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 evaluate the efficacy and safety of θ short burst rapid pulse stimulation(TBS)in treating schizophrenia by meta-analysis.Methods:Randomized controlled trials(RCTS)on TBS in the treatment of schizophrenia were searched from CNKI,Wanfang,VIP,China Biomedicine,Web of science,PubMed,Embase and Cochrane Library databases to December 2022.The main study indicator was the Positive and Negative Symptoms Scale(PANSS).Risk quality assessment of the included literatures was performed by two reviewers and statistical analysis was performed using RevMan5.3.Results:A total of 13 RCTS with 641 patients were included.Meta-anal-ysis showed that TBS targeting the left dorsolateral prefrontal cortex(DLPFC)with intervention duration longer than 2 weeks decreased the PANSS total scores(WMD=-4.63,95％CI:-5.75--3.51,P＜0.001),positive symptom scores(WMD=-1.13,95％CI:-2.00--0.26,P＜0.05),negative symptom scores(WMD=-2.51,95％CI:-2.77--1.53,P＜0.001)and general psychopathological symptom scores(WMD=-1.20,95％CI:-1.80--0.60,P＜0.001).The adverse reactions of TBS included dizziness,and no serious adverse e-vents were reported.Conclusion:TBS has high safety,and stimulation of left dorsolateral prefrontal cortex targets for more than 2 weeks could effectively improve psychiatric symptoms in patients with schizophrenia.

Drug metabolism and pharmacokinetics (DMPK) is an important branch of pharmaceutical sciences. The nature of ADME (absorption, distribution, metabolism, excretion) and PK (pharmacokinetics) inquiries during drug discovery and development has evolved in recent years from being largely descriptive to seeking a more quantitative and mechanistic understanding of the fate of drug candidates in biological systems. Tremendous progress has been made in the past decade, not only in the characterization of physiochemical properties of drugs that influence their ADME, target organ exposure, and toxicity, but also in the identification of design principles that can minimize drug-drug interaction (DDI) potentials and reduce the attritions. The importance of membrane transporters in drug disposition, efficacy, and safety, as well as the interplay with metabolic processes, has been increasingly recognized. Dramatic increases in investments on new modalities beyond traditional small and large molecule drugs, such as peptides, oligonucleotides, and antibody-drug conjugates, necessitated further innovations in bioanalytical and experimental tools for the characterization of their ADME properties. In this review, we highlight some of the most notable advances in the last decade, and provide future perspectives on potential major breakthroughs and innovations in the translation of DMPK science in various stages of drug discovery and development.

Objective: To investigate the impact of bladder filling status on the movement of uterine and on the volume of organs at risk(OAR), so as to provide theoretical basis for individualized internal target volume (ITV) and planning target volume (PTV). Methods: Simulation CT images for a total of 27 patients with locally advanced cervical cancer were acquired with empty bladder, 1.0 h after bladder filling, 1.5 h after bladder filling, respectively. The volumes of uterine corpus, cervix, OARs, CTV and PTV 1.0 h after bladder filling were delineated. The impact of bladder filling status on the displacements of cervix and corpus, volumetric changes of rectum, small intestine, and the volumes of small intestine, bladder and rectum within PTV were analyzed. The correlation between bladder filling status and uterine displacement and volume of OAR was also investigated, as well as the volume of cervix and corpus in the PTV with empty bladder and 1.5 h after bladder filling. Results: Bladder filling status is different for individual cases. The maximum movement range of cervix and uterine body with bladder filling state was 0-3.04 cm and 0-4.31 cm respectively. The anterior displacements of corpus (F=7.818, P<0.05), the volumetric changes of blander, as well the volume of bladder and small intestine in the PTV (F=46.197, 44.609, 29.546, P<0.05) were significantly different between different bladder filling status. The bladder filling status was correlated with the displacements of the anterior of corpus, volumetric changes of small intestine, and the volumes of bladder and small intestine within the PTV (r=-0.232, -0.298, 0.915, -0.336, P<0.05). The volumes of cervix and corpus out of the PTV were significantly different between the empty bladder and 1.5 h after bladder filling (t=-1.326, -1.559, P<0.05). Conclusions Bladder filling status was different for individual patients. The displacements of the anterior of the corpus were significantly affected by the bladder filling status. Increasing the anterior margin of PTV was recommended. The consistency of bladder filling status was critical for the precise cervical cancer IMRT.

Non-alcoholic fatty liver disease(NAFLD)is a chronic liver disease characterized by hepatic steatosis in the absence of other causes,such as chronic alcohol consumption,that cause secondary hepatic fat accumulation.NAFLD has become the most common liver disease worldwide over the past two decades,and the prevalence of NAFLD is 20-30％in Western countries.However,the mechanism of NAFLD re-mains unclear.The gut microbiota plays an important role in the metabolism of the host;in fact,it has been implicated in inflammatory diseases,metabolic syndrome and cardiovascular disease.Accumu-lating evidence has indicated that gut microbiota component changes are linked to human obesity,in-sulin resistance(IR),type 2 diabetes and NAFLD.Here,we provide insight into the role of gut microbiota,especially bile salt hydrolase(BSH)in modulating the bile acid pool and farnesoid X receptor(FXR),which promotes the synthesis of ceramide and contributes to the development of NAFLD.

Objective To investigate the influencing factors and their weights of professional choice among medical school graduates in Shanghai.Methods Base on literature review and interviews with medicine students in a university of Shanghai,a questionnaire of"employment intention for general practice in medical graduates"was developed.A questionnaire survey on influencing factors of general practice among five year medical students was conducted in the medical college of a university in Shanghai during May to June 2016.The weights of each factor were calculated with analytic hierarchy process(AHP). Results The valid questionnaires were retrieved from 14 male and 26 female students.The results showed that 53.8%(21/40)preferred Beijing, Shanghai, Guangzhou and other economically developed cities as future working place,and 38.5%(15/40)chose to go home town; for general practice 22.5%(9/40) chose"very like",70%(28/40)chose"like"and 7.5%(3/40)chose"not like"; only 10%(4/40) were willing to be a general practitioner, 55.0%(22/40)were depended on the working conditions of community health center,and 35%(14/40)were not ready to be a GP.AHP analysis showed that the weights of influencing factors were: the salary(0.380 2), the doctor-patient relationship(0.262 3),professional interest and occupation development prospects(0.220 4),social status and family contribution (0.137 1).Weight analysis for the affecting factors on professional interest and occupation development showed that the guidance of mentors in theoretical study and clinical practice were the major factors (comprehensive weight was 0.067 3 and 0.062 1,respectively),and the attitude GPs to general practice in community learning was more important(comprehensive weight was 0.042 5 and 0.019 6).Conclusion The willingness to be a general practitioner is not strong in the medical school graduates in Shanghai.It is important to improve the status and working conditions of general practitioners, and to strengthen education and guidance of the general practice in theoretical study and clinical practice for medical students.

Objective To compare the diagnostic value of DWI and ultrasound elastography(UE) in staging hepatic fibrosis in patients with chronic viral hepatitis B(CHB). Methods Fifteen healthy volunteers (control group) and 69 patients with CHB (disease duration more than 1 year) (patient group) were prospectively recruited. All of the subjects underwent DWI and UE experiments twice with the interval of less than 3 days. Liver ADC and shear wave velocity(SWV) values were obtained for subsequent analysis. Sixty?nine patients who had biopsy were grouped according to their pathological grading of fibrosis, from S0 to S4. One?way ANOVA was used to compare the ADC and SWV values between the five different fibrosis groups and control group. Spearman correlation analysis was used to analyze the correlations between the ADC and SWV values and those staging factors. Finally, receiver operating characteristic (ROC) curve analysis was performed to compare the diagnostic performance of ADC and SWV values in discriminating different stages of hepatic fibrosis. Results Based on the pathological results, the 69 patients were reclassified to five subgroups with 11, 13, 12, 15 and 18 patients in the S0, S1, S2, S3 and S4 groups respectively. ADC values were(1.39±0.09)×10-3,(1.39±0.08)×10-3,(1.38±0.10)×10-3,(1.20±0.06)×10-3,(1.12±0.07)×10-3 and(1.01±0.07)×10-3mm2/s for the control group and stages S0 to S4 respectively.SWV values were(1.17±0.07),(1.16±0.08),(1.23±0.10),(1.48±0.14),(1.85±0.14)and(1.97±0.12)m/s for stages S0 to S4 and the control group respectively. Statistically significant differences were observed among them (P<0.01). Both ADC (r=-0.894,P<0.01) and SWV (r=0.904,P<0.01) values were highly correlated with the stages of liver fibrosis. The area under ROC(AUC) for predicting fibrosis stages (≥S1, ≥S2, ≥S3 and S4) with ADC values was 0.893, 0.991, 0.966 and 0.952 respectively. Accordingly, the AUC for SWV values were 0.937, 0.993, 0.994 and 0.914. Conclusions The two imaging methods of DWI and UE showed good and similar diagnostic performance in discriminating the different stages of hepatic fibrosis.

Objective To investigate the epidemiology of respiratory viruses in children from Wuxi area.Methods A total of 2 747 cases of children diagnosed with acute respiratory infection in Wuxi during 2011 —2014 were collected.Reverse transcription-polymerase chain reaction was used to detect nine kinds of respiratory viruses,including influenza virus A (Flu A),influenza virus B (Flu B),parainfluenza virus (PIV)Ⅰ-Ⅳ,adenovirus (ADV),respiratory sycytial virus (RSV),human metaneumovirus (hMPV), human bocavirus (HBov),human coronaviruses (hCov)and human rhinovirus (HRV).The categorical data were compared using chi square test.Results A total of 856 among the 2 747 samples were tested positive for respiratory virus nucleic acid,with the positive rate of 31 .16%.The viral distribution was uneven in different seasons,and the infection peaked in winter and spring.The virus detection rate was highest in age 1 to 2 year group (up to 40.18%),and followed by age 6 to 12 year group (32.63%).Flu A virus was the most frequently detected virus,accounting for 7.54% (207/2 747);followed by PIV, accounting for 6.95 % (191/2 747);and Flu B accounted for 4.22%(116/2 747).There were 84 cases of mixed infection of two or more kinds of respiratory viruses,with positive rate of 3.06% (84/2 747 ). Conclusions Our study suggests that Flu A is the most common pathogen in children with acute respiratory infections in Wuxi area during 2011 —2014;virus detection rate is highest in age 1 to 2 year group;and parainfluenza virus is almost detected throughout the year,while the rest of respiratory viruses are commonly seen in winter and spring.

Objective To study the epidemiological characteristics and type of human adenovirus (HAdv) in Wuxi area in 2011-2013.Methods A total of 1983 acute respiratory infections samples were collected from Wuxi People's Hospital during 2011-2013.HAdv was detected by Real-time PCR,the positive samples were inoculated into Hep-2 cells to isolate the viruses.The amplificons were purified and sequenced,and the sequences were analyzed by Bioedit and MEGA 5.0.Results Human adenovirus was appeared throughout the year in Wuxi area during 2011-2013.In winter and spring,the highest rate (44.26％) was detected in 1-3 years old children.There were 4 strains (13.33％) for HAdV-3,6 strains for HAdV-7(20.00％) of B subgroup,5 strains (16.66％) for HAdV-1,8 strains (26.67％) for HAdV-2,3 strains (10.00％) for HAdV-5,4 strains (13.33％) for HAdV-6 of C subgroup.The phylogenetic tree formed two independent branches and C subgroup gradually became advantage.Conclusions Human adenovirus had obvious seasonal characteristics in Wuxi area during 2011-2013,mainly in winter and spring;1-3 years old children were the main susceptible population.Six types of B and C subgroups were the dominant epidemic strains,with the epidemic tendency transformed from subgroup B to C.

Objective To investigate the effects of kidney-deficiency on auditory cortex metabolism in the elderly by using the proton magnetic resonance spectroscopy(1H-MRS).Methods 50 volunteers,including 20 young subjects and 30 older subjects matched for gender,were measured by pure tone audiometry、“kidney-deficiency”-related test and were executed 3.0 T multi-voxel 1H-MRS tests,The ratios of N-acetylaspartate (NAA),choline (Cho) and lactate (Lac) to creatine (Cr) were measured and were compared between the two groups.The t-test analysis were used for statistic process.The relationship between auditory cortex metabolism and the symptom of kidney-deficiency was also analyzed.Resnlts The result of kidney-deficiency-related test and pure tone audiometry revealed that there was significant difference between the two groups and the older subjects had the more severity kidney-deficiency and high-frequency hearing loss (t=6.335、19.558,P＜0.05).The NAA/Cho ratio in the auditory cortex in the older group was significantly lower than that in the younger group (t=2.90,P＜0.05).There were no significant differences between two groups for the ratios of NAA/Cr and Cho/Cr (t=1.415、0.927,P＞0.05).Decrease of the ratio of NAA/Cho in the older group is significantly related with kidneT-deficiency(r=- 0.773,P=0.025).Conclusion kidney-deficiency play a very important role in the hearing loss and reduction of the number of neurons in auditory cortex of older healthy subjects.It suggests one possible underlying mechanism for the speech perception difficulties exhibited by aging adults.