Objective To observe the effects of Buyang Huanwu Decoction(BHD)on collateral circulation of patients with acute cerebral infarction(ACI)through transcranial Doppler sonography(TCD). Methods The randomized controlled trial methods were applied, and 80 ACI patients were randomly divided into treatment group and control group, 40 cases in each group. Two cases from each group were dropped out, and the left 38 cases of each group were included into the analysis. The control group was treated with the standardized western medicine regimen, and the treatment group was given BHD orally on the basis of treatment for the control group. The treatment for the two groups covered 7 days. On treatment day 3 and 7, TCD was adopted to investigate the blood flow velocity of the responsible vessels and the improvement of collateral circulation compensation. On treatment day 7, the scores of National Institute of Health Stroke Scale(NIHSS) in the two groups were compared. Results (1) On treatment day 3, collateral circulation improvement occurred in 12 patients(accounting for 31.58%)from the treatment group , and on treatment day 7 , the improved cases increased to 16(accounting for 42.11%). In the control group , 3 cases(7 . 89%) were improved on treatment day 3 , and 4(10 . 53%) improved on treatment day 7. The treatment group had better effect on improving collateral circulation than the control group, the difference being significant(P<0.01). (2) In the treatment group, 9 cases had increased blood flow velocity(Vm) of the responsible vessels on treatment day 3, and 11 cases had the increase on treatment day 7. In the control group, Vm increase occurred in one case both on treatment day 3 and 7. The treatment group had better effect on increasing Vm than the control group, the difference being significant(P<0.05). (3) On treatment day 7, NIHSS scores were decreased in both groups(P<0.05 or P<0.01), and the decrease of the treatment group was superior to that of the control group(P<0.01).(4) No adverse event was shown in the two g roups during the treatment. Conclusion BHD can constantly improve the blood flow velocity of the responsible vessel and promote collateral vessel building , which results into the recovery of the impaired neural function.

The objective of this article was to deliberate the relationship between trace elements and "Qi and blood" theory of traditional Chinese medicine by studying the similarities and differences in the contents of trace elements in SiJunzi decoction and Siwu decoction. Experiments indicate that there were some similarities and differences in the contents of trace elements in SiJunzi decoction and Siwu decoction, and it is very similar to "Qi and blood" theory of traditional Chinese medicine. When the Chinese herbs were decocted, the trace elements of Chinese herbs do not get into medicated solution uniformly. Different elements enter into the medicated solution in different periods of time and batches. It point out that the theory of methods of decocting Chinese herbs has a certain basis. These experiments remain existing some questions and doubts,it is worth to do some further related experiments and to be researched furthe.

Aiming for improving the understanding of enteral nutrition(EN)in active and remittent Crohn’s disease (CD),this paper reviewed the history of EN,clarified the mechanisms of nutritional treatment,with emphasis on the effectiveness and key points of EN in the treatment of active and remittent CD.

Objective To evaluate the feasibility of testing the high methylation of ppENK gene in stool with methylation-specific polymerase chain reaction (MSP) assay in pancreatic cancer diagnosis.Methods Twenty-four fresh stool samples of pancreatic cancer patients and six healthy control samples were collected.The methylation status of ppENK gene in all the stool samples was detected by MSP assay.The positive rate of wild-type ppENK gene in all the stool samples was determined by polymerase chain reaction (PCR).And 10 non wild-type ppENK gene negative pancreatic cancer samples were collected,and K-ras gene mutation was detected by PCR-restriction fragment length polymorphism (RFLP).The single cell suspension of pancreatic cancer PC3 cell line was added into stool sample from the same healthy individual,the positive rate of ppENK gene methylation was detected by MSP assay.The minimum number of pancreatic cancer cell was calculated when methylation was positive.Results The rate of methylation detection in 30 samples was 0 (0/30); and the rate of non-methylation detection was 10％ (3/30).The rate of wild-type ppENK detection was 6.7％ (2/30).By PCR-RFLP assay,eight were successfully amplified and seven had mutation in 12th code of K-ras gene in 10 selected wild-type ppENK gene negative pancreatic cancer samples.The minimum number of pancreatic cancer cells needed for ppENK methylation band positive detected by MSP was 50 cell/ml.Conclusion Detecting ppENK gene methylation status in stool samples of pancreatic cancer patients by MSP assay has not yet become the method of pancreatic cancer screening and diagnosis.

Objective To comprehend the clinical characteristics and treatment of primary hepatic amyloidosis.Methods A total of 10 cases of primary hepatic amyloidosis included. 4 cases from Peking Union Medical College Hospital and 6 cases from other hospitals.reported in the literature in recent 20 years were reviewed,Results (1)The frequent clinical symptoms related to primary hepatic amyloidosis presented as hepatomegaly(90%),abdominal distension(80%),shifting dullness(60%),anorexia(50%),fatigue(40%),edema(40%),weight loss(40%) and abdominal pain(30%).(2)Laboratory tests revealed elevated serum alkaline phosphatase which was (558.3?517.2)U/L,and other liver function involvement were rare:six patients(85.7%)had either a serum or urine monoclonal protein.(3)Liver biopsy is golden standard.The amyloid deposition was mainly located at sinusoida(4 casese,57.1%),and only 2 cases was at vascular(28.6%).Complication of bleeding after liver biopsy was reported(1 case).(4)The classical therapy scheme was melphalan and prednisone,four cases died from liver function failure and infection.Conclusion The clues to the diagnosis of primary hepatic amyloidosis include elevated monoclonal protein,hepatomegaly and an unexplained elevated serum alkaline phosphatase level which is not parallel with other liver functions.Live biopsy is golden standard.The treatment scheme include melphalan and prednisone,but its prognosis is poor.

Objective To develop a new multi-purpose face mask for oxygen provision in first aid,which can be used in both war time and peace time.Methods The structure,operating principle and application of a multi-purpose face mask,whose transparent silicone mask body has even the entrance of nested endoscopy and oxygen concentration regulating twist,are introduced in this paper.Results This mask can be used in painless endoscopy and emergent oxygen supply in tracheal intubatton.Conclusion The mask can greatly enhance the safety of painless endoscopy and it can also be used as mask for the use of general anesthesia.

Objective To identify the main clinical characteristics helpful for diagnosis and differential diagnosis of Crohn s disease (CD) from primary intestinal lymphoma (PIL). Methods Ninety cases of CD and 46 cases of PIL during 1983-2004 in Peking Union Medical College Hospital were investigated retrospectively. Results The average age of PIL was nearly 10 years elder than that of CD (45. 0?16. 2 vs. 36. 7?15. 7, P

Objective To probe the differences and similarities of clinical feature between alcoholic and biliary chronic pancreatitis (CP) and their therapy. Methods Retrospective analysis of the clinical features was made in 110 cases of CP in Peking Union Medical College Hospital from 1991 to 2000. Results ① In 110 cases of CP, the clinical manifestations were abdominal pain (85.4%), diarrhea (22.7%), calcification of pancreas (13.6%), and pseudocyst of pancreas (28.2%); 3 cases (2.7%) complicated with pancreatic carcinoma. ② The frequency of the different kind of clinical manifestations in alcoholic CP was higher than in biliary CP.③The frequency of diarrhea (29.1%),diabetes mellitus (41.9%) and calcification of pancreas (22.6%) in alcoholic CP was also higher than in those caused by bile duct system diseases (16.7%, 19.1% and 9.5%).④The response rate of medical treatment was 81.2%. Conclusions The clinical features and complications are more typical and occur earlier in alcoholic CP than those in biliary CP. With regard to management, medical treatment is less used than surgical therapy.

Objective To further understand factors that influence health-related quality of life (HRQOL) in patients with ulcerative colitis (UC),especially the role of perceived stress and coping modes in Chinese patients with UC.Methods This study was a cross-sectional study.Patients with UC were recruited from July 2013 to September 2014 in Peking Union Medical College Hospital.HRQOL was measured using the inflammatory bowel disease questionnaire (IBDQ).Perceived stress was measured by Perceived Stress Scale (PSS).Coping strategy was evaluated using Medical Coping Modes Questionnaire (MCMQ).Demographic data,course of the disease,clinical disease activity,and disease phenotype according to Montreal classification were also collected.Univariate analyses were conducted to determine which variables were associated with HRQOL,and those were statistically significant were entered into a multivariate regression model.Results We recruited 214 patients (response rate 92.2％),whose median age was 37.5 (29.0,49.3) years old and median course of UC was 4 (2,9) years.Through univariate analyses,better HRQOL was significantly associated with regular medical visits,lower number of previous relapses and hospitalizations,no steroid use,Montreal E1,lower Mayo scores,clinical remission,less perceived stress and less acceptance strategy use.However,multivariate analyses revealed that perceived stress (OR =1.112,95％ CI 1.058-1.169),acceptance (OR =0.310,95％ CI 0.141-0.685),number of hospitalizations (OR =2.924,95 ％ CI 1.328-6.437) and clinical activity (OR =5.058,95 ％ CI 2.312-11.066) were most strongly related to HRQOL.Conclusions HRQOL of UC patients are not only associated with clinical activity of the disease,but also associated with coping strategy and perceivedstress.Further research needs to focus on whether or not relieving stress and guiding patients to cope with ulcerative colitis would improve HRQOL.

Objective To evaluate the clinical value of the three-category classification of severe acute pancreatitis (SAP).Methods Clinical data of 337 traditional SAP patients,who were admitted to Peking Union Medical College Hospital (PUMCH)from January 2001 to December 2012,were retrospectively studied.These patients were classified into moderately severe acute pancreatitis (MSAP) and severe acute pancreatitis (SAP) according to the latest 2013 Atlanta Classification.SAP patients were further categorized as critical acute pancreatitis (CAP) and non-CAP.Disease severity,therapy and prognosis among three groups were compared.Results Among the total 337 traditional SAP patients,253 were classified as MSAP and 84 as SAP.In the group of SAP,40 patients were categorized as CAP and 44 as non-CAP.Compared with non-CAP patients,CAP patients had significantly higher mortality rate which was 70％ (28/40).Other results were all significantly higher in CAP group rather than non-CAP group,including ICU admission rate 77.5％(31/40),length of ICU stay (15.5 ± 20.6) days,Ranson,APACHE Ⅱ,BISAP,MCTSI,modified Marshall scores 4.6 ± 1.4,16.8 ± 5.8,3.0 ± 1.0,8.6 ± 1.7,and 7.4 ± 2.9,respectively (P ＜ 0.01 in each endpoint).These parameters of SAP group were also significantly higher than those of MSAP group (P ＜0.01).Conclusions Using the new three-category classification to distinguish traditional severe acute pancreatitis,namely MSAP,SAP,and CAP,can better reflect the severity of disease,predict outcome and guide clinical management.