Cerebral small vessel disease(CSVD)is a slowly progressive cerebrovascular disease caused by structural and functional disorders of small vessels and vascular neural units in the brain,and CSVD imaging markers may be evidence as manifestations of brain aging.Clinically,the onset of CSVD is not limited to individuals in middle-to-old age.Young patients without typical vascular risk factors may also have imaging markers,such as enlarged perivascular space and white matter hyperintensity.The diagnosis and treatment of these cases must be approached seriously.Compared with Western medicine,traditional Chinese medicine(TCM)has an advantage in treating disorders related to emotions,sleep,and cognition in patients with CSVD.Regarding CSVD,there are commonalities between anatomical structures,physiological functions,pathogenic mechanisms,and xuanfu and collateral theories in TCM.We combined the xuanfu and abnormal collateral theory and classified CSVD into three clinical stages:early-stage,dysfunction in xuanfu and stagnation in the qi collaterals;middle-stage,endogenous toxins and damage to the blood vessels;and late-stage,kidney and marrow deficiency and toxins damaging the brain collaterals.Different treatment strategies,such as promoting qi circulation,calming the mind,and dredging collaterals in the early stage;dispelling pathogenic factors and promoting blood circulation in the middle stage;tonifying the kidney and replenishing the marrow and removing toxins from collaterals in the late stage,are applied at different stages to offer novel perspectives on TCM treatment for CSVD.

With the rapid development of society and the improvement of Western medicine,the average life expectancy of the Chinese population has steadily increased. Since the beginning of the 21th century,China has officially entered an aging society and is currently in a phase of rapid growth in the elderly population. The effective management and improvement of the health levels of the elderly have become urgent issues that society needs to address. Traditional Chinese medicine (TCM),rooted in Chinese traditional culture,has developed a rich system of health preservation through thousands of years of historical practice,which has important guiding significance in actively coping with the aging of the population. This article discusses the historical evolution of the theory of health preservation in TCM,the interpretation of aging mechanisms by TCM,and the strategies for elderly health preservation from the perspective of TCM. By exploring TCM health preservation concepts,a theoretical framework for the health care of the elderly is constructed,so as to provide a scientific basis for their health management.

Objective:To compare clinical characteristics,treatment patterns and physiological indicators in bipolar disorder(BD)patients with different age of onset.Methods:Totally 380 patients with DSM-5 BD were se-lected in this study.Psychiatrists diagnosed the patients using the Mini International Neuropsychiatric Interview.The clinical information questionnaire and the Global Assessment of Functioning scale were utilized to collected clinical characteristics,treatment status,and physiological indicators.The onset age of BD was divided into 21 and 35 years as cut-off points.Multivariate logistic regression and linear regression were used to analyze related factors.Results:Among the 380 patients with BD,199 cases were early-onset group(52.4％),121 cases were middle-onset group(31.8％),and 60 cases were late-onset group(15.8％).There were 26.6％of patients in the early-onset group in-itially diagnosed as depression,23.1％in the middle-onset group,and 11.7％in the late-onset group.Multivariate analysis revealed that compared to the early-onset group of BD,the middle-onset(OR=2.22)and late-onset(OR=4.99)groups had more risk to experience depressive episodes,and the late-onset group(OR=6.74)had 6.74 times of risk to suffer from bipolar Ⅱ disorder.Additionally,patients in the middle-onset(β=-1.52)and late-on-set(β=-4.29)groups had shorter durations of delayed treatment,and those in the middle-onset(β=-1.62)and late-onset(β=-3.14)groups had fewer hospitalizations.Uric acid levels were lower in both the middle-onset(β=-28.39)and late-onset(β=-31.47)groups,and total cholesterol level was lower in the middle-onset group(β=-0.23).Conclusion:Patients with BD in different age of onset show significant differences in clinical charac-teristics,treatment conditions and physiological indicators.

2019 novel coronavirus(2019-nCoV) outbreak is one of the public health emergency of international concern.Since the 2019-nCoV outbreak, China has been adopting strict prevention and control measures, and has achieved remarkable results in the initial stage of prevention and control.However, some imported cases and sporadic regional cases have been found, and even short-term regional epidemics have occurred, indicating that the preventing and control against the epidemic remains grim.With the change of the incidence proportion and the number of cases in children under 18 years old, some new special symptoms and complications have appeared in children patients.In addition, with the occurrence of virus mutation, it has not only attracted attention from all parties, but also proposed a new topic for the prevention and treatment of 2019-nCoV infection in children of China.Based on the second edition, the present consensus further summarizes the clinical characteristics and experience of children′s cases, and puts forward recommendations on the diagnostic criteria, laboratory examination, treatment, prevention and control of children′s cases for providing reference for further guidance of treatment of 2019-nCoV infection in children.

Objective:To analyze the value of color Doppler flow imaging (CDFI) in evaluating effects of neoadjuvant chemotherapy (NAC) for breast cancer.Methods:100 patients with breast cancer who underwent surgery after NAC in Cancer Hospital of Inner Mongolia Autonomous Region from January 2018 to April 2019 were selected for retrospective analysis. According to effects of chemotherapy, they were divided into effective group and ineffective group. The changes in lesion size, ultrasound findings, grade of blood flow in lesions, resistance index (RI) and peak systolic velocity (PSV) before and after NAC were compared between the two groups.Results:The length, width, thickness and volume of masses in effective group after NAC [(2.03±0.24)cm, (1.69±0.24)cm, (1.06±0.14)cm, (3.64±0.39)cm 3] were smaller than those before NAC [(3.40±0.36)cm, (2.35± 0.26)cm, (1.78±0.19)cm, (14.24±1.53)cm 3] and those in ineffective group after NAC [(3.31±0.34)cm, (2.36±0.27)cm, (1.76±0.19)cm, (14.19±1.42)cm 3] ( P<0.05). After NAC, the the proportion of regular shape, clear boundary, more internal echo, and no abnormal posterior echo in effective group was statistically significant ( P<0.05), but there was no significant change in the ineffective group ( P>0.05). The proportion of clear boundary and excessive internal echo in the effective group was higher than that in the ineffective group ( P<0.05); the blood flow grade of the effective group after NAC was lower than that of the ineffective group ( P<0.05) After NAC, the RI (0.54±0.06) in effective group was lower than that in ineffective group (0.65±0.08) ( P<0.05), and there was no significant difference in PSV between the two groups ( P>0.05). Conclusions:The value of CDFI is high in evaluating NAC effect on patients with breast cancer. It can effectively measure and judge lesion size and blood flow changes, and provide basis for clinical curative effect evaluation.

OBJECTIVE： To optimize the purification technology of total flavonoids from Sparganium stoloniferum. METHODS： Separation and purification by macroporus adsorption resin， using sample solution pH， flow rate and concentration of eluent， the purification rate of total flavonoids as evalution indexes， the purification technology of total flavonoids from S. stoloniferum were optimized by Box-Behnken design-response surface methodology based on single factor test. Validation test was conducted. RESULTS： The optimal purification technology was sample solution pH 4.8， flow rate of eluent 2.0 BV/h， concentration of eluent 72％. The purification rate of total flavonoids in 3 batches of samples was 72.34％ （RSD＝1.77％， n＝3） in validation test， relative errors of which to predicted value （73.99％） was 2.13％. CONCLUSIONS： The optimal purification technology is stable and feasible， and can be used for the purification of total flavonoids from S. stoloniferum.

Objective: To investigate the relationship between neutrophil-to-lymphocyte ratio (NLR) and myocardial injury induced by acute carbon monoxide poisoning. Methods: A retrospective analysis was performed on 214 patients with acute carbon monoxide poisoning who were admitted to Emergency Depart-ment of Harrison International Peace Hospital, Hebei Medical University, from 2015 to 2017. According to the diagnostic criteria for toxic heart disease and the level of cardiac troponin I (cTnI), a biomarker of cardiac injury, these patients were divided into myocardial injury group (n = 84) and non-myocardial injury group (n=130). The general information of age and sex, as well as routine blood test results and cardiac injury biomarkers on admission, were collected. NLR was calculated and compared between the two groups. The relationship between NLR and cTnI was analyzed. Logistic regression analysis was used to identify the influenc-ing factors for myocardial injury induced by acute carbon monoxide poisoning. The receiver operating charac-teristic curve was used to evaluate the predictive value of NLR on admission for myocardial injury induced by acute carbon monoxide poisoning. Results: There were significant differences between two groups in male patients, the history of smoking, white blood cell count (WBC), NLR, creatine kinase-MB, and lactate dehydro-genase(P<0.01). In the myocardial injury group, NLR was positively correlated with cTnI (r=0.295, P<0.01). The multivariate logistic regression analysis showed that NLR (odds ratio OR=1.079, 95% confidence inter-val CI: 1.017~1.144, P<0.01), WBC (OR=1.216, 95% CI: 1.098~1.346, P<0.01), and male sex (OR = 2.693, 95% CI: 1.045~6.939, P= 0.05) were independent risk factors for myocardial injury induced by acute carbon monoxide poisoning. In predicting myocardial injury induced by acute carbon monoxide poisoning, NLR on admission had a sensitivity of 85.7% and a specificity of 45.4% at the optimal cut-off value of 4.83. Conclusion Increased NLR on admission has a certain predictive value for myocardial injury induced by acute carbon monoxide poisoning.

Objective To explore the factors related to the severity of disease symptoms in patients with acute leukemia (AL). Methods 198 AL patients with symptoms of disease (anemia, bleeding, infection, fever, etc.) from September 2013 to July 2016, were evaluated by the questionnaires of self-rating anxiety scale (SAS), self-rating depression scale (SDS), eysenck personality questionnaire (EPQA), Toronto alexithymia scale (TAS), family environment scale (FES), self-rating scale of illness conception and health seeking behavior (ICHSB). The results were compared with 198 healthy volunteers. Results The scores of SDS, SAS, factorⅠin FES, factor Ⅲ in FES, factor Ⅳ in FES, nervous and the total scores of EPQA, factor Ⅱ in TAS, factor Ⅱ in ICHSB were significantly higher in AL patients than those in healthy subjects [(41.09 ±6.85) scores vs. (36.74±6.99) scores, t=2.150, P=0.031; (38.64±7.51) scores vs. (31.79±7.57) scores, t= 3.327,P=0.001;(2.38±1.54) scores vs. (5.18±1.33) scores, t=3.319, P=0.001;(3.31±1.82) scores vs. (2.23±1.99) scores, t= 3.325, P= 0.001; (2.41±1.62) scores vs. (5.75±1.51) scores, t= 3.332, P= 0.001; (14.14±5.37) scores vs. (11.01±5.51) scores, t= 5.179, P= 0.000; (42.97±7.10) scores vs. (40.41±6.51) scores, t= 2.930, P=0.004;(22.97±4.57) scores vs. (21.54±4.13) scores, t=2.926, P=0.004; (16.37±3.89) scores vs. (15.92± 3.93) scores, t= 2.104, P= 0.034]. The difference was statistically significant (P< 0.05). The risk factors of AL were SAS (95 %CI= 1.064-1.210, P= 0.001), factor Ⅲ in FES (95 %CI= 1.104-1.694, P= 0.004), age (95 %CI= 1.027-1.094, P= 0.001), factor Ⅱ in TAS (95 %CI= 1.046-1.352, P= 0.005), besides, education level (95 %CI= 0.708-0.866, P= 0.001) acted as the protective role. Conclusions AL patients tend to the psychological problems such as depression, anxiety. Those will show much severer symptoms as a consequence of lacking of family warmth and concern, low expression of emotion, lacking of organization, low economic capacity, tension, and lacking of the ability to distinguish between emotion and physical feelings.

Objective To summarize the clinical characteristics,diagnosis and treatments of 50 chil-dren with no history of anti-coagulation rodenticide poisoning.Methods Fifty children lacking of poisoning history were admitted to our hospital from Feb 2011 to Dec 2015,who were due to hemorrhage and finally di-agnosed as rodenticide poisoning.The clinical manifestation,characteristics of blood coagulation dysfunction, toxicology screening results and treatments of 50 cases were retrospectively analyzed.Results All 50 cases were from rural area,and denied the history of taking rodenticide by mistake.The time from the onset to ad-mission to the hospital was from 1 d to 120 d,with an average of 11.66 d.Major clinical manifestations in-cluded:34 cases(68%)of skin ecchymosis,26 cases(52%)of epistaxis,10 cases(20%)of bleeding gums and 4 cases(8%)of hematoma at the injection site,with PT 20 to over 200 s and APTT 31 to over 200 s (maximal detection value).The children were diagnosed as rodenticide poisoning when one of brodifacoum, bromadiolone,and diphacinone-sodium or combination of brodifacoum and bromadiolone were detected from their blood specimens,with an concentration of 5 to 3 270 μg/L.The diagnosed children were intravenous dripped with specific antagonist vitamin K1 and the critically ill children were added fresh frozen plasma.All children recovered from hemorrhage within 24 hours after treatment.The level of PT,APTT was close to nor-mal after 3 to 7 days of treatment,and the using of vitamin K1 was accumulated about 30 to 70 mg.The chil-dren were given maintenance treatment of vitamin K1 for three months after discharge until the condition was stable.Conclusion Commonly used rodenticide has the characteristics of fat soluble, easy to accumulate, long incubation period,and long treatment period and so on.Children with no bleeding performance have the clinical tendency of acute bleeding,prolonged PT and APTT should be considered the possibility of rodenti-cide poisoning.Blood or urine samples should be screened for toxicology as soon as possible,and meanwhile children should be given antagonist treatment with special antidote vitamin K1 until the coagulation function is stable in normal range to avoid recurrence of the illness.

Objective: To investigate the clinical significance of monitoring ETV6-RUNX1 fusion gene in children with acute lymphoblastic leukemia (ALL) after allogeneic stem cell transplantation (allo-HSCT) . Methods: Clinical data of 13 children received allo-HSCT in Peking University Institute of Hematology from May 2009 to March 2016 were retrospectively collected. The ETV6-RUNX1 gene was examined by real-time quantitative polymerase chain reaction (RQ-PCR) . The correlation between its expression level and the disease status was analyzed. Results: Of 13 enrolled ALL cases, the ETV6-RUNX1 expression of 7 patients converted to positive after transplant at a median time of 137 days (range, 28-270 days) . The expression level of the first positive sample was 0.034% (range, 0.004%-0.061%) . The duration from ETV6-RUNX1 positive to hematological relapse was 196 days (range, 28-666 days) . Four patients experienced relapse at a median time of 294 days (range, 104-803 days) after allo-HSCT. The ETV6-RUNX1 expression converted to positive prior to MRD. Patients with positive ETV6-RUNX1 gene expression pre-transplantation would be more likely to relapse. Conclusion Monitoring ETV6-RUNX1 by RQ-PCR could be used to evaluate MRD status after allo-HSCT. Patients with positive ETV6-RUNX1 after transplant had a poor prognosis.