This article was aimed to interpret the composition of Mahuang Decoction. The analysis was made on key points of medication, herbal combination, weigh ratio, the combined prescription treatment of Taiyang cold damage syndrome (wind-cold exterior-excess pattern) and heart-heat syndrome, heart-yang deficiency, heart-blood defi-ciency, heart-yin deficiency, liver-heat syndrome, liver-cold syndrome, liver-blood deficiency, liver-yin deficiency, spleen-stomach stagnated heat syndrome, spleen-stomach cold deficiency, spleen-stomach qi and yin deficiency, lung-heat syndrome, lung-cold syndrome, lung-yin deficiency, lung qi and yin deficiency, kidney qi insecurity, kid-ney-yang deficiency, kidney-yin deficiency, kidney yin-yang deficiency syndrome. Attention should be paid to use Mahuang Decoction as the combined prescription to receive the best treatment effect in the clinical practice.

Case based teaching or case discussion teaching of basic medical courses can deepen students' understanding of basic medical subjects and allow them to acquire practical and real problem solving skills while leaning the fundamental knowledge of their subjects.This paper discusses the features and advantages of case based teaching and gives a detailed discussion of an effective way to implement case based teaching by taking case based teaching of medical immunology as an example.

Rectal carcinoid tumors are potential malignant and have been considered to be rare for a long time.But in recent years,the incidence has been increasing gradually,maybe due to the development of endoscopic technology,the widespread use of endoscopy for screening and the raising level of awareness.Because of the malignant tendency,early diagnosis and treatment are the most important things for patients.Nowadays,the misdiagnosis rate is still high and it is difficult to make differential diagnosis between benign and malignant tumors.The efficiency of chemotherapy and radiotherapy is not clear.Surgery is the only effective method,but there is no uniform standard for the choice of operation.At present,it is appropriate to consider tumor size,depth of invasion,lymph node,pathological type and other risk factors to determine a surgical modality.Colonoscopy is recognized to be the best means by follow-up and should be carried out regulady in a longer period of time.Therefore,it is important to summarize the diagnosis and treatment of rectal carcinoid.

Objective To construct the conditionally replicating adenovirus vector Ad-delE1b55kD-shRNA/Survivin-EGFP that can transfects into HT-29 effectually and selectively and contains shRNA targeting to human Survivin gene.Methods EGFP geoe and shRNA gene were inserted into pAd-delE1b55kD,then pAd-delE1b55kD-shRNA/Survivin-EGFP was obtained.The plasmid and pBHGE3 were cotransfected into HEK-293 cell to obtain the conditionally replicating adenovirus vector Ad-delE1b55kD-shRNA/Survivin-EGFP.Then DNA of the adenovirus vector was extracted and identified.The transfection efficiency of the vector to HT-29 and LO2 was detected.The expression of Survivin mRNA and protein was detected by RT-PCR and Western blot.Results EGFP gene and shRNA gene targeting to human Survivin mRNA were inserted into conditionally replicating adenovirus vector successfully,proven by sequencing.The transfection efficiency to HT-29 of Ad-delE1b55kD-shRNA/Survivin-EGFP was significantly higher than replication defective adenovirus and liposome vector(P

Sorafenib,a novel oral multikinase inhibitor,targts on serine/threonine kinase and tyrosine kinases receptor of the tumor cells and vasculature.So Sorafenib can inhibit the tumor cell proliferation and revascularization.400 mg sorafenib administered twice a day is chosen as the recommended dosage for several phase Ⅰ studies,and it shows broad-spectrum antitumor activity in renal cancer,hepatocellular carcinoma,melanoma and non-small-cell lung cancer(NSCLC)in phase Ⅱ and Ⅲ clinical trials.Now FDA has approved the usage of sorafenib in renal cancer therapy.

An endogenous suppressor of apoptosis, the inhibitor of apoptosis proteins(IAP) plays a key role in the occurrence and progression of cancer. In recent years cancer researches have been focused on gene-specific inhibitors with IAP as the target, so as to seek gene therapeutic strategies of less toxicity and higher efficiency. As members of IAP family, survivin and livin are over-expressed in tumors. Meanwhile, Smac can directly inhibit IAP. These findings suggest a promising alternative strategy for developing novel anticancer therapies.-

The standard surgery intern orientation is very important. The surgery intern orien-tation is completed by surgery education division (SED) in the U.S.A. The orientation includes speech from director of surgery department. the interaction part presided by surgical teachers, topic groups for discussing. Then the faculties of SED will explain the core competences which are required by accred-itation council on graduate medical education (ACGME), educational activities of department, the re-view process for resident physicians. The orientation also includes occupation development plan for residents; manners, teamwork and communication to patients; surgical basic skills training, system management, feedback and evaluation etc. The expectation of this article is for the improvement of Chinese surgery intern orientation.

Objective To analyze the curative effect of double path endoscopic surgery in the treatment of fungal sinusitis,and to compare with the effect of simple in endoscopic nasal passages windowing.Methods The clinical data of fungal sinusitis patients were analyzed.According to the different surgery way,the patients were divid-ed into two groups.The observation group:nasal endoscopic nasal passages open a window in the joint of fangs nest small windows double path;Control group:simple in nasal endoscopic fenestration.Results The observation group had 35 cases and the control group had 37 cases.After treatment,the symptoms score of the observation group was sig-nificantly lower than the control group [(1 .09 ±0.83)points vs (1 .47 ±0.77)points;t =2.01 5,P =0.048].The effective rate of the observation group was significantly higher than the control group (94.29% vs 75.68%;χ2 =4.81 3,P =0.028).7 days after treatment,the C -reactive protein(t =4.971 ,P <0.01 ),TNF alpha(t =9.1 9,P <0.001 ),beta IL -1 (t =5.635,P <0.01 ),white blood cells (t =3.25,P =0.002)and IL -6(t =3.86,P =0.002) in the observation group were significantly lower than the control group (P <0.05).The preoperative plasma level of 1 -3 -β-glucan D between the two groups had no statistical difference (P >0.05).2(t =5.978,P <0.01 ),4(t =6.335,P <0.01 ),6(t =9.348,P <0.01 ),and 8 days(t =8.226,P <0.01 )postoperatively,1 -3 -β-glucan D levels were significantly lower than the control group,the differences were statistically significant (P <0.05).The postoperative recurrence rate of the observation group was significantly lower than the control group (8.57% vs 27.03%,the Log -rank χ2 =4.061 ,P =0.044).Conclusion In fungal sinusitis treatment,the use of endoscopic nasal passages open window joint fangs nest small windows double path can more effectively remove lesions,its forward curative effect is superior to pure in nasal endoscopic fenestration.

OBJECTIVE To investigate the effect of tranilast on cardiac fibroblasts proliferation and phenotype transformation incubated with a high concentration of glucose and the possible mechanism. METHODS The cardiac fibroblasts were divided into seven groups in accordance with different nutrient solutions:normal control group(5.5 mmol · L-1 glucose),hypertonic group(5.5 mmol · L-1 glucose+mannitol 25 mmol · L- 1),high glucose group (25 mmol · L- 1 glucose),tranilast intervention groups (25 mmol·L-1 glucose+tranilast 50,100 and 200μmol·L-1),and activin receptor-like kinase 7(ALK7) inhibitor group(25 mmol · L-1 glucose+10μmol · L-1 SB431542). The cell proliferation was detected by MTT method. The transformation of cardiac fibroblasts was determined by immunfluorescence staining. The expression of fibroblast specific protein 1 (FSP-1),α-smooth muscle actin (α-SMA),transforming growth factor-β1(TGF-β1)and ALK7 was assessed by Western blotting. RESULTS Compared with nor?mal control group,A492 nm of cells in high glucose group was significantly increased(P<0.01),while the expression of α-SMA,TGF-β1 and ALK7 protein in high glucose group was significantly increased(P<0.01),but FSP-1 protein was significantly decreased(P<0.01). There was no difference between normal control group and hypertonic group. Compared with high glucose group,A492 nm of cells in tranilast or SB431542 intervention groups were decreased(P<0.05),and the expression of α-SMA,TGF-β1 and ALK7 protein was significantly decreased(P<0.05),but the expression of FSP-1 protein was increased (P<0.05)in tranilast or SB431542 intervention groups. CONCLUSION Tranilast can inhibit the proliferation and phenotype transformation of cardiac fibroblasts induced by high glucose,which may be related to down-regulation of the expression of ALK7.

Objective]The article summarizes professor Fu Ping clinical evidence-based medicine in the experience of vicarious menstruation. [Methods] From disease name,pathogenesis,therapy and so on,summarize the experience and thoughts of treating,and for a case to analyze treatment characteristics and therapeutic effect. [Results]Fu Ping holds the view that the reason for the occurrence of vicarious menstruation is liver fire invading lung,lung or kidney Yin deficiency,qi stagnation blood stasis or liver-yang hyperactivity and spleen deficienty; The location of disease is in the lung,closely related with liver and kidney.The main therapy is to nourish Yin and moisten lung or clear liver and decrease internal heat. For the syndrome of liver-yang hyperactivity and spleen deficiently,Fu Ping using method of breeding earth and suppressing wood to treat is medicable.[Conclusion]Professor Fu Ping's experience in treating vicarious menstruation is worthy of study.