Objective] To study the Xin'an doctor Sun Yikui Sun Wenyuan basis four diarrhea cases, in order to reveal Sun Yikui diarrhea syndrome differentiation syndromes characteristics. [Method] With Sun Wenyuan basis of diarrhea four proven cases as example, the combination of Neijing, Treatise on Febrile Disease, the Synopsis, Mingmen theory, Danxi academic ideas and related works and academic thoughts of Sun's, interpretation of Sun's diarrhea cases, comprehensive analysis of the syndrome differentiation syndromes characteristics. [Results] From the Sun Wenyuan basis diarrhea in four cases to know Sun Yikui grasp of vital theories and Danxi academic thoughts, clinical cure, the doer phlegmy wet, dyspepsia, the accountability of virtual are of pixu(deficient spleen), kidney deficiency, with particular emphasis on the pathological factors of kidney Yang deficiency, the author was good at using insurance and pills, Erchen Decoction, Benefit-stomach Shengyang Moisture-penetration soup, Liujunzi Decoction and revised prescriptions. [Conclusion] Sun Wenyuan basis contained diarrhea basis, Sun's clinically curing diarrhea with outstanding characteristics, the curative effect is distinct, we should combine classical and Sun's works to conduct the thorough research to the related basis, broaden the clinical cure drainage, help to improve the ability of clinical treating diarrhea.

Object] Yu Chang meaning the Lizhongtang grass in the medical records ,in order to reveal the Yu Chang on Lizhong decoction method inheritance. [Method] Yuyicao contained 4 cases of Lizhong Decoction for example ,combined with the Golden Chamber, Treatise on the related discussion and Yu Chang academic thought, this paper introduces the application of Lizhong decoction, a comprehensive analysis of its ideology. [Results] Found Lizhong decoction used in the medical records of its scope gradual y expanded, the basic rule for warming cold, spleen qi, syndrome and the evolution of the development to stop accumulation, ascending the clear and descending the turbid, clearing Yin and Yang, Wen Tong. The metaphor is spleen Yang, just the academic thoughts of being solid and soft. [Conclusion] Yu Chang clinical y used secondary decoction, playing outstanding characteristics, deeply researching on the related medical records, if they can combine the classic premise and Yu'sworks, it has a more profound understanding of traditional Chinese medicine diagnosis and treatment thought ,helping improve the ability of clinical diagnosis and treatment of disease.

Objective] From the analysis of Zhu Danxi's life with its clinical diagnosis treatment characteristics, in order to learn, inherit Zhu's academic thought essence and clinical characteristics of diagnosis and treatment. [Method] Danxi Xinfa, Gezhi Yu, golden hook on Xuan, pulse, because treatment contained case as the foundation, combined with his classic discussion and academic thoughts, this case's treatment after diagnosis and treatment, and a comprehensive analysis of its characteristics and the implication behind the academic thought. [Results] The clinical diagnosis and treatment analysis of Zhu has simple effect, using ginseng rhizome; diagnosis and treatment, good physique differentiation of Qi and blood deficiency, the similarities and differences;using four Jun Siwu;the main and col ateral channels disease, fine trial of yin and Yang and the characteristics. Zhu Danxi was good at Yin on treatment, and miscel aneous duties in the Qi, blood, phlegm, stagnation and other academic thoughts. [Conclusion] Zhu Danxi with concise and comprehensive, distinctive features, if deeply analyzing cases with Zhu life classic discussion and academic features, we can have a more profound understanding of the clinical diagnosis and treatment rules and characteristics, to pass its characteristics, enhance the ability of clinical diagnosis and treatment of disease.

Objective To summarize the experience of intraoperative neuromonitoring (IONM) system for monitoring and protection of recurrent laryngeal nerve (RLN) during thyroid surgery.Methods A total of 220 cases were enrolled in this study (53 males and 167 females),with the median age of 38.2 years old.There were 85 cases of thyroid cancer,19 cases of thyroid benign tumor,90 cases of thyroid goiter,3 cases of Hashimoto's diseases,and 23 cases of hyperthyroidism.113 cases had tumors larger than 5 cm in diameter.During the procedure,2 recording needle electrodes were put in cricothyroid muscle and 1 stimulator electrode was explored in tracheoasophageal groove.If any RLN was fight there or nearby,doctors can see the electromyogram and hear the toothonk.With careful dissection,RLN can be found out till exploring into the larynx site.Results Electromyogram showed in 207 cases (278 nerves),and it didn't show in 13 cases,among whom 9 cases were false-negative because of system or annesthesia problems,4 cases didn't manage to have needle electrodes put in properly due to cricothyroid muscle being invaded.No permanent RLN paralysis occoured.Transient nerve paralysis occurred in 2 cases,who recovered in 1 month after operation.Conclusion IONM system is an effective way to avoid damage to RLN in thyroidectomy.

Objective To explore the feasibility and efficiency of minimally invasive video-assisted thy-roidectomy on thyroid microcarcinoma, and sum up the experiences. Methods 9 patients with thyroid microcarci-noma who underwent the minimally invasive video-assisted thyroidectomy from Jan 2006 to Feb 2009, were retro-spectively studied. Results All of the patients, except 1 case converting to open thyroidectomy, underwent the minimally invasive video-assisted thyroidectomy successfully. The subcutaneous hydrops occurred in 1 patient. The skin burns around the incisions occurred in 1 patient. There were no complications of recurrent laryngeal nerve injuries, neck hematoma, hypocalcemia, or superior laryngeal nerve injuries. The follow-up period of 15 cases were from 3 months to 37 months. There were no evidences of recurrence and metastasis by both postopera-five ultrasonic/CT examination and radioiodine scintigraphy. Conclusions The minimally invasive video-assisted thyroidectomy is safe and feasible (similar to the traditional thyroidectomy), of gratifying cosmetic results, for low-risk differentiated thyroid microcarcinoma without lymph node metastasis. For the median-risk or high-risk, more patients, comparative studies and long follow-ups are necessary to draw definitive conclusions in terms of its recurrence and survival rate.

ObjectiveTo evaluate the safety and effectiveness of fast track surgery (FTS) in l aparoscopy-assisted radical distal gastrectomy (LADG) for gastric cancer.MethodsSixty-one patientswith distal gastric cancer were randomly divided into three groups:FTS + LADG group (n =19) undergoing LADG and FTS treatments,LADG group (n =22) undergoing LADG and traditional perioperative cares,and FTS + ODG ( open distal gastrectomy) group ( n =21 ) undergoing ODG and FTS treatments.FTS treatments included avoidance of mechanical bowel cleansing,restrictive perioperative intravenous infusion,early ambulation,early enteral nutrition.The age,sex,body weight,anastomotic mode,number of lymph node dissected,and tumor stage,serum albumin (ALB),blood urea nitrogen (BUN),C-reaction protein (CRP),flatus time,postoperative hospital stay,medical cost,and postoperative complications were compared between three groups. ResultsThe level of ALB in FTS + LADG group were higher than in LADG group at the 4th and 7th day after surgery ( P ＜ 0.05,P ＜ 0.01 ).Compared to LADG group,the variation of ALB from preoperation to 4th day after surgery in FTS + LADG group and FTS + ODG group was significant( P ＜ 0.01,P ＜ 0.05 ).CRP level between FTS + LADG group and FTS + ODG group were different significantly at 4th and 7th day after surgery ( P ＜ 0.05,P ＜ 0.05).FTS + LADG group has earlier recovery of gastrointestinal peristalsis than other two groups ( P ＜ 0.05,P ＜ 0.05 ).The medical cost in FTS + LADG group was less than in LADG group ( P =0.003 ),but higher than in FTS + ODG group (P ＜0.01 ).ConclusionsThe practice of FTS in LADG was safe,effective,improves nutritional status,eases stress reaction,accelerates gastrointestinal peristalsis and postoperative rehabilitation.

Objective To explore the efficiency of transcervical video-assisted mini-incision thyroidectomy for thyroid tumor. Methods 53 patients with thyroid tumors who underwent the video-assisted mini-incision thyroidectomy from Jan. 2006 to Dec. 2009 in the Department of Thyroid Surgery, Yantai Yuhuangding Hospital,were retrospectively studied. Results All of the patients, except 5 cases converting to open thyroidectomy, underwent the video-assisted mini-incision thyroidectomy successfully. The temporary recurrent laryngeal nerve injury occurred in 1 patients. The subcutaneous fluid accumulation occurred in 3 patients. The skin burns around the incisions occurred in 3 patients. There was no complication of hematoma, hypocalcemia, or superior laryngeal nerve injuries. The follow-up period was from 3 months to 35 months. There was no evidence of recurrence and metastasis by postoperative ultrasonic and CT scan and radioiodine scintigraphy. Conclusions The video-assisted mini-incision thyroidectomy is feasible, safe, and with the advantage of cosmetic results. For thyroid tumor,especially thyroid cancer, longer follow-up is necessary to draw definitive conclusion on recurrence and survival rate.

This study was aimed to explore traditional Chinese medicine (TCM) compatibility patterns or rules in the treatment of ankylosing spondylitis (AS) in the real world clinical situations.The effect of TCM treatment and immune inflammatory biomarkers were analyzed by association rules,which provided evidences for AS syndrome differentiation and treatment.Retrospective study was conducted on records of hospitalized AS patients at the Department of Rheumatism,the First Affiliated Hospital of Anhui University of Chinese Medicine from June 2012 to June 2016.The technology for complex networks was integrated to analyze the core prescription.The frequency and association rules of prescription patterns were analyzed using the SPSS 21.0 and SPSS modeler 14.2.The effect on immune inflammatory biomarkers was analyzed by association rules and random walk model.The results showed that,(1) warm,cold,and neutral herbs,sweet,bitter or pungent herbs,and with the channel tropism of spleen channel,stomach channel and liver channel are the most frequently prescribed herbs;(2) herbs with functions of tonifying and replenishing,blood-activating and stasis-resolving,qi-regulating,spleen-strengthening and dampness-resolving,wind-dampness dispelling,heatclearing are frequently prescribed,which are also interrelated and interacted on each other;(3) the top five pairs of couplet herbs with the highest confidence included Hong Hua paired with Tao Ren (98.15％),Yi Yi Ren paired with Fu Ling (95.47％),Gan Cao paired Gou Ji (94.57％),Gan Cao paired with Wei Ling Xian (94.48％),Pu Gong Ying paired Bai Hua She She Cao (94.40％);(4) Shan Yao was highly related to decreased C3,C4 and hs-CRP when compatibility with Fu Ling,Niu Xi,Ze Xie;Gou Ji was highly related to decreased IgA,IgG and IgM when compatibility with Bai Hua She She Cao,Chuan Xiong,Shah Yao.Xi Qian Cao was associated with Niu Xi when ESR and WBC decreased.Gou Ji and Du Huo were associated when SOD increased.(5) The group of internal medicine coordinated with external medicine has positive growth rate of walk and improvement index of inflammatory indexes (ESR,hs-CRP) compared to single internal medicine group.It was concluded that AS treatment in the Department of Rheumatism of our hospital was based on spleen.The treatment was focused on the regulation of cold and warm,sweet and bitter,liver and spleen.The treatment of AS is to eliminate evil factors and to reinforce healthy qi.TCM has advantages in the improvement of immune inflammatory indexes.The improvement of inflammatory indexes by the internal medicine coordinated with external medicine was better than the single use of internal medicine,which is worthy of further promotion.

Traditional Chinese medicine (TCM) is widely used in gouty arthritis treatment.Based on the real world,this article studied the implicit TCM prescription pattern in order to explore TCM prescription rule in acute gouty arthritis treatment.Based on herbs recorded in the Pharmacopoeia of the People's Republic of China,TCM prescriptions of 732 hospitalized acute gouty arthritis patients at the Department of Rheumatism and Immunology,the First Affiliated Hospital of Anhui University of Chinese Medicine from June 2012 to October 2016 were collected with software system.The frequency and association rules of prescription patterns were analyzed using the SPSS Modeler 14.2 Data Mining System.Cluster analysis was conducted using SPSS 22.0 statistical software.An initial statistical analysis was carried out to categorize herbs according to their medicinal types and dosage,natures,flavors,channel tropism and functions.Based on categorization,frequencies of occurrence were computed.The results showed that,(1) warm,cold or neutral herbs,sweet or bitter herbs,and with the channel tropism of spleen channel and stomach channel are the most frequently prescribed herbs (among 732 selected medicinal formulae);(2) spleen-strengthening and dampness-eliminating,wind-dispelling and damp-removing,blood-activating and stasis-resolving,heat-clearing,deficiency-tonifying,qi-regulating herbs are frequently used;(3) correlation analysis of TCM efficacy show that three couplet medicines with the highest confidence was spleen-strengthening and dampness-eliminating herbs and heat-clearing herbs (99.24％),blood-activating and stasis-resolving herbs and wind-dispelling and damp-removing herbs (99.01％),spleen-strengthening and dampnesseliminating herbs and qi-regulating herbs (98.92％).Correlation analysis of two TCM herbs showed that three couplet medicines with the highest confidence was Hong Hua paired with Tao Ren (99.7％),Yi Yi Ren paired with Shan Ci Gu (93.04％),and Yi Yi Ren paired with Chui Pen Cao (92.67％);(4) cluster analysis classified into five types,which were based on spleen-strengthening and dampness-eliminating and in combination with blood-activating and stasis-resolving herbs,heat-clearing and detoxification,wind-dispelling and damp-removing,representing prescription compatibility characteristics.It was concluded that gouty arthritis had a close relationship with the spleen.These prescriptions focus on herbs with spleen-strengthening and dampness-resolving which seems to be the key element in the treatment process.Meanwhile,the use of spleen-strengthening and dampness-eliminating herbs,blood-activating and stasis-resolving herbs,heat-clearing herbs,wind-dispelling and damp-removing herbs is the basis of prescription patterns.

Traditional Chinese medicine (TCM) is widely used as a complementary approach for osteoarthritis treatment.This article is based on the real world.The implicit prescription patterns behind TCM formulae were examined by association rules mining and cluster analysis,so as to explore the Chinese medicinal compatibility patterns or rules in osteoarthritis treatment.This study was based on real-world data from the hospital information system (HIS).Chinese medicinal prescriptions of hospitalized patients with osteoarthritis from June 2012 to June 2016 were collected from the Department of Rheumatism and Immunology,the First Affiliated Hospital of Anhui University of Chinese Medicine.TCM was listed according to the selected medicinal formulae and the added information was organized to establish a database.The frequency and association rules of prescription patterns were analyzed using the SPSS Modeler 14.2 Data Mining System.Cluster analysis of prescription patterns was also analyzed.An initial statistical analysis was carried out to categorize herbs according to their natures,flavors,channel tropisms and functions.Based on categorization,frequencies of occurrence were computed.At the same time,the relationship between TCM and immune and inflammatory markers was analyzed.The results showed that the main prescriptive features from the selected formulae of the mining data were that,(1) warm or cold herbs,sweet or bitter herbs,and with the channel tropism of spleen channel are the most frequently prescribed herbs in 3609 medicinal formulae;(2) herbs with blood-activating and stasis-resolving,restoring vital energy,water-eliminating and damp-removing,heat-clearing and or expelling wind-damp functions are frequently prescribed;(3) association rule analysis extracted three frequently used pairs of herbs,which are Hong Hua & Tao Ren (98.90％),Pu Gong Ying & Bai Hua She She Cao (97.88％),Fu Ling & Ze Xie (92.63％);(4) association rule between TCM and immune-inflammation index showed that the pair of Du Huo and Chen Pi was associated with increased superoxide dismutase (SOD) enzyme.The pair of Mai Ya and Dan Shen was associated with decreased high-sensitivity C-reactive protein (hs-CRP),erythrocyte sedimentation rate (ESR),complement component 3 (C3),complement component 4 (C4),immunoglobulin A (IgA) and immunoglobulin G (IgG).The pair of Mai Ya and Fu Ling was associated with decreased immunoglobulin M (IgM).It was concluded that osteoarthritis was closely related to spleen deficiency.These prescriptions focus on herbs for qi-nourishing and spleen-invigorating,blood-activating and stasis-resolving,spleen-invigorating and dampness-eliminating,heat-clearing and detoxicating which seems to be the key element in the treatment process.Meanwhile,the use of restoring vital energy herbs and spleen-strengthening herbs also forms the basis of prescription patterns.