Cognitive dysfunction refers to dysfunction of individual perception,memory,understanding,learning,creation and other dysfunctions caused by abnormal brain function and structure.Based on the fact that the spleen can't regulate transportation and transformation,govern blood and send up essential substance,combined with the microbiota-gut-brain axis,this article discussed the etiology and pathogenesis of intestinal flora imbalance affecting cognitive dysfunction in TCM.It was proposed that the spleen in TCM and intestinal flora are connected in physiology and pathology:the spleen regulates spirit and governs cognition,when the spleen fails to function normally that it can't dominate transportation and transformation,govern blood and send up essential substance will cause that the brain spirit can not be nourished;intestinal flora is closely related to the spleen in TCM,and affects brain function through the nervous system,endocrine,immune and metabolic mechanisms.This article can provide explore new ideas for the clinical research and treatment of cognitive dysfunction of traditional Chinese and Western medicine.

Objective:To analyze the viral nucleic acid and cytokines in 12 children with 2019-nCoV infection.Methods:Clinical and laboratory data of the children diagnosed with 2019-nCoV infection in Guangzhou Women and Children′s Medical Center from January to April 2020 were retrospectively analyzed. Throat and anal swabs were collected on alternate days for the detection of 2019-nCoV nucleic acid by fluorescence quantitative PCR. Flow cytometry was used to detect serum cytokines including IFN-γ, IL-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p70, IL-17A, IL-17F, IL-22, TNF-α and TNF-β during the early (both throat and anal swab tests were positive), the intermediate (throat swab test was negative, while anal swab test remained positive), and the convalescence (both throat and anal swab tests were negative) stages of infection.Results:A total of 12 children were enrolled in this study. The male-to-female ratio was 5∶1. The average age was (7.0±4.3) years. There were two asymptomatic, five mild and five common cases. No severe or critical cases were involved. Initially, throat and anal swab nucleic acid tests were simultaneously positive in nine children newly diagnosed in our hospital and the median time of viral shedding in throat swab was longer than that in throat swab [32 (4.5, 45.0) d vs 3 (2, 9) d, Z=11.0, P=0.010]. The median difference of viral shedding time between anal swab and pharyngeal swab was 25.5 (1.5, 42.8) d. The overall levels of serum cytokines IL-17A, IL -4 and IL-5 in different stages of the disease (early, intermediate and convalescence stage) were statistically different ( Z or F, P values were 8.33, 0.016; 5.36, 0.010 and 6.56, 0.004, respectively), and a significant increase was observed in the intermediate stage of infection. IL-17F, IL-2 and IL-22 were all increased during the infection, but there was no significant statistical difference among the three stages ( P>0.05). Conclusions:It was noted that intestinal viral shedding needed a longer time. Although the infectivity has not been determined, higher requirements have been put forward for disease prevention and control. Cytokines secreted by Th2 and Th17 cells were involved in the immune response in children with non-severe 2019-nCoV infection. Monitoring viral shedding and cytokine changes in pediatric patients would be conducive to disease assessment.

Objective To observe the characteristics of multifocal microperimetry and its relationship with visual acuity and multifocal ganglion cell complex (GCC) in nonarteritic anterior ischemic optic neuropathy (NAION).Methods A retrospective case study. A total of 38 patients (54 eyes) with NAION were enrolled in this study. 25 NAION eyes (25 patients) and 29 contralateral health eyes (29 patients) were randomly selected into case group and control group respectively. All eyes underwent best corrected visual acuity (BCVA), slit lamp microscope, indirect ophthalmoscope, color fundus photography, optical coherence tomography (OCT), visual field and multifocal microperimetry. Logarithm of the minimum angle of resolution (logMAR) was used to calculate BCVA. There were no significantly differences on age (t=?0.647), gender, dominant eyes (χ2=0.128, 0.099), intraocular pressure (t=0.376) between two groups (P>0.05). Macular GCC thickness, superior and inferior GCC thickness were measured by OCT, focal loss volume (FLV) and global loss volume (GLV) were obtained at the same time. Microperimetry were measured by macular integrity assessment instrument (MAIA microperimetry), and mean retinal sensitivities (MS) in macular area 10° and fixation rate in the macular central 2° and 4° were determined. The relationship between MS, macular GCC and BCVA were analyzed by Spearman correlation analysis.Results The mean logMAR BCVA of case group and control group were 0.68±0.79 and 0.07±0.06, respectively. There was significantly statistical difference in MS between two groups (t=?2.507, P=0.037). There were no significantly statistical difference in mean GCC (t=?1.245,P=0.259), superior and inferior GCC (t=?1.336, ?1.024;P=0.230, 0.346), FLV (t=1.058,P=0.331) and GLV (P=0.182) between two groups. The correlation between BCVA and MS (r=?0.809,P=?0.005) was observed. However, there were no correlation between BCVA and GCC, superior and inferior GCC, FLV, GLV (r=?0.98, ?0.466, ?0.061, 0.442, 0.442;P=0.817, ?0.244, 0.885, 0.273, 0.273). And also, there were no correlation between MS and GCC, superior and inferior GCC, FLV, GLV (r=0.238, 0.524, 0.286, 0.643, ?0.619;P=0.570, 0.183, 0.493, 0.086, 0.102).Conclusions MS reduced in early stage NAION eyes, which did not correlate with macular GCC.

Objective To explore the clinical characteristics of children with dengue fever (DF) hospitalized in Guangzhou in 2014 , and to raise clinician′s level of understanding of dengue fever in children.Methods Clinical data of 78 children hospitalized with DF in the Department of Infectious Diseases ,Guangzhou Women and Children′s Medical Center were retrospectively analyzed .Chi-square was used for discontinuous variables ,and t test was used for continuous variabbles .Results The 78 cases aged 27 days to 14 years old ,with median of 5 years old .Fifty cases (64 .1%) were male ,and 28 cases (35 .9%) were female.Epidemic areas had gathering trend ,mainly in central urban area .Major clinical manifestations were fever (100 .00%) , rash (82 .05%) , myalgia／fatigue (28 .21%) , but without diarrhea ,jaundice ,hematemesis or hematochezia .Laboratory tests suggested leukopenia (80 .77%) and thrombocytopenia (82 .05%) ,abnormal blood coagulation function with prolonged APTT (57 .69%) ,and abnormal liver function (47 .44%).Etiology examinations showed 66 cases of children had dengue virus nucleic acid detected 1－10 days after onset ,with the positive rate of 89 .19%(66／74).A total of 48 cases had IgM positive ,with the positive rate of 81 .36%(48／59).IgM began to appear as early as the first day of disease onset ,and the average period was (5 .5 ± 0 .8) days .Dengue virus type 1 was the main type . Conclusions In 2014 , dengue virus type 1 is the main strain causing dengue fever in children in Guangzhou .Fever ,rash ,leukopenia ,thrombocytopenia ,clotting disorders and liver function damage are the main clinical features .No serious or fatal cases are reported ,and the prognosis is good.

Objective To explore the diagnostic value of parametric imaging of CEUS in different cervical lymphatic diseases.Methods One hundred eleven patients diagnosed with cervical lymphadenopathy were included.All of the patients underwent parametric imaging of CEUS.According to the pathological results,all patients were divided into reactive hyperplasia group,tuberculosis group,metastasis group and lymphoma group.The features of perfusion phases (perfusion during the artery phase,or perfusion during the artery and parenchymal phase) and perfusion uniformity (homogeneous perfusion or heterogeneous perfusion) were compared among four groups.According to the pathological results,the reactive hyperplasia group and the tuberculosis group were merged into a benign group,and the metastasis group and the lymphoma group were merged into a malignant group.Then,the artery perfusion phase was regarded as benign,and the artery and parenchymal perfusion phase was regarded as malignant.The consistency between parametric imaging of CEUS and the pathological results was compared in two groups.Results The difference of perfusion phase and perfusion uniformity within the four groups had a statistical significance (all P＜0.05).The differences of perfusion phase between the reactive hyperplasia group and the metastasis group,the reactive hyperplasia group and the lymphoma group,the tuberculosis group and the metastasis group were statistical significant respectively (all P＜0.008).The differences of perfusion uniformity between the reactive hyperplasia group and the tuberculosis group,the reactive hyperplasia group and the lymphoma group,the lymphoma group and the tuberculosis group,the lymphoma group and the metastasis group were statistical significant respectively (all P＜0.008).The perfusion phase between the benign group and the malignant group had a statistical significance (P＜0.005),but the perfusion uniformity had no statistical significance in two groups.The consistency was good between the parametric imaging and the pathological results.Conclusion The parametric imaging of CEUS can offer valuable diagnostic information for the cervical lymph nodes underdetermined by conventional ultrasound.

Objective The article was to discuss the correlation between three?dimensional volume ultrasound VOCAL parame?ters and pathological grading of mass type breast invasive ductal carcinoma. Methods 106 breast nodule patients admitted in our hospi?tal who were pathologically confirmed with histological grading from March 2014 to February 2016 were included in the study. The patients underwent three?dimensional volume ultrasound preoperatively. Vocal system in GE LOGIQ E9 was used in lesion analysis to obtain energy histograms:average gray scale (MG), average energy (MP), vascular index ( R) , blood flow index ( VFI) . Analysis was made in the differ?ence among MG, MP, R and VFI of ductal carcinoma in situ, invasive ductal carcinoma grade I, invasive ductal carcinoma grade II, invasive ductal carcinoma grade III and fibroadenoma. Results No sig?nificant difference was found in MG of ductal carcinoma in situ and IDC I, fibroadenoma and ductal carcinoma in situ, fibroadenoma and IDC I(P>0.05), but the difference was statistically significant between other pathological levels (P<0.05). Significant difference was found in MP between pathological levels ( P<0.05) . No significant difference was found in R and VFI between ductal carcinoma in situ and fibroadenoma( P>0.05) , but the difference was statistically significant between other pathological levels ( P<0.05) . Conclusion Three?dimensional volume ultrasonic VOCAL parameters of MG、MP、R、VFI can reflect gray?scale levels and blood flow perfusion in mass type breast nodules of different pathological level, and predict the pathological grading before operation, which provides objective evidence for the evaluation of mass type breast invasive ductal carcinoma and the development of individualized treatment plan.

Objective To observe the characteristics of multifocal eletrotetinogram (mfERG) in nonarteritic anterior ischemic optic neuropathy (NAION) and its relationship with visual acuity and macular central retinal thickness (CRT).Methods By means of patients self-contrast analysis.40 patients (40 eyes) with NAION were collected underwent the examinations of best corrected visual acuity, fundus color photography, fundus fluorescein angiography and field of vision.All the disease and normal eyes had underwent the examination of frequency-domain optical coherence tomography (fdOCT) and mfERG.The CRT and retinal thickness about perifovea, parafovea were documented with fdOCT.All patients underwent the retinal macular function exam with mfERG.Centered by macular fovea, the reaction zone were divided into 5 rings from inside to outside by circles, ring 1 0.00°, ring 2 5.44°, ring 3 10.31°, ring 4 16.31°, ring 5 23.42°.Treated ring 1 hexagon as macular center the amplitude densities of P1 wave, the amplitude of P1 and N1 wave, and the latencies of P1and N1 wave at cvcry ring were observed.The relationship between mfERG characteristics and visual acuity or CRT were analyzed by Spearman correlation analysis.Results fdOCT revealed that there was significantly statistical difference in the retinal thickness about perifovea between disease eyes and contralateral eyes (P＜＜0.05).The increase of CRT and retinal thickness about parafovea had no significantly statistical difference between diseases eyes and contralateral eyes (P＞0.05).mfERG revealed that the decrease of amplitude densities about P1 wave at ring 1 to 2 had significantly statistical difference between two groups (P＜0.05);there were no significantly statistical difference in the amplitude densities of P1 wave at ring 3 to 5;the decrease of amplitude about P1 and N1 wave at ring 1 had significantly statistical difference between two groups (P ＜ 0.05).There was no significantly statistical difference in the amplitude of P1 and N1wave at ring 2 to 5, the latencies of P1 and N1 wave at ring 1 to 5 (P＞0.05).The correlation analysis revealed that the amplitude densities and amplitude of P1 wave at ring 1, amplitude of N1 wave at ring 1 had no effect on visual acuity (r=0.087,0.195,-0.134;P＞0.05) and CRT(r=-0.154,0.365, 0.412;P＞0.05).Conclusions Compared with contralateral eyes,the disease eyes were significantly decrease in amplitude densities of P1 wave at ring 1 to 2, amplitude of P1 and N1 wave at ring 1.There are no correlated between the amplitude densities of P1 wave at ring 1,amplitude of P1 and N1 wave at ring 1 and visual acuity or CRT.

Objective: To investigate the diagnostic values of separated renal multi-locular cystic lesions color Doppler ultra-sound and contrast-enhanced ultrasound performance in multi-locular cystic renal cell carcinoma and cysts. Methods:A total of 53 pa-tients (54 lesions) with multi-locular cystic renal cell carcinoma and cysts were included in the study. The presence of carcinoma and cysts was confirmed via histopathology and tested using ultrasound. Contrast-enhanced ultrasound was applied in 24 (24 lesions) of the total number of patients, and the receiver operating characteristic (ROC) curve was used to analyze the numbers of separation, thick-ness, and type of blood flow patterns of the lesions. The contrast-enhanced ultrasound characteristics were also analyzed. We analyzed the diagnostic value of the color Doppler ultrasound in the separated renal multilocular cystic lesions and the contrast-enhanced ultra-sound performance in multi-locular cystic renal cell carcinoma and cysts. Results:Based on the analysis of the ROC curves of the sepa-ration number, thickness, and type of the blood flow of the lesions in 53 patients (54 lesions), the diagnostic specificity was relatively higher in the lesions where the separation number was≥5 strips (86%), the thicknesses were>3 and≤4 mm (95%), and blood flow was band-like (86%). The areas under the curve of the three indexes were 0.7621, 0.8331, and 0.7962, respectively, which indicate high diagnostic values. The separation number of 4 strips, the thicknesses of>2 and≤3 mm, and the point-like blood flow could be used as critical values for the diagnosis. The contrast enhancement, enhancement peak, and disappearance were (11.2 ± 3.4), (21.7 ± 3.8), and (32.1±4.0) s in 14 patients with multi-locular cystic renal cell carcinoma and (18.4±4.5), (37.8±8.0), and (51.3±9.0) s in 10 patients with multi-locular renal cysts, with statistically significant differences (t=4.47, t'=5.90, t'=6.31, respectively;P<0.05). Conclusion:The sepa-ration number, thickness, and type of blood flow of lesions have relatively higher specificity in multi-locular renal cysts than in multi-locular cystic renal cell carcinoma. The ROC curves show a high diagnostic value. Contrast-enhanced ultrasound of the lesions helped in the differential diagnosis of multi-locular cystic renal cell carcinoma and renal cysts.

Objective:To establish an HPLC method compatible with the mass spectrometry for the determination of the content and related substances in amlodipine besylate tablets. Methods:The sample was separated on a CAPCELL PAK C18 column (250 mm × 4. 6 mm, 5 μm) with the mobile phase consisting of methanol and 20 mmol·L-1 ammonium acetate (60∶40) at a flow rate of 1. 0 ml·min-1 . The detection wavelength was set at 237 nm. The column temperature was 35℃ and the injection volume was 20 μl. Be-sides, an HPLC-QTOF MS method was used to identify the molecular structure of the related substances of amlodipine. Results: The related substances were completely separated from amlodipine. The linear range of amlodipine besylate was 10-100 μg · ml-1 ( r =0. 999 8), and the mean recovery was 99. 2%(RSD=1. 0%,n=9). The main related substances could be detected by HPLC-QTOF MS. Conclusion:The established method is accurate, reliable and reproducible, which can be used in the quality control of amlodip-ine besylate tablets.

Objective:This study aims to evaluate the consistency between contrast-enhanced ultrasound (CEUS) and enhanced computed tomography (CT) in determining the effect of radiofrequency ablation (RFA) on hepatocellular carcinoma. Methods: RFA procedures guided by either ultrasound or CT were performed on 35 patients with 68 lesions. Enhanced CT and CEUS were regularly conducted after the procedures to evaluate the effect of RFA. The full ablation, residual, and recurrence rates of tumors, as well as the di-agnostic accuracies and kappa values of CEUS and enhanced CT, were determined. Results:The full ablation and residual rates of tumors for the 68 lesions diagnosed by CEUS were 84%and 16%, respectively;whereas those for the lesions diagnosed by enhanced CT were 90%and 10%, respectively. No significant difference was found between the obtained rates using the two diagnostic methods (χ2=0.576 3, P=0.447 8). Moreover, the two methods exhibited high consistency (K=0.882 9, Sk=0.120 4). Of the 68 lesions, 13 recurred within 24 months. The recurrence rate evaluated by CEUS was 19%(13/68). No significant difference was found between the detection rates of CEUS (92%, 12/13 lesions) and enhanced CT (100%, 13/13 lesions) in diagnosing recurrent lesions (P>0.05). Enhanced CT could be used as the gold standard for evaluating tumor residual and recurrence rates after RFA. The overall diagnostic accuracy of CEUS reached 92%(63/68 lesions). Conclusion:CEUS and enhanced CT exhibit high accuracy and consistency in evaluating the effect of RFA on hepatocellular carcinoma. CEUS can provide a reliable diagnostic proof for tumor patients after undergoing RFA procedure.