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 influence of the Janus kinase-signal transducer and transcription activator(JAK-STAT)signaling pathway mediated by Kruppel-like factor 14(KLF14)on the prognosis of non-small cell lung cancer(NSCLC).Methods From January 2018 to September 2019,NSCLC tissues from 80 patients and malignancy-free paracancerous tissues from 25 patients were collected.Medical follow-up ended in April 2023.Immunohistochemistry was used to detect the expression of KLF14 in tissues,and the patients were divided into a high-expression group and a low-expression group according to the median level of KLF14 expression.Over-expres-sion or knock-down of KLF14 and JAK1 was achieved by transfection of KLF14 and JAK1 overexpression plasmid in A549 cells and transfection of KLF14 and JAK1 specific short hairpin RNA(shKLF14 and shJAK1)in HCC827 cells.The proliferation activity of cells was analyzed by cell clone formation test.Transwell analyzed the migration and invasion of cells.Results As compared with the normal paracancerous tissues,the expression of KLF14 in NSCLC tissue decreased(P<0.001).The low expression of KLF14 was significantly correlated with tumor diameter of>3 cm,lymph node metastasis and clinical stage Ⅲ(P<0.05).There was a significant difference in the overall survival rate between the high KLF14 expression group and the low KLF14 expression group,and the patients with low KLF14 expression had poor prognosis(P = 0.039).After overexpression of KLF14,the proliferation ability of A549 cells and the number of migration and invasion of these cells decreased significantly(P<0.05);while after knock-down of KLF14,the proliferation ability of HCC827 cells and the number of migration,and invasion of these cells increased significantly(P<0.05).As compared with Vector + KLF14 group,the number of colonies,migration and invasion of A549 cells in JAK1 + KLF14 group increased significantly(P<0.05).As compared with shNC + shKLF14 group,the number of colonies,migration and invasion of HCC827 cells in shJAK1 + shKLF14 group decreased significantly(P<0.05).Conclusions Low expression of KLF14 is associated with poor overall survival in NSCLC patients.Up-regulation of KLF14 significantly inhibits the proliferation and metastasis of lung cancer cells in vitro,and its mechanism may be related to inhibition of the JAK-STAT signaling pathway.

Objective:To explore the mediating effect of professional identification between compassion fatigue and death coping ability of nurses in the oncology department, and to provide a basis for strengthening their professional identification, reducing their compassion fatigue and improving their death coping ability.Methods:From October to December 2022, a questionnaire survey was conducted among 350 nurses in the oncology department from 12 hospitals in Hebei Province using the convenience sampling method. General Data Questionnaire, Professional Identification Scale for Nurse, Compassion Fatigue Self Test and Death Coping Ability Scale were used to conduct an online survey. The relationship among the three was statistically analyzed with SPSS 25.0, and the structural equation model was established using the AMOS 23.0 software to analyze the mediating effect of professional identification between compassion fatigue and death coping ability.Results:A total of 326 valid questionnaires were collected. Among such 326 nurses in the oncology department, including 12 males and 314 females, 121 were aged 21-30 years old, 153 were aged 31-40 years old, 42 were aged 41-50 years old, and 10 were aged 51-60 years old. The professional identification score of oncology nurses was (108.96 ± 20.29) points, the empathy fatigue score was (81.30 ± 9.00) points, and the death coping ability score was (112.39 ± 23.52) points.Pearson correlation analysis showed that compassion fatigue was negatively correlated with professional identification and death coping ability( r = - 0.428, - 0.326, both P<0.01), while occupational identity was positively correlated with death coping ability ( r = 0.565, P<0.01). Professional identification played a partial mediating role between compassion fatigue and death coping ability of nurses in the oncology department, and the mediating effect was - 0.34, accounting for 52.3% of the total effect. Conclusions:In this study, the professional identification score of nurses in the oncology department was at a moderate level, the compassion fatigue score was at the moderate to severe level, and the death coping ability score was at a moderate level. Professional identification is an important mediating variable between compassion fatigue and death coping ability of nurses in the oncology department that improve their professional identification, reduce their compassion fatigue and improve their death coping ability.

BACKGROUND: Syringomyelia is a progressive chronic disease that leads to nerve pain, sensory dissociation, and dyskinesia. Symptoms often do not improve after surgery. Stem cells have been widely explored for the treatment of nervous system diseases due to their immunoregulatory and neural replacement abilities. METHODS: In this study, we used a rat model of syringomyelia characterized by focal dilatation of the central canal to explore an effective transplantation scheme and evaluate the effect of mesenchymal stem cells and induced neural stem cells for the treatment of syringomyelia. RESULTS: The results showed that cell transplantation could not only promote syrinx shrinkage but also stimulate the proliferation of ependymal cells, and the effect of this result was related to the transplantation location. These reactions appeared only when the cells were transplanted into the cavity. Additionally, we discovered that cell transplantation transformed activated microglia into the M2 phenotype. IGF1-expressing M2 microglia may play a significant role in the repair of nerve pain. CONCLUSION Cell transplantation can promote cavity shrinkage and regulate the local inflammatory environment.Moreover, the proliferation of ependymal cells may indicate the activation of endogenous stem cells, which is important for the regeneration and repair of spinal cord injury.

Objective To investigate the correlation of serum osteoprotegerin (OPG) and calcium levels with cerebral microbleeds in patients with acute ischemic stroke. Methods A total of 97 patients with acute ischemic stroke were selected as the study subjects and divided into cerebral microbleed (group 31 patients with) and non-cerebral microbleed (group 66 patients) based on the results of susceptibility-weighted imaging. Demographic data and laboratory examination indicators were collected from the two groups, and serum OPG and calcium levels were measured. The levels of serum OPG and calcium were compared between patients with different degrees of lesion and bleeding sites. Spearman rank correlation analysis was used to determine the correlations of serum OPG and calcium with cerebral microbleeds. Multivariate Logistic regression analysis was conducted to explore the influencing factors of cerebral microbleeds. Receiver operating characteristic (ROC) curves were plotted to assess the predictive value of serum OPG and calcium for cerebral microbleeds. Results Significant differences were observed in age, proportions of patients with drinking and hypertension as well as diabetes, systolic blood pressure, diastolic blood pressure, and serum OPG and calcium levels between the cerebral microbleed group and the non-cerebral microbleed group (P < 0.05). Multivariate Logistic regression analysis revealed that older age, history of alcohol consumption, history of hypertension, high systolic blood pressure, and high OPG level were independent risk factors for cerebral microbleeds (OR=1.480, 1.330, 1.843, 1.632, 1.652; P < 0.05), while high calcium level was an independent protective factor for cerebral microbleeds (OR=0.721, P < 0.05). The AUC values for the prediction of cerebral microbleeds in acute ischemic stroke patients using serum OPG or calcium alone, and their combination were 0.853, 0.825, and 0.921, respectively, with the combined prediction showing higher value than the individual prediction (Z=2.895, 3.138; P < 0.05). Spearman rank correlation analysis revealed a positive correlation between serum OPG and the severity of cerebral microbleeds (r_s=0.736, P < 0.05) and a negative correlation between calcium and the severity of cerebral microbleeds (r_s=-0.752, P < 0.05). No significant differences were observed in serum OPG and calcium levels between patients with cerebral microbleeds in different locations (P > 0.05). Conclusion Elevated serum OPG and reduced calcium levels are observed in patients with acute ischemic stroke and cerebral microbleeds. The levels of serum OPG and calcium are closely related to the severity of cerebral microbleeds, and early combined detection can effectively predict the risk of cerebral microbleeds.

Objective:To explore the value of liver stiffness and spleen stiffness measured by two-dimensional shear wave elastography (2D-SWE) in predicting high-risk varices (HRV) with compensated cirrhosis patients.Methods:Seventy patients with compensated cirrhosis who attended the First Hospital of Lanzhou University from November 2019 to April 2022 were recruited. All patients underwent examinations of liver stiffness measurement (LSM) and spleen stiffness measurement (SSM) by 2D-SWE. Binary logistic regression was used to analyze the risk factors affecting the occurrence of HRV. The diagnostic performances of LSM, liver stiffness (by 2D-SWE)-spleen length-to-platelet (LSPS) score, and SSM in predicting HRV were compared.Results:SSM was not technically feasible in 6/70 (8.6%) patients due to small volume of spleen.Among 64 patients with compensated cirrhosis, 30/64 (46.9%) were HRV. Binary multivariate Logistic regression analysis showed that SSM and platelet counts were independent influencing factors for predicting HRV, with OR values of 1.126 ( P=0.006) and 0.971 ( P=0.039), respectively. The area under the receiver operating characteristic curve (AUC) of LSM, LSPS score, and SSM were 0.660, 0.828 and 0.858, respectively. The AUCs of SSM and LSPS score were significantly higher than that of LSM ( P<0.05), but there was no statistical difference between SSM and LSPS score ( P=0.608). Conclusions:LSM and SSM measured by 2D-SWE have high success rate. SSM and LSPS score have high value in predicting HRV in patients with compensated cirrhosis, and the diagnostic performances of the above two methods are significantly higher than that of LSM.

Objective:To explore the reports on the pain intensity and the use of pain relief strategies of parents in postoperative pain management of orthopedic children, and analyze related influencing factors.Methods:From January to August 2020, purpose sampling was used to select 200 parents of children who underwent elective surgery in the Department of Orthopedics of a Class Ⅲ Grade A children hospital in Suzhou City. The survey was conducted using the General Information Questionnaire, Wong-Baker FACES Pain Rating Scale, and Parents' Use of Pain Relief Strategies (PUPRS) Questionnaire. A total of 200 questionnaires were distributed, and 197 were effectively returned, with an effective rate of 98.5%.Results:The 197 orthopedic children's parents reported a score of (6.75±2.19) on the pain intensity of the children, 36.5% and 53.3% of them were moderate and severe respectively. The PUPRS score was 52.0 (9.00) , 70.6% and 28.4% were at medium and high levels, respectively. Multivariate analysis showed that parents' gender and education level were the influencing factors of PUPRS ( P<0.05) . Conclusions:Parents of most orthopedic children report severe postoperative pain intensity, and their use of pain relief strategies is at a medium to a high level, and is affected by gender and education level. However, the use of painkillers and certain pain relief strategies is lacking. In the future, clinical medical and nursing staff should formulate reasonable health education programs to further promote and improve parents' pain management practices.

Objective:To investigate the developmental behavior of early term infants at 6 months and its difference from that of complete full-term infants.Methods:A healthy maternal and infant birth cohort in maanshan city, established in Maanshan Maternal and Child Health Hospital from June 2015 to June 2016. Birth outcomes were copied from the hospital electronic medical record system after delivery. The Chinese Ages and Stages Questionnaires was used to assess developmental behavior. The chi-square test and multivariate unconditional logistic regression model were used to analyze the differences in the behavioral development of early and full term infants.Results:The birth rate of early term infants was 24.74% (500/2 021). The detection rates of communication, gross motor, fine motor, problem solving and individual-social areas in early term infants were 2.1%, 3.2%, 6.1%, 6.3% and 2.7%, respectively. The detection rate of problem-solving area in early term infants was significantly higher than that in the full-term infants (6.3% vs. 3.7%, χ 2=5.42, P<0.05). After controlling for confounding factors, compared with full-term infants, the risk of problem-solving area in early infants was significantly increased ( OR=1.65, 95%CI:1.01-2.70, P<0.05). Conclusion:The risk of behavioral retardation in Early term infants is significantly higher than that in full-term infants, and long-term follow-up and appropriate early development promotion interventions are needed to improve their quality of life.

Objective:To investigate the effects of adherent-invasive Escherichia coli ( E. coli) LF82 on the structure and function of intestinal barrier in mice with ulcerative colitis (UC). Methods:Twenty-four specific pathogen free (SPF) C57BL/6 mice were divided into UC with E. coli LF82 group, UC group and healthy control group with eight mice in each group. The UC mice model was induced by dextran sulfate sodium (DSS). One week before modeling, the mice of UC with E. coli LF82 group were intragastric administrated with 1×10 9 colony-forming unit (CFU) E. coli LF82 to colonize the bacteria strain. The effects of E. coli LF82 on colitis of mice with UC were evaluated by disease activity index (DAI), gross morphological injury score, colonic mucosal injury index (CMDI), myeoloperoxidase (MPO) activity and pathological features. The ultrastructure and the changes of cytoskeleton F-actin of mice colonic tissues were detected by transmission electron microscope (TEM) and direct immunofluorescence. The ability of colonic mucin production and degree of fibrosis were estimated by periodic acid Schiff reaction (PAS) stain and sirius red stain. T test, least significant difference, repeated measurement analysis of variance and one-way analysis of variance were used for statistical analysis. Results:On the fourth, fifth, sixth and seventh day after the modeling, the DAI scores of UC with E. coli LF82 group were all higher than those of UC group ((2.53±0.38) points vs. (2.01±0.53) points, (3.02±0.62) points vs. (2.67±0.24) points, (3.13±0.61) points vs. (2.20±0.24) points, (3.27±0.28) points vs. (2.20±0.69) points, respectively), and the differences were statistically significant ( t=3.37, 2.25, 9.56 and 10.24, all P<0.05). The gross morphological injury score of mice colon of UC with E. coli LF82 group was higher than that of UC group ((6.17±1.94) points vs. (2.83±0.98) points), and the difference was statistically significant ( t=-3.75, P<0.05). The CMDI and MPO activity of UC with E. coli LF82 group were both higher than those of UC group ((16.80±2.79) points vs. (11.80±3.11) points, (729.3±77.5) U/mg vs. (594.4±31.9) U/mg), and the differences were statistically significant ( t=-2.83; mean difference=134.82, 95% confidence interval ( CI) 72.12 to 197.51; both P<0.05). The results of TEM showed that the E. coli LF82 could invade the submucosa of colon and caused further injury of colonic tissues in mice. The distribution of cytoskeleton F-actin of mice colonic tissues changed. The results of PAS staining showed that the percentages of PAS positive cells of UC with E. coli LF82 group and UC group were both lower than that of healthy control group ((32.40±8.02)% and (41.90±8.99)% vs. (57.70±11.52)%), and the difference was statistically significant ( F=17.63, P<0.01). The percentage of PAS positive cells of UC with E. coli LF82 group was lower than that of UC group, and the difference was statistically significant (mean difference=-9.50, 95% CI -18.33 to -0.67, P<0.05). The results of sirius red staining showed that the villous epithelium of colon mucosa of UC with E. coli LF82 group was partially injured and collagen fibers hyperplasia was serious. The area ratios of collagen fiber of UC with E. coli LF82 group and UC group were both higher than that of healthy control group ((51.83±5.78)% and (37.11±5.59)% vs. (15.41±2.25) %), and the difference was statistically significant ( F=86.72, P<0.01). The area ratio of collagen fiber of UC with E. coli LF82 group was higher than that of UC group, the difference was statistically significant (mean difference=14.83, 95% CI 8.91 to 20.76, P<0.05). Conclusions:E. coli LF82 can aggravate DSS-induced colitis in UC mice, leading to changes in colon ultrastructure and cytoskeleton, it can also reduce the ability of mucus secretion of colon of mice and increase the degree of colonic tissues fibrosis.

Objective:To examine the relationship between pre-pregnancy BMI, gestational diabetes (GDM) and different indicators of childhood obesity at the age of 4.Methods:Based on Ma’anshan Birth Cohort Study, singleton children who were born in Ma’anshan of Anhui province from October 2013 to April 2015, were followed for 4 years, consecutively. During the first questionnaire survey, data including pre-pregnancy weight, height and socio-demography were collected. During 24-28 week of gestation, 75 g oral glucose tolerance test was conducted for them. Childhood height, weight, waist circumference and body composition were measured at the age of 4. Comparisons between groups were performed using chi-square test, analysis of variance or t-test. The relationship between pre-pregnancy overweight/obesity, GDM and childhood obesity-related characteristics were analyzed by logistic regression model and generalized linear model analysis. Results:The prevalence rates of overweight and obesity in children at the age of 4 were 13.08% and 6.03%, respectively. After adjustment for characteristics related to mothers and their children, significantly increased risk of obesity ( OR=3.27, 95% CI: 2.15-4.98), larger waist circumference ( OR=2.32, 95% CI: 1.72-3.14) and higher waist-to-weight ratio ( OR=2.29, 95% CI: 1.73-3.02) were seen in the offspring of women with pre-pregnancy overweight/obesity. Body composition (skeletal muscle, body fat, body fat percentage) of the offspring were strongly correlated with pre-pregnancy overweight/obesity of the mothers ( P<0.05). Maternal GDM was associated with higher risk of childhood obesity ( OR=1.78, 95% CI: 1.14-2.79), on mothers without GDM during pregnancy. However, neither larger waist circumference, or higher waist-to-weight ratio seemed to increase the risk. Moreover, maternal GDM was not associated with body composition measures (skeletal muscle, body fat, body fat percentage). Conclusion:Pre-pregnancy BMI and maternal GDM were independent risk factors for obesity in 4-year-old children, and pre-pregnancy BMI was correlated with various indicators of body composition in children.