Traditional Chinese medicine is one of the component parts of the international health care system. It has been an inevitable trend to merge traditional Chinese medicine into systemic medicine. Along with the emergence of the concept of systemic disease, the wide dissemination of evidence-based medicine and the establishment of thought pattern of systemic medicine, the exploration emphasis of modern medical science has been transferred from microcosmic or solid structure to macrocosmic unit and system relation. The mainstream development of modern medical science is to integrate different medical systems into a complete system. Therefore, the integration of traditional Chinese medicine and Western medicine is also necessary under this condition.

In recent years,researches on drugs concentrated in the ecosystem have become a hot topic. Environmental pharmacology is a new subject studying the source and fate of drugs in the environment. It is found that a lot of pharmaceuticals and pharmaceutically active compounds are released into the environment by the pharmaceutical industry,hospitals and agricultured activities. Drugs in the environment not only affect the ecosystem,which leads to bacterial resistance,but also affect the balance of flora in the biofilm. Furthermore,such drugs may induce epigenetic changes, which may leave to the body vulnerable to diseases. The enrichment of endocrine disruptors can inter?fere with the growth and function of the human reproductive system. China is becoming concerned about environmental drugs. The development of environmental pharmacology can help clarify the interac?tions between drugs and the environment while contributing to public health and food safety in China.

The important function of the gastrointestinal tract in monitoring and sealing the host intestine from intruders is called the gut barrier.A variety of specific and nonspecific mechanisms are in operation to establish the host barrier,including luminal mechanism,secretion of the digestive enzymes,the epithelial cells together with tight junctions between them and the gut immune system.The pathogenesis of gut barrier dysfuntion is multifactorial.They can lead to the translocation of the intestinal bacteria.Sometimes,even the multiple organ dysfunction syndrome can happen.Nitric oxide,one of the smallest products of the cell,is known to have a very large role in diverse physiologic and pathological processes.Recent study shows its toxic metabolite,peroxynitrite(ONOO~(-)),play a major role in the intestinal mucosal injury.The purpose of this literature review is to provide a better understanding of the mechanism of the protection and injury to the gut barrier function about nitric oxide and peroxynitrite.

Objective: The influence on the blood glucose,ALB,LYM,K+,Na+,Cl-,TG,TC and so on after the use of different nutrition formula was observed in patients with cerebrovascular disease and type 2 diabetes.Methods: 40 patients who suffered from cerebrovascular diseases and type 2 diabetes were divided into two groups: one group using the ordinary formula and the others using special-purpose formula of diabetes.The levels of blood glucose,ALB,LYM,K+,Na+,Cl-,TG,TC were monitored.Results: The patient's blood glucose after use of ordinary formula rised obviously and insulin or the oral drug for decreasing blood glucose was used.The blood glucose in special-purpose diabetes formula group didn' t increase obviously,and there was not the need of using insulin(P

The microflora plays an important role in providing nutrients to the intestinal mucosal cells.The disruption of the intestinal microflora balance may modify the intestinal barrier function, and influence the health.Dietary fibre can be divided into solububle fibre and insoluable fibre.Insoluable fibre plays an important role in faecal bulking and prevention of constipation.The human body can obtain energy for growth and maintenance of cellular function from fermentation of solable fibre.

Background In previous study,peripheral retinal nerve fiber layer (RNFL) thickness is considered to be the earliest structural changes which can be detected.3D-OCT can measure the thickness of macular ganglion cell complex (mGCC),which makes the detection of primary glaucoma possible in the early stage.Objective This study was to measure the thickness of mGCC and disc-peripheral RNFL in early stage of primary glaucomous eyes by 3D-OCT and assess the anatomic basis of glaucoma-induced optical nerve damage.Methods 3D-OCT images from 10 patients with advanced stage primary glaucoma in one lateral eye and early stage glaucoma in fellow eye from December 2010 to December 2012 were prospectively analyzed in China-Japan Friendship Hospital.The patients were diagnosed based on the recommended standard of National glaucoma group (1987 version) and received routine eye examination.3D-OCT scanning was performed using 3D-macular mode,3D-macular Wide mode and 3D-disc mode with TOPCON 3D-OCT 2000 system,and the images at macular 6 mm×6 mm area were analyzed.The posterior pole area was divided into 5 concentric rings from fovea toward periphery and equally subdivided into 100 small checks,with the area of 0.6 mm×0.6 mm for each.The probable values in each check were calculated as the ratio of each figure and corresponding normal value.The probable values were expressed as red color (P＜ 1％),yellow color (P＜5％) and gray color (P≥ 5％).Then the disc-periphery RNFL thickness and disc cup were evaluated.Results No evident abnormality was found in the thicknesses of photoreceptors layer and bipolar cell layer in both advanced glaucomous eyes and the early stage of glaucomous eyes in the 10 patients.Serious damage of visual field was seen in the advanced glaucomous eyes and presented with red color in the parapapillary RNFL area,mGCC area and macular RNFL area,showing an evidently attenuation of the thicknesses of parapapillary RNFL,mGCC and RNFL.However,the visual field was close normal in the early stage glaucomous eyes,and mGCC and macular RNFL showed yellow color,while green or yellow color was exhibited in the parapapillary RNFL area,indicating mGCC and macular RNFL thickness was reduced,but parapapillar RNFL thickness was near normal.Conclusions The change of mGCC thickness is earlier than that of peripheral RNFL at optic disc in primary glaucomaous eyes,which may imply that the disappear of macular ganglion cell body is earlier than that of the axon.

Background Lensectomy with anterior capsule preserving is still advisable under specific conditions during vitrectomy.Although lens epithelial cells were polished off during surgery,opacification in varying degrees could be observed.Understanding the composition of proliferative anterior capsule membrane is of an important clinical significance for the prevention and manegement.Objective This study was to investigate the management and pathology of the pupillary area membranous opacity underling preserved anterior capsule after lensectomy in diabetic eyes with silicone oil tamponade.Methods Twenty-three eyes of 21 patients with proliferative diabetic retinopathy (PDR) and cataract received vitrectomy combined with lensectomy preserved anterior capsule in China-Japan Friendship Hospital from January to December 2013,and the proliferative anterior capsular membrane specimens with the opacification grade C or D were obtained.The fibrotic membrane underlying anterior capsules were removed in order to make a clear optical area during the operation of silicone oil removal.The proliferative membrane at pupillary area was cut off by cutter probe for the eyes with the membrane attaching tightly or partial capsule laceration occurred.The available specimens were examined under the optical microscope and polarized microscope respectively after hemotoxylin and eosin staining,Van Gieson collagen staining,Masson collagen staining and Picrosirius staining.Results The proliferative fibrosis membranes were pilled to get a clear pupillary area in 15 eyes,with the successfully rate 65.2％ (15/23).In 14 eyes with degree C opacity,the proliferative fibrosis membranes were pilled in 9 eyes,with the successfully rate 64.3 ％ (9/14),and 5 eyes received anterior capsule cutthrough by cutter in pupillary area,with a diameter of 3-4 mm,and available specimens were obtained in 3 eyes.In 9 eyes with degree D opacity,the proliferative membranes were pilled in 6 eyes,with the successfully rate of 66.7％ (6/9),and 3 eyes underwent cut-through by cutter,and available specimens were obtained in 7 eyes.The best corrected visual acuity was obviously improved in 20 eyes and unchanged in 3 eyes after surgery.The histopathological examination showed fibroblasts,pigment particles and intracellular and extracellular vacuolus formation by hemotoxylin and eosin staining,fibril tissue with the pinke staining by Van Gieson,collage formation with green color by Masson staining in the specimens.Picrosirius staining plus polarization microscopy observation revealed that the collagen consisted of abundant type Ⅰ collagen with stronger reddish yellow color and small amount of type Ⅲ collagen with green color.Conclusions A combination of silicon oil removal with proliferative mambrane pelling is a available way to restore pupillary transparency in the eyes of PDR with cataract and silicone oil tamponade eyes.Proliferative residual lens epithelial cells,pigment epithelial cells and silicon oil granules are the main composition of opacity mambrane.The type Ⅰ collagen is dominant in proliferative collagen tissue.

Objective To investigate the preventative effect of perioperative intervention to lower extremity deep venous thrombosis (DVT) after gynecologic surgery. Methods The 1062 patients, who received gynecologic surgery during 2007 June to 2008 June, were derided into intervention and nonintervention groups randomizely. According to the risk factors of DVT, the patients in intervention group were divided into 4 subgroups: low, mid, high and extremely high rise Each group had its own preventive measures. If patients had spontaneous pain, tenderness and swelling, positivity of Neuhof or Homan syndrome, and extension of one low extremity superficial vein, the low extremity color Doppler ultrasound would be carried out immediately. The ultrasound would also be routinely carried out in the high and extremely high risk groups in intervention group after 2 and 7 days after surgery. A prospective study was carried out investigating incidence of DVT and coagulation function perioperation. The vein blood samples were taken at in a week before surgery and 48 hours post-operation. Results The incidence of DVT of intervention group was 1.10% (6/546), and in nonintervention group, the incidence was 3.29% (17/ 516). There was significant difference between two groups (P<0.05). The incidence of DVT in extremely high risk subgroup was 21.05% (4/19), which was significantly higher than that of low(0), mid(0) and high risk groups[2.13% (2/94), P<0.05]. D-dimer, antithrombin-Ⅲ(AT-Ⅲ) post-operation were all higher than that pre-operation in the two groups, but there was no significant difference (P>0.05). The indexes of coagulation system, such as blood platelet count, prothrombin time (PT), active partial throraboplastin time (APTT), fibrinogen (Fbg), thrombin time (TT), tissue-plasminogen activator (t-PA), plasminogen activator inhibitor(PAI), were not significantly changed perioperation (P>0.05 in all pre-or post-operation indexes). Conclusions Perioperative intervention measurement according to different risk of DVT could cut down the incidence of DVT. DVT preventive intervention is suggested to high and extremely high risk people.

Objective To investigate the relationship between amnestic mild cognitive impairment and functional genes associated with hyperphosphorylated tau protein.Methods One hundred and sixteen amnestic mild cognitive impairment (aMCI) patients and 93 normal controls were recruited for the study.Multi-dimension neuropsychologic tests were used to assess the cognitive function extensively.MassARRAY and iPlex systems were used to measure candidate SNP polymorphisms,analyze genotypic,allelic or haplotypic distributions and their interaction with ApoE ε4 and the correlation with the cognitive function in the subjects.Results ( 1 ) The scores of neuropsychologic tests in memory domain ( Auditory Verbal Learning Test (AVLT)-first immediate recall,AVLT-second immediate recall,AVLT-second immediate recall,AVLT-5 minute delayed recall,AVLT-20 minute delayed recall,AVLT-recognition,Rey-Osterrich Comolex Test-delay) in aMCI patients ( 3.0 ( 0-7.0 ),5.0 ( 1.0-10.0),6.0 ( 1.0-11.0 ),4.0 (0-11.0),3.0(0-10.0),20.0(8.0-24.0),11.2 ±8.3) were significantly lower than those in the normal controls(4.0(0-9.0),7.0(2.0-11.0),9.0(3.0-12.0),8.0(0-12.0),8.0(0-12.0),22.0 (10.0-24.0),16.1±8.0) (Z=-3.592,-6.802,-6.408,-8.173,-8.533,-5.647 andt=4.216 respectively,all P ＜0.01 ) ; (2) Genotypic distributions of rs242562 GG in aMCI (7.826％ ) were significantly lower than those in normal controls (20.65％,OR =0.3525,95％ CI 0.1411-0.8807,P =0.024 98),however there were no differences in the genotypic,allelic or haplotypic distributions between aMCI patients and controls of glycogen synthase kinase-3β,cyclin dependent protein kinase-5,calcium and calmodulin-dependent protein kinase-Ⅱ,cell division cycle 2,dual-specificity tyrosine-phosphorylation regulated kinase 1A and low density lipoprotein receptor-related protein 6; (3) MAPT/STH rs242562 genotype was correlated with AVLT-immediate recall,AVLT-delayed recall,Rey-Osterrieth Complex Test,Rey-Osterrieth Complex Test-delayed recall and Clock Drawing Test (H =9.763,12.258,10.508,9.624,10.767,F =3.700,3.123 and H =6.591 respectively,all P ＜ 0.05 ) ; (4) There were no differences in the distributions of MAPT/STH rs242562 GG genotype and ApoE ε4 haplotype between aMCI patients and normal controls.Conclusions MAPT/STH rs242562 GG genotype decreases the genetic risk of aMCI,which might have important role in memory function in aMCI.The interaction between rs242562 GG and ApoE ε4 doesn' t affect the susceptibility to aMCI.

Objective To investigate the features of white matter impairment and its relationship with cognition in patients with amnestic mild cognitive impairment (aMCI).Methods Eighty-three cases of aMCI and 85 normal aging volunteers were scanned with diffusion tensor imaging (DTI) using MR system.All subjects completed the neuropsychological battery.We analyzed the differences between two groups using tract-based spatial statistics and the association between regions in difference and cognition using correlation analysis.Results There were significant differences between aMCI and normal control in the neuropsychological battery including the Mini-Mental State Examination(26.2 ± 2.6 vs 28.3 ± 1.3,F =43.224,P =0.000),Mattis Dementia Rating Scale-2 (131.4 ± 6.9 vs 138.0 ± 3.5,F =62.308,P =0.000),Auditory Verbal Learning Test-delayed recall(2.4 ± 1.6 vs 7.5 ± 2.0,F =324.018,P =0.000),Boston Naming Test(8.7 ± 1.4 vs 9.2 ± 1.0,F =6.821,P =0.010),Rey-Osterrich Complex Figure Test (12.1 ± 7.3 vs 18.5 ± 6.1,F =40.674,P =0.000),Symbol Digit Modulation Test (30.0 ± 10.1 vs 38.6 ± 9.8,F =30.786,P =0.000),Trail-Making Test Part B ((256.8 ± 124.5) s vs (178.1 ± 59.0) s,F =27.601,P =0.000).Significantly higher diffusivity indexes and radial diffusivity were also found in aMCI subjects compared to healthy elders in the parahippocampal,superior longitudinal fasciculus,inferior longitudinal fasciculus,superior fronto-occipital fasciculus,inferior fronto-occipital fasciculus,unciform fasciculus,corticospinal tract,corpus callosum,cingulum,corona radiate.We also found that axial diffusivity was significantly increased in the parahippocampal,superior longitudinal fasciculus,inferior longitudinal fasciculus,superior fronto-occipital fasciculus,inferior fronto-occipital fasciculus,unciform fasciculus,corticospinal tract and corpus callosum,whereas fractional anisotropy changes were not observed in aMCI.Diffusivity indexes values in bilateral frontal lobe (left r =0.67 ; right r =0.70),left cingulum (r =0.63),parietal white matter (r =0.69) and radial diffusivity values in left parietal (r =0.68) were significantly related to Trail Making Test A among aMCI (all P ＜ 0.05).Conclusions In aMCI patients,there was a wide range of white matter damage,with no brain region-specific.Executive function deficit was related to the white matter impairment in bilateral frontal lobe,left cingulate and parietal lobe.The specificity and sensitivity of four DTI parameters fordetecting white matter lesions are variant.Trial registration Clinical Research Center of Jiangsu Province (BL2013025)