Chronic obstructive pulmonary disease （COPD）， as a chronic respiratory disease that can be prevented and intervened but cannot be completely cured， has increasing incidence and mortality rates year by year， often complicated by one or more comorbidities. However， there is currently no specific treatment available. Therefore， the healthcare issues related to COPD are urgent and prominent. Traditional Chinese medicine （TCM） delays the progression of COPD through multiple mechanisms， pathways， and targets. As a result， exploring the pathogenesis of COPD and identifying TCM treatment approaches and effective prescriptions are key issues that urgently need to be addressed in clinical practice. In TCM， COPD is categorized into syndromes such as "cough"， "asthma"， and "lung distension". It is believed that the deficiency in the origin runs through the entire disease. When external pathogens invade， Qi becomes disordered， and phlegm and blood stasis begin to accumulate， leading to an excess condition in the manifestation. Modern medicine research on the pathogenesis of COPD mainly involves aspects such as inflammatory response， oxidative stress， autophagy imbalance， and aging. Studies have found that Chinese medicine monomers， single herbs， and compound prescriptions can improve COPD by inhibiting inflammation， reducing oxidative damage， correcting autophagy， and delaying aging. However， there is no study that intuitively organizes the various pathogenesis mechanisms of COPD and their interrelationships. At the same time， research on the therapeutic effects of TCM on COPD primarily focuses on exploring a single mechanism or pathway， without integrating multiple mechanisms， pathways， and targets. Additionally， there are very few studies that summarize the corresponding relationships between the various pathogenesis mechanisms of COPD and the regulatory effects and signaling pathways of Chinese medicine. This study， for the first time， combines the latest literature in China and abroad to explain the various pathogenesis mechanisms of COPD and their interrelationships using a combination of graphs， text， and tables. It also outlines the signaling pathways， targets， and mechanisms of Chinese medicine monomers， single herbs， and compound prescriptions in regulating COPD， in order to provide new ideas and strategies for the in-depth research and systematic treatment of COPD with TCM.

OBJECTIVE To study pharmaceutical management provisions in the Evaluation Standards for Third-level Maternal and Child Health Care Hospitals in Hubei Province （2024 Edition） （hereinafter referred to as 2024 Edition of Hubei Maternal and Child Health Care Standards）. METHODS The formulation of pharmaceutical management clauses and management rules in the 2024 Edition of Hubei Maternal and Child Health Care Standards was elaborated and compared with the pharmaceutical management clauses in the Evaluation Standards for Third-level Maternal and Child Health Care Hospitals （2016 Edition） to find out their similarities and differences； the basis for the formulation of unique pharmaceutical management clauses was analyzed， so as to propose further improvement suggestions. RESULTS & CONCLUSIONS Compared with the Evaluation Standards for Third- level Maternal and Child Health Care Hospitals （2016 Edition）， the similarities in pharmaceutical management in the 2024 Edition of Hubei Maternal and Child Health Care Standards were mainly reflected in the relevant laws， regulations， rules and personnel requirements that should be followed， the full process management of drug procurement， reserve， storage and recall， drug dispensing and formulation management， etc. The unique provisions of the 2024 Edition of Hubei Maternal and Child Care Standards were mainly reflected in the establishment of children’s medication working group， the establishment of a list of children’s specific drugs， the development of surplus drug management system， and the management of off-label drug use， etc. The formulation of unique provisions for pharmaceutical management not only conformed to the newly released policy requirements in recent years， but also combined the characteristics and actual situation of maternal and child health care hospitals. 2024 Edition of Hubei Maternal and Child Health Care Standards should be further improved in terms of strengthening detail management and enhancing the rational application management of traditional Chinese medicine.

Idiopathic pulmonary fibrosis(IPF)is a progressive and inflammatory interstitial lung disease,clinically divided into stable and acute exacerbation periods of idiopathic pulmonary fibrosis(AE-IPF),which faces great difficulties in prevention and treatment,increasing the health and life burden of patients.At present,the diagnostic methods of AE-IPF are relatively limited,while biomarkers are safe,simple and specific,which are of great significance for the diagnosis and treatment of AE-IPF.Based on the theoretical connotation of AE-IPF(lung heat and collateral obstruction syndrome),this paper explores the application value of combining AE-IPF lung heat stagnation syndrome and biomarkers,explains the pathogenesis of AE-IPF lung heat stagnation syndrome at the molecular level,and analyzes the guiding role of combining syndromes and biomarkers in the clinical application of traditional Chinese medicine for AE-IPF lung heat stagnation syndrome.

In order to guarantee the quality of traditional Chinese medicines (TCMs), the crystallization transformation of complex extracts of TCMs and the influence of solid form on their physicochemical properties were studied.The extract of total flavonoids from Pueraria lobata was taken as a model.Crystallization transformation happened when lofting under different conditions, and the intrinsic dissolution tests were carried out.It was found that humidity was the key factor to induce crystallization of total flavonoids from Pueraria lobata.The greater the wettability was, the more the crystallization was.The dissolution rate of total flavonoids from Pueraria lobata with the most crystallization amount significantly decreased by 96.51% compared to the sample without crystallization.After further simulating the preparation process of total flavonoids from Pueraria lobata, it was found that the wet granulation process with introduced water would also lead to crystallization and reduced dissolution rate.As for all crystallization samples, there was an inversely proportional relationship between the dissolution rates and the amount of crystallization.The risk of crystallization existed both in the storage and preparation process of TCM extracts.Crystallization would significantly affect the dissolution rate, and thus the quality of TCM products.In this study, the crystallization transformation of amorphous complex TCM extracts was discovered, and the effect of the crystallization transformation on its dissolution behavior was systematically studied, which provides a new research idea for assuring the quality of TCM products and promoting the improvement of TCM preparation level.

OBJECTI VE To explore the effects of total flavonoids of Bidens polisa L.（TFB）on insulin resistance （IR）of HepG2 cells. METHODS B. polisa L. was refluxed and extracted with 80％ ethanol to obtain TFB. Palmitic acid was used to induce IR mode of HepG 2 cells in vitro . The effects of low-concentration ，medium-concentration and high-concentration （20，40， 80 mg/L） of TFB on the consumption of glucose were investigated. Using metformin as positive control ，the effects of low-concentration，medium-concentration and high-concentration （20，40，80 mg/L）of TFB on the protein expression of insulin receptor substrate- 1（IRS-1），c-Jun N-terminal kinase （JNK）and protein kinase C （PKC）were investigated. Molecular docking technology was used to explore the interaction between eight main active components of TFB such as quercetin ，quercitrin and IRS-1，JNK and PKC proteins. RESULTS The glucose consumption of TFB low-concentration ，medium-concentration and high-concentration groups were increased significantly （P＜0.05 or P＜0.01）. Compared with normal group ，the expression of IRS-1 and JNK protein in the model group decreased significantly ，and the expression of PKC protein increased significantly （P＜ 0.01）. Compared with model group ，the protein expression of IRS- 1 and JNK could up-regulated while the protein expression of PKC down-regulated in TFB low-concentration ，medium-concentration and high-concentration groups and metformin positive control group （P＜0.05 or P＜0.01）. The score of molecular docking energy between maritimetin in TFB and IRS- 1 protein was －7.9 kcal/mol（1 kcal＝4.816 kJ）. The scores of molecular docking energy of maritimetin ，rutin and JNK protein were －9.3 kcal/mol. The score of molecular docking energy between quercitrin and PKC protein was －4.9 kcal/mol. Interactions between components and proteins included forming hydrogen bonds ，hydrophobic bonds and so on. CONCLUSIONS TFB can significantly improve IR of HepG 2 cells，the mechanism of which may be related to the regulation of protein expression of IRS ，JNK and PKC. Maritimetin，rutin and quercitrin may be potential active ingredients for improving IR.

Objective:To explore the diagnosis and treatment of hepatocellular adenoma.Methods:The clinical data of 23 hepatocellular adenoma patients admitted to the Affiliated Hospital of Qingdao University from May 2013 to May 2020 were retrospectively analyzed.Results:Fifteen patients were female, the age ranged from 21 to 60. The maximum tumor diameter was from 2.5 cm to 15 cm.Most patients (15/23) were asymptomatic. There were 20 cases (87%) with single lesion and 3 cases (13%) with multiple lesions. Contrast-enhanced CT and MRI showed enhancement in the arterial phase, and de-enhancement in the portal phase as well as in the delayed phase. All cases underwent tumor resection. Hepatocellular adenoma was confirmed by pathology with partial canceration in one case and intratumoral hemorrhage in two cases. Sixteen cases were misdiagnosed preoperatively, 20 were followed up with the median follow-up time of 36 months. Recurrence was not found.Conclusion:Hepatocellular adenoma is uncommon and often misdiagnosed. Preoperative diagnosis is dependent on MRI.Given the fact of high rate misdiagnosis and a tendency of canceration,resection is recommended.

Objective:To analyze the characteristics of clinical distribution and change of aeroallergens in children with allergic diseases from 2015 to 2020.Methods:Children who visited Capital Institute of Pediatrics affiliated Children′s Hospital, suspected of allergic diseases and received serum aeroallergens specific immunoglobulin E (sIgE) test were retrospectively enrolled (1 to 14 years old). sIgE was detected by Phadia1000 system with radioallergosorbent test fluorescent enzyme-linked immunoassay. The characteristics and change of the aeroallergens among the 6 years was analyzed. Enumeration data were expressed by percentage and categorical variables were compared by the independent samples t-test and Pearson χ 2 test. Results:In total 4 608 tests (4 575 patients) of children were enrolled, the average age was (5.4±2.9) years old, with the median age of 5.0 years old. 3 176 were boys (68.9%), and 1 432 were girls (31.1%). 4 294 children were from the north of China (93.2%), 295 children were from the south of China (6.4%), and 19 children were from unknown regions (0.4%). In total the most common aeroallergen was mold mixture (1 956/4 457 tests, 43.9%) and Alternaria alternata (276/630 tests, 43.8%), followed by Artemisia (300/889 tests, 33.7%), Humulus scandens (12/38 tests, 31.6%) and grass mixture (909/2 874 tests, 31.6%). Among the 6 years, mold, grass pollen and tree pollen sensitization increased, and mold [38/130 (29.2%) vs 1 574/3 233 (48.7%)], grass pollen [11/77 (14.3%) vs 1 069/3 072 (34.8%)] increased significantly (χ 2 was 18.953 and 49.559, respectively, P=0.000). Positive rate of tree pollen increased [1/10 (10.0%) vs 516/2 122 (24.3%)], but did not have statistical significance (χ2=1.111, P=0.292). Dust mite [36/146 (24.7%) vs 321/1 408 (22.8%)] and hair of pets [7/33 (21.2%) vs 321/1 408 (17.1%)] sensitization didn′t change greatly (χ 2 =0.258, P =0.611; χ 2 =0.379, P =0.538). In 2015, the most common aeroallergens was mold (38/130, 29.2%), followed by dust mite (36/146, 24.7%), while in 2020, the most common aeroallergens was still mold (1 574/3 233, 48.7%), with grass pollen (1 069/3 072, 34.8%) and tree pollen (516/2 122, 24.3%) ranked after. Conclusion:Mold might be the most common aeroallergens in allergic children in Beijing area. With time went on, dust mite was gradually exceeded by grass pollen and tree pollen.

Objective:To analyze the characteristics of clinical distribution and change of aeroallergens in children with allergic diseases from 2015 to 2020.Methods:Children who visited Capital Institute of Pediatrics affiliated Children′s Hospital, suspected of allergic diseases and received serum aeroallergens specific immunoglobulin E (sIgE) test were retrospectively enrolled (1 to 14 years old). sIgE was detected by Phadia1000 system with radioallergosorbent test fluorescent enzyme-linked immunoassay. The characteristics and change of the aeroallergens among the 6 years was analyzed. Enumeration data were expressed by percentage and categorical variables were compared by the independent samples t-test and Pearson χ 2 test. Results:In total 4 608 tests (4 575 patients) of children were enrolled, the average age was (5.4±2.9) years old, with the median age of 5.0 years old. 3 176 were boys (68.9%), and 1 432 were girls (31.1%). 4 294 children were from the north of China (93.2%), 295 children were from the south of China (6.4%), and 19 children were from unknown regions (0.4%). In total the most common aeroallergen was mold mixture (1 956/4 457 tests, 43.9%) and Alternaria alternata (276/630 tests, 43.8%), followed by Artemisia (300/889 tests, 33.7%), Humulus scandens (12/38 tests, 31.6%) and grass mixture (909/2 874 tests, 31.6%). Among the 6 years, mold, grass pollen and tree pollen sensitization increased, and mold [38/130 (29.2%) vs 1 574/3 233 (48.7%)], grass pollen [11/77 (14.3%) vs 1 069/3 072 (34.8%)] increased significantly (χ 2 was 18.953 and 49.559, respectively, P=0.000). Positive rate of tree pollen increased [1/10 (10.0%) vs 516/2 122 (24.3%)], but did not have statistical significance (χ2=1.111, P=0.292). Dust mite [36/146 (24.7%) vs 321/1 408 (22.8%)] and hair of pets [7/33 (21.2%) vs 321/1 408 (17.1%)] sensitization didn′t change greatly (χ 2 =0.258, P =0.611; χ 2 =0.379, P =0.538). In 2015, the most common aeroallergens was mold (38/130, 29.2%), followed by dust mite (36/146, 24.7%), while in 2020, the most common aeroallergens was still mold (1 574/3 233, 48.7%), with grass pollen (1 069/3 072, 34.8%) and tree pollen (516/2 122, 24.3%) ranked after. Conclusion:Mold might be the most common aeroallergens in allergic children in Beijing area. With time went on, dust mite was gradually exceeded by grass pollen and tree pollen.

Objective Based on the Kabat-Zinn's mindfulness decompression therapy and Teasdale's mindfulness cognitive therapy,and using the solution-focused approach as the frame structure,we establish comprehensive,standard mindfulness interventions scheme of domiciliary patients with chronic obstructive pulmonary disease,which can provide the basis for the development of the community and residential care.Methods Twenty-six experts were selected as the target of the study and two rounds of correspondence were used to establish the final mindfulness intervention plan of the domiciliary patients with chronic obstructive pulmonary disease.Meanwhile,the reliability and representativeness of the consultation are tested by using the coordination degree,positive coefficient and authoritative coefficient of expert opinions.Results The positive coefficient of the two round correspondence experts were 88.46%(23/26)and 100.00%(23/23),and the expert authority coefficient was 0.90 and 0.91.The variation coefficient of the indicators after two rounds of expert consultation was 0.04-0.14,the coordination coefficient of experts was 0.32(P＜0.01)and 0.59(P＜0.01)respectively.The final construct of domiciliary patients of chronic obstructive pulmonary disease with the intervention programme consists of 5 steps,25 entries,which was suitable for the positive reading intervention scheme.Conclusions The results show that experts enquiry for representative and high credibility,and the mindfulness intervention plan of domiciliary patients with chronic obstructive pulmonary disease is scientific and practical.

Objective To report a newly developed method and procedure to establish a rat model of subarachnoid hemorrhage in detail, and to provide a better model simulating the clinical subarachnoid hemorrhage caused by a ruptured aneurysm for related research.Methods One hundred and twenty healthy SPF 2-3-month old male Sprague-Dawley rats were divided into 4 groups, 30 rats in each group.The three experimental groups were sacrificed at 6, 24 and 72 hours after modeling.Rat models of subarachnoid hemorrhage were established by inserting a fiber core in the internal carotid artery and piercing this artery.Successful establishment of the subarachnoid hemorrhage model was confirmed by observation of breathing, pupil, defecation, urination and inspection at autopsy dissection.The controllability and reproducibility of this model were verified by observation of clinical manifestation and explored by mortality analysis.Results Subarachnoid hemorrhage was successfully induced by fiber core piercing the internal carotid artery at the needed location.Conclusions This method of model preparation is stable and understandable.The operation is nimble, with a good reproducibility.This model can be successfully performed after a short time learning, well simulate the sudden hemorrhage caused by a ruptured aneurysm, and suitable for research on early brain injury and vasospasm after subarachnoid hemorrhage.