The construction of traditional theory of Chinese herbalism cannot do without the accumulated understanding of herb effect in clinical practice.Meanwhile,it closely relates to the natural history of using different theories of herb property to explain effect and mechanism at different stages.The compilation of Inner Canon of Yellow Emperor 《(黄帝内经》) and Shennong Bencao Jing 《神农本草经》) represent the initial formation of traditional herbalism in Chinese medicine.These two books have a relatively complete description of property and effects of herbs,but with different focus of concerning.After Shennong Bencao Jing,explaining the effect from property of herbs gradually become the developing trend and basic characteristics of herbalism.During the Ming-Qing Dynasties,publication of a large number of herbal annotation works further highlights this feature.

Ventilator is broadly used in the hospital all over the world,The paper describes three case of common troubles in clinical practice for Bird-brand ventilator and its troubleshooting.

Objective To construct a yeast two-hybrid recombinant bait plasmid of human programmed cell death ligand 1(PD-L1)immunoglobulin variable region(IgV)domain gene,detect its expression in yeast and detect the cytotoxicity and self-activation of PD-L1 IgV protein as well as the interaction between PD-L1 IgV and human thioredoxin(hTrx).Methods Human PD-L1 was analyzed by bioinformatics method,and primers were designed to amplify PD-L1 IgV domain based on the coding region of PD-L1 gene registered in NCBI GenBank database. PCR amplification was carried out with pENTERPD-L1 plasmid as template,and then cloned into yeast two-hybrid bait vector pGBKT7. The recombinant bait plasmid and pGBKT7 empty vector were transformed into Y2HGold yeast cells respectively,and the PD-L1 IgV gene and its expression were detected by PCR and Western blot;Meanwhile,the protein toxicity and self-activation of PD-L1 IgV were detected,and the interaction between PD-L1 IgV and hTrx was detected by drip plate method.Results The bioinformatics analysis results of PD-L1 were consistent with related reports. The recombinant bait plasmid pGBKT7-PD-L1 IgV was correctly constructed,and Y2HGold positive clone was obtained,in which PD-L1 IgV was stably expressed. The empty vector pGBKT7 and recombinant bait plasmid pGBKT7-PD-L1 IgV grew well on SD/-Trp and SD/-Trp/X-α-Gal plates with the same colony size and number and white colony,but they did not grow on SD/-Trp/X-α-Gal/AbA plates,which indicated that PD-L1 IgV protein had no toxicity and no self-activation effect on yeast. The results of drip plates test showed that all experimental groups grew well on SD/-Trp/-Leu plate,while only positive control group grew on SD/-Trp/-Leu/X-α-Gal/AbA plate and showed blue color,which indicated that bait protein PD-L1 IgV and hTrx did not self-activate,and there was no interaction between them.Conclusion Recombinant human PD-L1 IgV bait plasmid was successfully constructed. PD-L1 IgV protein showed no toxicity and self-activation effect on yeast cells,and there was no interaction between PD-L1 IgV and hTrx. Subsequently,hTrx can be used to construct a peptide aptamer library,from which peptide aptamers that specifically bind to PD-L1 IgV can be screened.

BACKGROUND:In the treatment of primary knee osteoarthritis, total knee arthroplasty is a common treatment, but there are some shortcomings in the traditional operation, which maylead to early failure of the prosthesis.
OBJECTIVE:To explore the difference of computer-assisted total knee arthroplasty by vastus medialis approach from the traditional total knee arthroplasty.
METHODS:A total of 79 patients with primary knee osteoarthritis were randomly divided into control group (41 cases) and observation group (38 cases), which underwent conventional total knee arthroplasty and computer-assisted total knee arthroplasty by vastus medialis approach. Surgical incision, operation time, total blood loss and drainage volume were recorded and compared in both groups. In 12 months of folow-up, Hospital for Special Surgery knee score was evaluated, and the complications were recorded and compared between the two groups.
RESULTS AND CONCLUSION:(1) Operative incision was significantly less in the observation group than in the control group. Operation time was significantly shorter in the observation group than in the control group. Total blood loss and drainage volume were significantly lessin the observation group than in the control group (alP< 0.05). (2) Patients in both groups were folowed up for 12 months. Index score and total score of knee function were significantly higher in the observation group than in the control group (al P< 0.05). (3) No adverse events such as infection, prosthesis loosening or fracture appeared in the observation group. In the control group, four cases affected prosthesis loosening. One case suffered from wound infection. Above events were improved obviously after active treatment. No serious complications occurred. The incidence of complications was significantly lower in the observation group than in the control group (P< 0.05). (4) The results show that, compared with the traditional operation, the choice of the femoral medial approach and the use of computer aided design technology can simulate the knee replacement process, set the cutting position, improve the accuracy and success rate of surgery, have less trauma, and effectively improve knee function, and reduce the incidence of postoperative complications.

Objective To summarize the clinical features of Budd-Chiari syndrome.Methods A total of 151 Budd-Chiari syndrome admitted in Peking University People's Hospital from 1996 to 2012 were analyzed retrospectively.Results Abdominal distension was the most common complaint,with 62.9％ (95/151)of lower extremity edema,53.0％ (80/151)of typical bottom-up flow of the abdominal wall longitudinal varicose veins and 60.9％ (92/151) with ascites.Laboratory tests results showed median of alanine aminotransferase (ALT) was 21.5 (15.0,30.0) U/L,aspartate aminotransferase (AST) was 30.0 (23.8,42.0) U/L,total bilirubin was 31.1 (23.3,47.8) μmol/L,blood albumin 37.5 was (31.8,41.5) g/L,prothrombin activity was 71％ (61％,84％).WBC was 5.2 (3.5,7.5) × 109/L,hemoglobin concentration was 126.5 (108.8,144.2) g/L,and platelet count was 117.0 (85.5,155.5) × 109/L.Abdominal B-ultrasound examination showed hepatomegaly existed in 68.9％ (104/151) patients.Intraoperative angiography and surgical exploration showed that 41.1％ (62/151) patients were simple inferior vena cava obstruction or stenosis,15.9％ (24/151)were simple hepatic vein obstruction or stenosis and 43.0％ (65/151) suffered from the inferior vena cava combined with hepatic vein stenosis or obstruction.Surgically confirmation of the lesions showed that inferior vena cava membrane-like structure combined with thrombosis was in 59.6％ (90/151) cases.Conclusions Liver congestion,inferior vena cava congestion and portal hypertension are the main clinical manifestations of Budd-Chiari syndrome.With slightly liver function injury,liver dysfunction of Budd-Chiari syndrome isn't parallel with its portal hypertension.

Objective To explore a layered nursing intervention based on risk assessment strategies application effect in elderly patients with hip replacement. Methods Chosen during January 2013 to December 2014 rows of orthopaedic trauma treated 224 patients of senile hip replacement as the research objectto divide into observation group and control group 112 caseseach according to admission time.Observation group applied based on risk assessment strategy stratification nursing intervention, the control group used conventional care. Compared two groups of patients with postoperative pain degree, hip function, complications, and patient satisfaction. Results For 24 h, 48 h, 72 h after the operation, Visual Analog Scale (VAS) scores of observation groupwere 2.25 ± 0.35, 2.01 ± 0.31, 1.92 ± 0.23, which were significantly lower than 3.53 ± 0.51, 2.84±0.45, 2.70±0.35 of the control group (t=21.900, 16.075, 21.900, P<0.01);3 months and 12 months after the surgery, the index of the Harris hip score observation group was 71.32 ± 7.45, 93.44 ± 9.65, which were obviously higher than 60.47 ± 6.65, 83.75 ± 9.21 of control group (t=11.498, 7.688, P<0.01);8.04%(9/112) incidence of complications such as infection of incision, increase of observation group was obviously lower than 20.54%(23/112) of the control group(χ2=7.146, P<0.05);97.32%(109/112) satisfaction was significantly higher than 78.57% (88/112) of the control group (χ2= 18.572, P < 0.05). Conclusions Stratified nursing intervention based on risk assessment strategy can help to alleviate the degreeof pain, improve hip function, reduce postoperative complications and improve patient satisfaction.

The humanistic thinking of life philosophy of traditional Chinese medicine (TCM) observed inlife activities is different from western theories and methods,which is more about life experience and feeling and rich in practical significance.The life philosophy of TCM is also different from traditional Chinese culture.The intuitive feeling of life is one of the main characteristics of life philosophy of TCM.Students of TCM soak in traditional Chinese medicine culture and are influenced by the thinking of real life caused by the care of realbody in TCM.Chinese medicine education should fully mobilize the tacit knowledge of life education in TCM,play excellent tradition of Chinese traditional life philosophy,and cultivate the life moral quality in students of TCM.

Objectives To evaluate the effect of peeling of internal limiting membrane (ILM) on the post-operative visual acuity in patients with diabetic macular edema, and to detect the role indocyanine green (ICG) plays in the surgery of peeling of ILM. Methods Thirty patients (31 eyes) with diabetic retinopathy at proliferative stage with macular edema underwent vitrectomy. The patients were randomly divided into two groups: 16 eyes in group A underwent single vitrectomy with panretinal photocoagulation and ocular filling with 20% SF6; 15 eyes in group B underwent vitrectomy and peeling of ILM after the posterior pole was stained with ICG. All of the patients were asked to keep the posture of facing down for 10-14 days. The follow-up lasted 3-12 months. Results In 16 eyes in group A, the visual acuity increase of 2 or more lines in 10 (62.5%) and alleviation of macular edema in 9 (56.2%) were found; the postoperative average macular retinal thickness examined by optic coherence tomography (OCT) was 393 ?m. In 15 eyes in group B, the visual acuity increase of 2 or more lines in 14 (93.3%) and alleviation of macular edema in 14 (93.3%) were found; the postoperative average macular retinal thickness was 319 ?m. The postoperative improvement of visual acuity in group B was much better than that in group A ( ? 2=4.210, P =0.05), while the postoperative macular retinal thickness in group B was obviously lower than that in group A ( P

OBJECTIVE:To survey and objectively evaluate the present situation and trend of the usages of the antivirals METHODS:To make a survey of the usage for above-mentioned drugs in 136 hospitals of 6 cities in the Yangtse valley of China during the period 1998～2000 concerning the sum of money for drugs,main pharmaceutical enterprises etc and to analyse the situation of clinical use and trend forecast RESULTS:The sum of money for the antivirals was 17 330 331 yuans,24 068 239 yuans and 47 427 419 yuans in 1998,in 1999 and in 2000,respectively Total expenditure and consumption for the antivirals in China increased year by year CONCLUSION:The antivirals is a kind of drug which has developmental potential,the expenditure and consumption will increase rapidly

Objective To observe the therapeutic effect of triclabendazole in patients with paragonimiasis skrjabini. Methods Four patients were treated with triclabendazole at dosage of 10 mg/kg bid for 3 days and were followed up for 6～10 months. The clinical symptoms, chest X ray, hemogram and liver function tests were observed before and after treatment. Results Migratory subcutaneous nodules in three patients all disappeared. Small amount of pleural effusion were absorbed in two patients. Severe headache subsided in a patient with cerebral lesion. MRI showed a bean sized calcified spot in the right frontal region. Chest X ray in 2 patients showed that pulmonary lesions were markedly absorbed and disappeared. There was no adverse effect of the drug.Conclusion Triclabendazole has marked therapeutic effect on paragonimiasis skrjabini. It is safe in administration and well tolerated.