The role of Huaiqihuang Granules in the long-term management of bronchial asthma in young children: a multicenter real-world study / 中华实用儿科临床杂志

Objective:To observe the role of Huaiqihuang Granules (HQ) in the long-term management of bronchial asthma in young children, and the effective effect on concomitant rhinitis.Methods:A prospective real-world multicenter study was conducted in children aged 2-5 years with asthma diagnosed in the outpatient department (from April 2016 to March 2019)who received either inhaled corticosteroid (ICS)/leukotriene receptor antagonist (LTRA)(control group); inhaled ICS/LTRA plus HQ(combination group), or HQ alone(HQ group). All patients were followed up at week 4, 8, 12 after treatment. The number of days with asthma symptoms, the frequency of severe asthma attacks, the level of asthma control, and the days with rhinitis symptoms in the last 4 weeks were recorded. Differences before and after treatment, and those among groups after treatment were compared using Kruskal- Wallis H test or Wilcoxon rank-sum test. Results:A total of 2 234 eligible patients were recruited, and 2 147 cases completed followed-up visits, including 477, 1 374 and 296 cases in the control group, combination group, and HQ group, respectively. After the treatment, all 3 groups showed significant declines in the days with asthma symptoms, frequency of severe asthma attack and the days with rhinitis symptoms (all P<0.01), and the rate of well-controlled asthma increased significantly ( P<0.01). It lasted until the end of follow-up. Among groups, patients in the combination group showed significantly less days of asthma symptoms than those of the other 2 group at week 8 and 12[0(0, 0.9) d vs.0(0, 0.3) d, P<0.05; 0(0, 0.1) d vs. 0(0, 1.0) d, P<0.01]. Patients in the combination group and HQ group showed a significantly lower rate of severe asthma attacks than that of the control group at week 12 [0(0, 1), 0(0, 1), 0(0, 2), all P<0.05]. The well-controlled rate of asthma in the combination group was significantly higher than that of the control group and HQ group at week 8 and 12 (89.6% vs. 85.9% vs.82.1%, H=15.28; 90.9% vs. 84.1% vs. 81.8%, χ2=29.32, all P<0.01). Conclusions:HQ can significantly alleviate symptoms of asthma and rhinitis, severe attack of asthma, and increase the control rate of asthma when used as an additional treatment or used alone.

A follow-up study on the outcome of 2 to 5 years old children with asthma at school age / 国际儿科学杂志

Objective:To investigate the outcome of asthma in young children after 3 years and the factors associated with the outcome.Methods:A total of 494 children aged 2 to 5 years with asthma diagnosed in 5 hospitals in Beijing from 2016 to 2017 were followed up by telephone using questionnaire survey.Information on the asthma attack, the disease control level, and the comorbidities of allergic diseases in the past 3 years was collected and analyzed.Results:Questionnaires were conducted in 387 children, including 261 males(67.4%)and 126 females(32.6%). Two hundred and forty-six patients(63.6%)had no any asthma symptom(remission) within 3 years, while 141 patients(36.4%)were found with asthma symptom(without remission). The main symptoms were as follows: wheezing in 116 cases(82.3%), recurrent cough in 59 cases(41.8%), shortness of breath in 45 cases(31.9%), chest tightness or waking up at night due to wheezing in 22 cases(15.6%). The causes of asthma attack were respiratory tract infection in 80 cases(56.7%), allergen exposure in 46 cases(32.6%), climate change or cold air stimulation in 59 cases(41.8%), strenuous exercise in 36 cases(25.5%), and irritating odor in 3 cases(2.1%). One-way anova analysis showed that significant difference( P<0.05)was respectively observed in age at follow-up, postnatal tobacco smoke exposure history, repeated respiratory tract infection before asthma onset, personal allergy history, snoring, allergic rhinitis, allergic rhinitis within 1 year, allergic conjunctivitis within 1 year between the remission group and without remission group.Multivariate unconditional logistic regression analysis showed that tobacco exposure after birth, allergic rhinitis and allergic conjunctivitis within 1 year were independent risk factors for the continuation of asthma symptoms to school age( P<0.05). Conclusion:Till the school age, more than 1/3 children still had asthma symptom and the risk factors for the unalleviated symptom were postnatal tobacco exposure, allergic rhinitis within 1 year and allergic conjunctivitis within 1 year.

Analysis of the changes and characteristics of pediatric outpatient visits in a general hospital in Beijing before and after the COVID-19 pandemic / 北京大学学报(医学版)

OBJECTIVE@#To analyze the changes and characteristics of pediatric outpatient visits in a general hospital before and after the coronavirus disease (COVID-19) epidemic.@*METHODS@#Based on the registration data of pediatric outpatient visits in the information system (HIS)of Beijing Tsinghua Changgung Hospital, from January 1 2018 to December 31 2020, aged 0 to 16 years, we analyzed the changes of outpatient visits before and after the epidemic, focusing on respiratory infection including influenza. The relationship between the outpatient visits and age and quarterly distribution were also studied.@*RESULTS@#(1) Respiratory infection accounted for the majority of outpatient visits in 2018 and 2019 (60.6% and 60.5%, respectively). Non-respiratory infection accounted for the main proportion of outpatient visits in 2020, while respiratory infection accounted for only 47.4%. Annual respiratory infection visits, respiratory infectious diseases visits especially influenza visits all decreased significantly in 2020 compared with that in 2018 and 2019 (P < 0.05). (2)Respiratory infection visits were highest in the infant group, lowest in the school age group (P < 0.05) and highest in the fourth quarter each year. It decreased significantly in the second quarter of 2020 with statistical significance when compared with the other quarters of 2020(P < 0.05). (3)Influenza accounted for the highest proportion of respiratory infectious diseases visits in each year. It was highest in first quarter, which was significantly different from the other quarters of the year (P < 0.05). There were different distributions of influenza visits throughout 2018 and 2019, while it was only distributed in the first quarter and 99% in January in 2020.@*CONCLUSION@#The respiratory infection and influenza visits have decreased significantly in our pediatric outpatient department after the COVID-19 epidemic, which is considered closely related to the lifestyle and personal protection after the epidemic. It is recommended that health education on respiratory infection and influenza prevention should be strengthened, especially in winter and spring, to promote the development of good respiratory and hand hygiene habits.

Dynamic change of population structure of Oncomelania hupensis / 中国血吸虫病防治杂志

Objective To understand the successive dynamic change of population structure of Oncomelania hupensis during a one-year period,so as to provide the evidence for snail control. Methods A river beach and a ditch infested with O. hupensis snails were selected and longitudinally investigated in the midmonth during one year. The snail survey indices included the sur-vival status,gender,number of whorls,length and width of shell,and gonad development status(measured by the color depth of gonad and the length ratio of gonad to liver),and the monthly snail eggs in the soil were collected and counted simultaneous-ly. In addition,the temperature and humidity of the soil and the daily data of air temperature and precipitation were measured or collected during the study period(every month). Results Both survival rate of snails and live snail density at the two environ-ments were positively correlated with the temperatures of air and soil. With a slight bimodal distribution ,the snail survival rate peaked from May to June,and in September. The living snail densities got the highest level in July and September in the river beach,and from April to May in the ditch. The regression equations of snail length(L)and width(W)were Lbeach = 2.355 +1.678W(F=2989.43,P<0.01)and Lditch=0.478+2.091W(F=2.989.43,P<0.01),respectively. The snails were the ones with 4.07-11.81 mm in the length(8.98 ± 0.92)mm in the river beach,and the snails were the ones with 3.63-9.92 mm in the length(7.03 ± 0.82)mm in the ditch. The main snails were the ones with five to eight whorls of shell in the river beach and four to seven whorls of shell in the ditch. The proportions of snails with less than or equal to five whorls(in the river beach)and four (in the ditch)were the highest in May and September,about 20％. The ratios of male and female snails were 1.66 in the river beach and 1.22 in the ditch,respectively. The gonad development status of male and female snails was basically synchronous and had a bimodal abundance period-from April to May and September to October. The numbers of snail eggs in the soil among months were significantly different,reaching the highest in June in the river beach(100.8/0.1 m2),and May in the ditch(82.5/0.1 m2). Conclusion The principal periods of breeding and alternation of generations of snails are April-May and September-October every year,which should also be the optimal time for mollusciciding in schistosomiasis susceptible zones.

Ways to Achieve Social Co-governance of Food Safety---Research Report of Social Co-governance in Yunnan Province / 中国药师

The 13th five-year plan pointed out clearly that it is necessary to implement food safety strategy , and form a manage-ment system for strict and efficient social co-governance of food safety .The paper introduced the practice and the results of food safety co-governance in Yunnan province , and provided some proposals with the purpose to help the development of food safety co -governance work in the other areas .

New Way of Cadre Quality Improvement in Food and Drug Supervision System / 中国药师

After the structural reform in the food and drug supervision system, the knowledge structure and the professional re-quirements of the supervisors is unmatched, which hinder the fulfillment of regulatory responsibilities and the performance of adminis-trative efficacy. Effective ways for team building are actively explored throughout the country. The paper introduced the adult corre-spondence education of the supervisors in Zhejiang Ningbo food and drug supervision system to provide a good example for training work throughout the country and some useful suggestions for the quality improvement of the supervision team.

Exploration of Education Training Program for National Food and Drug Supervisors during 2016 and 2020 / 中国药师

Food and drug supervision is a specialized job. However, the present supervisors coming from various departments have differences in supervision concepts, professional background, knowledge structure and work experience, which shows large gap with the requirements of supervision work. Therefore, it is urgent to strengthen the classified training for the improvement of quality construction and specialization. The article provided the curriculum system, teaching explanation and ideas about the classified training for all supervisors in the whole system, which may be beneficial to the training of food and drug supervisors.

Study on histopathology, ultrasonography and some special serum enzymes and collagens for 38 advanced patients of schistosomiasis japonica.

Thirty-eight cases clinically diagnosed as advanced schistosomiaisis were subject to splenectomy in Dongzhi County Special Hospital for Schistosomiasis because of portal hypertension, splenomegaly and/or hypersplenism. Liver biopsy was undertaken in all cases during surgical intervention. Before operation, ultrasonography on the liver and spleen was carried out. Also done was biochemical assay on several indices related to liver damage and fibrosis. Among the 38 cases, 24 were diagnosed as schistosomiasis by the finding of eggs in feces, 13 were diagnosed by positive serological test with IHA or COPT, and only in one case, the diagnosis of schistosomiasis was doubtful before operation. However, the eggs were found in the liver section upon histological examination. All the 38 cases had symptoms and signs of portal hypertension and most of them had general symptoms. Histories of hematemesis and melena were recorded in three cases. The causes of hospitalization were mainly splenomegaly and abdominal distension, and two were suffering from upper gastrointestinal bleeding. Upon histopathological examination, schistosome eggs were found in 33 out of 38 cases. Advanced schistosomaiasis was shown in 18 cases and schistosomiasis associated with hepatitis or cirrhosis was seen in other 20 patients. The main pathological changes were egg granulomas with different degrees of fibrosis and some differences in the pathological changes between schistosomal liver fibrosis (SLF) and mixed liver cirrhosis (both schistosome and hepatitis in origin) were seen. Compared with normal ultrasonography, in all the 38 cases, the length of the left and right liver, and the spleen, and the thickness of the left liver, the width of portal trunk, were all out of normal ranges. The differences between the patients and normal records were significant. However, there were no statistically significant differences in terms of above-mentioned indices as well as liver parenchyma changes on ultrasound between advanced schistosomaiasis and schistosomiasis complicated with hepatitis or cirrhosis (all P>0.5). According to WHO classification criteria on ultrasonography for schistosomiasis, among 20 cases combined with hepatitis or cirrhosis, 11 cases fell in Grade II, and nine cases in Grade III hepatic fibrosis, whereas among 18 cases with schistosomiasis fibrosis, 12 and six were in Grade II and III, respectively. The mean value of serum MAO, PIIIP, IVC and HA in the 38 cases were all significantly higher than normal range. However, no significant differences (all P>0.1) were seen between advanced schistosomiasis and those complicated with hepatitis or cirrhosis in terms of the levels of the four indices. The results showed that ultrasonography has its importance in the diagnosis and evaluation of liver fibrosis. However, in differentiation of the two types of liver damage, ultrasound does not provide important information. Histopathological examination, on the other hand, can provide useful information to identify the hepatic diseases.

Study on expression of endothelin in experimental cerebral concussion in rats / 中国组织工程研究

Objective To study changes and significance of endothelin(ET) in rat cerebral concussion.Methods 80 Wistar male rats were used for animal model of cerebral concussion,which were sacrificed on 1,3,7,14 and 30 days after injury and the brain tissue were taken off. The expression of ET was studied in the course of cerebral concussion by means of immunohistochemistry.Results Typical clinical manifestation was observed in the 100 g group in which the pathological changes included cerebral vascular constriction and dilatation,congestion and edema of cerebral tissue,neuronal degeneration,necrosis,and obviously decreased even disappeared Nissl bodies.Increased expression of ET was observed on the first day,the positive area was seen in the plasma of endothelial cells in cerebral cortex,hippocampus,cerebellum and thalamus.ET expression peak occurred on the 7th day,the positive area was also found in the plasma of Purkinje cells in the cerebellum.Decreased ET expression was found on 14th day and returned to normal level on the 30th day.Conclusion The main pathological changes of cerebral concussion contained blood circulation disorder,and degeneration and necrosis of substantial cells.ET was involved in the brain tissue injury during the pathological process of cerebral concussion and might be related to regulation of cerebral vascular reaction,and neuron degeneration and necrosis.