In recent years， the incidence of pulmonary nodules has kept rising. To give full play to the advantages of traditional Chinese medicine （TCM） in the treatment of pulmonary nodules and identify the breakthrough points of integrating TCM with Western medicine， the China Association of Chinese Medicine organized medical experts in TCM and western medicine to carry out in-depth discussion regarding this disease. The discussion encompassed the modern medical advances， TCM theories of etiology and pathogenesis， the role and advantages of TCM in the whole course management of pulmonary nodules， contents and methods of research on pulmonary nodules， and science popularization work， aiming to provide a reference for clinical practice and scientific research. After discussion， the experts concluded that the occurrence of pulmonary nodules was rooted in the deficiency of the lung and spleen and triggered by phlegm dampness， blood stasis， and Qi stagnation. TCM can treat pulmonary nodules by controlling and reducing nodules， improving physical constitution， ameliorating multi-system nodular diseases， reducing anxiety and avoiding excessive diagnosis and treatment， and serving as an alternative for patients who are unwilling or unfit for surgical treatment. At present， the optimal diagnosis and treatment strategy for pulmonary nodules has not been formed， which needs to be further studied from multiple perspectives such as clinical epidemiology， biology， and evidence-based medicine. The primary task of current research is to find out the advantages， effective prescriptions， and target populations and determine the effective outcomes of TCM in the treatment of pulmonary nodules. At the same time， basic research should be carried out to explore the etiology and biological behaviors of pulmonary nodules. The expert consensus on the diagnosis and treatment of pulmonary nodules with integrated TCM and Western medicine needs to be continuously revised to guide clinicians to conduct standardized， scientific， and accurate effective diagnosis and treatment.

Objective:To understand the composition of respiratory virus spectrum in hospitalized children with acute respiratory infections in Guilin City from 2021 to 2022, and to explore the epidemic characteristics of different respiratory viruses.Methods:Information of a total of 638 hospitalized children with acute respiratory infections (ARI) syndrome under the age of 14 years in Guilin city, Guangxi from September 2021 to October 2022 was collected as research data. The collected pharyngeal swabs from pediatric patients were subjected to real-time fluorescence reverse transcription polymerase chain reaction for nucleic acid testing, screening for 15 common respiratory viruses, and analyzing the virus spectrum characteristics of hospitalized pediatric patients with acute respiratory infections.Results:Among the 638 specimens, 365 were tested positive for at least one virus, with a positive rate of 57.21% (365/638). The detection rate for two or more viruses was 12.85% (82/638). There were 12 types of viruses detected, and the difference in virus detection rates among different seasons was statistically significant (P<0.002). The virus positive detection rate of samples from different age groups was the highest in the 0-2-year old group (40.66%), followed by the 3-5-year old group (34.80%) and the 6-year and older group (24.54%).Conclusions:During the period from September 2021 to October 2022, all 12 respiratory viruses were prevalent in Guilin area, with obvious summer peak as characteristics. It is suggested that corresponding prevention and control measures should be focused on pathogens that may cause acute respiratory infections in children during the local summer to prevent and control the spread and prevalence of respiratory infections.

Objective To explore the clinical features of occupational pneumoconiosis (hereinafter referred to as “pneumoconiosis”) complicated with interstitial lung disease (ILD). Methods A total of 56 patients with pneumoconiosis complicated with ILD were selected as the research subjects using a retrospective study method, and their clinical features were analyzed. Results The main clinical symptoms of the 56 patients were progressive dyspnea, cough, and expectoration, with detection rates of 76.8%, 75.0%, and 55.4%, respectively. The detection rates of hypoxemia and respiratory failure were 67.9% and 32.1% respectively. Among the 35 patients who underwent pulmonary function test, restrictive, mixed, and obstructive ventilatory disorders were detected in 37.1%, 22.9%, and 17.1% of cases, respectively, with a 74.3% detection rate for reduced diffusion capacity. High resolution computed tomography of the chest revealed ground-glass shadows, grid shadow, interlobular thickening, honeycomb shadows and tractive bronchiectasis, with detection rates of 57.1%, 35.7%, 35.7%, 23.2%, and 17.9%, respectively. Lesions were mostly diffusely distributed in both lungs, with a predominance in the lower lungs compared to the mid-upper lungs. Patients complicated with connective tissue disease, including systemic sclerosis, rheumatoid arthritis, systemic lupus erythematosus, polymyositis, and dermatomyositis, accounted for 33.9% (19 cases). Conclusion The clinical symptoms, pulmonary function, and arterial blood gas analysis results of patients with pneumoconiosis complicated with ILD show no specific features. However, a subset of pneumoconiosis patients with ILD also have coexisting connective tissue diseases.

Objective:To explore the changes in the functional connectivity (FC) of hippocampal subregions in nicotine addicts after repetitive transcranial magnetic stimulation (rTMS) using resting-state FC.Methods:This study was a cross-sectional study. The clinical and imaging data from 20 male nicotine addicts at Zhejiang Hospital between 2022 and 2024 were analyzed prospectively. All participants received rTMS treatment and were assessed with nicotine-related clinical scales and resting-state FC analysis before and after treatment. The clinical scale evaluations included the Fagerstr?m test for nicotine dependence (FTND), smoking severity index, Minnesota nicotine withdrawal scale (MNWS), short tobacco craving questionnaire (sTCQ), and visual analog scale (VAS). Paired t-tests and Wilcoxon signed-rank tests were used to compare the differences in clinical scale scores before and after treatment. Ten subregions of the bilateral hippocampus (including the hippocampus, dentate gyrus, entorhinal cortex, hippocampus-amygdala transition area, and subiculum) were used as seed points, and paired t-tests were conducted to compare the FC differences in these subregions before and after treatment. Pearson and Spearman correlation analyses were used to assess the correlation between changes in resting-state FC in the rTMS group and clinical scale scores. Results:Compared to pre-treatment, the scores on the FTND, smoking severity index, MNWS, sTCQ, and VAS all significantly decreased after rTMS treatment in nicotine addicts (all P<0.05). Compared to pre-treatment, post-treatment FC was reduced between the left dentate gyrus subregion and the bilateral supplementary motor area and left middle cingulate gyrus, while it increased between the left entorhinal cortex subregion and the right middle and superior temporal gyri, and between the left hippocampus-amygdala transition area subregion and the bilateral calcarine cortex and cuneus (Gaussian random field correction, voxel-level P<0.01, cluster-level P<0.05). Negative correlations were observed between the FC difference in the left hippocampus-amygdala transition area subregion and the right calcarine cortex and the difference in sTCQ-impulse score before and after treatment ( r=-0.447, P=0.048). Negative correlations were observed between the FC difference in the left hippocampus-amygdala transition area subregion and the right cuneus and the difference in the sTCQ-expectation score ( r=-0.559, P=0.010). Negative correlations were observed between the FC difference in the left hippocampus-amygdala transition area subregion and the left calcarine cortex and the differences in sTCQ-emotion and sTCQ-expectation scores ( r=-0.516, P=0.020; r=-0.466, P=0.038, respectively). Negative correlations were observed between the FC difference in the left hippocampus-amygdala transition area subregion and the left cuneus and the differences in sTCQ-emotion and sTCQ-expectation scores ( r=-0.459, P=0.042; r=-0.501, P=0.024, respectively). Conclusion:Changes in FC in certain hippocampal regions are observed in nicotine addicts following rTMS treatment, suggesting that hippocampal subregions may serve as potential biomarkers for nicotine addiction withdrawal to some extent.

Objective:To explore the alterations in resting-state functional connectivity (rs-FC) of hippocampal and insular subregions with other regions of the whole brain in nicotine addicts and their correlations with nicotine addiction.Methods:A total of 56 participants, including 27 nicotine addicts and 29 healthy controls, were recruited from community from January 2022 to June 2024. Multidimensional nicotine addiction scales were performed in nicotine addiction group. Resting-state functional magnetic resonance imaging (fMRI) was performed in the 2 groups; general data and rs-FC differences between hippocampal and insular subregions with other regions of the whole brain were compared between the 2 groups. Correlations of rs-FC alterations between hippocampal and insular subregions with other regions of the whole brain with nicotine addiction scale scores in the nicotine addiction group were analyzed.Results:No significant difference in age or years of education was noted between the nicotine addiction group and healthy control group ( P>0.05). Compared with the healthy control group, nicotine addiction group had enhanced rs-FC between the left entorhinal cortex of the hippocampus and left putamen, attenuated rs-FC between the left hippocampal-amygdaloid transitional area and widespread regions including the left angular gyrus, left superior parietal gyrus, left middle occipital gyrus, left precuneus, and left superior occipital gyrus, enhanced rs-FC between the left posterior insular (PI) and bilateral precuneus or pericalcarine cortex, attenuated rs-FC between the left ventral anterior insula and widespread regions including the right supramarginal gyrus, right supratemporal gyrus and right central sulcus, and attenuated rs-FC between the left ventral anterior insula and bilateral medial superior frontal gyrus, with significant differences ( P<0.05). Correlation analysis showed that rs-FC between the left PI and left precuneus was positively correlated with Fagerstr?m test for nicotine dependence (FTND) scores and heaviness of smoking index (HSI, r=0.462, P=0.015; r=0.492, P=0.009); rs-FC between the left PI and right precuneus was positively correlated with FTND scores and HSI ( r=0.417, P=0.031; r=0.472, P=0.013); rs-FC between the left PI and right pericalcarine cortex were positively correlated with FTND scores and HSI ( r=0.485, P=0.010; r=0.496, P=0.009). Conclusion:Abnormal rs-FC patterns have been observed between hippocampal and insular subregions and other regions of the whole brain in nicotine addicts; these alterations are associated with addictive severity and dependency of nicotine addiction.

OBJECTIVE To provide theoretical basis for the rational use of drugs in medical institutions， assist in improving the quality of pharmaceutical services， and thus meet clinical drug demands. METHODS Adopting consensus meetings， Liaoning Pharmaceutical Association，Jilin Pharmaceutical Association and Heilongjiang Pharmaceutical Association collaborated with clinical and pharmaceutical experts in the region to compile the expert consensus on off-label drug use in the three Northeastern provinces of China after many votes and discussions by collecting and collating the information related to off-label drug use in medical institutions from the three northeastern provinces of China，and referring to and citing off-label drug use stated in some expert consensus and medication catalog. RESULTS Finally， a total of 198 pieces of off-label drug use information for 70 drugs were included in the two sections of solid tumors and hematological diseases in Consensus of Experts on Drug Use beyond the Instructions in the Three Provinces of Northeast China. CONCLUSIONS Consensus of Experts on Off-label Drug Use in the Three Northeastern Provinces of Northeast China （solid tumors and hematology）offers a theoretical foundation for rational drug use in the treatment of solid tumors and hematological diseases within medical institutions，and has a positive significance in improving the effectiveness and safety of drug treatment.

Abstract Allergic diseases can occur in all systems of the body, covering the whole life cycle, from children to adults and to old age, can be lifelong onset and even fatal in severe cases. Children account for the largest proportion of the victims of allergic disease, Children s allergies start from scratch, ranging from mild to severe, from less to more, from single to multiple systems and systemic performance, so the prevention and treatment of allergic diseases in children is of great importance, which can not only prevent high risk allergic conditions from developing into allergic diseases, but also further block the process of allergy. At present, there is no consensus on the management system of allergic children in kindergartens and primary schools. The "Consensus on Allergy Management and Prevention in Kindergartens and Primary Schools", which includes the organizational structure, system construction and management of allergic children, provides evidence informed recommendations for the long term comprehensive management of allergic children in kindergartens and primary schools, and provides a basis for the establishment of the prevention system for allergic children.

ObjectiveCOVID-19 vaccination is critical for pandemic control， especially in the elderly. Compared with developed countries， the rate of full vaccination and booster vaccination for the elderly in China is low， making it urgent to accelerate the process of vaccination for the elderly in China. MethodsThis study summarizes the policy experiences of the United Kingdom， the United States， Singapore， and South Korea by sorting relevant literature and government websites， analyzes the current performance and reasons for COVID-19 vaccination among the elderly in China， and explores strategic suggestions for improving COVID-19 vaccination in the elderly in terms of vaccination priority groups， service provision， and vaccination intention. ResultsIt is important to vaccination rate for the elderly in China by focusing on the priority vaccination population， establishing a permanent mechanism based on the family doctor system， and increasing the willingness to vaccinate. ConclusionContinued reinforcement of COVID-19 vaccination for the elderly is needed， and the existing vaccination model is overwhelming. We should establish a permanent mechanism based on the family doctor system to transfer from a mobilization model to a regular vaccination model.

OBJECTIVE：To establish the method for simultaneous determination of 5-fluorouracil（5-FU）and its metabolites 5-fluoro-5，6-dihydrouracil （5-FUH2） in human plasma ，and apply it in the clinic. METHODS ：After plasma samples were processed twice by ethyl acetate ，UPLC-MS/MS method was adopted using 5-bromouracil （5-Bru） as internal standard. The determination was performed on Acquity UPLC HSS T 3 column with mobile phase consisted of methanol-water （30 ∶ 70，V/V）at the flow rate of 0.3 mL/min. The column temperature was 20 ℃，and sample size was 5 μL. An electrospray ion source was used to carry out negative ion scanning with multiple reaction monitoring. The capillary voltage was 1.5 kV；the taper hole voltage was 20 V；the desolvent temperature was 450 ℃；the desolvent air flow was 850 L/h；the cone hole gas velocity was 50 L/h. The ion transitions for quantitative analysis were m/z 129.00→41.90（5-FU），m/z 130.87→82.92（5-FUH2），m/z 189.00→42.10（5-Bru）， respectively. From Aug. to Oct. 2020，10 patients with advanced colorectal cancer were treated with continuous intravenous drip of 5-FU for 46 hours were collected from Harbin Medicinal University Cancer Hospital. Steady-state plasma concentration of 5-FU and plasma concentration of 5-FUH2 were determined at 18-30 h of continuous intravenous drip. The area under the curve （AUC）for 5-FU and concentration ratio of 5-FUH2/5-FU were calculated. RESULTS ：The linear range of 5-FU and 5-FUH2 were 20 to 1 000 μg/mL（R 2＞0.990）. The quantification limits were 20 ng/mL. RSDs of precision test were all lower than 20％，and relative error ranged ±10％. The extraction recovery and matrix effects didn ’t affect the determination of substance to be measured. Among 10 patients with advanced colorectal cancer ，the steady-state concentration of 5-FU were 180.04-622.83 ng/mL，and AUC of 5-FU ranged from 8.28 to 28.65 mg·h/L. The concentration of 5-FUH2 ranged 336.48-948.43 ng/mL，and concentration ratio of 5-FUH2/ 5-FU ranged 0.93-4.21. AUC of 5-FU in 10 patients had about 3-4 fold individual differences. CONCLUSIONS ：The established method has good precision and accuracy ，high sensitivity ，and simple operation. It can be used for plasma monitoring of 5-FU in patients with advanced colorectal cancer.

Objective:To investigate the role and mechanism of anterior gradient-2(AGR2)in intestinal mucosal barrier injury induced by tumor necrosis factor-α(TNF-α).Methods:Caco-2 cell monolayers were pre-transfected with an AGR2 plasmid and then exposed to TNF-α.Real-time PCR was employed to detect AGR2 mRNA expression, with western blot detection of AGR2 protein expression.Epithelial permeability was assessed by detecting transepithelial electrical resistance.Electron microscope was used to observe autophagic bodies.Results:Both AGR2 mRNA and protein expression levels were significantly reduced by TNF-α exposure compared with the levels in untreated control monolayers.AGR2 overexpression signifcantly ameliorated TNF-α induced epithelial barrier hyperpermeability, and mediated mitophagy in Caco-2 cell monolayers.Conclusion:This study suggested that AGR2 could inhibit TNF-α induced intestinal barrier dysfunction and this protective mechanism might be promoted by mediated mitophagy in Caco-2 cell monolayers.