Following the principles of evidence-based medicine,in accordance with the structure and drafting rules of standardized documents,based on literature research,according to the characteristics of chronic cough in children and issues that need to form a consensus,the TCM Guidelines for Diagnosis and Treatment of Chronic Cough in Children was formulated based on the Delphi method,expert discussion meetings,and public solicitation of opinions.The guideline includes scope of application,terms and definitions,eti-ology and diagnosis,auxiliary examination,treatment,prevention and care.The aim is to clarify the optimal treatment plan of Chinese medicine in the diagnosis and treatment of this disease,and to provide guidance for improving the clinical diagnosis and treatment of chronic cough in children with Chinese medicine.

Objective To validate the mechanism of Mori Cortex-Lycii Cortex(MCLC)in intervening acute lung injury(ALI)based on network pharmacology,molecular docking combined with animal experiments.Methods The TCMSP database was used to obtain the active components of MCLC;the SwissTargetPrediction database was used to predict the targets of active components;the GeneCards database and DisGeNET database were used to collect the disease targets of ALI;the key targets were screened by constructing a PPI network,and the key targets were subjected to GO and KEGG pathway enrichment;a drug-component-target-pathway network was constructed using Cytoscape software;AutoDock and PyMOL software were used to validate the molecular docking of some of the compounds and targets;LPS was used to establish a mouse model of ALI for experimental validation,and experimental validation was performed to main targets and pathways.Results Totally 44 active components of MCLC and 138 action targets were obtained;26 potential targets of MCLC intervention in ALI were obtained,mainly TNF,EGFR,NFKB1,MPO,TNFRSF1A,NOX4,etc.,and the key pathways were MAPK signaling pathway,IL-17 signaling pathway,NF-κB signaling pathway,etc.;molecular docking results showed that the core active components of MCLC and the main targets had strong binding activities;animal experiments showed that MCLC at medium and high dosages could effectively improve the lung histopathological damage in ALI mice,decrease the contents of IL-6 and TNF-α in serum(P<0.01),and increase IL-10 content(P<0.01);MCLC inhibited protein expressions of EGFR,PI3K,AKT,NF-κB p65 in lung tissue(P<0.01).Conclusion MCLC may intervene ALI by components such as quercetin and buddleoside,acting on targets including EGFR and TNF,through ulti-pathways of EGFR/PI3K/NF-κB signaling pathway,etc.

Objective:To compare the diagnostic efficacy of Chinese diagnostic model, the 1990 American College of Rheumatology (ACR) classification criteria and the 2018 ACR new classification criteria (draft) for Takayasu arteritis (TA).Methods:A total of 196 TA patients who came to our hospital from January 1, 2009 to May 31, 2019 in the TA database of the department of rheumatology and immunology, Zhongshan Hospital, Fudan University and 131 patients with other vascular diseases visited during the same period were selected. General characteristics, clinical data, laboratory tests and imaging tests of all patients were collected. Categorical variables were presented as numbers and percentages, between-group differences were analyzed using the χ2 test. Continuous variables were presented as the Mean± SD for a normal distribution or median and interquartile range (IQR) for a non-normal distribution. Between-group differences were analyzed using the Student's t-test or Mann- Whitney test, as appropriate. The sensitivity, specificity, positive predictive value, negative predictive value, accuracy and receiver operating characteristics of the above diagnostic/classification criteria area under the curve were analyzed. P<0.05 was considered significant. Results:In terms of sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and area under receiver operating characteristic curve (ROC), Chinese diagnostic models was 85.7%, 96.2%, 89.9%, 97.1%, 81.5%, 0.909, 1990 ACR criteria was 47.4%, 97.7%, 67.6%, 96.9%, 55.4%, 0.726, 2018 ACR classification criteria was 79.1%, 98.5%, 86.5%, 98.7%, 75.9%, 0.888. The difference between the Chinese diagnostic model and the 2018 ACR criteria in AUC was not statistically significant ( Z=1.186 , P>0.05). The sensitivity, accuracy and diagnostic efficiency of Chinese diagnostic model was the best, that of the 1990 ACR classification criteria was the worst, and the specificity of the 2018 ACR classification criteria was the highest. The Kappa value of the 2018 ACR classification criteria and the Chinese diagnostic model was 0.719, which had good consistency, and the Kappa value of the consistency between the 1990 ACR classification criteria and the Chinese TA diagnostic model was 0.516. Conclusion:The Chinese diagnostic model, which is based on the clinical characteristics of the Chinese TA population, has a good diagnostic efficacy for the Chinese population. The 2018 ACR classification criteria (draft) is highly consistent with the Chinese TA diagnostic model, and can be promoted and applied in practice.

Objective:To investigate the safety and feasibility of the occipital condyle screw and evaluate the safepath parameters for the occipital condyle screw.Methods:Data of 64 patients with upper cervical computed tomographic angiograms from September 2016 to September 2018 were retrospectively collected. Excluded occipito-cervical injury, tumor, and vertebral artery course variation. Mimics software was used to reconstruct the occiput, atlas and vertebral artery. Three candidate entry points were placed for each occipital condyle, the midpoint of posterior of occipital condyle as middle entry point, and the medial and lateral entry points were located 3 mm medial and lateral to the middle entry point. The vertebral artery-occipital bone distance (VOD) of each entry point were measured on sagittal plane, and the minimum feasible value was determined to be 4mm. After that 3.5 mm diameter virtual screw was inserted into each candidate entry point with VOD>4 mm, each screw with maximum and minimum cranial angulation was combined with appropriate medial angulation to get the maximum screw length. Then, the screw placement parameters were measured by 3-Matic, and the safe range of cranial angulation and the success rate of screw placement were calculated.Results:The VOD of medial and middle entry point were 8.07±2.13 mm and 7.70±2.19 mm respectively, and the feasibility rate of screw placement of those entry point were 97.7% and 96.1%, respectively. There were significant differences inVOD and feasibility rate of screw placement between medial and middle entry point. The VOD of lateral entry point was 5.63±1.66 mm, and the feasibility rate was only 78.9%, which was significantly lower than that of medial and middle entry point. The lateral entry point could obtain a larger medial angulation, which was supplemented by a longer screw length. The medial angulation and length of screw gradually decreased with the inward movement of the entry point. There were significant differences in medial angulation and screw length among groups. The safe range of cranial angulation of medial, middle and lateral entry points were 8.17°±2.55°, 12.58°±4.23° and 12.09°±3.83°, respectively, and the difference were statistically significant. Among the screw entry point that could accommodate screw fixation, the maximum screw placement success rate can be obtained by adding 5° cranial angulation to the lateral and middle entry point, which were 98.02% and 98.37%, respectively,while 100% success rate of screw placement could be obtained at the medial entry point at 3° cranial angulation.Conclusion:In the selection of the entry point in the horizontal direction, middle and medial entry points have higher success rate of screw placement and wider safe range of cranial angulation because of less affection of horizontal segment of the vertebral artery. However, the screw length of medial entry point is much shorter than middle and lateral entry point. As a result, the middle entry point may be an optimal entry point for the occipital condyle screw.

Objective To investigate the effects of Qingzao Jiufei Tang(QJD)and its decomposing agent on the levels of TNF-α,INF-γ levels of TNF-α of Qingo, P1 and AQP5 in lung tissue of mice infected with Mycoplasma pneu-moniae(MP),and to clarify its molecular anti-infective mechanism. Methods One hundred-forty-four SPF grade BABL/c mice were randomly divided into the normal group(group A),model group(group B),QJD group(group C),QJD de-composition agent I group(group D)、QJD decomposition group II Group(group E)and azithromycin group(group F), with 24 rats in each group. Besides the group A,the other 5 groups of mice were treated with MP infection. After the mod-eling,the mice were given corresponding drugs by gastric gavage,and samples were obtained on the days 3,7,10,14 af-ter the model was established. The lung tissue sections were examined by histopathology, and the degrees of inflammation in lung tissues in the mice were evaluated,and the lung index and the ratio of dry and wet lung weight ratio in the mice were calculated. The levels of MPN372 and P1 genes were determined by qPCR assay. The serum TNF-α and INF-γ levels in the mice were assessed by enzyme linked immunosorbent assay(ELISA). The expression of AQP5 protein was detected by Westernblot. Results After MP infection, the pathological examination revealed thickening of alveolar septum and bronchioles,and extensive inflammatory cell infiltration in the lung tissues. The lung index was increased and the ratio of dry and wet lung weight(P<0.05). TNF- α and INF-γ cedd and was increased, and reached the peak on the seventh day. The expression of AQP5 protein showed a downward tendency,and began to gradually increase on the 14th day. Com-pared with the group B,the expression levels of MPN372,P1 and TNF-α in the group D were down-regulated,and the ex-pression levels of INF-γ levein the group E were up-regulated from the 7th day. Conclusions QJD can control pulmonary inflammation in mice after MP infection. The decrease of production of MP toxin MPN372 and the expression of adhesion protein P1,the up-regulation of expression of INF-γ and AQP5 proteins,and down-regulation of TNF-α expression are one of the mechanisms of its action.

Objective To observe the effect of Qingzao-Jiufei decoction and its composition on the levels of IL-10,TNF-α, CD4+cells, CD8+T cells and the change of CD4+/CD8+ratio in the serum to explore the mechanism of anti-MP infection. Methods The 144 SPF grade BALB/c mice were randomly divided into the normal group, the model, the whole decoction group, the composition Ⅰ group, the composition Ⅱgroup with the method of random digital table, and the azithromycin group and every group had 24 mice. The following five groups were treated with infection of MP model. After successful modeling, the rats in the whole decoction group were treated by gavage with 1 g/ml Qingzao-Jiufei decoction. The rats in the composition Ⅰ group were treated by gavage with 0.61 g/ml composition Ⅰ decoction. The rats in the composition Ⅱ group were treated by gavage with 0.39 g/ml composition Ⅱ decoction. And the three groups were administered for 14 days. The rats in the azithromycin group were treated by gavage with azithromycin suspension once a day. After three days, the drug was stopped. Each group was infected on 3,7,10,14 day. Then mice were sacrificed, with the method of taking the eye of the mice to take blood. The level of IL-10, TNF-α in the mice blood with the method of ELISA were detected. The level of CD4+, CD8+T in the rinsing solution of mice spleen with the method of FCM and the CD4+/CD8+ ratio were detected. Results Compared with the model group, the expressions of CD4+T cells (24.50 ± 1.41 vs. 22.08 ± 1.99) and IL-10 (18.15 ± 0.36 vs. 8.75 ± 0.16) in the whole decoction group significantly increased. The expressions of CD8+T cells (7.29 ± 1.23 vs. 9.13 ± 1.14) and TNF-α (28.32 ± 1.90 vs. 37.97 ± 1.71) significantly decreased (P<0.05), and the level of CD4+/CD8+ratio increased. In the composition Ⅰ group, the expressions of CD8+T cells (7.50 ± 1.45 vs. 9.13 ± 1.14) and TNF-α(33.48 ± 1.08 vs. 37.97 ± 1.71) significantly decreased (P<0.05). In the composition Ⅱ group, the expressions of CD4+T cells (23.63 ± 1.10 vs. 22.08 ± 1.99) and IL-10 (17.82 ± 0.63 vs. 8.75 ± 0.16) significantly increased (P<0.05). Conclusions The mechanism of Qingzao-Jiufei decoction on anti-MP infection may be related to the regulation of the cellular immune.

Objective To evaluate the effect of nurse-led follow-up on medication adherence and quality of life for breast cancer patients receiving adjuvant hormonal therapy.Methods A randomized controlled trial was conducted with 157 patients in the intervention group and 154 in the control group.A self-design web-database medication monitoring platform was designed for managing patients such as texting,reminding and mailing.Participants were randomized to follow-up care as usual(yearly outpatient clinic visits) or nurse-led telephone follow-up(monthly consultation with structured intervention).Telephone follow-up was performed by four trained breast care nurses (BCN) and consisted of a semi-structured interview including managing the side-effects of endocrine therapy,compliance with hormonal therapy and an open discussion of these issues.Patients' medication adherence and quality of life were evaluated by Morisky Medication Adherence Questionnaire(MAQ) and FACT-B at baseline and 3,6 18 and 24 months,respectively.Results The Nurse-led telephone follow-up did not significantly improve the quality of life(P＞0.05).MAQ score in the intervention group was significantly greater than that in the control group(P＜0.05) at 3,6,18 and 24 months.Conclusion Nurse-led follow-up using computer-based monitoring system can improve patients' medication adherence,but there is no obvious increase in quality of life.

This study was aimed to evaluate the clinical effect and safety of Qing-Fei Tong-Luo (QFTL) ointment for treating children with pneumonia.Randomized controlled trial (RCT) was conducted among 460 cases of children with pneumonia.The observation group was given QFTL ointment combined with basic treatment.And the control group was only treated by basic treatment.Evaluation was given on the total clinical efficacy,disappeared time of fever,cough,expectoration,shortness of breath,and medication safety.The incidence of respiratory diseases was followed up on the 30th days after drug withdrawal.The results showed that in the aspect of clinical efficacy between two groups,the cure rate of the observation group was 98.26％,and that of the control group was 93.89％,with statistic significance (P ＜ 0.05).The cure rate of the observation group was better than that of the control group.There was statistical difference on expectoration disappeared time (P ＜ 0.05).There was no statistical difference on disappeared time of fever,cough and shortness of breath (P ＞ 0.05).There was statistical difference on the incidence of respiratory diseases on the 30th days followed-up after drug withdrawal (P ＜ 0.05).There was no statistical difference on the incidence of upper respiratory tract infection,pneumonia and asthma (P ＞ 0.05).No adverse reactions occurred in the observation group.It was concluded that QFTL ointment combined with basic therapy on the treatment of pneumonia in children was significantly better than the control group in the aspect of clinical efficacy,expectoration disappeared time and the incidence of bronchitis.It is safe and effective.The prognosis is good and worthy of promotion in the clinical practice.

Objective To investigate the efficacy and safety of HCPT combined with 5-fluorouracil(5-Fu) in treatment of bladder cancer .Methods Selected 92 patients with advanced bladder cancer in our hospi-tal from February 2011 to August 2015 , equally divided into observation group and control group of 46 patients based on the random number table ,the control group were received 5-Fu intravesical chemotherapy ,The obser-vation group were given the HCPT combined with 5-Fu chemotherapy ,the chemotherapy infusion were once a week,continuous perfusion were observed for 3 months.Results The response rates in the observation group was 95.7%and the control group was 76.1%,the observation group were significantly higher than the control group (P<0.05).The occurrence of bladder irritation adverse reaction ,blood abnormalities,liver and kidney dysfunc-tion,bone marrow suppression in the observation group during chemotherapy compared with the control group were no significant difference(P>0.05),all adverse reactions after symptomatic treatment were improved .All patients were followed up for 1 year,The mortality and recurrence rates in the observation group were 8.7%and 4.3%re-spectively,while the control group were 30.4%and 17.4%,the mortality and recurrence rates of the observation group were significantly lower than the control group (P<0.05).Conclusion HCPT combined with 5 -Fu chemotherapy for bladder cancer has strong anti -cancer effect and without increase the incidence of adverse re-actions,it can promote the improvement of the long -term prognosis,so it is a safe and effective topical bladder chemotherapy drugs .

Objective To investigate the feasibility and clinical effect of immediate ureterovesical reimplantation after ureteral rupture during laparoscopic hysterectomy. Methods From August 2010 to December 2015, 5 cases of ureteral rupture during the operation of laparoscopic hysterectomy were treated with immediate ureterovesical reimplantation under laparoscopy. Results All operations were successfully performed without transversion to open surgery. No patients with urinary leakage occurred. The mean follow-up were 21 months (range 3-60 months) . No cases with ureteral stricture were observed. Slight urine reflux was found in two patients, of whom obvious hydronephrosis and renal damage were not found. Conclusion Immediate ureterovesical reimplantation under laparoscopy is a feasible, safe and minimal invasive method for treatment of ureteral ruputure during laparoscopic hysterectomy.