Objective Our purpose was to find out a better way for modern learner to understand the ancient medical book named as Treatise on Febrile Diseases. [Methods] We adopted the way of document research to find out the key points for modern learners. [Results] There were many interchangeable words, ancient and modern words and Nanyang dialect speech in the book. Further more, some drugs had been evolved in a state of flux. [Conclusion] Our conclusion was: To make a better understanding of Treatise on Febrile Diseases, we must put our fingers on the original language and ideas, not just focus on the clauses. And we cannot use contemporary language to explain ancient words;otherwise we would misunderstand the truth.

Objective To approach Professor Zhu Guangli's regular pattern of differentiation of symptoms and signs in patients with hypertension accompanied by complications and in accord with the individual manifestations to add or subtract the ingredients in the prescription.Methods The patients with essential hypertension selected were those who the first time came to the Affiliated Guangxing Hospital of Zhejiang Chinese Medical University or Hangzhou Hospital of Traditional Chinese Medicine (TCM) of Zhejiang Province from September 2012 to January 2015, and were continuously followed up in the hospitals having their clinical data comprehensive. The complications, combination diseases and symptoms of hypertension were conducted as dependent variables, while the applied Chinese medicines were acted as independent variables. QUEST algorithms were employed to analyze the different dependent variables to evaluate the importance contribution rate (ICR) of every kind of Chinese medicine.Results There were 9 types of complications or combination diseases [including hyperlipemia, coronary heart disease, cardiac arrhythmia, hyperglycemia, trace albuminuria, lacunar cerebral infarction, elevation of creatinine in blood (azotemia), liver dysfunction and cardiac dysfunction] and 39 types of symptoms obtained (including dizziness, palpitation, chest oppression, insomnia, lack of strength, soreness of the waist and knees, dry mouth, loose stool, fatigue, apontaneous sweating, headache, shortness of breath, coprostasis, fullness in the stomach, blurred vision, limb numbness, low spirit, chest pain, poor appetite, abdominal distension, excessive dreaming, tinnitus, flush of the face, neck rigidity, hectic fever, bitterness in the mouth, cough, ructus, nocturia, fremitus, stenagma, pharyngalgia, heaviness in head, nocturnal sweating, frequent urination, coughing of sputum, chillness and cold limbs, aphthous stomatitis and sialosis) being the QUEST decision models. All kinds of the TCM employed in all the patients paying visits for 755 times were summed up, and the individual drug frequency of presentation in the prescription was recorded. In the study, 171 sorts of TCM and 10 620 of cumulative frequency (freq.) were involved in 755 prescriptions. The average sorts of TCM was 14.07±1.53 per prescription. The top ten kinds of TCM the most commonly used (freq.) were as follows: tuckahoe (588), Chinese yam (551), wolfberry fruit (496), white peony root (442), abalone shell (405), gastrodia tuber (395), lilyturf root (325), Huai wheat (293), curcuma root (281), rush pith (277), accounting for 38.16% in the total frequency. There were 33 kinds of TCM with frequency > 100, accounting for 74.65% in the total frequency. By the analyses of QUEST algorithms directing to the complications and combination diseases to add or subtract the items of TCM, it was discovered that the drugs with ICR > 5% were as follows: in lacunar cerebral infarction, the drug application frequencies or ICRs of batryticated silkworm and bitter cardamom were 32.69% and 50.74% respectively; in coronary heart disease, the ICRs of pseudostellaria root, astragalus root, white sandal wood and lepidium seed were 23.05%, 17.70%, 15.31% and 5.06% respectively; in cardiac arrhythmia, the ICRs of astragalus root, flavescent sophora root, Huai wheat and dragon tooth and dragon bone were 46.65%, 11.56%, 7.56%, 7.13% and 6.28% respectively; in cardiac dysfunction, the ICRs of lepidium seed and white hyaciath bean were 92.97% and 7.03%; in hyperlipemia, the ICRs of cassia seed, white sandal wood, dried rehmannia root and sargentgloryvine stem were 24.26%, 12.47%, 10.51% and 5.81% respectively; in hyperglycemia, the ICRs of trichosanthes root and dried hawthorn fruit were 51.02% and 30.18%; in trace albuminuria, the ICR of snow in June herb was 83.33%; in elevation of creatinine in blood, the ICRs of Chinese actinidia root, herb of snow in June, glossy privet fruit and centella were 81.37%, 6.21%, 6.21% and 6.21% respectively; in liver dysfunction, the ICRs of coral ardisia root, purse grass and herb of stringy stonecrop were 86.37%, 6.82% and 6.82% respectively. When the symptoms were used as the dependent variables, for the top 3 commonly seen symptoms, in the prescription, the items of TCM used with ICR > 5% were as follows: in cases with elevation of blood pressure, parasitic loranthus (ICR 89.59%) was used; with dizziness, gastrodia tuber (ICR 46.96%) and/or abalone shell (ICR 33.61%) were added; headache, rhizome of Chinese ligusticum and/or rhizome of Sichuan lovage and/or large gentian with ICR at 85.77%, 7.11% and 7.11% respectively. Conclusion Professor Zhu's essential thought in differentiation of disease and expectant treatment of hypertension in accord with the individual manifestations to add and subtract drugs in TCM is under the guidance of TCM principle of differentiation of symptoms and signs for treatment, and based on the classical theories in TCM, the reliable drugs whose actions are demonstrated clinically and experimentally are preferentially selected.

Objective To investigate whether cesarean section on pregnant women with chronic hepatitis B virus (HBV) infection may reduce mother-to-infant transmission risk of HBV.Methods Preserved serum samples of pregnant women at 15-20 weeks of gestation which were collected from July 2002 to August 2004 in 14 counties of Jiangsu Province were analyzed retrospectively.These samples were tested for HBV serologic markers with enzyme immunoassay,and 419 cases of positive hepatitis B surface antigen (HBsAg) were found.HBV DNA level of these HBsAg-positive women were further quantitatively measured with real-time polymerase chain reaction assay.Children of these 419 HBsAg-positive mothers were followed up during October 2009 to March 2010 and 298 of them were contactable (71.1％),among which 281 were enrolled in final analysis as they had complete information and had been vaccinated with three regular doses of HBV vaccine during infantile period.The 281 children were tested for serum HBV markers.The HBV infection rate in these children at age 5-7 was compared between those born by cesarean setion (CS group,n =136) and by vaginal delivery (VD group,n=145).T-test,x2 test or Fisher's exact test was used to analyze relevant parameters.Results(1) Maternal HBeAg-positive rates [25.7％ (35/136) vs 34.5％ (50/145)],HBV DNA levels in HBeAg-positive women [(2.30 × 106) IU/ml vs (2.09× 106) IU/ml],the percentages of HBIG injection after birth [38.2％ (52/136) vs 35.9％ (52/145)],breastfeeding ratios [82.4％ (112/136) vs 75.9％ (110/145)],and children' s ages at the follow-up [(5.9 ± 0.8) vs (6.0±0.6)] were comparable between CS group and VD group (all P＞0.05).(2) Among these 281 children,272 (96.8％) were HBsAg-negative,9 (3.2％) were HBsAg-positive and 163 (58.0％) were anti-HBs-positive.The prevalence of HBsAg-positive [(2.9％ (4/136) vs 3.4％ (5/145)],HBsAg negative and anti HBc positive [0.0％ (0/136) vs 1.4％ (2/145)] and anti-HBs positive [57.4％(78/136) vs 58.6％(85/145)] in CS group were similar to those in VD group.Conclusions Cesarean section does not reduce the risk of mother-to-infant transmission of HBV.In clinical practice,elective cesarean section should not be suggested in order to prevent HBV vertical infection.

[ABSTRACT]AIM:Toexplorethedevelopmentofhepaticsinusoidalcapillarizationintheearlystageofliverfi-brosis induced by carbon tetrachloride (CCl4) in rats.METHODS:Clean SD rats were randomly divided into normal con-trol group (group N, n=6) and liver fibrotic model group (group M, n=32).The rats in group N were intraperitoneal in-jected with saline and the rats in group M were intraperitoneal injected with CCl 4(2 mL/kg, twice a week for 4 weeks).At the end of the 3rd day and the 1st, 2nd and 4th weeks, all rats were killed and then the samples were collected .The patho-logical changes in the livers were observed by HE staining and Masson straining .The development of hepatic sinusoidal capillarization was observed by transmission electron microscopy (TEM) and immunohistochemical staining .The cell sur-face expression of vascular endothelium-associated marker CD31, collagen type Ⅳ(Col IV) and laminin (LN) was deter-mined.RESULTS:HE and Masson staining showed the formation of liver fibrosis after treatment with CCl 4 for 4 weeks. TEM showed that the fenestrate diameter of liver sinusoidal endothelial cells (LSECs) grew down, the fenestrate numbers of LSECs were decreased along with the development of liver fibrosis , and the consecutive basement membrane was formed at the end of the experiment .The expression of CD31 was significantly increased along with the development of defenestration , and the expression of Col IV and LN was significantly increased after the treatment with CCl 4 for 2 weeks and 4 weeks , re-spectively .CONCLUSION:The typical hepatic sinusoidal capillarization was detected in the early stage of liver fibrosis , and the deposition of LN in the liver sinusoidal walls was the mainly factor of formation of the consecutive basement mem -brane .

Objective:To investigate the clinical efficacy and safety of Zhibitai capsule in the treatment of senile hyperlipidemia patients with phlegm and blood stasis syndrome.Methods:From June 2014 to June 2015, 126 elderly patients with primary hyperlipidemia of phlegm and blood stasis syndrome admitted to Hangzhou Hospital of Traditional Chinese Medicine were randomly divided into control group and observation group, with 63 cases in each group.The patients in the control group were given basic treatment plus atorvastatin calcium tablets, and the patients in the observation group were treated with Zhibitai capsule on the basis of the control study.Both two groups received continuous treatment for 12 weeks.The clinical efficacy, TCM syndrome integral, blood lipid, hemorheology and adverse reactions of the two groups were observed.Results:The total effective rate in the observation group was 92.1%(58/63), which was higher than 81.0%(51/63) in the control group, and the difference was statistically significant(χ 2=8.199, P<0.05). After treatment, the TCM syndrome score of the observation group was (9.31±1.78)points, which was lower than that of the control group[(15.88±2.35)points], and the difference was statistically significant( t=17.689, P<0.05). After treatment, the levels of total plasma cholesterol, triglyceride, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol in the observation group were (5.16±0.28)mmol/L, (1.89±0.21)mmol/L, (3.34±0.11)mmol/L and (1.18±0.13)mmol/L, respectively, which in the control group were (5.31±0.15)mmol/L, (2.22±0.20)mmol/L, (3.47±0.16)mmol/L and (1.11±0.12)mmol/L, respectively, the differences between the two groups were statistically significant( t=3.748, 9.032, 5.314, 3.140, all P<0.05). After treatment, the whole blood low shear viscosity, high shear viscosity, plasma viscosity and fibrinogen in the observation group were (10.68±2.38)mPa/s, (4.11±0.31)mPa/s, (1.33±0.22)mPa/s, (3.01±0.22)g/L, respectively, which in the control group were (11.55±2.39)mPa/s, (4.43±0.30)mPa/s, (1.61±0.25)mPa/s, (3.25±0.22)g/L, respectively, the differences between the two groups were statistically significant( t=2.047, 5.888, 6.674, 6.123, all P<0.05). There was no statistically significant difference in the adverse reactions between the two groups( P>0.05). Conclusion:Zhibitai capsule can effectively improve the clinical efficacy, improve TCM syndromes, reduce blood lipids and improve hemorheology parameters in elderly patients with hyperlipidemia syndrome of phlegm and blood stasis syndrome, with no obvious adverse reactions, which is worthy of clinical promotion.

Objective Network pharmacology was used to explore the mechanism of action of Yixin Jianpi prescription in the treatment of coronary heart disease and chronic heart failure.Methods With the help of traditional Chinese medicine systems pharmacology(TCMSP),traditional Chinese medicine integrated database(TCMID)and other databases combined with literature data to screen the active ingredient targets of Yixin Jianpi prescription,the human gene database(GeneCards),online mendelian inheritance in man(OMIM)and other databases were used to search for disease targets.The STRING platform combines Cytoscape software to construct a"component-target-disease"network diagram and protein interaction network.Gene ontology(GO)functionality and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway analysis using the DAVID database.The key components are taken and the target is molecularly docked with AutoDuck tools.Results 265 potential targets of Yixin Jianpi Prescription were obtained,and 106 of them were common targets of"homotherapy for heteropathy";The key active ingredients were quercetin,kaempferol,β-sitosterol,etc.and the core targets were SRC,AKT1,MAPK1,TP53,etc.Biological processes involve positive regulation of gene expression,negative regulation of apoptosis,signal transduction,etc.involving lipid and atherosclerosis,fluid shear stress,atherosclerosis and inflammatory response.Molecular docking verified the stable docking of key components quercetin and kaempferol with SRC,AKT1 and MAPK1 targets.Conclusion The study reveals the multi-component,multi-target,and multi-pathway mechanism of"homotherapy for heteropathy"of coronary heart disease and chronic heart failure by Yixin Jianpi prescription,and provides a basis for exploring its new clinical applications.