OBJECTIVE:To establish the quality standard of Liuwei dihuang tablets.METHODS:The ingredients such as Radix Rehmanniae Praeparata and Alisma orientalis were identified by TLC,and the content of loganin in Cornus officinalis and the content of paeonol in Paeonia suffruticosa were determined by HPLC.RESULTS:The TLC spots of Radix Rehmanniae Praeparata and Alisma orientalis were distinctive and well-seperated.The linear ranges of loganin and paeonol were 5.77～115.40 ?g?mL-1(r=0.999 9)and 5.12～102.50 ?g?mL-1(r=0.999 8),respectively,and their average recovery rates were 98.4%(RSD=0.75%)and 97.08%(RSD=1.07%),respectively(n=6 each).CONCLUSION:The estab-lished standard is applicable for the quality control of Liuwei dihuang tablets.

[Objective] To explore the surgery protocol of the serious dislocation of acromio-clavieular joint,and compare the outcome of ORIF with AO/ASIF clavicle hook plate only to ORIF with eoraco-clavieular ligament reconstruction.[Method]Fity-two cases of the dislocation of acromio-clavicular joint were reviewed,Group A was ORIF only including 29 cases(male 20,female 9,mean age 45),according to the system of Rockwood,as TypeⅢ in 12 patients,TypeⅣ in 15 patients and TypeⅤ in 2 patients,the other 23 cases ORIF with eoraeo-clavieular l ligament reconstruction was Group B(male 15,female 8,mean age 50.6),according to the system of Rockwood,as TypeⅢ in 9 patients,TypeⅣ in 13 patients and TypeⅤ in 1 patients,AO/ASIF claviadar hook plates were used for all of the ORIF,and modified Weaver's method was used to reconstruct eoraco-clavieular ligament.Outcome was evaluated by Lazzcano scale after 8~12 months,and data was analyzed by SPSS 10.0.[Result]Good outcome was achieved in all of the patients,there was no significanty statistical difference between the two groups.[Conclusion]Clavicle hook plate is a kind of perfect internal fixation.Reconstruction of eoraco-clavleular ligament is not necessary if the AO/ASIF plate is used,unless serious avulsion of deltoid and trapezius muscle involved.

Objective To investigate the role of vascular endothelial growth factor-C (VEGF-C) and its receptors in the formation of lymphatic vessels and lymphatic metastasis in gastric cancer. Methods By the domestic and overseas literatures review,the expressions of VEGF-C and its receptors in gastric cancer,their role in tumor lymphatic metastasis and prospect in treatment of gastric cancer were summarized. Results There was a significant correlation between VEGF-C and its receptors and the formation of lymphatic vessels and lymphatic metastasis in gastric cancer. VEGF-C high expression might be an early event in lymphatic metastasis and could be considered as an independent predictive factor of lymphaticmicrometastasis. By inhibition of gastric cancer cell from secrete VEGF-C or blockage of the interaction of VEGF-C with VEGFR-3,it was possible to inhibit tumor angiogenesis and the invasion and distant spread of cancer cells,thereby decreased mortality and improve survival. Conclusion VEGF-C and its receptors may promote the formation of lymphatic vessels and lymphatic metastasis in gastric cancer. It may be an effective way to gastric cancer for the treatments against VEGF-C and its receptors.

Building a new concept of combat forces is an important initiative in the 12th Five-Year Plan of National Defense Strategies.In the era of biotechnology,global powers have been competing for brain control by means of accelerated development in brain science and the military theory of Innovation to Subdue.Based on elaboration on the concepts and developments of military applications of brain science as well as on analysis of impacts on the mechanism of winning,this paper proposes the operation concepts of pre-settingand bio-orientation,the combat modes of mechanized warfareand idiodynamic warfare,and weapon evolution into intellectualizationand brain-control orientation.This paper presents a practical system design of military applications of brain science:presetting—key technology—weapons′power source-mechanism of winning.The constitution and winning mechanism of the three-stage mode of battle effectiveness are summarized as improving the operation capability—war of super soldiers,changing the main force of operations—war of mechanized legions,altering the principles of operations—war of spiritual consciousness. This paper also suggests the upgradation from damage theoryto control theory,the shift from informatizationtointellectualization,and strategic breakthroughs from independent developmentto collaborative innovation.

Objective To study the resistances of CDl33 + subset purified from gastric cancer cell line to chemotherapy drugs and the mechanism of this resistance regarding to the mRNA expressions of both Bcl-2 and BAX in relation to the relative apoptotic genes.Methods CD133 + subset and CD133-subset were purified from KATOⅢ cell linc by magnetic activated cell sorting.The proliferating ability of these two subsets resistantnt to 5-FU,Cisplatin(DDP,PDD) and Etoposide was checked and compared by CCK-8 test.The apoptotic changes of these two subsets regarding to the expression of mRNA of both Bcl-2 and BAX were also analized by RT-PCR.Results In CD133 + subset,the contant percentage of CD133 + expression rate was 90％ via analysis of flow cytometye.Twelve hours after treatment of5-FU,DDP and VP-16,the cells in both CD133 + subgroup and CD133-subgroup would gradually start to change in apoptotic morphology.The growth inhibiting rate by CCK-8 measurement for 5-FU,DDP and VP-16 groups in CD133 + subgroup was significantly lower than that in CD133-subgroup.The data under different treatment respectively was,5-FU:(30.56 ± 1.99) ％-(88.60 ± 1.95) ％ vs (32.81 ± 2.67) ％-(95.73±2.12)％,P=0.045,cisplatin:(45.89 ±3.64)％-(81.20 ± 1.18)％ vs (50.21 ±3.22)％-(90.46±1.89)％,P=0.043,VP-16:(37.21 ±3.80)％-(78.49 ±3.22)％ vs (35.55 ±3.23)％-(89.32 ±-3.54) ％,P =0.048).After treatment of these three kind of anti-tumour drugs,the expression level of Bcl-2 mR-NA decreased significantly and the expression level of BAX mRNA increased significantly in both CD133 + subgroup and CD133-subgroup.However,these changing ranges of Bcl-2 mRNA and BAX mRNA were more obvious in CD133 + subgroup in comparison with those in CD133-subgroup.Conclusions In some degree,resistent potentiality of CD133 + cells to 5-FU,DDP and VP-16 has been identified,which may probably be due to the up-regulation of the expression of BAX and down-regulation of the expression of Bcl-2.

Objective To investigate the clinical effect of fissure for ligamentum teres hepatic (LTH) approach in hepatectomy.Methods The method of cross-sectional study was adopted.The clinical data of the 85 patients undergoing hepatectomy through fissure for LTH approach who were admitted to the West China Hospital of Sichuan University from February 2009 to December 2013 were collected.Among all the 85 cases, there were 61 of hepatocellular carcinoma, 12 of intrahepatic bile duct stones, 6 of bile duct cellular carcinoma and 6 of metastatic hepatic carcinoma.The operations involved dissecting fissure for LTH, dealing with portal vein, hepatic artery and bile duct inside the fissure, lowering the hepatic portal, mutilating hepatic parenchyma, and undergoing the hepatic left lateral lobectomy, left hemihepatectomy, mesohepatectomy, hepatic left and/or right trisegmentectomy.Operation method, operation time, volume of intraoperative blood loss, intraoperative blood transfusion, postoperative drainage-tube removal time and complications were recorded.The follow-up including recurrence and metastasis of tumor and survival of patients was conducted by outpatient examination and telephone interview up to August 2015.Measurement data with normal distribution were presented as (x) ± s.Measurement data with skewed distribution were presented as M (range).The survival rate was caculated by Kaplan-Meier method.Results The 85 cases of hepatectomy were successfully completed through fissure for LTH approach, including 19 cases of hepatic left lateral lobectomy (9 with hepatocellular carcinoma, 6 with intrahepatic bile duct stones, 1 with bile duct cellular carcinoma, 3 with metastatic hepatic carcinoma), 20 cases of left hemihepatectomy (8 with hepatocellular carcinoma, 5 with intrahepatic bile duet stones, 4 with bile duct cellular carcinoma, 3 with metastatic hepatic carcinoma), 5 cases of left hemihepatectomy + caudate lobectomy (3 with hepatocellular carcinoma, 1 with intrahepatic bile duct stones, 1 with bile duct cellular carcinoma), 14 cases of meso-hepatectomy (14 with hepatocellular carcinoma) and 27 cases of hepatic left and/or right trisegmentectomy due to hepatocellular carcinoma (15 of hepatic left trisegmentectomy and 12 of hepatic right trisegmentectomy).No perioperative death occurred.The median operation time was 280 minutes (range, 95-430 minutes).The median volume of intraoperative blood loss was 450 mL (range, 200-3 200 mL).There were 18 cases of intraoperative blood infusion.The postoperative peritoneal drainage-tube removal time was 3 days (range, 2-5 days).Eleven patients with postoperative complications recovered after symptomatic conservative treatment, including 6 with lung infection, 4 with peritoneal effusion and 1 with abdominal infection.There was no case of intra-abdominal bleeding, bile leakage or hepatic failure.No patient died within 1 month after operation.Seventy-nine patients were followed up for a median time of 38 months (range, 18-53 months) with a follow-up rate of 92.9％ (79/85).The 1-year overall survival rate and l-year disease-free survival rate were 79.0％ and 65.0％, and the 3-year overall survival rate and 3-year disease-free survival rate were 56.0％ and 34.0％, respectively.Conclusion Hepatectomy through fissure for LTH approach is safe, effective and easily operable, with a good short-term outcome.

BACKGROUND: To establish experimental animal model for rapid evaluation of combined wound with seawater immersion so as to benefit wound healing and recovery.OBJECTIVE: To explore the plan of simple evaluation of combined wound with seawater immersion.DESIGN: Group division and controlled experiment was designed.SETTING: Second Department of Orthopaedics, the 113 Hospital of Chinese PLA; Research Institute of Surgery, Daping Hospital, Third Military Medical University of Chinese PLA MATERIALS: Totally 32 health hybridized adult dogs were employed,mass weighted varied from 12 to 15 kg, of either sex.METHODS: The experiment was performed partially in the specific sea area of the Fifth and Sixth Room , Research Institute of Surgery of Daping Hospital of the Third Military Medical University of Chinese PLA from October 2001 to June 2002. The dogs were randomized into burn-blast combined wound group and projectile-burn combined wound group and each group was subdivided into immersion group (10 dogs) and the control (6 dogs). Burn-blast combined wound group: The model of burn and mild blast injury was prepared. In the control, the dogs were put in a room at 25 ℃ directly after injury; But in immersion group, the dogs were immersed immediately in simulated seawater with holder. Projectile-burn combined wound group: The model of burn and mild projectile injury was prepared. The managements were same as the previous after injury in the control and immersion group. The change of physiologic indexes was observed in 28 hours after injury. The indexes related to death were picked up for correlative analysis and establishing wound scoring scale, inducing body temperature, heart rate, mean arterial pressure (MAP), chloride concentration, PaO2 and causative factor, 0-5 score were designed, the higher the score was, the higher mortality would be.MAIN OUTCOME MEASURES: ① Analysis of dead cases in each group. ② Wound scoring. ③ Verification of wound in scoring scale.RESULTS: 32 dogs all entered result analysis. ① Analysis of dead cases and relationship: Totally, 12 dogs were died. The peak of death was in 10-12hours, no matter the immersion happened or not. 5 indexes were associated significantly with death, named body temperature, heart rate, MAP, PaO2 and chloride concentration (P ＜ 0.05). ② Comparison of wound scoring, predictive mortality and actual mortality in each group: The results in burn-blast control were (5.89±3.25) score, 0 and 17% successively. Those in projectileburn control were (6.78±2.02), 25% and 33% successively. Those in burn blast immersion group were (9.50±4.20) scores, 50% and 30% and those in projectile-burn immersion group were (11.13±3.57) scores, 50% and 60%.CONCLUSION: ① The established scoring scale is apt to obtain common physiological indexes so as to evaluate the wound rapidly, which is applica ble for either seawater immersed cases or non-immersed cases, indicating extensively applications. ② The correction of evaluation is acceptable with verification. ③ The scale is based on animal experimental data, for which,it is still different from the one of real wound evaluation.

Objective To systematically evaluate the efficacy of acupotomy treatment for the stenosing tenovaginitis of flexor digitorum.Methods Articles about RCTs of acupotomy treatment and local blocking for the treatment of stenosing tenovaginitis of flexor digitorum were retrieved from CBM, CNKI, VIP, Wanfang database, PubMed, Embase, and Cochrane library. And then according to the requirement of Cochrane Handbook for Systemetic Reviews 5.1.0, two reviewers independently chose tests, extracted data, had a cross check, accessed methodological qualities and finally used RevMan 5.3 software for Meta analysis. The total effective rate, cure rate and improvement rate of acupotomy treatment and local blocking in treating stenosing tenovaginitis of flexor digitorum were assessed by using odds ratio (OR).Results Totally 10 articles involving 1426 cases were included. The cure rate in acupotomy treatment group was higher than that of local blocking group [OR=13.11 (95% CI: 8.23–20.89),Z=10.83 (P<0.000 01)], funnel plot Begg’s testP=0.858, Egger’s testP=0.579; the improvement rate of local blocking rate was higher than that of acupotomy treatment group [OR=0.14 (95% CI: 0.10–0.19),Z=11.60 (P<0.000 01)], funnel plot Begg’s test P=1.000, Egger’s testP=0.926; the total effective rate of acupotomy treatment group was higher than that of local blocking group [OR=18.26 (95% CI: 9.95–33.50),Z=9.38 (P<0.000 01)], funnel plot Begg’s testP=0.592, Egger’s testP=0.936.Conclusion Acupotomy treatment for stenosing tenovaginitis of flexor digitorum is superior to local blocking injection. However, the quality of the RCTs is low, so more large-sample, multi-center, and high-quality clinical RCTs are required for further verification.

Objective:To assess the efficacy and safety of acupuncture compound anesthesia(ACA)for traditional thyroidectomy. Methods:Randomized controlled trials(RCTs)studying the use of ACA for traditional thyroidectomy were retrieved from PubMed,Excerpta Medica Database(EMBASE),Cochrane Library,Web of Science,China National Knowledge Infrastructure(CNKI),Chongqing VIP Database(CQVIP),Wanfang Academic Journal Full-text Database(Wanfang),and China Biology Medicine Disc(CBM)from inception to September 30,2021.Two investigators independently extracted data and assessed the risk of bias and quality of the studies.Anesthesia effectiveness was the primary outcome,while the secondary outcomes included various pain scales,vital signs,analgesic consumption,and adverse events.Review Manager 5.3 was used for meta-analysis.Weighted mean difference(WMD),standardized mean difference(SMD),and confidence interval(CI)were used for statistical descriptions. Results:A total of 16 papers were included,involving 1228 patients.Meta-analysis showed that anesthesia effectiveness was significantly improved after adding acupuncture as an adjunct[SMD=0.62,95%CI(0.40,0.83),P<0.0001,I2=36%].Besides,ACA can also moderate vital signs and reduce the feeling of pain[SMD=-1.61,95%CI(-2.61,-0.61),P<0.00001,I2=95%],analgesic consumption,and adverse events.Subgroup analysis of the electroacupuncture(EA)group further revealed that the effectiveness of low-frequency EA[WMD=0.43,95%CI(0.30,0.55),P<0.00001,I2=15%]and the entire operative stimulation of EA[WMD=0.55,95%CI(0.33,0.77),P<0.00001,I2=0%]was significantly better than high-frequency EA and short-time stimulation of EA during the operation.Further,no significant difference existed between conventional analgesia and acupuncture analgesia. Conclusion:ACA is beneficial to traditional thyroidectomy regarding efficacy and safety when acupuncture is applied as an adjunct.However,additional high-quality studies with larger sample sizes are needed to verify the findings.

Presented in the paper are the necessity,general ideas and principles of building a teaching center for virtual simulation experiment on disaster medicine,covering the teaching modules, capability objectives and education resources deployment among other basics of such a center.The authors propose to build a comprehensive platform for teaching by experimentation,integrating basic clinical skills training to trainings targeted to disaster rescue in view of actual needs in experiments and teaching.This way resources can be shared between the experiment center website and virtual simulation teaching software,promoting a regular,standardized and scientific development of disaster medicine in China.