[Objective]To explore LIU Wansu's methods in treating fire and heat disease from depression of yang qi.[Methods]To analyse LIU Wansu's understanding of fire and heat disease and highlight its treatment from depression of yang qi through reading his works like Exploration to Pathogenesis in Plain Questions,Yellow Emperor's Plain Questions on Xuanminglun Formulae and so on.[Results]LIU Wansu had profound medical knowledge,rich clinical experience and initiative spirit.Under the guidance of nineteen items of pathogenesis from Huangdi's Canon of Medicine,he expanded fire and heat disease and put up six exogenous pathogenic factors can transfer to fire theory.To be specific,excessive wind,cold,dampness and dryness would block Xuan Fu and depress yang qi,causing fire and heat disease.He regardeddepression of yang qi as a key link in six exogenous pathogenic factors' transferring to fire and put up cooling combined with ventilating method to dissipate depressed yang qi,including relieving exterior syndrome with pungent-cool drugs,clearing depressed heat,relieving exterior and interior syndrome,eliminating dampness and relieving depression as well as combination of cold and warm drugs.[Conclusion]LIU Wansu treated fire and heat disease from depression of yang qi,providing new methods in treating fire and heat disease for later generations as well as guiding significance in current clinical work.

Objective To study the MTHFR gene (677 gene loci and 1298 gene loci) mutations in Chinese patients with keloid. Methods The tissue DNA was extracted from 20 samples of keloids. and peripheral blood samples from the same patients were employed as the control. Polymerase chain reaction(PCR) was used to amplify the Mthfr 677 gene loci and Mthfr 1298 gene loci from the keloid tissue DNA and peripheral blood DNA. and the PCR products were sequenced directly and then compared with the GenBank data. Results Mutations were detected in 17 out of 20 keloids on Mthfr 677 gene loci, the mutation incidence was 85.0 %. Mutations were detected in 13 out of 20 keloids on Mthfr 1298 gene loci, and the mutation incidence was 65.0 %. The mutation involved point mutation, deletion and insetion as well as multisite and multitype. No MTHFR gene mutation was detected in all peripheral blood samples . Conclusion There is a strong correlation between the MTHFR gene (677 gene loci and 1298 gene loci) mutation and keloid.

OBJECTIVE:To observe clinical efficacy and safety of capecitabine and tegafur gimeracil and oteracil potassium synchronous radiotherapy in the treatment of recurrence after radical resection of colon cancer. METHODS:A total of 150 patients with recurrent after radical resection of colon cancer in our hospital during Jan. 2012-Dec. 2012 were divided into group A and B ac-cording to random number table,with 75 cases in each group. Both groups received three-dimensional conformal radiotherapy. Group A was additionally given capecitabine 2.5 g. Group B was additionally given tegafur gimeracil and oteracil potassium,40 mg,bid for body surface area <1.25 m2,50 mg,bid for body surface area ranged 1.25-1.50 m2 and60mg,bid for body surface ar-ea<1.50 m2. Clinical efficacies of 2 groups were compared;1-year,2-year,3-year survival andⅢ-Ⅳdegree toxic effect were fol-lowed up. RESULTS:The total response rate of group B was 86.67％,which was significantly higher than 66.67％ of group A, with statistical significance(P<0.05). 1-year,2-year,3-year survival rates of group B were 93.335,72.00％,58.67％,which was significantly higher than 74.67％,53.33％,41.33％,with statistical significance(P<0.05). The median disease progression time of group A was 8.0 months,which was significantly shorter than 9.5 months of group B,with statistical significance (P<0.05). There was no statistical significance in Ⅲ-Ⅳ degree toxic effect between 2 groups (P<0.05). CONCLUSIONS:Compared with capecitabine,tegafur gimeracil and oteracil potassium combined with three-dimensional conformal radiotherapy show significant therapeutic efficacy for recurrence after radical resection of colon cancer,can control disease progression,prolong the survival time and don't increase the risk of toxic effects.

Objective To evaluate the overall failure rate of one or two-stage exchange arthroplasty for infections in total knee arthroplasty (TKA) and the predictors affecting the outcome of exchange.Methods Thirty-nine cases received one or two-stage exchange arthroplasty for periprosthetic joint infections after primary TKA in Shanghai Sixth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine and Southeast Hospital affiliated to Xiamen University from January 2012 to November 2014 were reviewed.Periprosthetic tissue and articular fluid of all patients were analyzed by bacterial culture.All patients were followed up for more than one year.C-reactive protein (CRP),erythrocyte sedimentation rate (ESR),procalcitonin (PCT) and blood routine were tested every four weeks,and the evaluation on pain,total periprosthetic function,range of motion and deformation of arthroplasty were conducted.Differences between groups were analyzed using chi-square test or Student's t test when appropriate.A stepwise selection approach in logistic regression analysis was used to screen key predictors for outcome of one or two-stage exchange for infections in TKA.Results There were 39 patients who had undergone one or two-stage exchange for infections in TKA,including 20 males (51.3％) and 19 females (48.7％) with an average age of (62.4±11.7) years.Among the 39 patients,18 gram-positive strains were isolated from specimens,and 6 gram negative strains,2 Mycobacterium tuberculosis and 1 candida albicans.Ten of 39 reimplantations developed reinfection.Between the success and failure groups,there were significant differences in the time from primary TKA to revision (P =0.023),operative time (P =0.029),multidrug resistant organisms (P =0.045),the preoperative and post-operative ESR (P=0.002 and P＜0.001,respectively) and post-operative CRP (P=0.018).Multivariable logistic regression analysis demonstrated that time from primary TKA to revision (OR =0.96,95％CI:0.92-1.00,P=0.025),preoperative ESR (OR=0.97,95％CI:0.95-1.00,P=0.045) and post-operative ESR (OR =0.94,95％ CI:0.91-0.98,P =0.002) were independent indicators associated with the outcome of one or two-stage revision.Conclusions The failure rate after revision for infected TKA is relatively high.The time from primary TKA to revision,preoperative and post-operative ESR could predict the outcome of one or two-stage revision effectively.

in 30minutes.Antibody expression located accurately.Background stained clearly and no interfering signal.The back-ground was better than conventional immunohistochemistry of frozen remaining tissue.The positive expression rate of p40,34βE12,p504s with rapid immunohistochemistry in prostatic hyperplasia was 97.4%(77 /79),93.7%(74 /79),0%(0 /79),and in prostatic carcinoma was 0%(0 /39),0%(0 /39),97.4%(38 /39).The positive expression rate of p40,34βE12,p504s with conventional immunohistochemistry in prostatic hyperplasia was 96.2%(76 /79), 93.7%(74 /79),2.5%(2 /79),and in prostatic carcinoma was 0%(0 /39),0%(0 /39),92.3%(36 /39).The difference of expression between prostatic hyperplasia and prostatic carcinoma with rapid immunohistochemical detec-tion p40 group:χ2 =109.402,P =0.000,34βE12 group:χ2 =97.971,P =0.000,p504s group:χ2 =113.537,P =0.000;The difference of expression between prostatic hyperplasia and prostatic carcinoma with conventional immuno-histochemical detection p40 group:χ2 =105.410,P =0.000,34βE12 group:χ2 =97.971,P =0.000,p504s group:χ2 =96.388,P =0.000;The expression of prostatic hyperplasia with between rapid immunohistochemical detection and conventional immunohistochemical detection 34βE12 group was identical,p40 group:χ2 =0.207,P =0.649, p504s group:χ2 =2.026,P =0.155;The expression of conventional immunohistochemical detection with between rap-id immunohistochemical detection and conventional immunohisto -chemical detection p40 group and 34βE12 group were identical,p504s group:χ2 =1.054,P =0.305.The expression of three markers between prostatic hyperplasia and prostatic carcinoma had statistical significance(P <0.05).The expression results between rapid immunohisto-chemistry and conventional immunohistochemistry had no statistically significant difference (P >0.05).Conclusion MaxVision rapid immunohisto -chemical staining technique has the advantages of rapid,accurate,timely.It could be used to rapid diagnosis of prostate biopsy tissue.The combined detection of p40,34βE12,p504s has very high practi-cal value in the differential diagnosis of benign and malignant lesions of the prostate.

Objective To explore the microsurgical treatment strategy of ruptured anterior communicating artery aneurysms.Methods From September 2009 to February 2013,thirty-three patients with ruptured anterior communicating artery aneurysms were treated with microsurgical clipping via modified pterion approach.The clinical and follow-up data were analyzed retrospectively.Results At 3 to 44 months period followed-up after microsurgical clipping of ruptured anterior communicating artery aneurysms were obtained in 32 patients.According to Glasgow Outcome Score,the curative effects score were 5 in 28 cases,four in 2 cases,three in 1 case and death in 1 case.Conclusion Microsurgical clipping of ruptured anterior communicating artery aneurysms via modified pterional approach was an effective method with sufficient exposure.It has less invasiveness to the brain tissue,reliable neck clipping and satisfactory results.Safety and effectiveness of this procedure are based on preoperative radiological evaluation of three-dimensional morphological specificity of aneurysms,identification of the parental arteries and its branches,as well as temporary proximal occlusion.

Objective To investigate the effects of fast-track surgery on postoperative rehabilitation of patients with liver cancer. Methods Forty-one patients with liver cancer who had been admitted to Zhongshan Hospital of Fudan University from 9 to 30 in July 2008 were randomly divided into fast-track surgery group (n =20) and routine treatment group (n =21) according to the random number table. Patients in fast-track surgery group were preoperatively educated in order to lessen their anxiety. Bowel preparation was not applied before operation, and they were orally administered with 1000 ml of enteral nutrition emulsion (1300 kcal), then they were fasted for 4 hours before operation. Urethral catheter and gastric tube were removed after operation. They were orally administered with 1000 ml of enteral nutrition emulsion on postoperative day 2, and were encouraged to partake in off-bed activity shortly after the operation. The off-bed time, anus exhaust time, postoperative complica-tions, hospitalization time, expense, nutritional and metabolic indexes on postoperative day 1, 3 and 5, hepatic and renal function, immune and stress indexes between the 2 groups were compared by t test and chi-square test. Results There were significant differences in off-bed time, anus exhaust time, patients' weight, expense, total bilirubin level on postoperative day 1, 3 and 5, and level of serum TNF-α on postoperative day 3 between the 2 groups (t =7.065, 5.483, 3.754, 2.291,2.289, 3.218, 3.192, 2.434, 2.089, P <0.05). Conclusions Fast-track surgery can accelerate the postoperative rehabilitation of patients with liver cancer.

BACKGROUND: Effect of acellular surfactant and biological safety of bone graft materials highly correlated with selection of surfactant; therefore, a novel compound surfactant was used to prepare acellular bone graft materials in this study. OBJECTIVE: To evaluate acellular effect and biological safety of bio-derived bone tissue treated by a novel surfactant in order to obtain a safe and reliable bone graft material. METHODS: Surfactant was prepared with anionic surfactant sodium dodecyl benzene sulfonate (ABS), anionic surfactant sodium fatty alcohol ether sulfate (AES) and distilled water at the ratio of 13:7:80. Fresh bovine cancellous bone and surfactant which was used to remove cells and lipid by two-step flow were used to prepare a novel bio-derived bone graft material. The histological and microscopic observations of microstructure were made. Also acute body toxicity test, hematolysis experiment, cell toxicity test and biological safety were assessed on surfactant-treated bio-dedved bone graft material (STBB). A long-term animal experiment was conducted to observe the biocompatibility and biodegradability of STBB. The ultraviolet dispersion of light luminosity method was employed to measure the residual amount of surfactant in STBB. RESULTS AND CONCLUSION: STBB was a whitish porous cancellous bone. No cell was found in bone lacuna, bone canaliculus was empty, and the collagen fiber had an order arrangement. Acute body toxicity test was qualified according to GB/116886.11-1997 standard, hematolysis experiment was < 5%, and cell toxicity test was grade 0, confirming that STBB was safe. The remaining surfactant in STBB was lower than 0.1 g/L. The long-term animal experiment demonstrated that fiber was present at 4 weeks, bone lacuna had cellular growth and the fusion of STBB and host appeared. The STBB was partial absorbed by organism at 8 weeks and completely absorbed at 24 hours. The results indicated that STBB had an excellent biocompatibility and biodegradability. As a new bone implant material, STBB was safe and dependable for transplantation.

Objective To investigate the expression of p40 (ANp63),p504s and their diagnostic value in benign and malignant lesions of the prostate,also to compare with the expression of p63.Methods The expression of p40 (ANp63),p63 and p504s in 92 cases of benign prostatic hyperplasia and 67 cases of prostatic carcinoma were detected by immunohistochemical MaxVision method.Results p40 and p63 were positive in 95.7 ％ (88/92) and 87.0 ％ (80/92) of benign prostatic hyperplasia,and the intermittent and low expression in p63 were more common than those in p40.The positive expression rate of p40 was obviously higher than that of p63 in benign prostatic hyperplasia (x2 =4.381,P ＜ 0.05).Both p40 and p63 showed no expression in prostatic carcinoma,but p63 appeared with abnormal cytoplasmic staining in many cases of cancer cells,which was 17.9 ％ (12/67).The specificity of combined detection of p40 and p504s in the diagnosis of benign prostatic hyperplasia and prostate carcinoma was as high as 100 ％.Conclusion p40 is more sensitive than p63 in prostate basal cells.Combined detection of p40 and p504s is valuable to distinguish poorly differentiated benign prostatic hyperplasia from prostatic carcinoma.

ObjectiveTo investigate the effect of the displacement of the selected silver clip in the different respiratory state achieved by active breathing control ( ABC ) system on the displacement of the geometry constituted by all of the silver clips at the border of the cavity in external-beam partial breast irradiation (EB-PBI).MethodsTwo sets of CT images in state of moderate deep inspiratory breathing hold (mDIBH),deep expiratory breathing hold (DEBH),and free breath (FB) were acquired in the same CT simulation assisted by ABC system for each of the 27 patients after breast conservative surgery.All silver clips in the cavity were delineated based on each set of CT images.Thereafter,the irregular geometry based on the silver clips as the vertices was automatically formed.Four selected clips located at the top,bottom,lateral border and medial border of the cavity were correspondingly manually registered based on automatic registration of the CT images acquired in the same or different state of respiration including mDIBH,FB,and DEBH.The displacement of center of the geometry in the direction of right-left (RL),anterior-posterior (AP),and superior-inferior (SI) separately based on automatic registration and manual registration was evaluated.The difference of the displacement was analyzed by Kruskal-Wallis H-test and Kolmogorov-Smirnov Z-test.Results When registered between mDIBH and mDIBH,FB and FB,DEBH and DEBH,the differences of the displacement of the center of geometry were not statistically significant (H =0.00 - 1.76,P=0.184-0.954). When registered between mDIBH and DEBH,the differences were statistically significant ( Z =11.31 - 23.00,P =0.000 - 0.001 ).There were statistically significant differences in the displacement of geometry center based on the selected silver clip between different registration forms in AP and SI directions (Z=4.76-25.54,P=0.000-0.029).ConclusionsThe difference of intrafraction displacement of the geometry constituted by the clips between the same respiratory states in the three dimensional direction is not statistically significant,but the difference is statistically significant between the different respiratory states in AP and SI directions.