Objective] To explore the relationship between excessive internal heat in TCM and intestinal microflora ,provide scientific evidences for pathogenesis of excessive internal heat.[Method]With the research methods of clinical observation and literature review,analyze the characteristics of excessive internal heat,and collect research progress about intestinal microflora to find out the link.[Result] Head and facial tissue is more susceptible to injury,which is determined by the organizational characteristics. People suffering from excessive internal heat widely have problems of energy metabolism and mucosal immune disorders. Intestinal microflora plays an important role in energy production,conversion,storage and use.They can change the way that organizations use energy,and change AMPK phosphorylation to influence the energy metabolism of the body.Thus gut microflora imbalance may lead to disorders of energy metabolism.On the other hand,inflammatory mediators express abnormally in these people. Impaired immune function leads to inflammatory states,which causes imbalance of gut microflora.While intestinal microflora also can regulate intestinal mucosal immune response by adjusting related effective factors. [Conclusion]Excessive internal heat is closely related with intestinal microflora from the aspects of energy metabolism and mucosal immunity,which may provide new ideas to explore the pathogenesis of this disease.The researches based on intestinal microflora and diseases bring brilliant prospects of individual prevention and treatment for TCM and western medicine .

ObjectiveTo observe the effect of Chinese medication and acupuncture-moxibustion plus Western medication on the pregnancy rate after in-vitro-fertilization and embryo transfer (IVF-ET) in different age groups.MethodTotally 810 eligible patients enrolled between 1st January 2010 and 31st December 2013 from the Reproduction and Infertility Department were categorized into 3 groups according to the age, respectively 20-29 years old, 30-39 years old, and 40-49 years old. The pregnancy rates of the three groups were compared, and the pregnancy rate of IVF-ET after the treatment of the integrated treatment of Chinese and Western medicine was also statistically analyzed.ResultThe pregnancy rate was 54.3% in the group of 20-29 years old, versus 46.4% in the group of 30-39 years old and 26.0% in the group of 40-49 years old, and the total pregnancy rate of IVF-ET was 47.2%. ConclusionThe younger, the higher the pregnancy rate of IVF-ET, and intervention of traditional Chinese medicine following the assisted reproductive technique can enhance the pregnancy rate of IVF-ET.

This article mainly discusses the psychological state of senile patients in dental prosthesis on the view of medical ethics.To achieve good relationship and cooperation between doctors and patients,the author brings forward some suggestions.Doctors should make great efforts to improve their comprehensive qualificatios,show respect to patients and try to meet their reasonable demand,and moral responsibility must be strong enough when facing with senile patients.

0.05).After 30 minutes treatment,93% patients in labetalol group reached goal blood pressure(0.05).However,tachycardia was significantly(P

BACKGROUND:Tranexamic acid is a synthetic anti-fibrinolytic drug, and can effectively control blood loss after total knee arthroplasty through vein. OBJECTIVE:To evaluate the effectiveness and safety of tranexamic acid in reducing blood loss after primary unilateral total knee arthroplasty. METHODS:From 2014 to 2015, 100 patients from the Department of Lower Limb, Sichuan Orthopaedic Hospital underwent primary unilateral total knee arthroplasty, and randomly divided into test group which used tranexamic acid and control group which used tranexamic acid, with 50 cases in each group. 1 g tranexamic acid was infused into the vein at 10 minutes before total knee arthroplasty in the test group, but tranexamic acid was not given in the control group. RESULTS AND CONCLUSION:The amount of total blood loss, postoperative wound drainage in 24 hours, and the amount of blood transfusion were significantly less in the test group than in the control group (P < 0.05). No significant differences in intraoperative blood loss and the number of patients receiving blood transfusion were found between the test and control groups. No significant difference in preoperative hemoglobin levels was detected before surgery, but hemoglobin levels were decreased after surgery between the two groups. Postoperative hemoglobin levels were apparently higher in the test group than in the control group after surgery. At 24 hours after surgery, no significant difference in coagulation was detectable between the two groups. At 6 days, double lower limb vein color Doppler ultrasound examination did not reveal deep vein thrombosis in both groups. These findings verify that treatment with tranexamic acid in the vein before primary unilateral total knee arthroplasty can evidently diminish the amount of perioperative blood loss and blood transfusion, reduce the risk and cost of blood transfusion, which is good for rehabilitation and does not increase the risk of deep vein thrombosis.

OBJECTIVE To explore the pro-apoptotic mechanism of juglone in SiHa cells and to in?vestigate its associated signal transduction pathways. METHODS SiHa cells were treated with juglone 20μmol·L-1 for 24,48 and 72 h. Cellular morphology was detected by inverted microscopy.The cell viability was detected by methyl thiazolyl tetrazolium (MTT) assay. After 24 h treatment with juglone 20μmol·L-1,the cell apoptosis was detected by flow cytometry while the expressions of apopto?sis-related protein BCL-2,BAX and cleave-caspase-3,PI3K/AKt pathway-related protein PTEN,AKT and pAKT were detected by Western blotting. RESULTS After treatment with juglone for 24, 48 and 72 h,the growth of SiHa cells was significantly inhibited. Compared with cell control group,cells in juglone treated gruop were sparse,slipped off the wall,became round and the cell proliferation inhibitory rate was 43.3%,63.0%and 73.1%(P<0.05,P<0.01),respectively. Twenty-four hours post treatment, the early apoptosis rate of juglone treated gruop cells was increased by(6.47±1.79)%(P<0.01)compared with cell control group. Western blotting results showed that the expression of BCL-2 decreased by 53.0%while the expression of BAX and caspase-3 increased by 85.5%and 183.3%,respectively. The expression of PTEN was increased by 75.0% but the pAKt was decreased by 45.8%(P<0.01). CONCLUSION Juglone can upregulate the expression of PTEN, thus inhibiting PI3K/AKt pathway and promoting apoptosis of SiHa cells.

Objective To investigate the predictive value of acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) for nursing workload in emergency intensive care unit (EICU).Methods A retrospective cohort study was conducted. Critical patients except for trauma admitted to EICU of West China Hospital of Sichuan University from June 2012 to July 2016 were enrolled. APACHE Ⅱ score and therapeutic intervention scoring system (TISS-28) score were calculated in each case. The relationship between APACHE Ⅱ score and TISS-28 score was analyzed by correlation analysis and curve estimation.Results A total of 1148 patients were enrolled, including 689 male (60.0%), and age of (56±19) years old, APACHE Ⅱ score was 19 (13, 25), and TISS score was 19 (13, 25). The Spearman correlation coefficient between APACHE Ⅱ score and TISS-28 score was 0.849 (P < 0.001), and that among the linear model quadratic model, composite model, growth model, logarithm model, cubic model and exponential modelR2 were 0.669, 0.710, 0.792, 0.764, 0.765, 0.765, respectively (allP < 0.01), and the most suitable description for relationship between APACHE Ⅱ score and TISS-28 score curve was cubic model. The nursing workload was significantly increased when APACHE Ⅱ score ≥30, and it was decreased when APACHE Ⅱ score < 30.Conclusion APACHE Ⅱ was a useful score for predicting the nursing workload in EICU.

Objective:To explore the mechanism of promotion effect of juglone combined with cisplatin on the apoptosis of human cervical cancer HeLa cells,and to clarify the effects of its associated signal transduction pathways.Methods:The HeLa cells at logarithmic growth phase were divided into control group,juglone group, cisplatin group and juglone combined with cisplatin group (combined treatment group).The inhibitory rates of proliferation of HeLa cells were detected by MTT assay.The apoptosis was detected by Hoechst 33258 staining. The expressions of Bcl-2, Bax and caspase-3, AKt, and pAKt were detected by Western blotting method. Results:The MTT results showed that the HeLa cell proliferation at 24,48 72 h in each drug group was inhibited;compared with control group,the profileration of HeLa cells in juglone group and cisplatin group was significantly inhibited,especially in combined group. Compared with single drug group,the inhibitory effect in combined treatment group was more significantly.After treatment for 12 h,the typical morphological changes of apoptosis were found in juglone group and cisplatin group by Hoechst 33258 staining,especially in combined treatment group. The Western blotting results showed that the expression levels of Bcl-2 and pAKt in HeLa cells in juglone group and cisplatin group 12 h after treatment were decreased obviously,whereas the expression levels of Bax,Caspase-3,and AKt were increased significantly, especially in combined treatment group compared with control group. Conclusion:Juglone combined with cisplatin could inhibit the PI3K/AKt pathway,thereby promoting the apoptpsis of HeLa cells.

Objective Preoperative preparation of blood is common.The preoperative blood ordering and transfusion practices for elective obstetric surgery were evaluated in our Renji hospital in order to develop a reasonable preoperative blood preparation schedule for those procedures where a cross-match appears necessary.Methods We evaluated blood ordering practices in total 16 232 elective obstetric surgeries in our hospital from January 1,2013 to June 30,2017 retrospectively.The age of patients,preoperative diagnosis,surgical procedures type,preparation volume of blood,intra-operative transfusion volume of blood,and excessive usage ratio of blood were calculated and analyzed.Results 455 patients transfused intraoperatively total 1 610 U red blood cells.The usage ratio of blood was 2.80％ for patients and 4.87％ for blood preparation volumes respectively.Placenta previa,ectopic pregnancy,twin pregnancy accounted for the first three of the possibility of intraoperative blood transfusion in obstetric surgeries.Conclusion The relationship between preoperative diagnosis and the risk of blood transfusion in obstetric surgery should be take attention to.Preoperative blood typing,antibody screening and appropriate cross-matching could ensure the safety of obstetric surgery.

Objective: To investigate the mediating effect of insomnia among mobile phone addiction, aggressive behaviors and self-perceived identity among university students. Methods: A total of 740 university students were sampled from five universities in Binjiang District, Hangzhou City using a cluster random sampling method. The mobile phone addiction, aggressive behaviors and self-perceived identity were assessed using the Mobile Phone Addiction Index Scale, the Athens Insomnia Scale, the Chinese college students' version of the Buss-Perry Aggression Questionnaire, and the Self-Perceived Identity Scale, and the mediating effect of insomnia among mobile phone addiction, aggressive behaviors and self-perceived identity was examined using Process macro program and Bootstrap method. Results: A total of 740 questionnaires were allocated, and 700 valid questionnaires were recovered, with an effective recovery rate of 94.59%. The respondents included 221 men (31.57%) and 479 women (68.43%), and there were 607 respondents with a specialty of medicine (86.71%). There were 331 participants detected with mobile phone addiction (47.29%), 90 with aggressive behaviors (12.86%) and 289 with low-level self-perceived identity (41.29%), and the prevalence rates of mild, moderate, severe and extremely severe insomnia were 28.00%, 26.14%, 26.43% and 19.43% among respondents, respectively. Mobile phone addiction had a direct predictive effect on aggressive behaviors (β=0.301, P<0.001) and self-perceived identity (β=-0.129, P<0.001), and presented an indirect predictive effect on aggressive behaviors (effect of mobile phone addiction on insomnia: β=0.083, P<0.001; effect of insomnia on aggressive behaviors: β=0.999, P<0.001; effect of insomnia on self-perceived identity: β=-0.698, P<0.001). The contributions of mediating effects caused by insomnia were 21.61% and 31.02% to total effects. Conclusions Insomnia presents partial mediating effects among mobile phone addiction, aggressive behaviors and self-perceived identity among university students. Mobile phone addiction may directly affect aggressive behaviors and self-perceived identity, and indirectly affect aggressive behaviors and self-perceived identity via insomnia.