Objective:To optimize the extraction condtions in the modification of the formula of Jiaotai Pill. Methods: The semi bionic extraction (SBE) conditions were optimized through homogeneous design while berberine, cinnamic acid, total alkaloids, volatile oil and dry extract were adopted as markers. Results: PH in first extraction was adjusted to 2.20 by the use of HCL solution. And then PH in second and third extraction adjusted to 6.50 and 7.80 , duration of run was 170 min, 80 min and 40 min, respectively. Conclusion: Semi bionic extraction in Jiaotai Pill is approximated to theoretical extraction value.

[Objective]To study the method of multi-spiral CT(MSCT) 3D reconstruction technique assisting cervical pedicle screw fixation(PSF) and double-door laminoplasty in the treatment of multilevel degenerative stenosis with traumatic instability(MDSTI) of lower cervical spine.[Method]From September 2006 to August 2007,PSF combined with double-door laminoplasty were performed in 9 patients with MDSTI of lower cervical spine.MSCT 3D reconstruction techniques,including volume rendering(VR) and multi-planar reconstruction(MPR),were used to assist preoperative diagnosis,plan and measurement to guide procedure.Postoperative MPR was used again:through coronal format,the degree of screws perforation was measured precisely and the different positions of pedicle screws were divided into three grades according to Richter's method;through axial format,the increase in sagittal diameter and canal area of every laminoplasty level were measured precisely.A comparison between pre- and postoperative ASIA scores was used to present neural function recovery.[Result]Nine patients with MDSTI of lower cervical spine underwent PSF and total 44 screws.According to the classification of Richter,grade 1 were 72.7%(32/44),grade 2 were 27.3%(12/44).No screw perforation occurred(grade 3) and no screws revision resulted from misplacement.No iatrogenic damage occurred.Double-door laminoplasty was performed in total 42 volumes.The postoperative cervical spinal canal sagittal diameter and traverse area were significantly improved(P

Objective To explore central lymph node metastasis (CLNM) of cN0 papillary thyroid carcinoma(PTC).Methods We evaluate the clinical data of 245 patients with cN0 unilateral TPC undergoing total thyroidectomy and bilateral central lymph node dissection.Results Central lymph node metastasis of cN0 TPC was 36.8％ (91/245),significantly related to gender(x2 =5.626,P =0.018),age (x2 =6.255,P =0.012),tumor size (x2 =20.063,P ＜ 0.001) and capsule invasion (x2 =15.024,P ＜ 0.001).The central lymph node metastasis was 51.7％ (60/116) in 116 patients with tumor size ＞ 1 cm,and the contralateral CLNM was 22.4％ (26/116) which was related to capsule invasion (x2 =9.737,P =0.002) and delphian LNM(x2 =10.982,P =0.001) There were 6 cases (2.4％) suffering from temporary unilateral recurrent laryngeal nerve injury.96 cases (39.2％) suffered from temporary hypoparathyroidism and 3 cases (1.2％) from permanent hypoparathyroidism.The median follow-up time was 40 months.6 cases were found regional lymph node recurrence on the ipsilateral side.Tumor size ＞ 1 cm was significantly related with recurrence (P =0.008),as CLNM with higher recurrence rate (P =0.001).Conclusions CLNM is common in cN0 PTC patients,and central lymph node metastases increase the risk of recurrence.Prophylactic bilateral central lymph node dissection is suggested for tumor size ＞ 1 cm cases.

Objective To study the clinical significance of recognizing Zuckerkandl tubercle (ZT) during thyroid surgery. Methods One hundred and sixty-one patients (218 sides) having underwent thyroid lobectomy or thyroidectomy were retrospectively analyzed. The presence of ZT, the position and size of ZT, and the relationship between ZT and recurrent laryngeal nerve (RLN), superior parathyroid (SP) were observed. Results In 218 sides, 179 sides (82.1%) found ZT, with right side in 93 cases and left side in 86 cases. The main relationship between ZT and RLN was A type, accounting for 90.5%(162/179). There were no statistical differences in ZT grade and the relationship type between ZT and RLN between left side and right side (P>0.05). There was negative correlation in ZT grade and the relationship type between ZT and RLN (r=-0.269, P<0.01). In right side, 92.3%(72/78) of SP located on the top of ZT at 10-11 o′clock position;in left side, 94.6%(70/74) of SP located on the top of ZT at 1-2 o′clock position. Conclusions ZT is an important anatomical mark in the thyroid surgery, which helps to identify and protect the RLN and SP, so as to reduce surgical complications.

Through the study on traditional Chinese medicine (TCM) data mining methods, the traditional mining model was revealed to have certain limitations. New ways and means should be searched in order to tap the potential, deep level and greater value of TCM knowledge. In view of the situation, advantages of strategy pattern thought for medicine data mining were discussed. And deep research was carried on. New ideas on TCM data mining based on strategy pattern was proposed.

Objective:To observe and analyze the function of intestinal barrier in patients with pouchitis, and to explore the role of nucleotide oligomerization domain 2 (NOD2) in ileal pouchitis, so as to provide new ideas for the pathogenesis of pouchitis.Methods:From January 2011 to December 2016, the clinical pathological data of patients with ileal pouch-anal anastomosis who underwent pouch mucosa biopsy at the Endoscopy Center of General Hospital of Tianjin Medical University were retrospectively analyzed. According to the disease activity index of pouchitis, patients were divided into pouchitis group (20 cases) and non-pouchitis group (30 cases). In addition, UC patients who did not undergo surgery were selected as the control group (10 cases). The intestinal structure of patients of the pouchitis group and non-pouchitis group was observed under transmission electron microscope. The positive expression rates of occludin, alpha human defensin and NOD2 in the control group, non-pouchitis group and pouchitis group were detected and calculated by immunohistochemistry. Levene test, independent sample t test and Spearman correlation analysis were used for statistical analysis. Results:Under the transmission electron microscope, the tight junction epithelial structure and microvilli of intestinal mucosal of patients in the pouchitis group were severely injured. The results of immunohistochemistry showed that the positive expression rates of occludin, alpha human defensin and NOD2 in the intestinal mucosa of patients in the pouchitis group were all lower than those of the control group and non-pouchitis groups ((19.3±0.4)% vs. (84.0±0.3)% and (77.9±0.5)%; (60.0±1.3)% vs. (85.0±0.1)% and (77.3±0.4)%; (46.1±1.6)% vs. (72.0±0.7)% and (60.7±0.5)%), and the differences were statistically significant ( t=-8.451, -7.514, -3.943, -2.970, -5.115 and -2.982, all P<0.05). The correlation analysis showed that the expression level of NOD2 was positively correlated with occludin and alpha human defensin ( r=0.671 and 0.628, both P<0.01). Conclusions:Intestinal barrier function is impaired in patients with ileal pouchitis, and NOD2-related intestinal barrier injury may play an important role in the pathogenesis of ileal pouchitis.

Objective To explore the relationship between Nestin expression level and prognosis in osteosarcoma,and to provide a new idea for treatment.Methods Thirty patient with osteosarcoma who had received treatment were included this study according to the criteria.HE staining was applied to evaluate the response to chemotherapy,meanwhile immunohistochemistry was applied to evaluate Nestin expression levels before and after chemotherapy.Kaplan Meier survival curve was drawn to analyze the outcomes.Results The response of chemotherapy was good in 17 patients and poor in 13.24 cases were strongly positive in Nestin staining,five were weakly positive,and one was negative.The expression level of Nestin in osteosarcona was correlated to the chemotherapy response and prognosis (P ＜ 0.05),while higher level of Nestin expression referred to poorer response of chemotherapy and lower overall survival rate.Conclusions The expression level of Nestin in osteosarcoma tissue is associated with the effect of chemotherapy and prognosis;higher expression level of Nestin indicates poorer prognosis and efficacy of chemotherapy.

Objective To study the effects of emergency operation with 2~5 cm incision to treat fresh closed heel tendon disjunction.Method 23 cases of fresh closed heel tendon disjunction were operated in post-injury 3~12 hours and the incisions were 2~5 cm long. Results None of these cases was complicated with wound infection or cutaneous necrosis.The follow-up was from 6 months to 6 years,averaging 2.2 years;in which,according to the Arner-Lindholm standards,20 were excellent,3 were good.Conclusion A satisfactory effect can be obtained through the smaller incision to treat the fresh closed heel tendon disjunction.

Objective To explore the effect of posterior internal fixation surgery with pedicle screw/rod instrument system in the treatment of thoracic vertebrae fracture-dislocation complicated with a severe thoracic injury. Methods In the 8 cases examined, the range of injury was from T5 to T9, including 1 case of compression fracture-dislocation and 7 cases of burst fracture-dislocation according to Hanley and Eskey’ s classification. According to Frankle’ s classification, 4 were grade A, 3 were grade B, 1 was grade C. All cases were complicated with multiple fractures of bilateral ribs, pulmonary contusion and haemothorax. After the pathogenic condition being stable, reduction and internal fixation were performed with the posterior surgery pedicle screw/rod instrument system. In 5 cases, spinal canal anterolateral decompression was performed homeochronously. The intervals between accidents and operation were 3 to 9 days. Results Operations were performed safely in all patients. The reposition of the alignment and height of vertebraes was good. Postoperative CT scanning showed: in 2 cases, bone block occupied about 10% volume of vertebral canal, and 1 was 50%. The follow-up were 4～36 months, averaging 15 months. No postreduction disposition, internal fixation loosening or breakage occurred. The Frankel’ s classification of neurological function was improved by 1 grade on average. Conclusions After a positive treatment of thoracic injury, it is safe and feasible to treat the fresh thoracic vertebrae fracture-dislocation with the posterior surgery pedicle screw/rod instrument system, and the curative effects are satisfied.

0.05)but there was a correlation of IL-1?/IL-10 ratio with thrombus mass (Pearson r=0.87, P=0.01