This article introduced five cases of professor JIANG Jian using later generation's prescriptions of Qingwei Shegan Tang,Qingkong Gao,Xietong Shen Fang,Jianbei Jingutong Fang,Juantong San,Juhe Wan,and Shen xiao Gualou San to treat pain syndrome of gastralgia,hypochondriac pain,headache,backache,and breast-ache. During the treatment of pain syndrome,professor JIANG Jian’ clinical experience by using later generation's prescriptions was extraordinary,deserved to learn an reference.

Objective To evaluate the diagnostic value of physical examination,digital mammography and color Dopplor ultrasonography for breast masses.Methods The materials of clinic,digital mammography and color Dopplor ultrasonogrpahy(US)in 92 women(raged from 18～80 years old in age,with average of 49.8 years old)with breast masses confirmed by pathology were retrospectively analysed,including benign in 43 and malignant in 49.Digital mammographic findings including the location,shape,margins,calcifications and the lymph node of axillary of the breast lesions,and color Dopplor ultrasonographic findings including mainly the characteristics of lesions on two-dimensional sonography,the distribution of the internal and peripheral vessels of the lesions were observed,the physical examination mainly observed the skin and nipple,and the margins,texture and movement of the lesions.Results In diagnosing breast masses,the sensitivity,specificity,positive predictive value,negative predictive value and accuracy were 85.71%,79.07%,82.35%,82.93% and 82.61%,respectively with digital mammography,79.59%,83,72%,84.78%,78.26% and 81.52%,respectively with US,71.42%,76.74%,77.78%,70.21%,73.91%,respectively with physical examination,while were 91.84%,93.02%,93.75%,93.3% and 90.91%,respectively in combination with three methods,which were significantly higher than that of each single examination(P＜0.05),but there were no differences between each examination(P＞0.05).Conclusion It can improve the diagnosing accuracy of breast masses by suitable combination of three of digital mammography,color Dopplor ultrasonography and physical examination.

Objective To explore the anti-infection mechanism of carboxyamidotriazole (CAI) through studying the effects of CAI on the proliferation, apoptosis and degranulation of RBL-2H3 mass cells.Methods Compound 48/80 (C48/80) was used to induce the model of activation and degranulation in RBL-2H3 cells.The morphological change of cell degranulation was observed by neutral red staining.The release levels of histamine and β-hexosaminidase were measured by ELISA method and chromogenic assay, respectively.The cell activity was determined by CCK-8 method.And cell apoptosis was detected by Hoechst 33342 fluorescent staining.Results Compared with the control group, 10, 20, 40 μmol/L CAI inhibited C48/80-induced degranulation of RBL-2H3 cells in different degrees.CAI (20, 40 μmol/L) reduced the histamine release (P<0.01), and CAI (40 μmol/L) decreased the β-hexosaminidase release (P<0.01).In addition, the viability and apoptosis of RBL-2H3 cells were not affected at the concentrations of CAI used.Conclusions CAI can effectively inhibit the activation and degranulation of RBL-2H3 mast cells, and this effect is not through cytotoxicity.The anti-infection effect of CAI may partially due to the down-regulation of mast cell activity.

An iceberg model for better understanding the patients was developed.In this model the seeking for consultation is visible part of illness behavior,but the thoughts,concerns and expectations toward his or her illness are the hidden parts.Through detailed history taking,using appropriate language skill (Leichester Assessment Package) and nonverbal communication skill (space distance,eye contact,listening,pronunciation,appropriate silence),physicians can acquaint comprehensive knowledge about the hidden thoughts,concern and expectation of patients about their illness.This model would help general practitioners to raise communication and consultation ability and skills in their practice.

Objective To observe the clinical effects of traditional Chinese medicine and foam dressing in the treatment of stageⅢ pressure sores. Methods A total of 94 patients with stageⅢ pressure sores in neurology department of Hangzhou Red Cross Hospital from January 2015 to December 2016 were recruited and randomly divided into control group (n=44) and observation group (n=50) by random number table method. Besides routine treatment and care of pressure sores, control group was given traditional Chinese medicine, while patients of observation group received traditional Chinese medicine combined with foam dressing treatment. The treatment effects of the two groups were observed and compared. Results The total effective rate of pressure sore in was 90.00% in the observation group and 86.36% in the control group, and there was no statistical difference (P>0.05). The average healing time of the observation group was (13.56±4.35) days, which was significantly shorter than that of the control group (21.45±3.47) days, and the difference was statistically significant (P< 0.01). Conclusions The effects of traditional Chinese medicine combined with foam dressing in the treatment of stageⅢ pressure ulcer is better than that of traditional Chinese medicine, which can improve the cure rate of pressure ulcer, shorten the healing time of pressure ulcer, and is worthy of clinical promotion.

bjective? To explore the effects of Daiwenjiu Gao combined with ear acupoint bean-pressing on migraine of deficiency of both qi and blood. Methods? From June 2015 to July 2017, we selected 111 outpatients with migraine of deficiency of both qi and blood in Hangzhou Red Cross Hospital. All of the patients were divided into three groups including group of Daiwenjiu Gao, group of ear acupoint bean-pressing and group of Daiwenjiu Gao combined with ear acupoint bean-pressing with the method of random number table, 37 cases in each group. There was a loss to follow-up in group of Daiwenjiu Gao and group of Daiwenjiu Gao combined with ear acupoint bean-pressing respectively, and there was a case refusing treatment in group of ear acupoint bean-pressing; there were 36 cases with valid data in each group finally. Group of ear acupoint bean-pressing received ear acupoint bean-pressing for migraine; group of Daiwenjiu Gao carried out ear acupoint application by Daiwenjiu Gao for migraine; group of Daiwenjiu Gao combined with ear acupoint bean-pressing combined two treatments for migraine; the intervention continued for four weeks in three groups. The Sun's criteria was used to evaluate the severity, duration, frequency of outbreak, accompanying symptoms of headache of patients one and six months after intervention. SPSS 17.0 was used to statistical analysis. Results? Among patients with migraine of deficiency of both qi and blood in three groups, there were statistical differences between group of Daiwenjiu Gao and group of Daiwenjiu Gao combined with ear acupoint bean-pressing (P＜0.01), and there were also statistical differences between group of ear acupoint bean-pressing and group of Daiwenjiu Gao combined with ear acupoint bean-pressing (P＜0.01) one and six months after intervention. Conclusions? Daiwenjiu Gao combined with ear acupoint bean-pressing is with a simple operation, few adverse reactions, and it has better effects for migraine of deficiency of both qi and blood than general treatments which is worth to be used widely in clinical application.

Objective:To analyze the current status, hotspots and frontiers of pain catastrophizing at home and abroad from 2012 to 2022, so as to provide reference for research on pain catastrophizing in China.Methods:Article retrieval were conducted on the Web of Science, China National Knowledge Infrastructure, WanFang Data and VIP using the Chinese and English keywords "pain catastrophizing". The search period was from January 1, 2012 to August 24, 2022. The articles were analyzed using the CiteSpace software.Results:A total of 2036 English articles and 83 Chinese articles were included. The overall number of articles was increasing year by year, with the countries and institutions with the highest publication volume being the United States and the University of Washington. Research hotspots at home and abroad included pain, low back pain, quality of life, influencing factors, anxiety, depression, joint replacement, scale validation, kinesiophobia and so on.Conclusions:The research on pain catastrophizing abroad is increasingly receiving widespread attention, while domestic research is still in its infancy. Domestic researchers can use various methods to explore the occurrence and influencing factors of pain catastrophizing among different disease groups in China, deeply explore the mechanism of pain catastrophizing, and focus on the correlation between pain catastrophizing and exercise rehabilitation outcomes to help patients cope with pain.

Objective To assess the CT characteristics of thoracoabdominal localized Castleman disease (LCD) in 55 cases and correlate with histopathologic features. Methods Fifty-five patients with LCD proved histopathologically in thorax ( n = 25 ) and abdomen ( n = 30 ) were collected during past 20 years. The unenhanced and contrast-enhanced CT were performed in all patients. Two radiologists reviewed CT images and the CT findings were analyzed simultaneously. Results In 54 patients with hyaline-vascular type ( n = 50 ) and mixed type ( n = 4 ) localized CD, the lesion typically presented as solitary mass (90. 7% , 49 cases), with irregular or lobular or infiltrative margin ( 83.3% , 45 cases),central calcification (38. 9%, 21 cases), marked enhancement (100% , 54 cases), focal non-necrosis low attenuation areas (72. 2%, 39 cases), lymphadenopathy (70.4%, 38 cases) and dilated feeding vessels adjacent to the mass (96.3%, 52 cases). One lesion with plasma cell type localized CD presented as a mass with irregular margin, mild enhancement and central necrosis. Four morphologic patterns wereclassified on CT, including solitary mass with well-circumscribed margin (n =4), irregular or lobular margin ( n = 30), infiltrative or halo-like margin ( n = 16 ), and multiple coalescent maasses ( n = 5 ). Conclusion CT features of thoracoabdominal localized CD are closely related to the location and pathological type. LCD with hyaline-vascular and mixed type has typical CT characteristics, while LCD with plasma cell type has no typical CT findings.

Objective To explore the effects of isogenous micro-grafting(MG)technology and the combined use of botulinum toxin type A(BTX-A)on hair regeneration in mice.Methods Forty-five C57BL/6 mice were randomly divided into five groups:normal saline group(NS group),MG group(MB-0 group),MG+low-dose BTX-A group(MB-2 group),MG+medium dose BTX-A group(MB-10 group),MG+high-dose BTX-A group(MB-50 group).The growth of hair on the backs of the mice was observed after the administration of the drugs,and the hair follicles were evaluated by hematoxylin-eosin(HE)staining on the 7th,14th,and 21st days of the experiment,and the expression of vascular endothelial growth factor(VEGF)and β-catenin was evaluated by immunohisto-chemical staining on day 21.Results After treatment with micrograft and botulinum toxin type A,the skin darke-ning time was shortened(P＜0.05),and the coverage rate of new hair increased on the 14 th day(P＜0.05).Compared with the NS group,the number of hair follicles increased(P＜0.05)and the expression of VEGF andβ-catenin increased in each other group.Conclusion Isogenous micro-grafting technology combined with botuli-num toxin type A has a promotional effect on hair regeneration in mice,and the mechanism may be related to the promotion of vascular growth and activation of β-catenin signaling.

Objective To investigate the effects and mechanisms of oridonin(ORI)on human keloid-derived fi-broblasts(HKF).Methods The effects of ORI on the proliferation activity of HKF were assessed using the CCK-8 assay.The experiment was divided into control and experimental groups.Cell scratch and Transwell assays were conducted to evaluate the migration and invasion capabilities of HKF.Real-time quantitative PCR(RT-qPCR)and Western blot were used to examine the impact of ORI on the expression of extracellular matrix-related mRNA and fi-bronectin 1(FN1),α-smooth muscle actin(α-SMA),type Ⅰ collagen(COL Ⅰ),and COL Ⅲ in HKF.The ex-periment was also divided into control,model,and transforming growth factor(TGF)-β1+ORI groups.RT-qPCR and Western blot were utilized to determine the effects of ORI on the expression of TGF-β1-induced mRNA and nu-cleotide-binding oligomerization domain-like receptor protein 3(NLRP3),apoptosis-associated speck-like protein containing a CARD(ASC),Smad2,Smad3,phosphorylated Smad2(p-Smad2),and p-Smad3 in HKF.Results CCK-8 assay demonstrated that the cell inhibition rate of HKF progressively increased with increasing concentra-tions of ORI.Compared with the control group,the experimental group exhibited a significant reduction in the mi-gration area at 24 hours and a decrease in the number of invasive cells.Furthermore,there was a significant down-regulation in the expression levels of FN1,α-SMA,COL Ⅰ,and COL Ⅲ(P＜0.05).In comparison with the con-trol group,the model group showed a significant upregulation in the expression of NLRP3,ASC,Smad2,Smad3,p-Smad2,and p-Smad3(P＜0.05).Relative to the model group,the TGF-β1+ORI group demonstrated a signifi-cant downregulation in the expression of NLRP3,ASC,Smad2,Smad3,p-Smad2,and p-Smad3(P＜0.05).Conclusion ORI the proliferation,migration,and invasiveness of HKF,as well as the formation and deposition of the extracellular matrix,through the blockade of the TGF-β1/Smad signaling pathway and the NLRP3-mediated in-flammatory response.