To raise clinical curative effect through quantitative and synthesize analysis of Traditional Chinese Medicine (TCM). According to Zhongjing’s medicine usage regulation and the author’s clinical fulfillment, a generalization, contrast and synthesize analysis among the same kind medicines is carried on in the text. It put forward the conception of "First-line medicine" for the first time and carried on detailed treatise of its nature, effect, classification, application and regulation. Meanwhile, the important role and function of "First-line medicine" is conf irmed in the text, and hope it is wished to helpful to the usage of TCM in clinical practice.

Objective To evaluate the clinical effects of total knee arthroplasty (TKA) in treatment of severe adults Kashin-Beck disease (KBD). Methods Sixteen cases of KBD patients underwent TKA in Shaanxi Provincial People's Hospital, including 2 males (2 knees) and 14 females (17 knees), aged 41 to 56 years, mean (56.38 ± 6.40) years, left knee in 8 cases and right knee in 11 cases, knee varus in 15 cases and valgus knees in 4 cases. Visual Analogue Scale/Score (VAS), Hospital for Special Surgery (HSS) scores, knee range of motion, varus deformity and postoperative complications were observed before and after TKA. Results In this group of TKA patients, the levels of VAS scores in pre-total knee arthroplasty (pre-TKA), 2 weeks post-total knee arthroplasty (post-TKA), 3 months post-TKA, and at the end of the follow-up were 7.51 ± 1.00, 3.56 ± 1.29, 1.83 ± 1.40 and 1.10 ± 0.87, respectively. The level of VAS scores in 2 weeks post-TKA was significantly lower than that in pre-TKA (P<0.01), and the VAS levels were continued to decrease in post-TKA (all P< 0.01). Total HSS score at the end of the follow-up post-TKA was 78.60 ± 5.30, which was significantly higher than that in pre-TKA (43.59 ± 10.08, t=19.21, P< 0.01). At the end of the follow-up post-TKA, in addition to the muscle strength, the levels of pain, knee function, activity, flexion deformity and stability (25.94 ± 4.17, 15.88 ± 3.70, 14.09 ± 1.03, 6.79 ± 2.25, 8.58 ± 1.30) were significantly higher than those in pre-TKA (11.56 ± 5.39, 7.56 ± 1.75, 9.86 ± 3.85, 3.05 ± 3.22, 5.00 ± 3.07, t= 16.00, 8.32, 6.43, 7.07, 6.95, all P< 0.01). At the end of follow-up post-TKA, the knee degree of extension [(3.05 ± 2.71)°] was significantly lower than that in pre-TKA [(15.11 ± 11.30)°, t= -5.40, P< 0.01], the knee degree of flexion [(115.79 ± 9.65)°] was significantly higher than that in pre-TKA [(93.95 ± 22.40)°, t=6.02, P< 0.01), the degree of varus [(2.40 ± 2.40)° ] and valgus [(3.75 ± 2.50)° ] deformity was significantly lower than those in pre-TKA [(11.33 ± 10.43)°, (18.00 ± 5.72)°, t = - 4.15, - 3.61, all P< 0.05]. One patient was diagnosed as knee tuberculosis in 6 months post-TKA. There was no complication in this group of patients. Conclusion The TKA in severe adults knee of KBD can significantly reduce knee pain, improve knee function, correct joint deformities and improve quality of life in patients, and shows good clinical results.

Objective:To explore the mRNA differential expression and clinical effect of leptin in different kinds of ovarian cancer.Methods: 129 patients with ovarian cancer and 42 controls were collected from Jun.2015 to Jun.2016 in our hospital.We got a small tissue by ovarian biopsy guided under the ultrasonic processing,detected the total RNA,purified mRNA and analyzed the correlation of the expression of leptin in different kinds and clinical stages of ovarian cancer.Results: Compared with the control groups,the mRNA expression of leptin in each group was increased(P<0.05),and the serous adenocarcinoma group increased obviously(P<0.05).Patients with clinical stage FIGO Ⅲ was significantly higher than other stages in serous adenocarcinoma group(P<0.05).Conclusion: Leptin could express in different kinds and clinical stages of ovarian cancer,and may be a new detection index for early diagnosis of ovarian cancer.

Objective:To identify the HLA-DRB alleles associated with vitiligo and psoriasis in Chinese Han people of Jilin region.Methods:HLA-DRB alleles of 82 vitiligo patients and 80 psoriasis vulgaris patients were detected by polymerase chain reaction sequence-specific primer(PCR-SSP),under the comparison with 86 healthy persons.Results:①The frequence of HLA-DRB1* 07 and HLA-DRB1*12 alleles increased obviously in vitiligo group compared with control group(P

Objective:To analyze the serum IgG titers to Aggregatibacter actinomycetemcomitans ( Aa ) and associated factors in patients with aggressive periodontitis (AgP).Methods:Venous blood samples were collected from 62 AgP patients and 45 periodontal healthy controls , unstimulated whole saliva and pooled subgingival plaque samples of AgP patients were also collected for the detection of Aa ( PCR method) .Serum IgG titers to Aa serotype c were measured by enzyme-linked immunosorbnent assay ( ELISA) .Results:The detection rates of serum IgG to Aa serotype c in the AgP patients and the healthy controls were both 100%.The AgP patients exhibited significantly higher IgG titers to Aa serotype c than the healthy controls (11.1 ±1.9 vs.9.1 ±1.8, P<0.01).There was no significant difference in serum IgG levels to Aa serotype c and in the prevalence of high-responding patients to Aa serotype c between the incisor-first molar type AgP patients and generalized AgP patients .Serum IgG titers to Aa serotype c in the Aa-positive AgP patients ( the patients who were Aa-positive in subgingival plaque or saliva ) were sig-nificantly higher than those of the Aa-negative patients (11.9 ±1.3 vs.10.7 ±2.1, P<0.05).Con-clusion:Serotype c was the main serotype of Aa in Chinese patients with AgP .Serum IgG responses in generalized AgP patients were comparable to those in incisor-first molar type AgP patients .

Objective To investigate the mental health and its influential factors in wounded or disabled in patients 100 d after earthquake.Methods Sixty-one patients,sampled from inpatients who were wounded or disa bled during the earthquake and hospitalized 100 d,were assessed with SCL-90.Results Twenty-eight(45%) patients'scores of SCL-90 were>160.The mental health of wounded or disabled patients after earthquake WaS corre lated with the severity of themselves physical disability.acception of early psychological intervention and the condition of wound or death in family members;but was not correlated with age,gender and education.Conclusion Patients who were wounded or disabled during earthquake had high incidences of mental disorder 100 d after earthquake.Their psychological recovery is as important ag physical recovery.

Objective: To explore the association of the single nucleotide polymorphisms (SNPs) in N-formylpeptide receptor (FPR) gene with the susceptibility of aggressive periodontitis (AgP). Methods: A total of 94 AgP patients and 73 healthy controls were entered into the study. Peripheral blood sample was obtained from each subject by venepuncture. Genomic DNA was isolated from each sample.The target fragment of FPR gene was amplified by PCR. The SNPs in FPR gene were detected by denature high performance liquid chromatography ( DHPLC) combined with DNA sequencing. Results: There were two non-synonymous SNPs in the 370 bp FPR gene fragment;289C/A and 301G/C. The 289C/Awas a novel SNP. No variation in nucleotides 329 and 378 was detected. There were no statistically significant differences in distributions of the genotypes and alleles for FPR289 and FPR301 between AgP patients and healthy controls. Using multivariate logistic regression (adjusted for age and gender) , it was showed that the adjusted Ors of AgP for the C~+ genotype and allele C of FPR301 combined with smoking were 5.74 and 5.20 respectively. Conclusion: The presence of the C~+ genotype/allele C of FPR301 together with smoking conferred a higher risk for AgP. The result suggests that the SNPs in FPR gene may not be associated with the susceptibility of AgP in Chinese.

Objective This study explored the expression of polyclonal protein SUZ12 in patients with intrahepatic cholangiocarcinoma(ICC),and its role in predicting the survival and treatment of ICC patients.Methods The expression of SUZ12 and p16INK4a was detected by immunohistochemical assay in 207 liver tissue samples including ICC patients,BilIN-1,-2,-3 and non-tumor-like cholangiocarcinoma.The expression of these proteins was assessed to be related to the pathological characteristics of the ICC patients receiving chemotherapy and the outcome of survival as well as the subsequent chemotherapy response.Results The expression level of SUZ12 was gradually increased from non-neoplastic bile duct tissue to BilIN-1,-2,-3 and ICC.The expression of p16INK4a protein was expressed in non-neoplastic-like cholangiocarcinoma,but it decreased gradually in BilIN-1,-2,-3 and ICC tissues.SUZ12 expression was associated with undifferentiated ICC,lymph node metastasis and advanced cancer.Kaplan-Meier curve analysis showed that ICC patients with high expression of SUZ12 had a significant reduction in overall survival and disease-free survival in comparison with ICC patients with the low expression of SUZ12.SUZ12 expression was significantly associated with overall survival of patients receiving adjuvant gemcitabine-based chemotherapy(AGC).Conclusion SUZ12 expression is able to predict the overall survival and disease-free survival of ICC patients with adjuvant gemcitabine-based chemotherapy.

BACKGROUND:Intermittent negative pressure has been proven to promote the repairing of soft tissue and bone healing, but the effect of negative pressure on the tendon-bone healing after anterior cruciate ligament reconstruction has not been reported.
OBJECTIVE:To research the effect of intermittent negative pressure on tendon-bone healing after anterior cruciate ligament reconstruction and on the biomechanics of tendon grafts.
METHODS:A total of 24 New Zealand white rabbits were randomly selected to establish the models of anterior cruciate ligament reconstruction of autogenous semitendinosus. The hind leg of one side was selected randomly as the negative pressure group, and the joint of the negative pressure side was connected with the micro-negative pressure aspirator through drainage tube and maintained a low-intensity and intermittent negative pressure;the contralateral hind leg was as the control and connected with ordinary drainage tube. Drainage tubes of both sides were removed at the same time after 5 days. At 6 weeks after modeling, the joint fluid was drawn to detect the expression levels of interleukin-1β;femur-ligament-tibia complex was used for tension measurement of tendon graft, and histological observation of tendon-bone interface.
RESULTS AND CONCLUSION:One rabbit had joint infection, and final y 23 rabbits were included in the study. Tension measurement results showed that maximum load for breakage in negative group pressure was significantly greater than that in the control group (P<0.05). Histological observation found that the number of osteoblasts in the negative pressure group was significantly more than that in the control group, and the difference was statistical y significant (P<0.01). Detection of synovial fluid showed that iterleukin-1βcontent in synovial fluid of the negative pressure group was lower than that in the control group, and the difference was statistical y significant (P<0.01). Intermittent negative pressure may play an active role in tendon-bone healing and modeling of tendon graft after anterior cruciate ligament reconstruction.

Objective:To investigate the potential association between FADS1 rs1 74537 polymorphism and serum proteins in patients with aggressive periodontitis,which may provide benefits for diagnosis and treatment of aggressive periodontitis.Methods:A total of 353 patients with aggressive periodontitis (group AgP)and 1 25 matched controls (group HP)were recruited in the study.Genotyping of FADS1 rs1 74537 and serum biochemical indexes were tested at the study’s start.The relationships between the levels of TP,GLB,ALB,A/G and genotyping were analyzed.Results:(1 )The detection rate of allele G in group AgP was higher than that in group HP(68.1% vs.61 .2%,P=0.046,OR=1 .35,95% CI 1 .00-1 .83 );the detection rate of genotype GG in group AgP was higher than in group HP(45 .5%vs. 34.4%,P=0.029,OR=1 .60,95%CI 1 .05 -2.44).(2)In group AgP,the patients with GG geno-type exhibited significantly lower TP,GLB than the patients with GT+TT genotype [(77.08 ±7.88)g/L vs.(79.00 ±4.66)g/L,P=0.007;(28.1 7 ±7.63)g/L vs.(29.88 ±3.49)g/L,P=0.007)and the higher A/G(1 .72 ±0.22 vs.1 .67 ±0.22,P=0.040),but there was no significant difference in ALB between the patients with GG genotype and the patients with GT+TT genotype.In group HP,there were no significant differences in TP,GLB,A/G and ALB between individuals with genotype GT+TT and with genotype GG.(3 )Compared with individuals with genotype GT+TT in group HP,the AgP pa-tients with genotype GT +TT exhibited significantly higher TP,GLB [(79.00 ±4.66 ) g/L vs. (75.20 ±4.53)g/L,P<0.01;(29.88 ±3.49)g/L vs.(26.55 ±2.94)g/L,P<0.01 )and the lo-wer A/G(1 .67 ±0.22 vs.1 .88 ±0.30,P<0.01 ),but there was no significant difference in ALB. There were no significant differences in TP,GLB,A/G and ALB the between the AgP patients with ge-notype GG and the healthy subjects with the same genotype either.Conclusion:FADS1 rs1 74537 poly-morphism is associated with aggressive periodontitis.The patients with genotype GG in group AgP had relatively lower TP,GLB and higher A/G.Genotype GG might be a risk indicator for aggressive periodon-titis by reducing host defense capability and contributing to inflammatory response in the occurrence and development of aggressive periodontitis.