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 investigate the value of MR 3D CUBE T2WI sequence in displaying anatomical structure of knee joint.Methods Sixty cases of knee joints (30 cases in lesion group and 30 cases in control group) were scanned with conventional 2D and 3D CUBE T2WI sequence by HDXt 3.0T superconducting magnetic resonance of GE Signa imaging system and hased-array coil.The meniscus,articular cartilage,anterior and posterior cruciate ligaments demonstrated by two sequences were evaluated as excellent,good and poor grade,the results were comparatively analyzed by statistics.Results 3D CUBE T2WI was superior to conventional 2D sequence in displaying of articular cartilage,anterior and posterior cruciate ligaments,and inferior to conventional 2D sequence in displaying of meniscus(all P =0.000).When we put excellent and good levels of image quality as according with diagnostic requirement.The satisfaction rate demonstrating anterior and posterior cruciate ligaments by 3D CUBE T2WI sequence in lesion and control group were 100％,articular cartilage was 93.33％ in control group and 90.00％ in lesion group,while the meniscus was 30.00％ in control group and 33.33％ in lesion group.Conclusion MR 3D CUBE T2WI sequence is a sensitive technique in demonstrating ligaments and articular cartilage of knee joint,but it was inferior to conventional 2D sequence in displaying of meniscus.We should adopt it according to clinical diagnosis.

Objective To study the drug-time process of aurantiin in Rhizoma Drymariae in vivo.Methods By the optimization of the chromatographic condition,a reversed-phase HPLC was established to measure the content of aurantiin in the serum and the tissues of rats.Results After administration of total flavones of Rhizoma Drymariae to the rats by gavage,aurantiin started to be absorbed in 30 minutes and arrived at the peak in 90 minutes.The blood drug concentration decreased evidently 4 hours after gavage and maintained at a certain level in 8 hours.The drug concentration was highest in the stomach and bowels,but decreased quickly.The concentration in the liver,lungs and kidney came next and can be determined in the muscles and fat;however,it was very low or zero in the brain.Conclusion This method is convenient,sensitive,rapid and without the interference of other impurities.It is suitable for the determination of aurantiin content in the serum and tissues of rats.Administering total flavones of Rhizoma Drymariae to the rats by gavage,aurantiin is absorbed slowly and maintains for a long time and subsides slowly in the blood.

A lot of problems have turned up with the development of the urban employee's basic medical system. So we need to establish a set of scientific medical evaluation index system to weigh it. This article discusses the evaluation index of the medical insurance from the respects of fairness, efficiency and development.

Objective To describe the current status of adult overweight and obesity in urban and suburb areas of Tianjin.Methods 2 283 adult people including 1 131 from urban and 1 152 from suburb were selected by multi-stage cluster random sampling.The waist circumference,weight and height of the subjects were measured.Then the BMI was calculated.Results The mean BMI of adult people in Tianjin was 25.05?5.02 kg/m2,the overweight rate was 36.9%,the obesity rate was 20.0% and the abdominal obesity rate was 63.9%.The prevalent rates of overweight,obesity and abdominal obesity in different age groups showed significant differences.The rates of overweight,obesity and abdominal obesity increased with ages in urban area.The overweight rate in 40～49 yrs and the obesity rate in 50～59 yrs reached their peak values in suburb.Besides the overweight rate in urban was significantly higher,the obesity rate and abdominal obesity rate were no significant differences between urban and suburb.The prevalent rates of overweight,obesity and abdominal obesity showed no significant differences between the adult male and female in Tianjin,but the prevalent rates of obesity and abdominal obesity in female were significantly higher than those in male in the suburb.The prevalence of obesity in the middle-ages showed significant differences between different occupational population,the retired taking the highest while the workers taking the lowest value.The prevalence of obesity showed no significant differences between population with different education background and different income situation.Conclusion The rates of adult overweight and obesity in Tianjin were higher than those of all over the country in 2002,and the abdomen obesity reached to 63.9%.Intervention should be taken to change this situation as soon as possible.

Objective To explore the application of mini-laparoscopy in the diagnosis and management of nonpalpable undescended testis in children.Methods 38 cases of impalpabal testes(46 testicular) had been operated by mini-laparoscopy in children with cryptorchidism.Results 38 children with nonpalpable undescended testis (46 testicular) had been operated by mini-laparoscope.Results After laparoscopic exploration,inguinal probe and postoperative pathology,it had been confirmed that 2 testicular were absent,34 testicular were found in high inguinal location,10 testicular were located in intraperitoneal cavity.In addition to the absent testicular,the rest had been performed with mini-laparoscope:one period descent fixation 41 testes,Fowler-Stephens (F-S) installment orchiopexy three testes.Follow-up with side testicular atrophy 2,including one period orchiopexy a testis,F-S installment fixation a testicular; Testicular rebound 1,who had been operated with one phase of testicular descent fixtion.Conclusion For inguinal failed to find the testicular,children with cryptorchidism should be done by laparoscopy because of its positioning accuracy,and most children can do a period drop fixed,but for those really intraperitoneal more exalted person,stage surgery should be needed.Its overall treatment effect is satisfactory and is worth popularizing.

Objective     To compare the clinical efficacy of subxiphoid video-assisted thoracoscopic surgery (XVATS) and conventional intercostal VATS (CVATS) extended thymectomy for myasthenia gravis (MG). Methods    The clinical data of MG patients who underwent extended thymectomy in the Department of Thoracic Surgery of Xuzhou Central Hospital from October 2016 to October 2021 and finished the follow-up were retrospectively reviewed. They were divided into an XVATS group and a CVATS group according to the procedure. The perioperative variables and clinical efficacy of the two groups were compared. Results    A total of 84 patients were collected, including 43 males and 41 females, with a mean age of 52.3 years. There were 41 patients in the XVATS group and 43 patients in the CVATS group. There was no mortality, cardiopulmonary thrombosis, prolonged air leak, or mediastinal infection. Additionally, the CVATS group recorded 5 (11.6%) patients of conversion to open thoracotomy, 1 (2.3%) patient of postoperative MG crisis, 1 (2.3%) patient of bleeding in thorax, and 1 (2.3%) patient of chylothorax. The operation time (127.4±50.4 min vs. 122.9±38.6 min), intraoperative bleeding [46.9 (25.7, 79.2) mL vs. 45.7 (21.9, 92.1) mL], incidence of complications [0 vs. 7.0% (3/43)], chest tube duration (4.3±1.9 d vs. 4.8±2.8 d), follow-up time (19.1±8.5 months vs. 22.5±13.7 months), the proportion of residual mediastinal fat tissue [12.2% (5/41) vs. 4.7% (2/43)], and total MG remission rate [29.3% (12/41) vs. 51.2% (22/43)] were not statistically different between the two groups (P>0.05). However, the two groups showed  significantly different incidence of conversion to open thoracotomy [0 vs. 11.6% (5/43), P=0.024], postoperative hospital stay time (8.2±3.3 d vs. 11.4±5.8 d, P=0.003) and total drainage volume [396.7 (173.8, 542.5) mL vs. 218.8 (102.1, 430.0) mL, P=0.038]. Conclusion    XVATS extended thymectomy is technically safe and feasible; however, more evidence is warranted before the recommendation of this approach for the treatment of MG.

OBJECTIVETo investigate the application of the dorsal metacarpal perforator sliding flap for web-space reconstruction in congenital syndactyly.

METHODSAccording to the size and shape of skin defect at the web space after division operation of syndactyly, the corresponding intermetacarpal perforator sliding flap was designed. The edge of the flap was cut off, but its underlying tissue was not dissected. From May 2007 to November 2012, 28 web-spaces in 15 patients with syndactyly (10 male and 5 female) were reconstructed.

RESULTSAll the 28 flaps survived completely. The flap size ranged from 3 cm x 2 cm to 1.5 cm x 1.0 cm. 14 cases with 26 flaps were followed up for 10-22 months (average, 14.5 month). The reconstructed web spaces had normal appearance and movement range. The 2-point discrimination distance was 9-13 mm (average, 11 mm). According to the Swanson Standard, 18 fingers were graded as excellent, 8 as good and 2 as fair (excellent and good, 92.6%, 26/28).

CONCLUSIONSReconstruction of web-space in syndactyly with the dorsal metacarpal perforator flap has the advantages of easy handling, good cosmetic and functional results.

Objective To investigate the value of CARE Dose 4D technique in decreasing radiation dose and improving image quality of multi-slice spiral CT in adult chest scanning.Methods 100patients of chest CT scanning were equally divided into study group and control group randomly.CARE Dose 4D Technique was used in study group.Effective mAs value,volume CT dose index (CTDIvol) and dose length product (DLP) were displayed automatically in machine while chest scanning; those values and actual mAs value of every image were recorded respectively.The image quality at apex of lung,lower edge of aorta arch,middle area of left atrium and base of lung on every image of 400 images was judged and classified as three level (excellent,good,poor) by two deputy chief physicians with double blind method,the image noise at corresponding parts was measured.Results While setting 80 mAs for quality reference mAs,the effective mAs value in study group most decreased 44 mAs than control group with an average decrease of 9.60( 12.0% ) ,CTDIvol with 4.75 mGy with an average decrease of 0.95 mC y( 11.0% ) ,DLP 99.50% in study group,with 98.0% in control group.But it was higher at apex of lung and base of lung,lower at middle area of left atrium,and similar at lower edge of aorta arch in study group than contrast group.The image noise were lower at apex of lung and base of lung in study group than control group (t =6.299 and 2.332,all P ＜ 0.05 ) ,higher at middle area of left atrium in study group than control group (t=3.078,P ＜0.05) and similar at lower edge of aorta arch in study group than control group (t =1.191,P ＞0.05).Conclusions CARE Dose 4D technique provides a function regulated mAs real-time on line,it not only raises utilization rate of radiation and decreases radiation dose,but also promises and increases image quality in chest CT scanning,and has some clinical significance.

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.