To elaborate the principal pathogenesis is that imbalance of zang-fu organs and disorder of qi lead to internal wind ,which instigates pathogenic phlegm ,fire and blood stasis to the lesion of brian function.Then to advocate applying Chinese medicine intervening timely the treatment,so as to dispel pathogeny and recuperate the function of zang-fu organs. Moreover to illustrate the concrete clinical adhibition and do some salutary exploration particularly in the aspect of decreasing the number of outbreak.

Objective To study the hemodynamic change and the machanism of anomalous enhancement of hepatic peripheral area in arterial phase in patients with tumor embolismus in portal vein.Methods The imaging data in 30 cases of hepatic carcinoma (hepatic cell carcinoma in 28 cases and metastatic carcinoma in 2 cases)with tumor embolismus in portal vein confirmed by CT and angiography were reviewed and analysed.Results The tumor embolism were formed in portal stem vein is 3 cases,portal stem vein right and left branches in 18 cases,and right and left branches in 9 cases.The cavernous transformation of portal vein was in 26 cases.The blood vessel grouped and thickened in hepatic portal,the fissure of liver and fossa of gallblader were showed on CT.The hepatic peripheral area was enhanced in arterial phase in 10 cases.Conclusion The collateral branch underwent cavernous transformation after formation of tumor embolism in portal vein the liver blood supply is still maintain.The hepatic peripheral area in arterial phase are anomalously enhanced,it is suggested that the portal vein blood supply is reduction and the arterial blood supply is complemently increased.

BACKGROUND: Currently, acid etching and bonding technology have been widely used in clinical stomatology. Data have indicated that the main content of inorganic elements (calcium and phosphorus) has a certain difference between the dental enamel and dentin of the young and adult permanent teeth. OBJECTIVE:To measure the content of main inorganic elements, calcium and phosphorus, in the dental enamel and dentin from young and adult permanent teeth with spectrophotometry and ethylene diamine tetraacetie acid titration method. METHODS:Each 20 adult and young permanent teethin vitrowere selected. Plaster stone and water was mixed; when it was nearly dried, the teeth were verticaly cast in the mixture and the tooth surface was exposed. The models were cut into the slices using syj-200 precision cutting machine, and then the slices were put into nitric acid and dissolved through heater to prepare standard solution. At last, the concentrations of calcium and phosphorus in the hard tissue of both young and adult permanent teeth were measured with spectrophotometric method and titration method. RESULTS AND CONCLUSION:The content of calcium and phosphorus and calcium/phosphorus ratio in the hard tissue of young permanent teeth were less than those of adult permanent teeth (P < 0.05), reflecting that the organic matter content was more than that in adult permanent teeth, but their mineralized degree was inferior to that of adult permanent teeth (P < 0.05). These findings indicate that the young permanent teeth are more acid proof than the adult permanent teeth; therefore, the acid etching time can be properly prolonged for young permanent teeth in clinical treatment, in order to achieve better effects.

Objective To analyse the radiological features and the diagnostic method of pulmonary alveolar proteinosis(PAP).Methods X-ray and CT manifestations of PAP in 37 cases confirmed with fiberoptic bronchoscopy and bronchoalveolar lavage were studied retrospectively.Results The radiologic features of PAP could be characterized as geographic,the “crazy-paving” pattern,lobar or segmental consolidation(air-brochogram sign)and like intersititial fibrosis.The radiologic manifestations were stable and more serious than the symptoms.Conclusion PAP is of typical radiologic feature,it is not difficult for diagnosis in combination with clinical characteristics.

This paper describes a practical process for a SGLT2 inhibitor dapagliflozin. The target product was synthesized from 1-chloro-2-( 4-ethoxybenzyl)-4-iodobenzene and 2, 3, 4, 6-tetra-O-acetyl-alpha-D-glucopyranosyl bromide by iodine-magnesium exchange, and coupling and acetyl removing reactions with the total yield of 50%. This practical process highlights fewer reaction steps, less waste and mild reaction conditions.

Incidence of acute closed Achilles tendon rupture is high in clinic. Accurate diagnosis of this injury depends on a combination of physical signs and imaging examinations. Although conservative and surgical interventions are common for acute closed Achilles tendon rupture, its optimal treatment remains controversial. This literature review focuses on the research progress concerning this injury so as to analyze its risk factors, diagnostic methods, treatments, early functional rehabilitation, postoperative complications and prognosis evaluation.

OBJECTIVE: To analysis the characteristics of sudden sensorineural hearing loss (SSHL) patients with tinnitus, and explore the relationship of characteristics of tinnitus and audiology. METHOD: Patients diagnosed as SSHL with tinnitus were studied in the research. All patients' clinical features were analyzed, such as tinnitus frequency, pure tone audiometry, tinnitus, hearing loss degree, results of residual inhibition test. RESULT: Thirty cases were identified as mild degree hearing loss, 13 cases as moderate degree, 28 cases as severe degree and 34 cases as profound degree. And hearing impaired frequency of 13 cases was ascertained at low-frequency, 39 cases at middle-high-frequency, and 53 cases at full-range-frequency. The incidence of patients with low-frequency was about 41. 9% (44/105), and it was about 21. 9% (23/105) in those with middle-frequency. And it was 36. 2% (38/105) in cases of high-frequency tinnitus. The chi-square test show statistically significant differences between patients with the low-frequency, middle-frequency and high-frequency of the hearing loss (P<0. 05). In tinnitus residual inhibition test, positive rate of convergence type masking curve was about 72.0%, tinnitus separated type masking curve 20.0%, overlapping type was 57.9%, and the spacing type was 43.5%. There was a statistically significant difference among cases with different type masking curve (P<0. 05)with the spacing residual inhibition test positive rate. CONCLUSION There are individual differences of clinical characteristics among SSHL patients with tinnitus. Tinnitus frequency is consistent with the frequency of hearing loss. Patients had the more serious the degree of hearing loss, who had more serious tinnitus grading. Cases with the converged type curve will be fit for tinnitus masking. Therefore, combining the tinnitus detection with the audiological tests, we could obtain the clinical characteristics of SSHL patients with tinnitus.
Audiometry, Pure-Tone ; Deafness ; Hearing Loss ; Hearing Loss, Sensorineural ; complications ; pathology ; Humans ; Tinnitus ; complications ; pathology

Biotherapeutic's higher order structure(HOS)is a critical determinant of its functional properties and conformational relevance.Here,we evaluated two covalent labeling methods:diethylpyrocarbonate(DEPC)-labeling and fast photooxidation of proteins(FPOP),in conjunction with mass spectrometry(MS),to investigate structural modifications for the new class of immuno-oncological therapy known as bis-pecific antigen-binding biotherapeutics(BABB).The evaluated techniques unveiled subtle structural changes occurring at the amino acid residue level within the antigen-binding domain under both native and thermal stress conditions,which cannot be detected by conventional biophysical techniques,e.g.,near-ultraviolet circular dichroism(NUV-CD).The determined variations in labeling uptake under native and stress conditions,corroborated by binding assays,shed light on the binding effect,and highlighted the potential of covalent-labeling methods to effectively monitor conformational changes that ultimately influence the product quality.Our study provides a foundation for implementing the developed tech-niques in elucidating the inherent structural characteristics of novel therapeutics and their conforma-tional stability.

Objective To evaluate the effect of anticoagulant therapy by pulmonary ventilation/perfusion (V/Q) imaging in chronic thromboembolic pulmonary hypertension (CTEPH) patients.Methods Thirtysix CTEPH patients (16 males,20 females,average age:(53.8±13.8) years) diagnosed by pulmonary angiography from January 2013 to December 2015 were included in this retrospective study.All patients received anticoagulant therapy for more than 6 months.They underwent pulmonary V/Q imaging before and 6 months after anticoagulant therapy.The numbers of pulmonary segments with perfusion defect,percentage of perfusion defect score (PPDs) and pulmonary arterial systolic pressure (PASP) before and after anticoagulant therapy were measured by echocardiography.Pair t test was used for data analysis.Results Before anticoagulant therapy,there were 319 pulmonary segments with perfusion defect in 36 CTEPH patients,8.9± 3.4 on average,and reduced to 8.4+3.6 after anticoagulant therapy (t =3.101,P＜0.01).The PPDs before and after anticoagulant therapy were (43.3±19.7)％ and (40.8±+20.5)％ (t=2.364,P＜0.05).In the subgroup of 9 patients with improved pulmonary perfusion,the PASP significantly decreased from (68.7±27.3)to (56.1 +±34.8) mmHg (1 mm Hg =0.133 kPa;t =2.465,P＜ 0.05) after anticoagulant therapy.In contrast,in the subgroup of 27 patients with no improved pulmonary perfusion,the PASP before and after anticoagulant therapy were (71.3±26.9) and (76.7±35.0) mmHg respectively (t=-1.511,P＞0.05).Conclusion Pulmonary V/Q imaging is a reliable method for evaluating the changes of pulmonary perfusion before and after anticoagulant therapy,and it is valuable for assessing the effect of anticoagulant therapy in CTEPH patients.

Objective:To explore the clinical effects of single pedicle transfer of expanded axial flap across the midline of the frontal-parietal region in reconstruction of large scar deformities in the face and neck.Methods:From January 2016 to August 2019, 10 male patients, aged from 20 to 52 years with post-burn facial and cervical scar deformities, were admitted to the First People′s Hospital of Zhengzhou, with the size of scar ranging from 15 cm×7 cm to 23 cm×11 cm. In the first stage, a cylindrical skin and soft tissue expander with rated capacity ranging from 400 to 600 mL was placed in the frontal-parietal region. Another cylindrical expander with rated capacity ranging from 50 to 100 mL was placed in the temporal region of the patient with scars in front of the ear and in cheek. The injection time was 3 to 5 months with the total injection volume being 1.5 to 2.5 times of the rated capacity of expander. In the second stage, the superficial temporal artery frontal branch and its branches were explored, the expander was removed, the scars in the face and neck were conducted resection and contracture relaxation, and the single pedicle transfer of expanded axial flap across the midline of the frontal-parietal region for reconstruction was performed. When the branches of the superficial temporal vessels were difficult to be detected by Doppler ultrasonic blood stream detector, the patient underwent computed tomography (CT) angiography and three-dimensional reconstruction. The donor site in frontal-parietal region was directly sutured, and the wound of the exposed donor site at the pedicle and temporal region was temporarily covered with scar skin. After the suture wound was healed and the hair in expanded flap grew out, hair removal and laser hair removal were performed. Three to four weeks after transplantation of expanded flap, the flap pedicle was cut off, restored, and trimmed in the third stage. The status about the completion of operation, the implantation of expander in the temporal region, CT angiography and three-dimensional reconstruction were recorded. The effective resection area of expanded flap, the length across the midline and the length of the pedicle, and the survival status of the expanded flap and complications after operation were observed. The appearance of donor and recipient sites, the scar recurrence, the appearance and function improvement of patients, and the satisfaction degree of patients were followed up.Results:All the 10 patients successfully completed three stages of operation, of which 6 patients had an auxiliary expander placement in the temporal region, and 5 patients underwent CT angiography and three-dimensional reconstruction. The effective resection area of expanded flap ranged from 18 cm×8 cm to 25 cm×13 cm. The distal end of the flap across the midline extended 4-6 cm to the opposite side, and the length of pedicle was 2-6 cm. All the expanded flaps of patients survived well after formation and transfer. The venous reflux disorder and obvious swelling occurred in 6 patients at the distal end of the flap after operation, and the blood supply recovered after acupuncture bloodletting, etc. Follow-up of 6 to 24 months showed that the color, texture, and thickness of the expanded flaps were similar to those of the facial skin, and no recurrence of scar was observed; the incision in the donor site of the frontal-parietal region was concealed, the hair growth of the temples and head was normal, and the reconstructed hairline was natural; compared with those before operation, the appearance, head-up, mouth-opening, and other functions of patients were significantly improved; the patients were satisfied with the effect of reconstruction.Conclusions:Clinical application of single pedicle transfer of expanded axial flap across the midline of the frontal-parietal region in reconstruction of large scar deformities in the face and neck can achieve a good appearance and function, and the donor site shows good shape, which enriches the application range of the trans-regional blood supply flap. It is a reliable method for reconstruction of large scar deformities in the face and neck.