To explore the Chinese materia medica (CMM) for the second time has been attached increasingly importance in recent years. The author discusses the importance of the secondary exploitation to the development of traditional Chinese medicine (TCM). At the same time, the author analyzes the current situation of TCM, and points out that the advantages and disadvantages of TCM. They are complicated with each other, and this complicated situations have brought about the difficulties of development of TCM. So the author brings forward that the secondary exploitation for CMM is a positive approach to solve the current problems, for it not only adapts to the complexion of exploring the new drug, but also keeps inherent characteristic of TCM, and aims at the disadvantages of the traditional techniques of TCM. In addition, the author recounts the method of secondary exploitation for CMM from choosing the object, deepening the base research to reforming the techniques. In the end, the author tables some proposals for the secondary exploitation for CMM.

Objective To investigate the effect of killing the biofilm persisters by miconazole combined with two compound which can inhibit the drug efflux of C. albicans. Methods Lab reference strains of C. albicans YEM30(CAF2-1) formed the mature biofilm in the 96 well plates, and then treated with miconazole combined with Enniatin B (CDR1 inhibitor) and Milbemycins ot25 (CDRI/CDR2 inhibitor) respectively. After incubated for 48 hours by CFU counting on the YPD plates, the analysis of persisters with SAS8.0 software package for q test. Results Miconazole combined with drug efflux inhibitor can kill more persisters than miconazole alone(P <0.001), and combining with Enniatin B have a better results in eliminating the biofilm persisters than with Milbemycins α25. Conclusion Antifungal drugs combined with drug efflux pump inhibitors can kill more strains which can tolerate very high concentration of antifungal drugs. And searching the potential drug efflux pump inhibitors may be a new way for eliminating the persisters in biofilm, and consequently controlling the chronic recurrent fungal infectious diseases.

From 1977 to 1990, 50 patients with renal cell carcinoma were given postoperative radiotherapy. The 3-,5- and 10-year survival rates were 60.0%,51.5% and 31.8%. The 5-year survival rate of StageⅠ～Ⅱ lesions was 69.2% and that of stageⅢ～Ⅳ lesions was 43.8%, which are better than those treated by surgery alone. Regional lymphatic metastasis, invasion of the nearby organs and vena caval cancerous thrombosis were the ominous signs, especially the former two. 83.3% of the patients died of distant metastasis. Lung was most common(58.3%)and then, bone metastasis (25.6%). The authors believe newer combination therapy against distant metastasis is needed to improve the results.

Objective To assess the effectiveness of Chinese medicine treatment in endometriosis(EMT) by evidence-based medicine methods.Methods Retrieve articles mainly from Wanfang data,VIP information,CNKI and China TCM Database.Bring the articles report into research on the basis of strict quality evaluation.Consolidate cure rate and effective rate for meta-analysis.Results Based on 8 articles report,cure rate of Chinese medicine treatment is superior to western medicine treatment,and effective rate is equivalent to western medicine treatment.There is no side effect and other harmful consequence in evidence.Conclusions Chinese medicine treatment is superior to western medicine treatment in treating EMT.However,existence of some data methodological problems maybe directly affect the authenticity of the findings.So,more rigorous,randomized controlled trials should be designed in order to draw more reliable conclusions.

Objective To evaluate the value of linear array ultrasonic with high-frequency in the diagnosis of renal artery stenosis (RAS).Methods 1 828 patients who were doubted with RAS were studied.All of them were checked by ultrasonic with convex array probe and linear array probe.Results The sensitivity,specificity,false positive rate,false negative rate of convex array probe were 8.20％,97.10％,2.90％,21.80％.The sensitivity,specificity,false positive rate,false negative rate of linear array probe were 91.13％,99.80％,0.20％,8.87％.Conclusion Linear array with high-frequency can keep the measurement angle less than 60°,and can show the plaque,nature of the plaque and narrow rate of renal artery.It may be more helpful in the diagnosis of RAS.

[Objective]For revealing the definition of the concept of the Yin of liver and the Yang of liver ,and its historical evolution. [Method]The definition of the concept of the Yin of liver and the Yang of liver and the mainstream view of Yin and Yang of before the Song Dynasty, Song Dynasty and modern is investigated in this paper. The definition of the concept of the Yin of liver and the Yang of liver of different periods, different ideological background and different mainstream view of Yin and Yang is clarified by historical investigation. [Result]Because of the influence of Confucius studies, there is not the definition of the concept of the Yin of liver and the Yang of liver based on the object of liver in the TCM theory of Han and Tang dynasties. The Yin of liver and the Yang of liver mainly refer to the yin qi and yang qi in the liver. Because of the influence of neo-confucianism, the concept of the Yin of liver and the Yang of liver based on the object of liver was established in the TCM theory of Song and Ming dynasties. The Yin of liver and the Yang of liver mainly refer to the body and function of liver. Under the background of modernization of TCM, the concept of the Yin of liver and the Yang of liver based on the object of liver was established in the basic theories of TCM. However, there is a controversy of the concept of the Yin of liver and the Yang of liver, because of the effect of modern philosophy and science, ignoring the change of Chinese philosophy. [Conclusion]The clear concept of the Yin of liver and the Yang of liver of different periods, different ideological background and different mainstream views of Yin and Yang will reduce the influence of the fictional historical. Whether in ancient literature research, the liver like zang-fu theory of TCM theory, research, or the modern liver zang-fu theory of TCM, and establishing the theory of Chinese medicine has a positive meaning.

OBJECTIVETo investigate the reconstruction of thumb II-III degree defect by big toe wrap-around flap combined with second toe proximal interphalangeal joint.

METHODSBetween May 2004 to July 2012, 25 cases with thumbs II-III degree defects were treated. The ipsilateral big toe wrap-around flap combined with second toe proximal interphalangeal joint was designed to reconstruct the thumb defects based on the thumb size on the healthy side. The distal end of hallux was covered by flap at tibial side. The wound at the fibula side was covered by skin graft and flap. The bone defect at the second toe was filled with remnant hallux or iliac bone.

RESULTSAll the 25 reconstructed thumbs survived completely. The patients were followed up for 6-26 months without any joint degeneration. According to the finger reconstruction functional criterion publicized by China Medical Association, the finger function was assessed as excellent in 10 case, good in 11 cases, poor in 4 cases. Joint necrosis happened in 2 cases and bone malunion in 2 cases. The 4 cases received dead bone debridement and iliac bone graft. No malfunction occurred in the donor site.

CONCLUSIONSOur surgical method is a currently effective way to reconstruct II-III degree thumb defects. Satisfactory functional and cosmetic results can be achieved both in donor site and recipient site.

Aged ; Bone Transplantation ; methods ; China ; Hallux ; Humans ; Ilium ; transplantation ; Necrosis ; etiology ; Postoperative Complications ; pathology ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; methods ; Surgical Flaps ; Thumb ; surgery ; Toes

Objective To investigate the significance of pulse indicating the continuous cardiac output (PICCO) technique in patients with post-trauma capillary leak syndrome (PTCLS). Methods Twenty traumatic patients with PTCLS received PICCO monitor from 2011 to 2014 were enrolled in this study. analyzed, The patients, with twelve males and eight females, aged from twenty three to fifty. And twenty patients in the control group, with ten males and ten females, aged from twenty one to fifty two. Twenty six patients were injuried by traffic, ten patients were injuried by crash and four patients were injuried by sword. No significant differences were found in age、gender、weight、scores of ISS、Murray and APACHEⅡof all patients. All patients were survived. The balance of fluids, Lactate, Central venous oxygen saturation (ScvO2) and the mean artery pressure (MAP) were compared at 0, 24, 48 and 72 h after entering into the ICU. The duration of ICU stay and ventilation were also compared. Results (1)No significant differences in MAP、Lac and ScvO2 were observed in two groups. (2)No significant differences in the balance of fluids when patients entered into ICU, but significant differences were found at 24, 48 and 72 h post-entering into ICU (P < 0.05). (3)Significant differences in the duration of ICU stay and ventilation between the two groups were observed (P < 0.05). Conclusion PICCO technique can provid a quantitative target for PTCLS patients, with decreasing fluid infusion, and reducing the duration of ICU stay and ventilation.

Objective To explore the effect of Ulinastatin on proinflammatory cytokines of patients undergoing operation of intracranial aneurysm embolization. Methods 40 patients undergoing operation of intracranial aneurysm embolization were randomly divided into 2 groups (n = 20): ulinastatin group (Group U), normal saline group (Group C). In group U, 6 000 IU/kg Ulinastatin was infused via vein before anesthesia induction, the group C received the injection of isovolume normal saline. Exsanguinated arterial blood at T1, T2, T3, T4 and T5 five time points were taken to measure TNF-α and IL-6 in serum. Results The contents of TNF-α and IL-6 in serum both increased at T3, T4 and T5 compared to that at T1 in both groups; both TNF-α and IL-6 significantly decreased in Group U compared to that in Group C at the same time point. Conclusion Ulinastatin may inhibit the release of inflammatory mediators and lighten cerebral ischemia-reperfusion injury in patients undergoing operation of intracranial aneurysm embolization.

Objective]This paper is for the theoretical formation of clear livering factors development process . [Method]Adopt the method of literature investigation, explore the meaning of liver governing smoothing and dispersing Qi. [Result]It has three meanings: Like smooth doesn't like depression;dredge(The ascending and descending of Qi);spread. The support theory behind it is:Five elements theory;The movement theory of Qi;Zhu Zhenheng ’ s theory of“Liver Governs Smoothing and Dispersing”. Relationships between three meanings and support theory is:With five elements theory explaining the function of the liver governing smoothing and dispersing Qi ,it eventual y uses the movement theory of Qi; With Zhu Zhenheng ’s theory of“Liver Governs Smoothing and Dispersing”, explain the function of the liver governing smoothing and dispersing Qi is different from the the movement theory of Qi. [Conclusion]Liver governing smoothing and dispersing Qi is a new theory of reconstruction by modern scientific theories and methods.