Ye Gui was praised in medical faculty for his knowledge and experience of nourishing fluid in stomach,however after reading his medical record all over,Ye Gui' academic idea of diffusing and obstruction-removing gastric yang in treating gastroenteropathy based on syndrome differentiation was more outstanding.The theory was based on "no vigorous gastric yang insulted easily gathered turbid yin".The concrete application features were in terms of "obstruction-removing and tonifying yangming meridians,and together treating liver and stomach","combination of diffusing and obstruction-removing gastric yang,warming spleen and removing obstruction in collaterals et al" and so on.Adopting the method of diffusing and obstruction-removing gastric yang at the right moment especially benefited the treatment of gastroenteropathy based on syndrome differentiation.

Objective To evaluate the diagnostic value of (1,3)-β-D-glucan assay (G test) in the plasma of premature infants with invasive fungal infection(IFI) and determinate the best diagnostic value of G test.Methods The premature infants who were at risk of IFI from NICU were enrolled in Shengjing Hospital of China Medical University from July 2010 to September 2011.The concentration of (1,3)-β-D-glucan were detected by GKT-5MSet microbial dynamic detection system,and the fungal and bacterial culture were performed in the same samples of blood.We used to perform statistic analysis for sensitivity,specificity,positive predictive value and negative predictive value at different cutoff values,and draw receiver operating characteristic curve for G test.Results Forty-four infants were eligible for the study,of 17 permature infants with IFI,and of 27 ones with non IFI,in whom bacterial culture was positive in 12 cases and culture was negative in 15 cases.The concentration of (1,3)-β-D-glucan in IFI group [5 ～ 3 117 pg/ml,median (Q75-25)190.60(501.44) pg/ml] was higher than that in non IFI group[5.0 ～434.3 pg/ml,median(Q75-25) 5.86(5.62) pg/ml],the difference was significant(Z =-3.77,P ＜ 0.01).15 pg/ml was the best cutoff value,and the area under curve was 0.839,95 ％ CI(0.697,0.980).Conclusion G test is useful in the diagnosis of IFI in premature infants with high sensitivity and specificity.G test can be used for the screening of high-risk patients with high risk of fungal infection ratio.

OBJECTIVETo compare the effect on surgical indicators and functional outcome between preoperative skeletal traction and skin traction for adult femoral fracture and guide the choice of preoperative traction method of adult femoral fractures.

METHODSFrom February 2008 to September 2012, 68 patients aged greater than 18-year-old with femoral fractures were treated and randomly divided into two groups according hospitalization order,the odd with skeletal traction of tibial tubercle (group A) and the even with skin traction (group B). In group A, there were 25 males and 9 females with an average age of (36.3±9.9) years old,including 11 cases with transverse fracture, 15 cases with oblique fracture, 8 cases with spiral fracture. In group B, there 26 males and 8 females with an average age of (37.1±11.0) years old,including 10 cases with transverse fracture, 13 cases with oblique fracture,11 cases with spiral fracture. The operative time,blood loss,the number and amount of blood transfusion ,fracture healing time, hemoglobin, pain scores and functional scores between two groups were analyzed and compared. Results:All patients were followed up, the follow-up time was (33.5±6.5) months in group A, (31.3±7.5) months in groupB. In group A,the operation time was (108.8±14.2) min and the intraoperative blood loss was (383.1±117.1) ml and the postoperative blood transfusion was 14 cases and the blood transfusion was (350.0±122.5) ml and the average bone healing time was(15.0±3.3) weeks. In group B, the operation time was (111.6±12.7) min and the intraoperative blood loss was (392.0± 116.7) ml and the blood transfusion was 11 cases and the blood transfusion was(327.3±129.1) ml and the average healing time was (15.5±3.4) weeks. These obseration indicators had no significant difference between two groups. There was no significant difference between two groups in terms of Hemoglobin, the pain scores before and after traction, the femoral fractures efficacy score,knee function score and knee range.

CONCLUSIONPreoperative skeletal traction does not reduce surgery time, blood loss and pain and so on. The bone healing time and limb functional outcomes were also not significantly improved.

Adult ; Blood Loss, Surgical ; Bone and Bones ; surgery ; Dermatologic Surgical Procedures ; Female ; Femoral Fractures ; physiopathology ; surgery ; Fracture Fixation, Internal ; Fracture Healing ; Humans ; Male ; Middle Aged ; Preoperative Period ; Traction ; Young Adult

AIM:To investigate the peripapillary retinal nerve fiber layer ( RNFL ) thickness and the macular ganglion cell complex ( GCC ) thickness in primary open angle glaucoma ( POAG ) eyes and to compare them with normal control eyes, and to evaluate the diagnostic ability of peripapillary RNFL thickness and macular GCC thickness in POAG.
●METHODS:This was a cross-sectional study consisting of 56 POAG patients. The control group consisted of 60 normal subjects (60 eyes) were matched in terms of age, sex, diopter and axial length. The peripapillary RNFL thickness and the macular GCC thickness of POAG eyes and normal control eyes were measured and compared by RTVue-100 optical coherence tomography ( OCT ) . To assess the diagnostic utility of peripapillary RNFL thickness and macular GCC thickness in POAG, receiver operating characteristic curves ( ROC ) and areas under the ROC ( AUC) were used.
●RESULTS:The POAG eyes had a thinner peripapillary RNFL and macular GCC than the control eyes at all the regions ( P < 0. 001 ). Multivariable linear regression analysis showed that the peripapillary RNFL thickness and macular GCC thickness was significantly thinner in association with the POAG diagnosis. ROC and AUC analysis showed that the best AUC parameters were C/D (AUC=0. 936; 95% Cl=0. 903, 0. 964) and superior RNFL thickness (AUC=0. 910;95% Cl=0. 889, 9. 455). The AUC of nasal RNFL thickness, inferior RNFL thickness, temporal RNFL thickness, superior GCC thickness, inferior GCC thickness, and average GCC thickness were all above 0. 8 with a good diagnostic value.
●CONCLUSION:The peripapillary RNFL thickness and macular GCC thickness in POAG eyes are thinner than that of normal control eyes. Decreased peripapillary RNFL thickness and macular GCC thickness may be associated with POAG. The peripapillary RNFL thickness and macular GCC thickness have a good diagnostic value.

Esophageal cancer is a cause of cancer mortality and accounts for the sixth most common cause of cancer-related death. The focus of recent study has shifted towards testing novel agents that target specific molecular abnormalities known to occur in esophageal squamous cell carcinoma (ESCC). The preclinical studies involving various cancer models, including ESCC, epidermal growth factor receptor (EGFR) over-expression, are linked to epithelial cell proliferation, differentiation and migration, and have an inverse relationship to tumor chemotherapy curability. Nimotuzumab is a humanized anti-EGFR monoclonal antibody that binds to the extracellular domain of the EGFR and inhibits EGF binding. In many phase Ⅱ trials, nimotuzumab showed marked antiproliferative, proapoptotic and antiangiogenic effects in tumors that overexpress EGFR. Some phaseⅢtrials are ongoing.

Objective To discuss the clinical application of multi-slice spiral CT angiography (MSCTA) in acute spontaneous intracranial hemorrhage .Methods 41 cases of acute spontaneous intracranial hemorrhage diagnosed with CT (including subarachniod cavity hemorrhage 29, intra-cerebral hematomas 12)were examined with MSCTA,the techniques of volume rendring (VR) and maximum intensity projection(MIP)were used. 7 cases of intracranial aneurysm closed by titanic clamp , 2 cases of cerebral arteriovenous malformation(AVM) and one case of AVM treated by intra-zest aneurysm excision,the post-operative MSCTA examination were received.Results 11 cases of intra-cerebral aneurysm, 4 cases of cerebral AVM and 1 case of AVM with intra-zest aneurysm were found among the 41 cases of acute spontaneous intracranial hemorrhage. MSCTA clearly demonstrated the size,neck and artery of aneurysms as well as the location, size ,zest shape, artery and vein of AVM. Pre-operative MSCTA findings of 7 cases of intracranial aneurysm clapped by titanic clap ,2 cases of cerebral AVM and 1 case of AVM treated by intra-zest aneurysm excision were confirmed with the operative findings.Post-operative MSCTA showed that the clamp location was normal; arteries were passable; zests of AVM were excised. Conclusion MSCTA is a non-injured, rapid and effective way to find the cause of acute spontaneous intracranial hemorrhage.It also has clinical application of post-operatiove assessment for intracranial aneurysm and cerebral AVM.

In this paper, a systematical and retrospective review was made on how the drug purchasing system of Chinese healthcare institutions has evolved from decentralized purchasing to centralized purchasing based on four stages as budding stage, initial stage, adjustment stage and deepening stage. In each stage, the working characteris-tics, achievements and problems have been analyzed. Targeting at the problems and challenges confronted with cur-rent drug purchasing, recommendations was made to reform and improve public hospitals’ centralized purchasing sys-tem, such as persisting centralized purchasing online at provincial level, sticking to “four favorable” principles, breaking through the mechanism of compensating medical cost with drug-selling profits, promoting coordinated inter-action reforms in healthcare insurances, distribution and pricing, strengthening comprehensive services and supervi-sion, etc.

Objective To study the method of Traditional Chinese Medicine EMR System application evaluation, design the evaluation index. so that to make the Traditional Chinese medicine EMR system evaluation more scientific and normative. Methods Based on the current situation of traditional Chinese medicine EMR system functional evaluation and the evaluation methods of EMR System Function Application Level Classification Evaluation Methods and Standards (Trial)formerly issued by the Ministry of Health to research traditional Chinese medicine EMR system application evaluation methods. Results Evaluation methods of traditional Chinese medicine EMR system should be the establishment form 3 part:establishing evaluation index system and evaluation standard, establishing qualitative and quantitative evaluation, and establishing evaluation scores system. Conclusion Traditional Chinese medicine EMR system application evaluation method provides a scientific basis for designing traditional Chinese medicine EMR system evaluation index system.

[Objective]To analysis the unstable pathogeny of the superior cervical congenital deformity for the operative method selection. [Methods]65 patients with congenital superior cervical deformity were treated from January 2003 to June 2007,in which there were 39 male patients,and 26 female patients. The X-ray,CT and MRI were examined generally before operation. In the images,there were 32 cases with formation failure deformity,18 cases with segmentation failure deformity,and 15 cases with abnormal structure deformity. 37 cases with easy reduction and no anterior compression were treated with posterior internal fixation and self cancellous bone graft for fusion. The other 28 cases with impossible reduction and anterior spinal cord compression were treated with anterior odontoid resection and decompression,and then posterior internal fixation and self cancellous bone graft for fusion.[Results]All of the operations were sucesseful without never and vascular injury and other serious complication. There were 47 cases following up 12 to 24 months in the 65 cases,and the mean follow up 15 6 months.One case's broken up titanium rod were treated with replacing new rod and bone graft,and the other cases showing bone fusion. There 28 cases following up in 34 cases with superior cervical pain and resticted movement,in which the pain was decreased or disappeared. There were 19 cases following up in 31 cases with numb limbs and superior never center injury. The preoperative Frankel score showed 5 cases B,8 cases C,and 17 cases D. The postoperative Frankel score of following up cases showd 5 cased C,6 cases D,and 8 cases E,and the score increased one or two degree.[Conclusion]The posterior,or anterior-posterior approach was selected by the condition of congenital superior cervical pathogeny,atlantoaxial reduction and spinal cord compression.

[Objective]To investigate the application of thoracolumbar injury classification and severity thoracolumbar injuty chassification and severityscdre(TLICS)score in spinal fracture caused by earthquake.[Method]Night-five patients with spinal fractures were treated in Chendu Army General Hospital and Chendu Air Force Hosptial by Wenchuan earthquake medical team from Chinese PLA General Hospital.There were 49 males and 46 females with mean age of 48.6 years.The general patient data,injury mechanism,and injury time were recorded.The different treatments were decided by the TLICS score.[Result]There were 107 vertebral fractures in the 95 patients,out of whom 76 patients were injured by building collapsed,and the other 19 by falling from buildings.TLICS score was more than 4 in 36 patients,4 points in 15 patients,less than 4 points in 44 patients.40 patients were treated with open operation,15 patients with vertebraplasty,and the other patients with conservative treatment.[Conclusion]The earthquake spinal fractures can be treated with different treatments based on the different TLICS scores.