage ; Drug Delivery Systems ; Glucosides ; administration & dosage ; Guinea Pigs ; Monophenol Monooxygenase ; metabolism ; Nanoparticles ; Quantum Dots ; Zinc Oxide

Objective: To study the effect of Neiyi-Tongjingling on the content of TGF-β1 and Smad2/3 protein in ectopic endometrium of rats with endometriosis. Methods: Atotal of 42 rats were randomly divided into the sham operation group, model group, high, medium and low dose groups of traditional Chinese medicine and western medicine group with 7 rats in each group. Except for the sham-operated group, the rats in the other groups established EMs models by means of rat autologous intimal transplantation. The drug was administered at the 5th week after the model was established. The western medicine group was given 0.5 mg/kg gestrinone solution twice a week. The high, medium and low dose groups of traditional Chinese medicine were given 49.50 mg/kg, 24.75 mg/kg and 12.38 mg/kg of Neiyi-Tongjingling liquid, respectively. While the model group and sham operation group were given the same volume of normal saline once per day for 4 weeks. The volume of ectopic lesions in each group was observed. The HE staining was used to observe the pathological changes of intima tissue. Immunohistochemical SP method was used to detect the expression of TGF-β1 and Smad2/3 proteins in intima tissue. Results: The volume of ectopic endometrium (57.91 ± 13.10 mm³, 48.93 ± 8.15 mm³, 76.21 ± 17.14 mm³, 57.88 ± 15.98 mm³ vs. 141.58 ± 54.25 mm³) in the western medicine group and the high, medium and low dose group of Chinese medicine were significantly lower than that in the model group (P<0.05). Compared with the model group, the content of TGF-β1 (0.08 ± 0.00, 0.08 ± 0.01, 0.10 ± 0.00 vs. 0.13 ± 0.03) and Smad2/3 (0.09 ± 0.02, 0.08 ± 0.01, 0.10 ± 0.01 vs. 0.12 ± 0.02) in ectopic endometrium tissue of three Chinese medicine groups decreased significantly (P<0.05). Conclusions The Neiyi-Tongjingling can treat EMs by inhibiting the growth of ectopic endometrium, reducing the volume of ectopic lesions, and reducing the expression of TGF-β1 and Smad2/3 proteins.