This article was aimed to interpret the composition of Mahuang Decoction. The analysis was made on key points of medication, herbal combination, weigh ratio, the combined prescription treatment of Taiyang cold damage syndrome (wind-cold exterior-excess pattern) and heart-heat syndrome, heart-yang deficiency, heart-blood defi-ciency, heart-yin deficiency, liver-heat syndrome, liver-cold syndrome, liver-blood deficiency, liver-yin deficiency, spleen-stomach stagnated heat syndrome, spleen-stomach cold deficiency, spleen-stomach qi and yin deficiency, lung-heat syndrome, lung-cold syndrome, lung-yin deficiency, lung qi and yin deficiency, kidney qi insecurity, kid-ney-yang deficiency, kidney-yin deficiency, kidney yin-yang deficiency syndrome. Attention should be paid to use Mahuang Decoction as the combined prescription to receive the best treatment effect in the clinical practice.

Hepatic hemangioma is one of the most common benign tumor,It mainly occour in middle-aged women. With the development of medical technology and the improvement of standard living, the discovery rate haihger than before. There are different opinion in different scholar about the choice of surgical treatment. This paper summarizes the surgical treatment and operative indication of hepatic hemangioma.

Case based teaching or case discussion teaching of basic medical courses can deepen students' understanding of basic medical subjects and allow them to acquire practical and real problem solving skills while leaning the fundamental knowledge of their subjects.This paper discusses the features and advantages of case based teaching and gives a detailed discussion of an effective way to implement case based teaching by taking case based teaching of medical immunology as an example.

Rectal carcinoid tumors are potential malignant and have been considered to be rare for a long time.But in recent years,the incidence has been increasing gradually,maybe due to the development of endoscopic technology,the widespread use of endoscopy for screening and the raising level of awareness.Because of the malignant tendency,early diagnosis and treatment are the most important things for patients.Nowadays,the misdiagnosis rate is still high and it is difficult to make differential diagnosis between benign and malignant tumors.The efficiency of chemotherapy and radiotherapy is not clear.Surgery is the only effective method,but there is no uniform standard for the choice of operation.At present,it is appropriate to consider tumor size,depth of invasion,lymph node,pathological type and other risk factors to determine a surgical modality.Colonoscopy is recognized to be the best means by follow-up and should be carried out regulady in a longer period of time.Therefore,it is important to summarize the diagnosis and treatment of rectal carcinoid.

Cancer stem cell hypothesis has become a new theory. According to this theory, cancer stem cells play a decisive role in car-cinogenesis, progression, and metastasis. This theory offered new ideas and strategies for cancer treatment. However, only a small fraction of cells in a tumor were cancer stem cells. Therefore, the identification and enrichment of these cells are significant challenges for numerous researchers conducting further study. Micro-sphere culture has been an effective tumor stem cell enrichment technolo-gy in recent years. The application of this technique makes the cancer stem cell research process easy. In addition, it makes the evalua-tion of tumor progression and prognosis of patients in clinical possible. This article will focus on the applications of this technology, and microsystem integration will be described in detail.

Objective To discuss the efficacy of sufentanil combined with propofol in iv anesthesia during laparoscopic cholecystectomy.Methods Totally 182 patients received laparoscopic cholecystectomy.They were divided into two groups according to odd or even number of hospitalization.The control group (81 cases) were given remifentani combined with propofol for iv anesthesia.The observation group (101 cases) were given sufentanil combined with propofol for iv anesthesia.The anesthetic effect of sufentanil combined with propofol for iv anesthesia during laparoscopic cholecystectomy was evaluated by breathing recovery time,opening time,extubation time,VAS scores after 1,6,12 h,and complications during anesthesia.Results Breathing recovery time,opening time,and extubation time of observation group were longer than those of control group (P ＜ 0.05).The VAS scores after 1,6,and 12 h of observation group were lower than those of the control group (P ＜ 0.05).During anesthesia,the proportion of restlessness in observation group was lower than that in control group (P ＜ 0.05).The complication rate of observation group was lower than that of control group (P ＜ 0.05).Conclusion Sufentani combined with propofol has a good anesthetic effect on patients receiving laparoscopic cholecystectomy with mild postoperative pain and less restlessness.It is worthy of clinical use.

BACKGROUND: The imaging methods of evaluating the volume of necrotic femoral head are based on Kerboul angle and necrosis index revealed on X-ray, as well as CT and MRI three-dimensional reconstruction, but the accuracy of each method is different, and none is widely accepted. Additionally, the association of the volum and degree of necrotic femoral head with the status of blood supply to the femoral head remain unclear. OBJECTIVE: To evaluate the accuracy of each imaing method for assessing different stages of femoral head necrosis, and to confirm a convenient method used for measuring the volum of necrotic femoral head. METHODS: This diagnostic in vivo animal trial was finished in the Affiliated Zhongshan Hospital of Dalian University, Liaoning Province, China. The canine models of steroid-induced necrosis of femoral head were prepared, and received CT and MRI examinations, followed by three-dimensional reconstruction combined with Micro-CT to make accuratediagnosis; the degree of necrotic femoral head and its association with the status of blood supply were evaluated throughangiography and histopathological examination. All above outcome measures were compared with the Association Research Circulation Osseous to testify the consistency of this precise method with traditional methods. The experiment follows the national guidelines for the Care and Use of Laboratory Animals, and Consensus author guidelines on animal ethics and welfare by the international Association for Veterinary Editors (IAVE). The article was prepared in accordance with the Animal Research: Reporting of In Vivo Experiments Guidelines (ARRIVE Guidelines). RESULTS AND CONCLUSION: The aim of the study is to obtain a accurate measurement method by detecting different stages of osteonecrosis using different imaging techniques, which enables surgeons make exact diagnosis and clinical stage of osteonecrosis, thus desiging standardized treatment program.

Objective To analyze the curative effect of double path endoscopic surgery in the treatment of fungal sinusitis,and to compare with the effect of simple in endoscopic nasal passages windowing.Methods The clinical data of fungal sinusitis patients were analyzed.According to the different surgery way,the patients were divid-ed into two groups.The observation group:nasal endoscopic nasal passages open a window in the joint of fangs nest small windows double path;Control group:simple in nasal endoscopic fenestration.Results The observation group had 35 cases and the control group had 37 cases.After treatment,the symptoms score of the observation group was sig-nificantly lower than the control group [(1 .09 ±0.83)points vs (1 .47 ±0.77)points;t =2.01 5,P =0.048].The effective rate of the observation group was significantly higher than the control group (94.29% vs 75.68%;χ2 =4.81 3,P =0.028).7 days after treatment,the C -reactive protein(t =4.971 ,P <0.01 ),TNF alpha(t =9.1 9,P <0.001 ),beta IL -1 (t =5.635,P <0.01 ),white blood cells (t =3.25,P =0.002)and IL -6(t =3.86,P =0.002) in the observation group were significantly lower than the control group (P <0.05).The preoperative plasma level of 1 -3 -β-glucan D between the two groups had no statistical difference (P >0.05).2(t =5.978,P <0.01 ),4(t =6.335,P <0.01 ),6(t =9.348,P <0.01 ),and 8 days(t =8.226,P <0.01 )postoperatively,1 -3 -β-glucan D levels were significantly lower than the control group,the differences were statistically significant (P <0.05).The postoperative recurrence rate of the observation group was significantly lower than the control group (8.57% vs 27.03%,the Log -rank χ2 =4.061 ,P =0.044).Conclusion In fungal sinusitis treatment,the use of endoscopic nasal passages open window joint fangs nest small windows double path can more effectively remove lesions,its forward curative effect is superior to pure in nasal endoscopic fenestration.

Objective To construct the conditionally replicating adenovirus vector Ad-delE1b55kD-shRNA/Survivin-EGFP that can transfects into HT-29 effectually and selectively and contains shRNA targeting to human Survivin gene.Methods EGFP geoe and shRNA gene were inserted into pAd-delE1b55kD,then pAd-delE1b55kD-shRNA/Survivin-EGFP was obtained.The plasmid and pBHGE3 were cotransfected into HEK-293 cell to obtain the conditionally replicating adenovirus vector Ad-delE1b55kD-shRNA/Survivin-EGFP.Then DNA of the adenovirus vector was extracted and identified.The transfection efficiency of the vector to HT-29 and LO2 was detected.The expression of Survivin mRNA and protein was detected by RT-PCR and Western blot.Results EGFP gene and shRNA gene targeting to human Survivin mRNA were inserted into conditionally replicating adenovirus vector successfully,proven by sequencing.The transfection efficiency to HT-29 of Ad-delE1b55kD-shRNA/Survivin-EGFP was significantly higher than replication defective adenovirus and liposome vector(P

Sorafenib,a novel oral multikinase inhibitor,targts on serine/threonine kinase and tyrosine kinases receptor of the tumor cells and vasculature.So Sorafenib can inhibit the tumor cell proliferation and revascularization.400 mg sorafenib administered twice a day is chosen as the recommended dosage for several phase Ⅰ studies,and it shows broad-spectrum antitumor activity in renal cancer,hepatocellular carcinoma,melanoma and non-small-cell lung cancer(NSCLC)in phase Ⅱ and Ⅲ clinical trials.Now FDA has approved the usage of sorafenib in renal cancer therapy.