Objective:To explore the clinical effect of Pingchuan Decoction combined with routine western medicine therapy in the treatment of acute attack of bronchial asthma in children. Methods:From January 2017 to June 2019, 118 children with acute attack of bronchial asthma were selected from the Seventh People’s Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, and they were randomly divided into control group (59 cases) and observation group (59 cases) according to the random number table. The control group was treated with routine western medicine therapy, and the observation group was treated with Pingchuan Decoction on the base of control group, and both groups were treated for 14 days. The main symptom scores before and after treatment were evaluated. The percentage of forced vital capacity expressed as percent predicted (FVC% pred) and the forced expiratory volume in 1 second expressed as percent predicted (FEV1% pred) were measured by pulmonary function meter. The levels of CD3 +, CD4 + and CD4 +/CD8 + in peripheral blood were detected by flow cytometry. The adverse reactions during the treatment were recorded and the clinical efficacy was evaluated. Results:The total clinical effective rate was 93.2% (55/59) in the observation group and 71.2% (42/59) in the control group, where the difference between the two groups was statistically significant ( χ2=9.790, P=0.002). After treatment, the scores of cough, wheezing and wheezing rale in the observation group were significantly lower than those in the control group ( t=27.695, 17.573, 32.827, P<0.001). After treatment, FVC% pred [(80.21 ± 4.06)% vs. (71.71 ± 3.95)%, t=11.526], FEV1% pred [(78.84±3.92)% vs. (72.26 ± 3.59)%, t=9.508] in the observation group were significantly higher than those in the control group ( P<0.01). The levels of CD3 + [(74.05 ± 5.13)% vs. (67.44 ± 4.98)%, t=7.101], CD4 + [(48.43 ± 4.31)% vs. (42.20 ± 4.06)%, t=8.082] and the ratio of CD4 +/CD8 + (1.67 ± 0.29 vs. 1.34 ± 0.25, t=6.620) in the observation group were significantly higher than those in the control group ( P<0.01). During the treatment, the incidence of adverse reactions was 10.2% (6/59) in the observation group and 6.8% (4/59) in the control group, and there was no significant difference between the two groups ( χ2=0.437, P=0.509). Conclusion:The Pingchuan Decoction combined with routine western medicine therapy can reduce the clinical symptoms of children with acute attack of bronchial asthma, improve lung function, improve organism immunity and clinical effect with safety.

Objective:To explore the application value and initial clinical experience of fluorescence-enhanced laparoscopy combined with indocyanine green in radical cystectomy with pelvic lymphadenectomy.Methods:A retrospective analysis was performed on the clinical data of a total of 8 patients admitted from May 2018 to August 2019 who underwent laparoscopic radical cystectomy with pelvic lymphadenectomy for muscle-invasive bladder cancer using the fluorescent laparoscopy system.There were 6 males and 2 females; aged 58 to 71 years, with an average of 65.8 years. The preoperative pathology was urothelial carcinoma, with 2 cases in T 2a stage, 4 cases in T 2b stage, and 2 cases in T 3a stage. The patient was injected a total of 2 ml of 2.5 mg/ml of indocyanine green through a rigid cystoscope using a 18 gauge cystoscope injection needle before surgery. The PINPOINT endoscopic fluorescence camera system performed surgery in real-time. A systematic examination of the surgical area under near-infrared fluorescence was performed every 5 minutes. Observation and recording of indocyanine green combined with fluorescence laparoscopy to mark the bladder tumor area and identify the sentinel drainage. Results:Eight cases were successfully completed under the fluorescence laparoscopic system.In terms of tumor markers, cystoscopy with indocyanine green allowed 7 of the 8 patients to successfully identify the tumor area under fluorescent laparoscopy. Six of the 8 patients with sentinel lymph nodes identified by indocyanine green lymphangiography were also successful, of which 3 were positive for lymph nodes. At the same time, intravenous indocyanine green was used to observe that the blood supply to the bladder and the end of the ureter was good. The operation time was 190-310 minutes, with an average of 235 minutes; the bleeding volume was 150-380 ml, with an average of 180 ml; the postoperative hospital stay was 10-22 days, with an average of 14.5 days. Postoperative pathological staging 2 cases in T 2a stage, 3 cases in T 2b stage, 3 cases in T 3a stage, with total number of lymph nodes 8-14, average 10. The 8 cases were followed-up for 4-12 months, average 5.5 months, without indocyanine green related complications. Conclusions:Indocyanine green fluorescent laparoscopy can accurately locate and identify the bladder tumor area and pelvic lymph nodes during radical cystectomy, which can reduce positive margins and unnecessary enlarged lymph node dissection.

Objective To evaluate the efficacy and safety of single flexible ureteroscope vs.flexible ureteroscope combined with intraoperative ultrasonography guided in the endogenous renal cyst incision and drainage.Methods Retrospective analysis of case data of 64 patients with endogenous renal cysts admitted from January 2015 to December 2017.All the patients undrwent contrast-enhanced CT,urinary tract imaging,ultrasound B to confirm bosniak classification Ⅰ and Ⅱ renal cyst.The patients (38 males,26 females) were divided into single flexible ureteroscope group [group A,32 cases of patients,average age (54.2 ±6.6) years,unilateral or bilateral cystic patients:19 cases/ 13cases,simple cyst of kidney or polycystic kidney:24 cases/8 cases,average maximum diameter of the renal cyst (5.4 ± 1.3) cm,combined with renal calculus:8 cases,combined with hydronephrosis:7 cases,1 case who had the history of laparoscopic renal cyst decapitation,1 case who had the history of percutaneous renal cyst puncture] and flexible ureteroscope group combined with intraoperative ultrasonography guided [group B,32 cases of patients,average age (52.3 ± 9.3) years,unilateral or bilateral cystic patients:21 cases/11 cases,simple cyst of kidney or polycystic kidney:25 cases/7 cases.Average maximum diameter of the renal cyst (5.3 ±1.2) cm,combined with renal calculus:9 cases,combined with hydronephrosis:8 cases,2 case who had the history of laparoscopic renal cyst decapitation,1 case who had the history of percutaneous renal cyst puncture].The double J stent was placed two weeks before the surgery into the body of patients.During the operation,the surgical procedure were used by the electronic flexible ureteroscope and holmium laser (0.8 J,20 Hz),combined with ultrasound B in the monitoring,to find the suitable incision position.It would be defined as the successful result if we could put the head of flexible ureteroscope into the inside of renal cyst and see the image of mist in the screen of ultrasound B.According to the standard,the result of operation wound be defined compared to before operation (success:shrink more than 80％ or maximum diameter was smaller than 1 cm;improvement:shrink about 50％-79％;ordinary result:shrink about 30％-49％;failure:shrink smaller than 30％).Effective rate =(success cases + improvement cases)/total cases.We compared the differences of two groups in the time,efficacy,safety and complication of surgery.Results Compared the results of single flexible ureteroscope groups vs flexible ureteroscope group combined with intraoperative ultrasonography guided in the success cases of surgery,after 8-30 months following-up,total operative complication rate was [8 cases(25％)vs.1 case(3.1％)],success rate of operation in 6 month later [(20 cases (62.5％) vs.28 cases (87.5％)].Flexible ureteroscope group combined with intraoperative ultrasonography guided had advantages statistically (P ＜ 0.05).However,there was no statistical difference for the two groups in the time of operation [(33.4 ± 6.7) min vs.(35.1 ± 8.6) min],single operative complication (intraoperative wounding bleeding:3 cases vs.1 case,postoperative urinary infection:3 cases vs.0 case,perinephric space effusion:2 cases vs.0 case,renal function impairment:1 case vs.0 case)(P ＞0.05).Conclusions Flexible ureteroscope combined with intraoperative ultrasonography guided can help the urologist can improve the success rate of surgery and reduce the chance of surgical injury intraoperatively.

Objective:To observe the clinical effect of Xu's Liu Wei Xiaoqinglong Decoction on children's pneumonia with the syndrome of phlegm blocking in the lung.Method:86 cases were randomly divided into 2 groups,43 cases in each.Treatment group was treated by Liuwei Xiaoqinglong Decoction (granules),Control group was treated by San Ao Decoction (granules),both taken orally,twice per day,for 7 days.The clinical effects and syndrome integrals improvement were observed.Result:The total effective rate of the treatment group was 95.34％ and it was 81.39％ in the control group,the difference between the 2 groups was statistically significant (P＜0.05).And the syndrome improvement of the treatment group was also significantly better than that of the control group.The disappearing time of major symtoms was statistically significantly shorter than that of the control group (P＜0.05).Conclusion:Xu's Liu Wei Xiaoqinglong Decoction has certain effect on children's pneumonia with the syndrome of phlegm blocking in the lung and it should be applied in patient with simple syndrome of phlegm blocking in the lung,or in early stage of phlegm blocking in the lung,compared with cases with syndrome of phlegm blocking in the lung accompanied by spleen deficiency.

Objective To compare the clinical efficacy of herbal ion application and penetration therapy applied in the dog days, or in both of the dog days and coldest days for the treatment of recurrent respiratory tract infection (RRTI) in children. Methods This intervention was designed as a multi-center, randomized, single-blind, repeated-measurement design. A total of 240 RRTI children were randomly divided into Sanfu group (N=120, herbal ion application and penetration therapy applied in the dog days) and Fujiu group (N=120, herbal ion application and penetration therapy applied in both of the dog days and coldest days). Each group was treated for one year and then was followed up for one year. Before and after the treatment, we observed the frequency of respiratory tract infection, the period of onset, signs and symptoms of traditional Chinese medicine (TCM), and detected the salivary secretory immunoglobulin A (sIgA) at different time points. Results (1) The therapeutic effect of Fujiu group was better than that of Sanfu group, and the difference was significant (P<0.05). (2) The frequency of respiratory tract infection was reduced, the period of onset was shortened, and TCM signs and symptoms were improved in both groups, and the effect of Fujiu group was superior to that of Sanfu group (P<0.05). (3) Salivary sIgA showed a continuous upward trend in Fujiu group while a mild downward trend in Sanfu group at different time points (P<0.05). Conclusion Herbal ion application and penetration therapy applied in both of the dog days and coldest days shows better effect for the treatment of children RRTI than that applied only in the dog days.

Objective To study the effect of Pingchuan Formula(PCF)on Rho/Rock signaling pathway in the mice of asthmatic model, explore the mechanism of PCF on asthma. Methods Forty BALB/C mice were randomly divided into four groups:a control group, a model group,a dexamethasone group and a PCF group. After treated with medicine for 4 weeks, albumen expression of RhoA and RockI in lung tissues were detected by using Western blot, mRNA expressions of RhoA and RockI were detected by using Real-time PCR. Results The albumen and the mRNA expression of RhoA and RockI in the model group were(1.05± 0.20),(1.06±0.08),(6.60±1.09), (6.53±1.84), the control group were(0.76±0.08), (0.84±0.14), (3.82± 1.77), (3.65±1.46),there was a significant difference between two groups(P<0.01). The albumen and the mRNA expression of RhoA and RockI in the dexamethasone group were(0.78±0.11), (0.87±0.32), (4.19± 2.33), (4.09±1.08), there was a significant difference compared with the model group(P<0.01). The PCF group were(0.86±0.12), (0.93±0.14), (4.38±2.01), (4.50±1.13), there was a difference compared with the model group(P<0.05). These was no difference between the dexamethasone group and the PCF group(P>0.05). Conclusion The expressions of Rho/Rock signaling pathway were controlled significantly by PCF, and the curative effect was similar to dexamethasone.

ObjectiveTo investigate the serum prostate-specific antigen (tPSA),serum free PSA to total PSA ratio (f/tPSA),prostate volume (PV) and prostate-specific antigen density (PSAD) in early prostate cancer (PCa) diagnosis.MethodsRetrospective analysis was performed on serum PSA values and related test results from 252 cases of BPH patients and 49 patients with PCa.Prostate volume (PV) was measured by transrectal ultrasound (TRUS),and the f/tPSAand PSAD values were calculated.The differences of serum tPSA,f/tPSA,PV,and PSAD between BPH and PCa group were compared,the area under the ROC curve was used to evaluate these four indicators for its diagnostic sensitivity and diagnostic specificity.ResultsThe values of tPSA,PSAD in PCa group were significantly higher than BPH group ( P ＜0.05),while the values of f/tPSA,PV in PCa group were significantly lower than BPH group ( P ＜0.01orP ＜0.05).The ROC area showed that serum tPSA(0.8013),f/tPSA(0.7390),PV(0.5613) had lower diagnosis value than PSAD(0.9214) in early prostate cancer ( PSAD ＞ tPSA ＞ f/tPSA ＞ PV).When the upper limit of normal PSA was set to take 4ng/ml,the sensitivity was 91.49％,diagnostic specificity was 51.05％.When the f/tPSA threshold set to 0.16,the diagnostic sensitivity was 57.78％,diagnostic specificity was 78.72％.When PSAD threshold was set to 0.15,diagnostic sensitivity was 88.24％,diagnostic specificity was 81.52％.ConclusionsPSA,f/tPSA and PSAD are indicators for biopsy or followup in early diagnosis of prostate cancer.In particular,the diagnostic value of PSAD has higher sensitivity and specificity than PSA and f/tPSA in the diagnosis of prostate cancer.

To observe the changes of interferon-γ (IFN-γ) and interleukin-4 (IL-4), factors related to T helper 1/T helper 2 (Th1/Th2), in airway inflammation in an asthmatic model of mice and the effects of Pingchuan Formula (PCF), a compound traditional Chinese herbal medicine.

Objective To assess the outcomes of modified spiral ileal orthotopic neobladder.Methods From January 1998 to January 2008, 32 patients (all male) underwent radical cystectomy and spiral ileal orthotopic substitution for muscle invasive bladder cancer. A segment of 40 to 45 cm ileal loop was isolated, detubularized, and reconfigured in spiral shape to form a pouch. Bilateral ureters were reimplanted by inserting the 1 cm distal segment into the pouch to form a Split-Cuff nipple.The bottom of the pouch was opened and anastomosed with the urethra (4 stitches). Results There were no perioperative deaths. The mean operative time was 281.2±48.7 min. Blood loss was 545.4±181.9 ml. Twenty cases required a blood transfusion, the mean volume of intraoprative blood transfusion was 430.8±235.9 ml. The average hospital stays were 26.8±9. 7 days. Rate of daytime continence was 93. 7% (30/32) while nighttime continence was 81.3% (26/32). Urodynamic studies were carried out in 23 cases 6 months after surgery. Neobladder capacity at first desire to urinate was 315.0± 33.4 ml(270-420 ml). The maximum neobladder capacity was 490. 3±39.7 ml(350-600 ml).The maximum flow rate (Qmax) was 16.5 ± 5.9 ml/s. Full resting pressure was 22. 5 ± 11.8 cm H2O. Peak voiding pressure was 78.3 ± 14.7 cm H2O. After mean 58. 4 months' follow up (range 22 to 132), 4 cases died of metastasis of bladder cancer. Conclusion Modified spiral ileal orthotopic neobladder is a reasonable option for treating invasive bladder cancer.

To evaluate the effects of Bushen Gubiao Recipe (BGR), a compound traditional Chinese herbal medicine, on toll-like receptor 4 (TLR4) signaling pathway and CD4(+)CD25(+)foxp3(+)regulatory T cells (CD4(+)CD25(+)foxp3(+)Tregs) in mice with recurrent respiratory tract infections (RRTIs).