This article put forward the ‘heart-kidney centric theory’ on basis of analyzing the physiologic function, pathomechanism, onset rules and measures of prevention and treatment of cardio-cerebrovascular disease and degenerative disease induced by kidney deficiency. According the new theory, a new TCM drug, the Tongmai Qiangshen Wine, was developed.In human body, kidney produces essential qi and produces energy source for human body; heart transports the essential qi and is the physiologic mechanism of transport of energy source. Deficiency of essential qi will result in stasis of blood vessel, on the other hand, stasis of blood vessel can cause defi ciency of essential qi. The opposition, mutual rooting, waxing and waning, mutual convertibility of them reflect the development rules of cardio-cerebrovascular disease and degenerative disease induced by kidney deficiency, and determin the vital process of birth, growth, adult, aging and death. The construction of heart-kidney centric theory and the development and application of Tongmai Qiangshen Wine not only provide new theory and model for prevention and treatment of cardio-cerebrovascular disease and degenerative disease induced by kidney deficiency, but also provide new thoughts for preparation of new TCM drugs from aspects of how to maintain the feature of TCM, how to inherit and create on basis of combing holism with disease, principle, method, medicines.

Objective To observe the anisotropy of myocardial fiber orientation and conduction cells in canine pulmonary vein , and to investigate the expression of funny current (If ) channel subunit HCN1 ,HCN2 ,HCN4 mRNA in cadiocytes of pulmonary veins and left atrial in acute atrial fibrillation (AF) modle of caine .Methods Fourteen adult mongrel canines were randomly divided into atrial fibrillation group(n=7) and control group(n=7) .A model of acute AF has been developed in rapid atrial pacing (RAP) . The cardiocytes in control group were detect using hematoxylin hematoxylin and eosin (HE) and Periodic acid-Schiff(PAS) stain in the pulmonary vein .The mRNA expressions of HCN1 ,HCN2 ,HCN4 in two group were quantified by semiquantitative reverse transcription transcription-polymerase chain reaction(RT-PCR) .Results There were complex myocardial fiber orientation in pul-monary veins especially in PV-LA junction .PAS-positive cells could be seen in the endomembrane of pulmonary veins muscle sleeve .There were mRNA expression of HCN2 and HCN4 in pulmonary veins and left arial in two group ,but there was no mRNA expression of HCN1 .The mRNA levels of HCN4 from high to low were:pulmonary veins of atrial fibrillation group ,left atrial of atrial fibrillation group ,pulmonary veins of control group ,left atrial of control group(P<0 .05) .HCN2 mRNA levels from high to low were:pulmonary veins of atrial fibrillation group ,left atrial of atrial fibrillation group ,control group(P<0 .05) .There were no difference in the HCN2 mRNA level in pulmonary veins and left atrial in control group (P>0 .05) .Conclusion There are anisotro-py ,conduction cells in pulmonary veins .Up-regulation of pulmonary veins and left atrial HCN 2 ,HCN4 mRNA in atrial fibrillation caine ,may be correlated with the atrial fibrillation and maintenance .

Objective To obtain the acceptable range for posed smile characteristic index,in order to supply diagnostic and therapeutic basis for orthodontic treatment.Methods The 200 subjects included in the study consisted of 100 experienced orthodontists and 100 laypersons.Both two frontal posed smile photographs of man and woman were changed by several smile characteristic indexes,including the amount of incisor exposure,amount of gingival display,smile arc,buccal corridor fill,horizontal inclination of maxillary occlusal plate and distance from lower lip to maxillary incisor.All the subjects were desired to evaluate each images according to their own aesthetic standard.Results Each acceptable range for the amount of incisor exposure,amount of gingival display,smile arc,buccal corridor fill,horizontal inclination of maxillary occlusal plate and distance from lower lip to maxillary incisor,was 75 ％-100 ％ (male and female),0-2 mm (male) and 0-3 mm (female) ; 50 ％-100 ％(male and female) ; 0 ％-15 ％ (male) and 0 ％-20 ％ (female) ; 0-6° (male and female) ; 0 mm (male and female)(P＜0.05),respectively.And there was perception difference between the orthodontists and the laypersons on smile evaluation (P＜0.05).Conclusions Posed smile analysis should be an im portant aspect of orthodontic diagnosis and treatment planning.Orthodontists should not disturb con sonant smiles but create them with proper bracket positioning.

Objective To determine the methods and effects of common bile duct(CBD) exploration and primary suture by laparoscopic procedure after laparoscopic cholecystectomy (LC) . Methods After LC, 35 patients' CBD were explored.After hte CBD stone was removed by choledochofiberscopy completely and CBD stenosis was excluded, the CBD was sutured primarily. Results 32 cases of CBD gallstone were removed ,and 3 exploration were negative.All the 35 CBD were sutured primarily . Two patients occurred bile leakage 1～3 day after the operation ,which were cured by conservative therapy.29 patients were followed-up for 3～24 months,no residual stone or bile duct stricture was found. Conclusions Primary suture CBD is safe and effective in laparoscopic CBD exploration,if the patient selected correctly.

ObjectiveTo evaluate the clinical efficacy and safety of nylon ligation combined with endoscopic high-frequency electric snare for the treatment of colorectal polyps.MethodsThe clinical data of 345 patients with colorectal polyps who received the treatment of nylon ligation combined with endoscopic high-frequency electric snare at the Zhongshan Hospital of Fudan University from January 2006 to January 2011 were retrospectively analyzed.Complications including bleeding and perforation were observed.Postoperative wound healing and local residual recurrence were assessed during follow-up.ResultsA total of 362 colorectal polyps were successfully removed.The mean diameter of the colorectal polyps was 2.7 cm (range,1.5-4.0 cm). Operative bleeding occurred in 1 patient,and perforation in 1 patient.The results of histological examination showed that 93.6％(339/362) colorectal polyps were adenoma,17 were hyperplastic polyps,5 were inflammatory polyps,and caneeration of colorectal polyps in 1 patient was detected.Endoscopic follow-up was completed in 334 patients at the first month after operation,and 9 patients with residual benign colorectal polyps received endoscopic resection.No residue or recurrence was found in the other patients.Endoscopic follow-up was completed in 308 patients at the second months after operation,and no residue or recurrence was found.The overall effective rate was 97.1％ (299/308).ConclusionEndoscopic nylon ligation combined with endoscopic high-frequency electric snare is effective and safe for the treatment of colorectal polyps.

Objective To evaluate the clinical efficacy and safety of metallic hemoclips in the treatment of gastric defects during endoscopic full-thickness resection. Methods Patients with submucosal tumors derived from the muscularis propria and adhesion of the gastric serosa diagnosed by EUS and CT were enrolled in the study.A total of 62 patients,22 males and 40 females,mean age 58.5 years,were recruited into the present study from June 2009 to December 2010,in which 37 patients were with tumors in gastric fundus,20 in gastric body and 5 in antrum.All patients were treated with endoscopic full-thickness resection.After the operation,metallic hemoclips were used to close the defects through endoscopic biopsy channel.The closure success rate with metallic hemoclips were assessed.The patients were followed up endoscopically for evaluation of efficacy and safety of the procedures.Results All patients underwent endoscopic full-thickness resection.Uncontrollable bleeding occurred in 1 patient,who subsequently underwent emergent laparoscopic surgery and was excluded from the study.Metallic hemoclips were applied to close defects in 57 patients,and metallic hemoclips combined with omentum obstruction in 4 patients.The overall success rate was 100％ in 61 patients.Endoscopic follow-up was completed in all patients in average of 4.4 months.The clinical wound healing rate was 100％.No complications such as fever,abdominal pain were found in 2months after the procedures.Conclusion Application of metallic hemoclips during endoscopic full-thickness resection for gastric defects is a safe and effective technique.

The importance of chitinases in the physiological and developmental processes of fungi and insects makes themselves and their inhibitors important targets for biological pesticides. A chitinase was isolated from Bombyx mori and purified to electrophoretic homogeneity by ammonium sulfate precipitation and Sephadex G-150 column chromatography. The molecular mass was estimated to be about 88 kDa by SDS-PAGE, while the K(m) was calculated to be 22.3 micromol/L. Moveover, the optimal reaction temperature was 45 degrees C, and the optimum pH was 6.0. The effect of metal ions and organic reagents on chitinase activity was investigated. The activity was enhanced by high concentration of Mn2+, while was strongly inhibited by Cu2+ and SDS. These results provide a basis for screening the chitinase-based biological pesticide.
Animals ; Bombyx ; enzymology ; Chitinases ; isolation & purification ; metabolism ; Enzyme Stability ; Insect Proteins ; isolation & purification ; metabolism ; Temperature

Objective To evaluate the efficacy of a new endoscopic suturing device(OverStitchTM, Apollo Endosurgery, USA)for gastrointestinal wall defect after endoscopic full?thickness resection (EFTR). Methods Clinical data of the patients with submucosal tumors who underwent endoscopic suturing closure of gastrointestinal wall defect at the Endoscopy Center of Zhongshan Hospital from April 2015 to June 2015 were retrospectively analyzed. Results Five patients were included in this research with 4 lesions located in stom?ach and 1 lesion located in descendent duodenum. The mean diameter of lesions was 3?? 2 cm (ranging 2?? 0?5?? 0 cm). All patients underwent complete closure and none of them was converted to laparoscopic surgery or laparotomy. The mean repairing time was 16?? 6 min (ranging 11?? 0?22?? 0 min). The mean postoperative hospi?talization time was 5 days ( ranging 4?6 d). Two patients complained about slight abdominal pain and elevated body temperature. CT showed minor pleural effusion in one case. These patients received antibiotics, were on gastrointestinal decompression and asked to maintain the semi?supine position and discharged after 3 to 4 days. Conclusion Endoscopic suturing closure of gastrointestinal wall defect with the OverStitchTM en?doscopic suturing device is technically fast, feasible and safe.

ObjectiveTo evaluate the efficacy and safety of submucosal tunneling endoscopic resection (STER) for upper gastrointestinal (GI) submucosal tumors (SMTs) originating from the muscularis propria (MP) layer.MethodsA total of 26 upper GI-SMTs originating from the MP layer were treated by STER after endoscopic ultrasonography (EUS) and CT examination.The lesions were localized endoscopically and a submucosal tunnel was created to expose the tumor.The lesion was then resected under direct endoscopic view and the mucosal incision site was closed with hemostatic clips.ResultsOf the 26 SMTs,14 were located at esophagus,7 at cardia and 5 at stomach,with 11 originated from superficial MP layer and 15 from deep MP layer ( including 2 gastric SMTs adherent with serosa).All lesions were successfully resected by STER with an en bloc resection rate of 100％.The average operation time was 68.5 min ( range 25-145min).Four to six (mean five) hemostatic clips were used to close the mucosal incision site.The average lesion size was 1.8 cm ( range 1.0-3.2 cm).The pathology results were 17 leiomyomas,7 stromal tumors (GISTs),1 glomus tumor and 1 Schwannoma.All resected lesions showed both lateral and vertical tumorfree margins.Subcutaneous emphysema occurred in 2 patients (7.7％ ).One patient (3.8％ ) developed left pneumothorax and subcutaneous emphysema,and 2 others (7.7％) pneumoperitoneum.All of them recovered uneventfully on conservative treatments.No delayed bleeding,GI tract leakage or secondary peritoneal/thoracial infection occurred.None of the 26 cases developed submucosal hematoma or infection.No tumor residual or recurrence was found during follow-up period (range 3-9 months).ConclusionSTER is a safe,efficacious and feasible new method for providing accurate histopathological evaluations,as well as radical treatments for upper GI-SMTs from the MP layer.It can regain the mucosal integrity of the GI tract,preventing leakage and secondary infection.

Objective To evaluate the efficacy and the feasibility of peroral endoscopic myotomy (POEM) for achalasia (AC). Methods The clinical data of 8 patients diagnosed as having AC and receiving POEM at our center from August 2010 to December 2010 were reviewed. The patients were 16-62 years old, mean 43yr, whose disease courses lasted for 2-20 years, mean 8.4 years. The key procedures of POEM were as the following, esophageal mucosal incision, submucosal tunneling by endoscopic submucosal dissection ( ESD), endoscopic myotomy of the circular muscle and closure of mucosal entry by hemostatic clips. Results All the 8 patients underwent POEM successfully. The mean operation time was 68.5 min ( ranging 45-115 min). The mean submucosal tunneling length was 9.5 cm ( ranging 8-13 cm). The average length of endoscopic myotomy of inner circular muscle was 8.5cm ( ranging 7-11 cm). No severe complications related to POEM occurred. Patients were followed up for 1-4 months ( mean 2. 5 months). Dysphagia was relieved significantly during the follow-up in 7 patients. But dysphagia and vomiting re-occurred in one patient 15 days after the operation. Endoscopy revealed a submucosal fistula, which was managed by incision. Conclusion As a new minimally invasive therapy for AC, POEM is very effective to relieve dysphagia in a short term. However, further observation is needed to evaluate long-term efficacy and complications.