The Expert Consensus on Clinical Application of Qinbaohong Zhike Oral Liquid in Treatment of Acute Bronchitis and Acute Attack of Chronic Bronchitis （GS/CACM 337-2023） was released by the China Association of Chinese Medicine on December 13^th， 2023. This expert consensus was developed by experts in methodology， pharmacy， and Chinese medicine in strict accordance with the development requirements of the China Association of Chinese Medicine （CACM） and based on the latest medical evidence and the clinical medication experience of well-known experts in the fields of respiratory medicine （pulmonary diseases） and pediatrics. This expert consensus defines the application of Qinbaohong Zhike oral liquid in the treatment of cough and excessive sputum caused by phlegm-heat obstructing lung， acute bronchitis， and acute attack of chronic bronchitis from the aspects of applicable populations， efficacy evaluation， usage， dosage， drug combination， and safety. It is expected to guide the rational drug use in medical and health institutions， give full play to the unique value of Qinbaohong Zhike oral liquid， and vigorously promote the inheritance and innovation of Chinese patent medicines.

Objective:To investigate the distribution of physical and chemical water improvement areas of drinking water-borne endemic fluorosis in Inner Mongolia Autonomous Region, as well as the use of household water purifiers.Methods:From April to October 2021, a survey was conducted in a drinking water-borne endemic fluorosis areas in Inner Mongolia Autonomous Region where physical and chemical water improvement was carried out. The survey included the basic situation of the affected villages (number of permanent households, number of permanent residents, historical water fluoride content) and the use of residential water purifiers. Household peripheral water samples were collected to test the water fluoride content. Water purifier installation rate, normal usage rate, qualified water fluoride rate in normal usage, and the proportion of households covered by filter replacement departments were calculated.Results:In Inner Mongolia Autonomous Region, the physical and chemical water improvement areas of drinking water-borne endemic fluorosis were distributed in 2 735 villages in 11 leagues (cities) throughout the region, with 192 950 permanent households and 540 216 permanent residents. The average historical water fluoride content in all leagues (cities) was 2.18 mg/L, and the current average water fluoride content was 0.40 mg/L. A total of 134 763 water purifiers were installed, with an installation rate of 69.84% (134 763/192 950). A total of 10 773 households were surveyed, with 10 396 households using water purifiers normally and a normal usage rate of 96.50% (10 396/10 773). Among them, 10 158 households had qualified water fluoride of normal usage, with a qualified water fluoride rate of 97.71% (10 158/10 396). Of the 10 396 households using water purifiers normally, 3 974 households (38.23%) had filter cartridges used within one year, and 3 961 households had qualified water fluoride, with a qualified rate of water fluoride of 99.67% (3 961/3 974). Six thousand four hundred and twenty-two households (61.77%) had filter cartridges used for more than one year, with 6 197 households had qualified water fluoride and a qualified rate of water fluoride of 96.50% (6 197/6 422). There was a statistically significant difference in the qualified rate of water fluoride between purifiers with different filter cartridge usage times (χ 2 = 110.73, P < 0.001). Among the 10 773 surveyed households, the filter cartridges replacement department covered 10 470 households, accounting for 97.19% (10 470/10 773). Conclusions:In Inner Mongolia Autonomous Region, the physical and chemical water improvement areas of drinking water-borne endemic fluorosis are widely distributed, and the normal usage rate of household water purifiers is relatively high. The qualified rate of water fluoride in household water purifiers with filter cartridges used for more than one year is low.

Objective To investigate the causal association between bronchial asthma and bone mineral density at different sites using a two-sample Mendelian randomization (MR) approach. Methods Summary data for exposure factors and outcome were obtained from different genome-wide association studies.Single nucleotide polymorphisms strongly associated with bronchial asthma were selected as instrumental variables,and those in linkage disequilibrium were excluded.The inverse-variance weighted (IVW) method was used as the primary method for MR analysis,complemented by weighted median,simple mode,weighted mode,and MR-Egger regression methods.Sensitivity analyses were conducted to assess the stability of the results. Results The random-effects model of IVW analysis showed that heel bone mineral density (OR=0.986;95% CI,0.974 to 0.998;P=0.023) as the outcome dataset had a reverse causal effect with bronchial asthma,while lumbar spine bone mineral density (OR=1.031;95% CI,0.984 to 1.081;P=0.195),femoral neck bone mineral density (OR=1.014;95% CI,0.973 to 1.057;P=0.505),and forearm bone mineral density (OR=1.011;95% CI,0.935 to 1.094;P=0.775) as outcome datasets showed no causal effect with bronchial asthma.The MR-Egger intercept test results indicated that the P-values for the intercepts of lumbar bone mineral density,femoral neck bone mineral density,forearm bone mineral density,and calcaneal bone mineral density were all over 0.05,suggesting no horizontal pleiotropy and relatively stable results. Conclusion MR analysis reveals a reverse causal effect between bronchial asthma and heel bone mineral density,suggesting that clinicians should strengthen the monitoring of heel bone mineral density in patients with bronchial asthma to timely detect and intervene osteoporosis.

Hepatocellular carcinoma (HCC) is one of the malignant tumors of the digestive system with the highest morbidity and mortality. The vast majority of patients with intermdiate and advanced HCC have low response rates and poor long-term survival to a series of treatments mainly based on transcatheter arterial chemoembolization (TACE). In recent years, molecular targeted therapy, immunotherapy and their combination with TACE have developed rapidly. This article reviews the research progress of TACE combined with systemic drug therapy in HCC and looks forward to the future direction of precise treatment of HCC.

Objective:To understand the demographic characteristics and treatment intention, treatment status and therapeutic effect of patients with skeletal fluorosis in Inner Mongolia Autonomous Region (reffered to as Inner Mongolia) in order to provide a basis for next step treatment program.Methods:From March to June 2020, a face-to-face questionnaire survey was conducted among 3 570 patients with skeletal fluorosis in 11 leagues (cities) of Inner Mongolia to understand their basic information, treatment intention, treatment status and therapeutic effect. Patients with skeletal fluorosis of different demographic characteristics were compared with each other in their treatment intention and treatment status, and the therapeutic effects of different drugs were compared by χ 2 test. Results:A total of 3570 patients with skeletal fluorosis were investigated. There were slightly more women than men with skeletal fluorosis (1.29 ∶ 1.00, 2 014/1 556). The ages were mainly from 40 to 79 years old (95.4%, 3 406/3 570). Mongols patients accounted for 36.0% (1 285/3 570). Patients with low education (primary school and below) accounted for 82.2% (2 935/3 570). Eighty-five per cent (3 035/3 570) of the patients had drug treatment intention and 37.1% (1 325/3 570) of the patients had drug treatment. Thirty-seven point five per cent (1 338/3 570) of the patients had surgery intention and surgery was performed in 0.2% (8/3 570) of the patients. Combination therapy (98.5%, 194/197) and chondroprotective agents alone (98.3%, 173/176) were more effective than anti-inflammatory and analgesic agents alone (84.2%, 48/57) in the treatment of skeletal fluorosis ( P < 0.05). Surgery was effective (8/8). Conclusions:Most of the patients with skeletal fluorosis are middle-aged and elderly, and the patients with skeletal fluorosis in Mongols account for a certain proportion. At present, all the patients with skeletal fluorosis who have the will to be treated have not been effectively treated, and the means of treatment is relatively single. It should be advocated to carry out various forms of treatment of skeletal fluorosis, so that patients could relieve symptoms, reduce pain and improve their quality of life.

Solid pseudopapillary neoplasm of the pancreas (SPN) is a rare pancreatic tumor with low-grade malignancy. Surgical resection is the preferred therapeutic approach for SPN patients, which has favourable prognosis with extremely low incidence of recurrence and metastasis and 5-year survival rate as 95%. With the improvement of radiological and pathological diagnosis, the detection rate of SPN is increasing. However, its pathogenesis is still unclear. Meanwhile, the diagnostic criteria and treatment strategies of SPN require standardization. Herein, the authors review the current status and advances in SPN based on related literature and clinical experience of the authors′ team on treatment of SPN, in order to deepen the knowledge of SPN, improve the ability for the preoperative diagnosis, promote standardized treatment and maximize benefits of the patients.

Objective:To systematically evaluate the clinical efficacy of programmed death-1 and programmed death ligand 1 (PD-1/PD-L1) inhibitors versus traditional first-line regimens for the treatment of solid tumors.Methods:Databases including PubMed, Embase and Cochrane Library were searched for literatures from the date of their establishment to October 2018 with the key words including "PD-1/PD-L1, solid tumors, melanoma, non-small cell lung cancer, renal cell carcinoma, immunotherapy" . The randomized controlled trial or non randomized controlled trial of high quality about PD-1/PD-L1 inhibitors and traditional fist-line regimens for the treatment of solid tumors were received and enrolled. Patients underwent PD-1/PD-L1 inhibitors immunotherapy were allocated into treatment group, patients underwent traditional first-line regimens treatment were allocated into control group. Two reviewers independently screened literatures, extracted data and assessed the risk of bias. Count data were described as odds ratio ( OR) and 95% confidence interval (95% CI). The heterogeneity of the studies included was analyzed using the I2 test. Funnel plot was used to test potential publication bias if the studies included≥5, and no test was needed if the studies included<5. Results:(1) Document retrieval: a total of 11 available randomized clinical trials were included. There were 5 161 patients, including 2 677 in the treatment group and 2 484 in the control group. (2) Results of Meta analysis. ① There was a significant difference in the objective response rate between the treatment group and the control group ( OR=4.49, 95% CI: 3.01-6.68, P<0.05). The bilateral symmetry was presented in the funnel plot based on the 9 studies, suggesting that publication bias had little influence on results of Meta analysis. ② There was no significant difference in the disease control rate between the treatment group and the control group ( OR=1.53, 95% CI: 1.01-2.32, P=0.05). The bilateral symmetry was presented in the funnel plot based on the 9 studies, suggesting that publication bias had little influence on results of Meta analysis. ③ There was a significant difference in disease stability rate between the treatment group and the control group ( OR=0.49, 95% CI: 0.33-0.73, P<0.05). The bilateral symmetry was presented in the funnel plot based on the 9 studies, suggesting that publication bias had little influence on results of Meta analysis. ④ There was no significant difference in disease progression rate between the treatment group and the control group ( OR=0.71, 95% CI: 0.45-1.15, P>0.05). The bilateral symmetry was presented in the funnel plot based on the 9 studies, suggesting that publication bias had little influence on results of Meta analysis. ⑤ There were significant differences in overall incidence of adverse events and incidence of adverse events not less than three levels between the treatment group and the control group ( OR=0.53, 0.54, 95% CI: 0.38-0.74, 0.31-0.93, P<0.05). The bilateral symmetry was presented in the funnel plot based on the 11 studies, suggesting that publication bias had little influence on results of Meta analysis. Conclusion:Compared with traditional first-line regimens treatment, PD-1/PD-L1 inhibitors immunotherapy can improve the objective response rate and decrease the incidence of adverse events.

Pancreatic cancer is called as "the king of carcinoma" owing to its poor prognosis. The current treatment methods range from the world-famous Whipple surgery to combination chemotherapy, neoadjuvant radiotherapy and chemotherapy, and emerging immunological checkpoint inhibitors. However, they all have certain limitations and the overall survival rate of pancreatic cancer has not been improved significantly in recent decades. With the further study of tumor immunology, tumor immunotherapy has gradually become the focus of cancer therapy. As a novel immunotherapy idea, oncolytic virus therapy is gradually accepted by scholars for its safety and effectiveness. Oncolytic virus can specifically infect and lyse tumor cells. It can not only directly lyse tumor cells by self-replication but also release immune molecules and tumor antigens by lysing tumor cells, which further enhance immune anti-tumor effect without damaging normal tissues. In addition, the oncolytic virus can carry the abundant exogenous target gene through gene editing technology to further enhance the anti-tumor effect of the oncolytic virus. Due to the complexity of the microenvironment of pancreatic cancer, the oncolytic virus monotherapy has limited effects, and combination therapy has shown promising prospects. Compared with other tumor immunotherapy, oncolytic virus therapy displays high killing efficiency, targeting ability and small adverse reaction, multiple anti-tumor pathways to avoid drug resistance and low cost, and is expected to become an ideal new way for oncotherapy. Based on domestic and overseas literatures, the authors have reviewed the development of ancolytic virus therapy, treatment mechanism of oncolytic virus and its advances in pancreatic cancer in this article.

Objective:To explore the effects of respiratory resistance training combined with active cycle of breathing techniques in nursing care for patients with lower cervical spinal cord injury.Methods:From April 2017 to March 2019, we selected 78 patients with lower cervical spinal cord injury in Trauma Emergency Center of the Third Affiliated Hospital of Hebei Medical University as subjects. All patients were divided into observation group and control group with the method of random number table, 39 cases in each group. Control group carried out the respiratory system nursing with the self-developed compound sequential technology on sputum exclusion. On the basis of that in control group, observation group implemented the resistance inspiratory training and expiratory training with the respiratory resistance training combined with active cycle of breathing techniques. We compared the volume of sputum excretion, pulmonary function[forced vital capacity (FVC) , forced expiratory volume in one second (FEV1) , peak expiratory flow (PEF) and maximal expiratory pressure (MEP) ] and incidences of pulmonary complications during hospitalization between two groups.Results:A total of four weeks after training, the volume of sputum excretion of observation group on the fifth day after surgery was lower than that of control group with a statistical difference ( P<0.05) . There were four pulmonary function indexes (FVC、FEV1、PEF、MEP) in observation group better than those in control group with statistical differences ( P<0.05) . The incidence of pulmonary complications of observation group was lower than that of control group with a statistical difference ( P<0.05) . Conclusions:Respiratory resistance training combined with active cycle of breathing techniques can promote the early excretion of sputum of patients with lower cervical spinal cord injury, improve the pulmonary function and reduce the incidence of pulmonary complications.

The 13th World Congress of the International Hepato-Pancreato-Biliary Association was held from 4th to 7th September 2018 in Geneva,Switzerland.Thousands of wellknown specialists and scholars from 96 countries around the world were invited for the great event.The congress aimed to explore the latest achievements of diagnosis and treatment of hepatobiliary and pancreatic diseases from both the clinical and basic perspective.In this article,authors reviewed and analyzed the up-to-date research information and combined clinical researches of the author team,in order to share the experience and achievements in the field of hepato-pancreato-biliary surgery with colleagues and provide new information and inference for optimization of diagnosis and treatment in this field.