Prof. SUN Guang-rong holds that how to define the representative clinical case records out of regular ones,what to learn from it,and how to direct other people to learn from it are the key questions to answer before moving to the study; in research process of the project of the Representative Clinical Case Records Collection and Study of Contemporary Eminent and Experienced Chinese Medicine Practitioners,conventional study method and modern information technology are used in conjunction on all the clinical case records of the screened eminent and experienced doctors from all over the country,the defined representative case records are studied and sorted out according to disease or symptom,highlights before and notes and comments following the case record details,guiding people easily to read each great Chinese medical talents,their academic thought and clinical technology; the academic analysis on each eminent and experienced practitioner is the most important part of the project and with it the academic whole story can be seen in a natural and close related way.

Objective: To systematically evaluate the clinical effects of Maxing Shigan Decoction (MXSGD), a compound traditional Chinese herbal medicine, combined with Western medicine on pneumonia in children. Methods: In this study, the relative trials published from 1994 to 2008 were searched in Chongqing Weipu Database, Chinese Journal Full-text Database, Wanfang database, Chinese Biomedical Literature Database and other electronic database by using the method of Cochrane systematic review. At the same time the information from related journals, professional data and network were hand-searched. The methodological quality of the included trials was assessed by two evaluators, and homogeneous evaluation by meta-analysis was performed. Statistical analysis of clinical data was performed by using RevMan 4.2.7 software provided by the Cochrane Collaboration. Results: A total of 146 reports were found, while only eight randomized controlled trials met the inclusion criteria. The methodology quality of the reports included in the study was evaluated by the Jadad scale, and the specific random method, allocation concealment, blinding and intention-to-treat analysis were not described in all of the eight trial reports. As MXSGD combined with Western medicine group (treatment group) was compared with Western medicine group (control group), the meta-analysis indicated that the odds ratio for the total effective rate was 4.06, and the 95% confidence interval was from 2.63 to 6.27. MXSGD combined with Western medicine was good at increasing the total effective rate as compared with Western medicine, and the difference was statistically significant (P<0.000 01). Conclusion: MXSGD combined with Western medicine can improve clinical symptoms and increase the total effective rate of the patients with pneumonia in children. However, its clinical effects should be further identified by high quality, multicenter and randomized controlled trials with large-scale design.

Objective To compare the effect of ISO-C3D navigation and conventional C-arm fluoroscopy in iliosacral screws insertion for treatment of posterior pelvic ring injuries.Methods Sixty-five patients with posterior pelvic ring injuries managed by minimally invasive percutaneous iliosacral screws from June 2006 to January 2012 were reviewed.There were 37 males and 28 females,at age range of 18-63 years (mean 35.9 years).Pelvic fracture classification based on Tile system was type B1 in 10 cases,type B2 in 15,type B3 in nine,type C1 in 18 and type C2 in 13.Patients were divided into ISO-C3D navigation group (Group A,n =35) and C-arm fluoroscopy group (Group B,n =30) according to the difference in intraoperative fluoroscopy methods.Intraoperative fluoroscopy time,time cost in inserting a screw,patient satisfaction rate for bone reduction,bone union time and excellent-good rate of postoperative function were recorded.Results Eighty cannulated screws were inserted for the 65 patients.Average fluoroscopy time and time cost in inserting a screw were shorter in Group A than in Group B (P ＜0.01),but there was no statistical difference between the two gronps in patient satisfaction rate for bone reduction.No patient presented with infection,vascular nerve injury or other complications.Follow-up was 6-24 months (mean 12.7 months) for all the patients.Functional recovery showed no statistical difference between the two groups at postoperative 6 months.All fractures were healed and no delayed union or nonunion happened.Conclusion As compared with conventional C-arm fluoroscopy,computer-navigated surgery can reduce fluoroscopy time and improve screw insertion accuracy.

Objective To evaluate 3D printing used in the treatment of complex acetabular fractures.Methods Between January 2009 and December 2013,121 patients with complex acetabular fracture were treated at our department.3D printing was used in surgical planning in 53 of them,including 36 males and 17 females with an average age of 41.2 ± 10.4 years (3D group).The other 68 patients received conventional surgery without use of 3D printing,including 42 males and 26 females with an average age of 42.6 ± 8.9 years (conventional group).By the Judet-Letournel classification system,there were respectively 7 and 9 T-type fractures,4 and 6 posterior column with posterior wall fractures,21 and 28 transverse and posterior wall fractures,5 and 6 anterior with the second half transverse fractures,and 16 and 19 double column fractures.Surgical time,blood loss,transfusion,fluoroscopy times and complications were recorded in the 2 groups.At the final follow-ups,the clinical results were assessed by Merle D'Aubigné & Postel scoring and the radiographic results were assessed by Matta records.The 2 groups were similar in preoperative demographic data (P ＞ 0.05).Results In the 3D and conventional groups,respectively,surgical time was 3.5 ±O.9 hours versus 4.5 ± 1.1 hours,blood loss was 1,200.2 ±232.8 mL versus 1,550.4 ±211.6 mL,transfusion was 8.9 ± 3.8 U versus 12.3 ± 2.9 U,and fluoroscopy times were 8.7 ± 2.1 versus 11.9 ± 2.4.The differences between the 2 groups were statistically significant (P ＜ 0.05).The 3D and conventional groups were respectively followed up for 20.3 and 37.8 months on average.All the acetabular fractures healed.The time from surgery to full-weight-bearing walking averaged 3.5 months.Iatrogenic ischiadic nerve injury occurred in 5 and 7 cases and superficial infection in 3 and 5 cases in the 3D and conventional groups,respectively.No iatrogenic vascular injury,nonunion,or implant failure occurred in the 2 groups.By the Merle D' Aubigné & Postel records,the excellent and good rate was 64.2％ (34/53) in the 3D group versus 64.7％ (44/68) in the conventional group.By the Matta records,the excellent and good rate was 73.6％ (39/53) in the 3D group versus 75.0％ (51/68) in the conventional group.The differences were not statistically significant (P ＞ 0.05).Conclusion Since 3D printing can contribute to better preoperative plan,it helps to lead to more accurate operation,shorter surgical time,and enhanced perioperative safety.

BACKGROUND:Percutaneous hol ow screw under X-Ray fluoroscopy has been shown to treat fracture of acetabulum of the pelvis, but the time of internal fixation was long, and the amount of radiation exposure to the patients and physicians was large.
OBJECTIVE:To test the application of the ISO-C3D METHODS:Thirty-one patients with fracture of the acetabulum were treated with percutaneous hol ow screw under a fluoroscopy-based ISO-C computerized navigational system for fracture of acetabulum. 3D computerized navigational system. The interval from injury to operation was 4 to 13 days. Al patients were fol owed up for one year.
RESULTS AND CONCLUSION:The average bleeding volume during operation was only 18 mL, except that the bleeding volume of only one patient, who suffered from the sacroiliacjoint injury and received open reduction and internal fixation, was up to 300 mL. The total number of screws used in the operation was 42, among which 24 were screws for acetabular anterior column fracture and 18 for posterior column fracture. Al screws were implanted once precisely. The average time of internal fixation was 59 minutes, and the mean time for fluoroscopy was 39 seconds. The 31 patients were pain-free one week after the operation and no complication (infection, vascular nerve injury or implant breakage) was noted post-operatively. When the fol ow-up ended, radiography revealed fracture union with satisfactory screw fixation (no screw breakage or loosening). According to Matta functional scoring, results were excellent in 23 cases, good in 8 cases, with an excellent and good rate of 100%. According to Majeed functional scoring, the results were excellent in 22 cases, good in 6 cases and average in 3 cases, with an excellent and good rate of 90%. These results indicated that ISO-C3D computerized navigational system can supply stable internal fixation without an increase of complication.

Objective To introduce the application of computer aided technology in the treatment of pelvic malunion and observe the effect of this technique on the operation.Methods Data of 9 consecutive patients with pelvic malunion who were enrolled in our hospital from January 2009 to December 2012 were retrospectively observed.There were 4 patients who had undergone surgery with computer aided technology,including 3 men and 1 woman with an average age of 34 years (computer aided technology,CAT) group.According to the Tile classification,4 cases were all type C.There were 1 case with open pelvic fractures,2 associated with the craniocerebral injury,2 associated with the thoracic injury and 2 associated with the abdomen trauma.There were 5 patients who had undergone surgery without computer aided technology,including 3 men and 2 women with an average age of 32.6 years (conventional group).According to the Tile classification,4 cases were all type C.There were 1 case with open pelvic fractures,2 associated with the craniocerebral injury,3 associated with the thoracic injury and 1 associated with the abdomen trauma.The Majeed score,the visual analogue score (VAS),operation time,blood loss,blood transfusion,intraoperative fluoroscopy,degree of improvement in lower limb length,iatrogenic injury and the complication were all recorded respectively.Results For the CAT group,the operation time was 195-230 min,the blood loss was 800-1 6 00 ml,the blood transfusion was 6-16 U,intraoperative fluoroscopy was 6-11 times and the degree of improvement in lower limb length was 2-3 cm.The Majeed score in the final follow-up was 78-90 points,including 3 excellent cases and 1 good.The VAS after surgery was 0-4 points.For the conventional group,the operation time was 210-330 min,the blood loss was 600-4 500 ml,the blood transfusion was 6-28 U,intraoperative fluoroscopy was 7-18 times and the degree of improvement in lower limb length was 1-3 cm.The Majeed score in the final follow-up was 79-89 points,including 3 excellent cases and 2 good.The VAS after surgery was 1-4 points.Conclusion Surgeons can make full preoperative planning by the computer aided technology before the operation.This technology which reduces the operation time can make the operation more accurately,effectively and safely.

Objective: To observe the safety of the Song-Relaxing and Zhen-Vibrating abdomen manipulation in treating patients with prediabetes and its effects on blood glucose and lipid metabolism.Methods: One hundred and two patients with prediabetes were divided into a manipulation group and a control group according to the random number table method, with 51 cases in each group. All patients received the general behavioral intervention for prediabetes, with additional Song-Relaxing and Zhen-Vibrating abdomen manipulation in the manipulation group and oral metformin hydrochloride tablets in the control group. Both groups received the intervention for six months. Results: Fourteen patients dropped out during the treatment, and a total of 88 patients completed the trial, including 45 cases in the manipulation group and 43 cases in the control group. After the treatment, the prediabetes control rate was 93.3％ in the manipulation group and 74.4％ in the control group, and the difference between the two groups was statistically significant (P<0.05); no patient in the manipulation group progressed to diabetes, while the rate of conversion to diabetes in the control group was 6.9％, with a significant difference between the two groups (P<0.05). After the treatment, the body mass index (BMI), glycosylated hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), 2-hour postload plasma glucose (2hPG) level during an oral glucose tolerance test (OGTT), fasting insulin (FINS), homeostasis model assessment-2 of insulin resistance (HOMA2-IR), total cholesterol (TC), and triglycerides (TG) decreased in both groups versus baseline, with significant differences within the groups; the levels of all indicators were lower in the manipulation group than in the control group (P<0.05), and the differences between the two groups were more prominent at the sixth month (P<0.01). At the sixth month, the high-density lipoprotein cholesterol (HDL-C) in the manipulation group was increased, while there was no significant change in the control group. In the control group, three patients reported mild gastrointestinal reactions at the initial dosing, which improved after medication adjustment. No other adverse events were observed in either group. Conclusion: Both metformin hydrochloride tablets and the Song-Relaxing and Zhen-Vibrating abdomen manipulation can improve blood glucose and lipid metabolism and reduce insulin resistance and clinical discomfort in patients with prediabetes, but the Song-Relaxing and Zhen-Vibrating abdomen manipulation has higher efficacy and safety.

Guilu-Erxian Gum, a famous prescription of Traditional Chinese Medicine, which could warm the kidney and benefit essence, tonify qi and nourishing the blood. It's main function is to treat chronic kidney deficiency, sour waist and soft knees, lack of essence and blood, spermatorrhea and impotence. This prescription has been changed and expanded in the dosage, preparation and efficacy of Chinese medicine included in the classics. Pharmacological studies have shown that it can strengthen the bone, play the role of anti-tumor, relieve bone marrow suppression, improve sperm quality and relieve post-traumatic stress disorder. The modern clinical application of this priscriptionhas been greatly expanded. It can be used in the treatment of adverse reactions after chemotherapy, liver cirrhosis, hypoproteinemia, osteoporosis, osteoarthritis, AD and other diseases. It is often used in combination with other medicine or treatment methods, and could achieve good results.

Traditional Chinese medicine (TCM) health preservation shows unique advantages in the international communication and overseas development.It is characterized by its cultural complexity and medical science,along with the policy support from the "Belt and Road Initiative" of TCM,as well as the increasing attention both at home and abroad.However,many problems and obstacles which cannot be ignored still hinder the enrichment and development of TCM health preservation in the world.This paper focused on analyzing these problems and obstacles,and indicated that the basic principle of international communication of TCM health preservation is to build a relatively steady long-term purpose and several segmented adjusting periodic orientations.At the same time,according to the characteristics of different regions along the line,changing the modes and contents of propagation is also needed.

As an important new Chinese medicine international culture promotion platform,Overseas Chinese Medicine Center (OCMC) should seize the opportunity of the "Belt and Road" Initiatives to be the main force and national team of transmitting Chinese medicine overseas.Through the research and practice of OCMC expanding Chinese medicine territory,the author adopted "Chinese medicine + " mind in four directions (i.e.,breaking a passage by characteristic traditional Chinese medicine treatment,developing characteristic Chinese medicine education,enhancing Chinese medicine talent localization,seeking high-level international cooperation of scientific research,and etc.) to impel OCMC spreading Chinese medicine culture to the world.