This article summarizes LI Shimao's academic view of tracing the origin and differentiating the pulse and syndrome in six aspects.1) Emphasizing pulse in diagnosis:he put forward the new theories of pulse diagnosis such as differentiating syndrome by pulse diagnosis outline theory,deficiency and excess pulse diagnosis outline theory and interpreting pulse mechanism with Qi and blood outline theory.2) Emphasizing sweat promotion method in the three methods (including sweat promotion,emetic method and purgative method):he promoted sweat with acrid-warm drugs not only in the treatment of excess cold syndrome,but also in the treatment of deficiency cold syndrome.3) Emphasizing Yang deficiency in cold damage syndrome:he regarded Yang deficiency as an important reason for the attack of externally-contracted wind-cold.4) Emphasizing fire constraint in warm disease:he was the first to pinpointed that the nature of warm disease is stagnated heat,he was good at treating warm disease with clearing,venting and enriching methods of which venting is the core and he invented Xinjia Shengjiang San (新加升降散) to treat stagnated heat;5) Emphasizing treating phlegm and stasis in the complicated diseases:he thought the difficult and complicated diseases in modem medicine were similar to the phlegm syndrome and stasis syndrome in Chinese medicine,so he liked modifying Daotan Tang (导痰汤),ZHANG Zhongjing's formulae,WANG Qingren's formulae for removing blood stasis and Taohong Siwu Tang (桃红四物汤) to treat phlegm and stasis syndromes;6) Emphasizing emergencies in rescue period:he thought Chinese medicine did a great work in treating emergencies,and modern scientific and technological methods should be used in studying emergencies in Chinese medicine.

Objective To investigate the effect of total flavones of Rhizoma Drynariae on femur distraction osteogenesis in the rabbits. Methods Thirty-two healthy rabbits were randomly divided into treatment group and control group, 16 rabbits in each group. The femoral fracture was treated with unilateral femoral distraction and was fixed with a self-made distraction instrument. After 7-day intermittent period, the fractured femur was distracted at a rate of 1 mm/d, twice a day for 10 continuous days. The treatment group was fed with total flavones of Rhizoma Drynariae from the first post-operative day to the end of the experiment. And then all of the animals were sacrificed after fixation for 28 days. The bone specimens were used for histological observation and immunohistochemical detection. Results The area of mature bone in the newborn bone tissue of the treatment group was increased, and osteoblasts number and the percentage of trabecular bone area were significantly higher than those of the control group . The bone morphogenetic protein-2 (BMP-2) and transforming growth factor-β1 (TGF-β1) were stained brown deeply, the staining degree being stronger than that of the control group. Conclusion Rhizoma Drynariae total flavones can effectively accelerate the formation and maturation of newborn bone tissue during bone distraction.

Objective To investigate the effect of unfractionated heparin (UFH) on the expression of heme oxygenase-1 (HO-1) in intestinal mucosa of mice with sepsis.Methods Thirty-six male C57BL/6J mice were randomly divided into sham group,cecal ligation and puncture (CLP) group and UHF group,n =12 in each group.Model of intestinal injury in sepsis was induced by CLP.In sham group,the mice were exposed without ligation of cecum.In UFH group,the mice were treated intravenously with 8 U of UFH via the tail vein half an hour before the operation and 12 hours after the surgery respectively.Six mice in each group were randomly chosen at 4 hours and 24 hours after operation to collect inferior vena venous blood samples and terminalileum tissues.The serum levels of interleukins (IL-1 β,IL-6),and tumor necrosis factor-α (TNF-α) were determined by enzyme linked immunosorbent assay (ELISA).The serum level of D-lactate was determined by colorimetry.Pathological changes of ileum tissue and Chiu score were observed after hematoxylin eosin (HE) staining.The HO-1 expression was detected immunohistochemically.Results In sham group,no significant changes in the serum levels of IL-1 β,IL-6,TNF-α and D-lactate were observed.Twenty-four hours after the operation,the structure of intestinal mucosa was basically normal without obvious pathology change and no HO-1 positive cells were found.The serum levels of IL-1 β,IL-6,TNF-α,and D-lactate in CLP group were gradually increased,and they were significantly increased as compared with sham group [IL-1 β (ng/L):40.87±2.88 vs.22.60±2.05 at 4 hours,113.73±3.96 vs.22.07±2.74 at 24 hours;IL-6 (ng/L):63.89±3.26 vs.44.89±3.38 at 4 hours,176.56±5.45 vs.45.76±4.02 at 24 hours;TNF-α (ng/L):194.62± 14.13 vs.152.05±6.22 at 4 hours,599.62± 10.20 vs.155.90± 14.18 at 24 hours;D-lactate (mmol/L):0.24± 0.02 vs.0.19 ± 0.01 at 4 hours,0.33 ± 0.04 vs.0.20 ± 0.02 at 24 hours,all P ＜ 0.05].Twenty-four hours after the operation,edema and inflammation in ileal mucosa,intestinal villi structural damage were observed,the Chiu score was significantly higher than those in the sham group [4.5 (3.0-5.0) vs.0 (0-1.0),P ＜ 0.05],and a small amount of HO-1 positive cells were localized in the intestinal mucosa.Compared with CLP group,the serum levels of IL-1 β,IL-6,TNF-α,and D-lactate of UFH group were significantly decreased [IL-1 β (ng/L):31.53 ± 2.90 vs.40.87 ± 2.88 at 4 hours,61.13 ± 2.80 vs.113.73 ± 3.96 at 24 hours;IL-6 (ng/L):51.16 ± 5.68 vs.63.89 ± 3.26 at 4 hours,81.16 ± 4.54 vs.176.56 ± 5.45 at 24 hours;TNF-α (ng/L):171.76± 5.60 vs.194.62± 14.13 at 4 hours,328.48 ± 10.79 vs.599.62± 10.20 at 24 hours;D-lactate (mmol/L):0.21 ±0.01 vs.0.24±0.02 at 4 hours,0.24±0.02 vs.0.33±0.04 at 24 hours,all P ＜ 0.05].Twenty-four hours after the operation,intestinal injury was ameliorated,the Chiu score was significantly lower [1.5 (1.0-5.0) vs.4.5 (3.0-5.0),P ＜ 0.05],and HO-1 positive cells in the intestinal mucosa was remarkably increased.Conclusion UFH can enhance the expression of HO-1 in intestinal mucosa,reduce the release of inflammatory factors,ameliorate the intestinal inflammatory response,and thus play a protective role in intestinal tissue in mice with sepsis.

BACKGROUND:The mechanical characteristics of intramedul ary and intramedul ary fixations for treating intertrochanteric fracture were hot research of finite element, but there was few comparative research on tension side and pressure side of proximal femur. In our study, we found that the distribution of the stress zone was important indication to researches on intertrochanteric fracture and internal fixation design. OBJECTIVE:To explore the effects of intramedul ary and extramedul ary fixations for treating intertrochanteric fracture on pressure side and tensile side of proximal femur. METHODS:CT scan and Mimics modeling of volunteer’s femur were conducted, and the model Evans type I intertrochanteric fracture was constructed and treated with proximal femoral nail antirotation and dynamic hip screw respectively. The stress condition of proximal femur in weight status was simulated. The Abaqus 6.13 was used for finite element analysis, and the tension side and pressure side of proximal femur in both fixations were also analyzed. RESULTS AND CONCLUSION:(1) The stresses of compressive side and tensile side in proximal femoral nail antirotation group were both less than that in dynamic hip screw group. The stress of proximal femur in proximal femoral nail antirotation group was more similar to that in physiological status. (2) These findings verified that for treating intertrochanteric fracture, intramedul ary fixation exerted better mechanical behavior than extramedul ary fixation. The protection of compressive side and tensile side of proximal femur had achieved by intramedul ary fixation.

Objective To compare the efficacy of small splint fixation and plaster fixation in treating distal radius fracture. Methods One hundred and four cases of type A2 distal radius fracture admitted from January of 2012 to May of 2013 were randomly divided into small splint fixation group and plaster fixation group. After reduction, patients in the two groups were fixed with small splint and plaster separately. Wrist function scores, 36-item Short Form ( SF-36) scores and roentgenographic scores were evaluated for the two groups at different time points. Results ( 1) Within 3 months of follow up, the improvement of wrist function in small splint fixation group was significantly superior to that in plaster fixation group (P<0.05), and the differences of wrist function scores were insignificant between the two groups with the prolongation of follow-up (P>0.05). (2) SF-36 scores of the two groups were gradually increased along with the follow up. After follow-up for one week, 2 weeks, one month and 3 months, the SF-36 scores in small splint fixation group were significantly higher than that in plaster fixation group ( P<0.05) , but there was no significant difference after 6 months ( P>0.05). ( 3) After follow up for one year, the excellent rate for roentgenographic scores was higher than 80% in both groups, and there was no significant difference between the two groups (P>0.05). Conclusion Both small splint fixation and plaster fixation have satisfacory efficacy in treating type A2 distal radius fracture. But during the therapeutic process, wrist function scores and life quality scores in the small splint fixation group were higher than those in the plaster fixation group.

Objective To investigate whether specific cellular uptake of 99Tcm-survivin-ASODN in nude mice bearing human HCC is influenced by its cytosine content.Methods Three kinds(A1,A2,A3) of synthesized survivin ASODN with three cytosine contents(10％,20％,30％),20 bases per single-strand were prepared.They were labeled with 99Tcm by conjugating with a bifunctional chelator HYNIC,purified through Cellufine GH-25 and then encapsulated with liposome.Antisense gene imaging and the biodistribution of 99Tcm-HYNIC-survivin ASODN in nude mice bearing HCC were performed.The data were analysed by Kruskal-Wallis H test.Results At 4 h post injection,all the 3 labelled compounds showed increased uptake by tumor,liver and kidney.With increase in cytosine content,the uptake increased in kidney (％ID/g:1.50±0.06,2.80±0.09 and 3.96±0.03),and decreased in tumor (％ID/g:2.08±0.08,1.69±0.01 and 1.20±0.09).T/NT in imaging (4.49-4.93,4.12-4.21,3.35-3.85;H=12.50,P＜0.05) and in biodistribution (4.08-4.94,4.02-4.18,3.66-3.85;H=10.82,P＜0.05) were all significantly different.Conclusion ASODN with lower cytosine content shows higher uptake by HCC tumor cells and less stasis in kidneys,thus providing better quality in antisense gene imaging.

Objective:The present study aimed to conduct a clinical analysis of nosocomial infections in hospitalized cancer pa-tients and propose effective precautionary measures. Methods:We retrospectively analyzed 56,430 cases of discharges from the Cancer Institute and Hospital of Tianjin Medical University between January and December 2012. Results:Among 825 cases, the rate of noso-comial infections was 1.46%;46.42%of the patients aged>60 years. The highest infection rate was observed in the Medical Depart-ment of Stomach Cancer. The highest composing rate was recorded in the Department of Hepatobiliary Cancer. The major pathogenic bacteria were Gram-negative bacilli;fungal infections were relatively rare. The most vulnerable body parts were the abdomen and diges-tive tract, which were mainly infected by pathogenic Escherichia coli. Conclusion:Healthcare workers should consider the importance of influencing factors and take precautionary measures to reduce the rate of nosocomial infections in cancer patients.

Objective To investigate the expressions of FAT10 and p53 mutant in gastric cancer tissues and their relations. Methods Immunohistochemistry and RT-PCR were used to detect the expressions of FAT10 and p53 in gastric cancer tissues (n=62), para-cancerous tissues (2-5 cm apart from cancer, n=62), and normal gastric tissues (7>5 cm apart from cancer, n=62). The association of FAT10 with p53 and clinical outcomes were analyzed by Spearman and Pearson correlation. Results The immunohistochemistry examination showed that expressions of FAT10 [51.61%(32/62)] and p53 [45.16% (28/62)] were significantly higher in cancerous tissues than in para-cancerous tissues [12.90%(8/62) and 14.51% (9/62), χ2=21.26 and 20.69, P<0.01] and normal tissues [6.45% (4/62) and 9.68% (6/62), χ2=13.91 and 19.61, P<0.01]. Overexpressions of FAT10 protein and mRNA in cancerous tissues were closely related to lymph node metastasis and TNM staging (both P value<0.05). There was a positive correlation between FAT10 and p53 in protein and mRNA expressions (protein r=0. 865, P<0.05; mRNA r=0.761, P< 0.01). Those with positive expression of FAT10 had lower survival rate compared to those with negative expression (P<0.05). Conclusions The positive relation between over-expression of FAT10 and p53 implicates that both are involved in the gastric carcinogenesis, and FAT10 is a novel gastric cancer marker with prognostic significance.

It is difficult to implement the multidimensional teaching targets through the flipped classroom, which is mainly based on the technique of video. In view of the fact that flipped classroom and virtual reality teaching have the same theoretical basis, and both of them embody the thought of construc-tivism learning theory, the flipped classroom teaching model can be extended with the help of virtual reality technology. Before class, both of "virtual reality" and "watch the teaching video" can be used as a tool for flipping, in class, in the course of "creating the environment", the students should use the virtual reality technology according to the teaching content, and after class as the means to consolidate the practice. Thus, it can fully motivate students' learning motivation, improve their ability of problem solving and help them accumulate experience or wisdom. The most important thing is that teachers can give students some guid-ance and feedback about personality and value.

Objective To summarize the safety and efficacy of Sunitinib in the treatment of metastatic renal clear cell carcinoma. Methods Fifteen patients with clear cell metastatic RCC were treated with Sunitinib,with 11 males and 4 females,aged from 26 to 74 years with median age of 55 years.Thirteen cases of 15 were T3 to T4 stage,and 8 cases underwent radical nephrectomy,while 5 other cases underwent renal biopsy with the pathological diagnosis of renal cancer.The other two cases (one man and one woman)with the solitary kidney renal cell carcinoma ( stage T1a) and renal insufficiency,were diagnosed as metastatic renal cell carcinoma by biopsy.Sunitinib monotherapy was administered by the regimen of 6 weeks per cycle with daily oral Sunitinib 4 weeks,followed by 2 weeks off ( from 1 - 10 cycles).Response was evaluated by RECIST.Renal tumor was 9.52 ± 3.3 cm in diameter at baseline,and the assessment of metastases included retroperitoneal lymph nodes (6 cases),mediastinal lymph nodes (3 cases),brain (2 cases),lung (6 cases),bone (2 cases) and liver (2 cases).Karnofsky score,tumor changes,adverse events and the survival of each patient was assessed and recorded. Results The follow-up duration was from 1.5 - 15months,with median follow-up of 6 months,and tumor response was evaluated by RECIST.Seven of 15 patients (46.7％) treated with Sunitinib achieved partial responses (PR),7 patients (46.7％) demonstrated stable disease (SD),and 1 patient (6.7％) developed progressive disease (PD) during the follow-up.Objective Response Rate (ORR) was 46.7％,PR + SD was 93.3％,6 months PFS was 93.3％,and median PFS was 12 months,respectively.Renal tumor was 8.7 ± 4.0 cm in diameter after therapy.Two PR patients with the obvious effectiveness had experienced progressed hypertension,and one cases with hypertension that could be controlled below 140/90 mm Hg ( 1 mm Hg =0.133 kPa) by a single drug before treatment,showed increased blood pressure ( ＞ 160/105 mm Hg) following the second cycles treatment,who were administered increased dosage and combination therapy.The other case without history of hypertension,showed high blood pressure ( ＞ 150/100 mm Hg) in the third cycle,and could be controlled well by antihypertensive drugs.Fortunately,the tumor of these two cases reduced obviously by more than 50％. 1/2 adverse reactions of 12 cases:yellowing of the skin and yellow sweat ( 12 cases,80％ ),fatigue ( 12 cases,80％ ),4 cases of hypothyroidism (26.7％),bilirubin and triglyceride levels elevated in 7case (46.7％); Four cases showed 3/4 degree adverse events with the emergence of gastrointestinal bleeding in one case secondary to platelets reduction (6.7％).Three cases (20％) showed serious fatigue,nausea,vomiting and severe hand-foot skin reaction. Conclusions Sunitinib is recommended for the treatment of metastatic renal clear cell carcinoma with good efficacy and safety.