bjective To induce a treatment program of evidence-based acupuncture and moxibustion for oculomotor paralysis by retrieving and analyzing the current literature for improving clinic technology.MethodsOne case was used as example and it was introduced how to raise clinical questions,retrieve relative literature,evaluate the retrieval literature and at last,stipulate treatment program based on the retrieval evidences.ResultsThe acupuncture and moxibustion treatment program for oculomotor paralysis established by evidence-based medicine was adopted to treat the patient for 10 times,as a result the patient got much better.Conclusion: Through clinically raising questions,searching for evidence,analyzing evidence,making a strategy decision,practicing evidence-based course,the patient could attain satisfactory therapeutic effect,and the physician could raise theoretical level and clinical ability.

Type I allergic reaction is the most common and serious one in the adverse drug reactions (ADR) of TCM injections. Skin test can be used to predict the occurrence of allergic reactions, which is a simple and effective method for safe use of TCM injections. To a certain extent, it can reduce ADR of medicine and ensure the safety of clinical medication. However, the medicine instructions of TCM injections that clearly point out the need for skin test are few, and there are many problems of skin test in clinical practice. For example, lack of systematic research on skin test, no uniform standard for clinical judgment, lack of diagnostic reagents and proprietary methods of skin test. Therefore, specifications for clinical skin test of TCM injections are needed to provide guarantee for the safe use of TCM injections.

Objective To observe the effect of Professor Deng Tietao’s Brain-strengthening Recipe 1 on learning and memory abilities of rats with vascular dementia, and to explore its molecular biology mechanism. Methods The vascular dementia rat model was established by permanent occlusion of the bilateral arteria carotis communis. Sixty male SD rats were randomly divided into 5 groups, namely sham-operation group, model group, nimodipine (5.4 mg·kg-1·d-1) group, and high-and low-dose Chinese medicine groups (57.6 and 14.4 g·kg-1·d-1, respecitvely) . After medication for 30 days, the learning and memory abilities were evaluated by Morris water maze test. The histological changes of the rat hippocampal tissues were observed after HE staining, and the mRNA expression of N-methyl-D-aspartate receptor subunit 2B ( NR2B) in rat hippocampus was measured by real-time fluorescence quantitative polymerase chain reaction (RT-PCR) . Results The water maze test results showed that the escape latency of the rats in the sham-operation group was significantly decreased on the third day, and was significantly decreased in the high-dose Chinese medicine group on the fourth day ( P<0.05 compared with the model group). The results of spatial probe test showed that the times of rats passing through the platform within 60 seconds were significantly higher in high-dose Chinese medicine group ( P<0.01compared with the model group) , but the time for rat staying at the quadrant of the platform in the other four groups did not differ from that in the model group ( P>0.05). HE staining results for the model group were presented as the absence of neural cells in hippocampus CA1 region, karyorrhexis of nerve cells, indistinctness of nuclear membrane, disappearance of nucleolus, shrinkage of nerve cells, increase of cytoplasm acidophily, and reactive hyperplasia of astrocytes. And in the hippocampal CA1 region of high- and low-dose Chinese medicine groups, the injured neural cells were found, and the lesions were slighter than those of the model group. Compared with the model group, the mRNA expression of NR2B was increased in nimodipine group and high-dose Chinese medicine group ( P<0.05) . The mRNA expression of NR2B showed a increasing trend in low-dose Chinese medicine group, but the differences were insignificant compared with that of the model group ( P>0.05). Conclusion Brain-strengthening Recipe 1 has obvious effects on improving the learning and memory abilities of vascular dementia rats, and the therapeutic mechanism is associated with reduction of the degree of neuronal damage in hippocampus and with the upregulation of the mRNA expression of NR2B.

Aim To investigate the effect of intrathecal injection of CCR2 antagonist on pain behaviours,spinal astrocytes activation in the spinal cord in a rat model of bone cancer pain. Methods Forty female SD rats weighing 150 ~180 g were randomly divided into five groups ( n=8 each ):(Ⅰ) sham group;(Ⅱ) sham +RS102895 group;(Ⅲ) bone cancer pain group;(Ⅳ) bone cancer pain + DMSO group;(Ⅴ) bone cancer pain+RS102895 group. Rats received i. t. injections of either RS102895 (3 g·L-1 ) 10 μl or 10%DMSO 10 μl at the time of 10-12 days after the operation. Bone cancer was induced by intra-tibial inoculation of 1 × 105 Walker 256 breast cancer cell. Mechanical hind paw withdrawal threshold test was performed one day before and at 3rd,6th,9th, 10th,11th and 12th days after surgery. Immunofluorescence was used to observe the activation of the spinal astrocytes. Results Compared with group Ⅰ, the rats in bone cancer pain group appeared obvious mechanical hyperalgesia (Ⅲ、Ⅳ、Ⅴ) ,the volume,shape and mean optical den-sity ( MOD) of spinal astrocytes could be seen obvious-ly increased,groupⅡhad no obvious statistical signifi-cance (P>0. 05). Compared with group Ⅳ ,i. t. in-jections of RS102895 increased the paw mechanical withdrawal threshold, suppressed the action of astro-cytes,reduced the MOD of spinal astrocytes. Conclu-sion CCR2 might participate in the formation of bone cancer pain via activating spinal astrocytes. CCR2 will be a potential target for the treatment of bone cancer pain.

OBJECTIVETo observe preventive and therapeutic effects of Tanshinone IIA (T II A) on oxaliplatin induced peripheral neuropathy (OlPN) and to explore its effects on the expression of calcitonin gene related peptide (CGRP) and never growth factor (NGF).

METHODSTotally 36 phase II - III patients with malignant tumor of digestive tract undergoing chemotherapy program with oxaliplatin, were equally assigned to the T II A group (using THA at 80 mg/day 1 day before oxaliplatin chemotherapy for 3 successive days) and the control group (using chemotherapy program with oxaliplatin alone) by segmented randomization. After 4 cycles of chemotherapy, the incidence degree and incidence of OlPN were evaluated. Sensory nerve conduction velocity (SNCV) and motor nerve conduction velocity ( MNCV) were tested by EMG evoked potential device. Serum levels of CGRP and NGF were also detected in the two groups before and after chemotherapy. The correlation of serum levels of CGRP and NGF to OIPN was assessed using linear correlation analysis.

RESULTSAfter chemotherapy the OlPN incidence was 27.8% (5/18 cases) in the T II A group, obviously lower than that in the control group (55.6%, 10/18 cases; P < 0.05). Compared with before treatment in the same group, SNCV and MNCV of common peroneal nerve were slowed down, serum NGF levels decreased, and serum CGRP levels obviously increased in the two groups (all P < 0.05). Compared with the control group after treatment, SNCV and MNCV of common peroneal nerve were obviously accelerated, serum NGF levels increased, and serum CGRP levels obviously decreased in the THA group (all P < 0.05). Results of linear correlation analysis indicated serum NGF level was negatively correlated with peripheral neuropathy (PN), serum CGRP expression was positively correlated with neurotoxicity (P < 0.05).

CONCLUSIONT II A could reduce the incidence of OlPN, which might be associated with inhibiting the expression of CGRP and up-regulating NGF activities.

Calcitonin Gene-Related Peptide ; blood ; Diterpenes, Abietane ; therapeutic use ; Gastrointestinal Neoplasms ; drug therapy ; Humans ; Nerve Growth Factor ; blood ; Neural Conduction ; drug effects ; Organoplatinum Compounds ; adverse effects ; Peripheral Nervous System Diseases ; chemically induced ; drug therapy ; Up-Regulation

Objective:To explore the method of building the formative assessment (FA) system in diagnostics teaching and investigate its implementation effect.Methods:We planned and formulated the formative assessment system in diagnostics teaching of undergraduate curriculum. The correlation between the scores of the formative assessment and final exam were analyzed. A questionnaire survey on students' attitudes towards FA and an interview on teachers' perspectives were conducted. SPSS 17.0 was used for statistical analysis. Linear correlation analysis was used to compare the final exam scores with formative assessment scores, and Wilcoxon rank sum test was used to compare the scores of questionnaire items.Results:The scores of FA were significantly positive related to the scores of final exam ( r = 0.559, P < 0.001). The questionnaire analysis showed that students significantly valued the formative assessment superior to the summative assessment ( Z = -8.632, P<0.001). It was generally approved of the promotion of FA in students' self-direct learning and self-supervision and the advances in acquirement of knowledge and skills. Conclusion:It is feasible of carrying FA in diagnostics teaching which could provide better learning outcome and might have an extensive prospect of application.

Objective To compare the clinical efficacy and carry out analysis on pharmacoeconomic cost-effect of three therapeutic schemes in the treatment for stroke. Methods Through a retrospective survey method, 115 stroke patients, based on different treatment methods, were divided into 3 groups:Xuesaitong group (A), carthamin yellow group (B), and Xueshuantong group (C). An analysis on pharmacoeconomic cost-effect was conducted. Results The costs of three therapeutic schemes were 1030.4 yuan, 1876 yuan, and 1545.6 yuan, respectively. The total effective rates of stroke patients in groups A, B and C were 85.37%, 88.57% and 90.04%, respectively. The cost-effect ratios of groups A, B and C were 12.07, 21.18, and 17.17. The added cost-effect ratios of groups B and C compared with group A were 264.25 and 110.32, respectively. Conclusion Xueshuantong Injection has more pharmacoeconomic advantage than Xuesaitong and carthamin yellow Injections in treating stroke.

Alzheimer’s disease (AD) is a chronic degenerative disease of central nervous system.The disease onset slow,early typical performance for the decline in judgment,lack of initiative,moodiness,etc,clinical manifestations of memory loss, cognitive dysfunction based.Cerebrolysin is a akind ofneurotrophicpeptidegic mixture obtained by normalized enzymolysisof lipid-free porcine brain proteins,it is rich in various amino acids,small molecule polypeptide and various essential elements such as magnesium, phosphorus and selenium.Several studies have shown that cerebrolysin can significantly improve the memory,anxiety,fatigue,dizziness and other symptoms of AD patients.In this paper,the research progress of cerebrolysin in treatment of Alzheimer’s disease were reviewed to provide reference for the comprehensive development and clinical application of cerebrolysin .

Objective To evaluate the feasibility and effect of transthoracic echocardiography(TTE)on guiding the occlusion of the soft-rim atrial septal defect(ASD).Methods Sixty two patients with the soft-rim ASD were enrolled.The size of ASD was measured and rim of ASD was observed by TTE on various views by using color Doppler system with tissue harmonic function before occlusion,and filmy rim of ASD with flapping which could not sustain occluder was eliminated.The size of occluder was selected by integratively judging the size of ASD and"sustainable diameter of ASD"The waist size of occluder was measured after releasing occluder and compared with the longest diameter of ASD and"sustainable diameter of ASD"measured by TTE.Results The longest diameter of ASD measured by TTE before occlusion was 11-35 mm[average(21.6±5.2)mm],the "sustainable diameter of ASD"was 15-37 mm[average(25.6±5.(J)mm],the size of selected occluder was 18-44mm[average(30.7±5.5)mini and the waist size of released occluder was 13-35 mm[average(24.2±5.6)mm].Fine correlation was existed between the longest diameter of ASD measured by TTE and the waist size of released occluder(r=0.86,P＜0.000I).Morever,improved correlation was found between the"sustainable diameter of ASD"measured by TTE and the waist size of released occluder(r=0.89,P＜0.0001).Occluder was firmly fixed without falling in all patients.Conclusions TTE with tissue harmonic function can be used to measure the size of soft-rim ASD and the"sustainable diameter of ASD".It is a feasible,and effective method on guiding occlusion of soft-rim ASD.

OBJECTIVETo explore the current application and features of Aconite prescriptions with incompatible herbs in grade A class three hospitals in east China and central China through a clinical study and comparative analysis.

METHODClinical prescriptions containing Aconite with incompatible herbs were collected. Association rules were utilized to analyze the compatible features of these herbs.

RESULTThis analysis found that the frequently used incompatible herba; pairs are Aconiti Lateralis Radix Praeparata-Pinelliae Rhizoma, with the support rate of 44.45%, occupying nearly half of the surveyed prescriptions; Pinelliae Rhizoma is the most frequently used herb in the two areas, with support rate up to 76.24%. Among the top 10 herbal pairs in the support rate, except for Aconiti Lateralis Radix Praeparata and Pinelliae Rhizoma, the top 10 herbs in Central China were mostly for warming the middle jiao and tonifying qi, such as Zingiberis Rhizoma, Atractylodis Macrocephalae Rhizoma and Codonopsis Radix; Whereas those in east China were mostly for activating and nourishing blood, such as Angelicae Sinensis Radix, Chuanxiong Rhizoma, and Salviae Miltiorrhizae Radix et Rhizoma. Among the top 10 herbal pairs in the support rate, except for Aconiti Lateralis Radix Praeparata-Pinelliae Rhizoma, the core herbal pairs applied in central China were mainly for resolving phlegm and warming the middle jiao, such as Pinelliae Rhizoma-Glycyrrhizae Radix et Rhizoma, Pinelliae Rhizoma-Zingiberis Rhizoma; Whereas those in east China were principally for activating blood and tonifying qi, like Atractylodis Macrocephalae Rhizoma and Pinelliae Rhizoma, Angelicae Sinensis Radix and Pinelliae Rhizoma. Among the core herbal groups in the two areas, the most frequently used herbal groups in the two areas are Aconiti Lateralis Radix Praeparata, Glycyrrhizae Radix et Rhizoma and Pinelliae Rhizoma with the support rate of 59.73%, accounting for the highest proportion among all of herbal groups.

CONCLUSIONThere are the combined clinical application of Aconite with incompatible herbs, mostly with Aconiti Lateralis Radix Praeparata-Pinelliae Rhizoma, but with differences in the combined application in east China and central China.

Aconitum ; chemistry ; Drug Incompatibility ; Drug Prescriptions ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; Humans ; Pinellia ; chemistry ; Sophora ; chemistry