Traditional Chinese Medicine (TCM), as a treasure of the Chinese nation, plays a significant role in maintaining public health. In 2019, the Central Committee of the Communist Party of China and the State Council proposed for the first time the establishment of a TCM registration and evaluation evidence system that integrates TCM theory, "personal experience" and clinical trials (referred to as the "Three-in-One" System) to promote the inheritance and innovation of TCM. Subsequently, the National Medical Products Administration issued several guiding principles to advance the improvement and implementation of this system. Owing to the complexity of its implementation, there are still differing understandings within the TCM industry regarding the positioning of the "Three-in-One" Registration and Evaluation Evidence System, as well as the connotation and value orientation of the "personal experience." To address this, Academician WANG Qi, President of the TCM Association, China International Exchange and Promotion Association for Medical and Healthcare and TCM master, led a group of academicians, TCM masters, TCM pharmacology experts and clinical TCM experts to convene a "Seminar on Promoting the Implementation of the ′Three-in-One′ Registration and Evaluation Evidence System for Chinese Medicinals." Through extensive discussions, an expert consensus was formed, clarifying the different roles of the TCM theory, "personal experience" and clinical trials within the system. It was further emphasized that the "personal experience" is the core of this system, and its data should be derived from clinical practice scenarios. In the future, the improvement of this system will require collaborative efforts across multiple fields to promote the high-quality development of the Chinese medicinal industry.

Objective:To analyze the distribution and drug sensitivity of pathogens in bronchoalveolar lavage fluid(BALF)of children with severe community acquired pneumonia(CAP)in Qingdao from 2018 to 2020.Methods:The clinical data of 482 children with severe CAP in Qingdao admitted to Women and Children′s Hospital of Qingdao University were collected.BALF was collected by bronchoscopy for detection of bacteria and mycoplasma.Results:(1)Bacterial infection was detected in 139 cases(27.84%), mycoplasma infection in 119 cases(24.69%), and virus infection in 141 cases(29.25%). (2)The detection rates of bacteria and virus infection in the 1-12 months old group were higher.The detection rate of mycoplasma pneumoniae was the highest in the group over 5 years old.(3)A total of 139 strains were positive in bacterial culture of lavage fluid under bronchoscope: 55 strains(39.57%) of gram-negative bacilli and 84 strains(60.43%) of gram-positive cocci.Streptococcus pneumoniae was the most common gram-positive bacteria.Haemophilus influenzae was the most common gram-negative strain.(4)Streptococcus pneumoniae and Staphylococcus aureus were highly sensitive to amoxicillin clavulanate potassium, vancomycin and linezolid.The resistance rate to erythromycin was high(100%). (5)Haemophilus influenzae, Escherichia coli, Pseudomonas aeruginosa and Klebsiella pneumoniae were highly sensitive to meropenem and cefoperazone sulbactam.They were highly resistant to amoxicillin, ampicillin and cefuroxime(>80%).Conclusion:Severe CAP in Qingdao area is mainly caused by virus and bacteria within 1 year old.Mycoplasma pneumoniae infection is the main cause of children over 5 years old.Respiratory syncytial virus, adenovirus and parainfluenza virus are main causes of virus infection.Streptococcus pneumoniae and haemophilus influenzae are the main pathogens, which are more sensitive to vancomycin, linezolid, meropenem and cefoperazone sulbactam, but resistant to erythromycin and amoxicillin.

Objective:To analyze the clinical features of bronchiectasis, in order to improve the diagnosis, treatment, and prognosis.Methods:The clinical data of 78 children with bronchiectasis at Qingdao Women and Children′s Hospital of Qingdao University from January 2010 to January 2020 were analyzed, including age, regional distribution, etiology, clinical manifestations, lung function characteristics, results of lung high-resolution CT, results of fiberbronchoscopy examination, treatment, and prognosis.Results:Among 78 children with bronchiectasis, there were 35 males(44.9%)and 43 females(55.1%), with a median age of 8.7(6.1, 9.0)years.There were 51 children in rural areas(65.4%)and 27 children in urban areas(34.6%). The incidence of children in rural areas was higher than that in urban areas.The top three causes of bronchiectasis were 40 (51.3%)cases after infection, nine cases(11.5%)of primary immunodeficiency and seven cases(9.0%)of inhalation.The main clinical manifestations were wet cough, expectoration, wheezing and repeated respiratory infection.High-resolution CT of the lungs showed 36(46.2%)cases with diffuse bronchiectasis and 37 (47.4%) cases with localized bronchiectasis.Forty-nine(62.8%) cases had abnormal pulmonary ventilation function.Sixty-one(78.2%)cases were treated with fiberoptic bronchoscopy, of which 49(80.3%)cases had "fishbone" changes.After anti-infection, fiberbronchoscopy examination, expectorant and physical therapy, 67 cases were discharged and followed up for more than one year.Among them, 55 cases had symptoms improved, 12 patients had recurrent respiratory tract infection, and three patients died.Conclusion:The clinical manifestations of bronchiectasis in children have no obvious specificity.Early diagnosis, identification of the cause and comprehensive management are critical to prognosis of bronchiectasis.

Radiotherapy is the most common treatment for nasopharyngeal carcinoma, and the radiotherapy technique is essential for the prognosis of nasopharyngeal carcinoma. Due to the complexity of the structure of the intensity-modulated device and the accuracy of the clinical requirements of radiotherapy, it is inevitable that higher requirements will be imposed on the process of intensity-modulated radiotherapy. Currently, gaps exist in the radiotherapy equipment and personnel qualification among radiotherapy units, and thus the homogenization in the radiotherapy remains to be strengthened in China. With the application of radiotherapy information management system, digital medicine and artificial intelligence technologies in the field of radiotherapy, the original process fails to meet the application needs of the new precise radiotherapy technology. Therefore, this process is designed based on the existing radiotherapy procedures for nasopharyngeal carcinoma in combination with the latest developments in the field of radiotherapy, aiming to establish a novel standard process recommendation, ensuring the standardization and homogenization of radiotherapy and achieve the individualized intensity-modulated radiotherapy for nasopharyngeal carcinoma patients.

Objective To understand the prevalence,treatment and influence factors of hypertension in maintenance hemodialysis (MHD) patients in Anhui Province.Methods A total of 2724 adult patients on MHD from January 1st 2014 to March 31st 2014 in 26 hospitals of southern,northern and central Anhui Province were investigated.Their demographic characteristics,primary disease,complications,medications,dialysis and laboratory examination were explored.The prevalence treatment rate and control rate of hypertension were analyzed.Associated factors for controlling hypertension [systolic blood pressure (SBP) ＜ 140 mmHg and diastolic blood pressure (DBP) ＜ 90 mmHg] were assessed by logistic regression analysis.Results (1) The prevalence of hypertension in the hemodialysis patients was 87.0％.Their treatment rate and control rate were 93.2％ and 23.9％ respectively.The average of SBP was (145.90±21.18) mmHg,and the DBP on average was (83.60± 12.21) mmHg.The most commonly used anti-hypertensive drug is calcium channel blocker (88.2％).Over one third (45.7％) of patients were treated with two kinds of anti-hypertensive drug,26.2％ with 1 kind,21.7％ with 3 kinds,and 6.4％ with 4 kinds or more.(2) Compared with non-hypertension patients,patients with hypertension have older age,higher body mass index (BMI),phosphorus,SBP and DBP,as well as lower hemoglobin and Kt/V (all P ＜ 0.05).(3) The multivariate logistic regression analysis showed that Ca ＞ 2.50 mmol/L (OR=2.084,95％CI 1.008-4.307,P=0.047) positively correlated with controlling hypertension,while smoke (OR=0.594,95％CI 0.356-0.911,P=0.046) and BMI 18.5 ～ 23.9 kg/m2 (OR=0.516,95％CI 0.293-0.907,P=0.022) negatively correlated with it.Conclusions High prevalence yet low control rate of hypertension in MHD patients in Anhui Province were observed.Hypocalcemia may be a protective factor for hypertension control,while smoke and BMI may be risk factors for it.

Objective To investigate the clinical characteristics and outcome of T-cell acute lymphoblastic leukemia (T-ALL) with SIL-TAL1 rearrangement.Methods 62 newly diagnosed T-ALL patients including 15 patients with SIL-TAL1 rearrangement were systemically reviewed.Results Compared with SIL-TAL1-T-ALL patients,SIL-TAL1 + T-ALL patients was characterized by higher white blood cell count (P =0.029) at diagnosis,predominant cortical T-ALL immunophenotype (P =0.028) of the leukemic blasts,a higher prevalence of acute tumor lysis syndrome (P ＜ 0.001) and disseminated intravascular coagulation (P ＜ 0.001),which led to a higher early mortality (26.7 ％ (4/15) vs 4.3 ％ (2/47),P =0.011).Compared with SIL-TAL1-patients,SIL-TAL1+ patients had shorter relapse free survival (2 months vs 12 months,P =0.007) and overall survival (4 months vs 25 months,P =0.002).Conclusion SIL-TAL1 rearrangement identifies a distinct subtype with inferior outcome which could allow for individual therapeutic stratification for T-ALL patients.

A HPLC method for simultaneous determination of uridine, inosine, guanosine, adenosine and cordycepine
in Cordyceps sinensis was developed. The sample solution was prepared with 0.5% phosphoric acid solution by ultrasonic extraction. The separation was performed on a ZORBAX SB-AQ (150 mmí4.6 mm, 5 μm)column with gradient elution by 0.1% formic acid solution and acetonitrile, with column temperature 30℃, at a flow rate of 0.8 mL/min, and detected at wavelength of 260 nm. The result of method validation showed that the developed method had high accuracy and good repeatability. This method has been successfully applied for analysis of 5 kinds of nucleosides in different parts of C. sinensis. The results indicated that content of nucleosides in stroma is higher than that in insect body and whole C. sinensis.

Objective To observe the effects of hyperbaric oxygen (HBO) on the expression of FasL mRNA and caspase-3 protein in renal tissue after renal ischemia-reperfusion injury (IRI) in order to elucidate the underlying mechanisms.Methods Rats were randomly divided into thrcc groups: sham group(n=8),IRI group(n=8) and IRI+HBO group(n=8).The IRI group and the IRI+HBO group recieved 45 minutes hibateral renal ischima and the IRI +HBO group received additional HBO therapy at the 1st,24th and 48th hour after ischemia.The kidneys were removed at the end of HBO therapy.Malondialdehyde (MDA) level and superoxide dismutase (SOD) activity were measured to determine the extent of oxidative stress.The expression of FasL mRNA and caspase-3 protein was detected by quantitative real-time PCR and immunohistochemical staining in renal tissue respectively.Results Compared with the sham group,MDA level increased markedly and SOD activity decreased markedly after ischemia.After HBO treatment,MDA level decreased and SOD activity increased significantly (P ＜0.05).In IRI group,the expression of FasL mRNA and caspase-3 protein were higher than those in the sham group (P＜0.01),which were reduced significantly by HBO treatment (P＜0.01).Conclusion The expression of FasL mRNA and caspase-3 protein increases along with the lasting of reperfusion and HBO exhibites protection against cell apoptosis through improving the antioxidant-oxidant balance and reducing IRI in acute stage of IRI.

ObjectiveTo investigate the association between R405Q polymorphism of GLI1 gene and tetralogy of fallot(TOF).Methods In the case-control study,the R405Q polymorphism of GLI1 gene in 112 children with TOF and 200 healthy controls were detected with polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP).The distribution of genotype and allele frequency at R405Q polymorphism site were analyzed and to investigate its relationship with the risk of TOF.ResultsThe distribution of genotype frequency at R405Q polymorphism site was not different between TOF group and the healthy control group(x2 =5.317 ,P = 0.07) .However, the distribution of allele frequency at R405Q polymorphism site was significantly different between TOF group and the healthy control group (x2 = 6.790, P = 0.009) , and the relative risk for TOF in A allele carriers was higher than that in G allele carriers (OR = 1.561,95％ CI 1.116 ～ 2.185) Conclusion The R405Q polymorphism of GLI1 gene is associated with TOF and people with A allele have higher risk with TOF.GLI1 gene might be the genetic susceptibility gene of TOF.

This article sum up the fourteen years experience of usage for a linear accelerator in our hospital. The goal is to ensure the secure usage and reduce the damage accidence and attain the rules of quality assurance in radiotherapy by WHO. The ultimate aim is to raise economic benefit and social benefit by linear accelerator.
Particle Accelerators ; Quality Control ; Radiosurgery ; instrumentation