Traditional Chinese medicine (TCM) is a very practical subject, which has its unique theoretical system and clinical characteristics. In the course of clinical practice, the exact clinical efficacy is the key of existence and development. But the existing evaluation system is difficult to objectively evaluate the clinical efficacy of TCM. Therefore, how to objectively evaluate the clinical efficacy and get definitive evidence is the focus of the evaluation of clinical efficacy of TCM. Relative to modern medicine, TCM is more concerned about the changes of feelings and clinical symptoms of the patient in the course of the evolution of the disease. Soft targets mainly used for the evaluation of the clinical efficacy of symptoms and functional activity of the disease. The level in soft targets of processing technology is often used methods in clinical evaluation. But it has often produced the phenomenon which the results of the evaluation is mutual contradiction, which will ultimately affect the effect of evaluation of clinical efficacy of TCM. In order to better evaluate the clinical efficacy of TCM, in the process of adoption of soft targets, it clearly identify it's role, highlighting the characteristics of interventions on disease, and as much as possibly avoid the level in soft targets of processing technology to real assess clinical efficacy of TCM.
Drug Therapy ; Drugs, Chinese Herbal ; therapeutic use ; Evaluation Studies as Topic ; Humans ; Medicine, Chinese Traditional ; Research Design ; Treatment Outcome

Objective:To explore the histogenesis and differentiation of dermatofibroma (DF) and dermatofibrosarcoma protuberans (DFSP). Methods: Clinical information and microscopic characteristics of 26 cases of DF and 26 cases of DFSP were investigated. The immunohistochemical study was performed on microarray sections by a panel of antibodies including FactorⅩⅢa, HLA-DR, CD34, CD14, S-100, MSA, and Ki67. Probe was labeled by in vitro transcription. The mRNA expression levels of TGF-? and bFGF were investigated by in situ hybridization. Results: All cases showed positive for Factor ⅩⅢa,HLA-DR and CD34 to different extent. The medians of positive rates in DF were FactorⅩⅢa 90%, HLA-DR 70%, and CD34 5%, and in DFSP were FactorⅩⅢa 10%, HLA-DR 5%, and CD34 80%. CD14 was positive in 3 cases of DF and 1 case of DFSP. S-100 was positive in 6 cases of DFSP and 2 cases of DF. MSA was positive in 5 cases of DFSP and 3 cases of DF. In all cases, positive rate of Ki67 was less than 5%. The mRNA expression levels of TGF-? was elevated in DF in comparison with DFSP. Conclusion: Both DF and DFSP can differentiate to dendritic cells (DC) in different degree. Considering the character of microscopic features and immunohistochemical phenotype, cells of DF are much similar to mature DC, while those of DFSP much similar to immature dermal reserve cell (DRC). The differences of cell differentiation between DF and DFSP result in different prognosis. DF is a benign tumor, while DFSP a low grade malignant tumor. The different expression of FactorⅩⅢa and CD34 may be helpful to differential diagnosis of DF and DFSP.

Objective To establish the disease-syndrome integrated animal models suitable for the studies of TCM through differen- tiating the property of TCM syndromes of spontaneous diseased animal models.Methods With the observation on general behaviors, irritable degree,turning endurance time,pain threshold,urine and stools,luster of hair,growing speed of hair,body weight,tongue condition,degree of eyeball protruding,conjunctiva chroma,blood pressure,heart rate,etc.of spontaneous hypertension rats(SHR) and the comparison with normal rats,the study was carried out on the macroscopic description of property of TCM syndrome of SHR (14～18 weeks of age)and their ethology.Results The blood pressure of SHR at the early stage tended to raise with age growing. Compared with the normal group,the heart rate of SHR rats was obviously quicker(P

To investigate the clinical efficacy and safety of phototherapeutic keratectomy ( PTK ) in the treatment of bullous keratopathy ( BK) .METHODS: A retrospective analysis of 60 cases ( 60 eyes) of BK patients from Department of Ophthalmology in our hospital October 2011 to July 2014 was undergone. Clinical data of all patients with treatment of PTK were analyzed. Best corrected visual acuity ( BCVA ) , corneal curvature, corneal astigmatism, corneal thickness and corneal endothelial cell density ( ECD ) , postoperative complications before and after surgery were compared. RESULTS: BCVA, corneal curvature, corneal astigmatism of patients before surgery were 0. 05 ± 0. 01 and 37. 02±5. 38, 1. 08±0. 67D, which were significantly less than those of postoperative ( respectively 0. 45 ± 0. 13 and 46. 27 ± 7. 02, 1. 92 ± 0. 73D ), the differences were statistically significant (all P<0. 05). Corneal thickness of patients was 492. 33 ± 18. 27μm before surgery, which was higher than that after surgery 377.27±22.49μm (P<0.05). The difference of visual acuity before and after surgery was statistically significant in this group (P<0. 05). During the follow-up period of 6mo, no recurrence of the original corneal lesions, only 2 cases of postoperative slight haze, it was completely dissipated after given the hormone eye drops.CONCLUSlON: Excimer laser technology has high safety in the treatment of bullous keratopathy, it should be promoted in clinical practice.

AIM:To observe related biological parameters of 3 minutes dark-room provocative test in patients with laser peripheral iridectomy(LPI) in the fellow eyes of acute primary angle-closure (APAC) by ultrasound biomicroscopy (UBM).To explore the risk factors in primary angle closure suspect(PACS) patients with progressive angle closure after LPI.METHODS: Seventy-eight eyes of APAC patients without peripheral anterior synechia were selected.Each eye underwent 3 minutes dark-room provocative test after LPI.Anterior segment parameters, including anterior chamber depth (ACD), anterior chamber angle open distance500 (AOD500), peripheral iris thickness (PIT), iris convex (IC), the position of iris insertion and trabecular-ciliary process distance (TCPD), and the number of positional angle closure(NPAC) were observed and analyzed by statistic methods.RESULTS:Patients with APAC were examined by UBM after LPI and 26 eyes(33%) occurs at least one positional angle closure,19 eyes(24%)were positive in 3 minutes dark-room provocative test among them.It occurs a positive relationship between the elevation intraocular pressure and the number of positional angle closure in dark-room provocative test(r=0.84, P<0.01).AOD500, IT and IC were significantly changed from normal light to darkroom between positional angle closure positive group and positional angle closure negative group(all P<0.01).In single factor analysis, AOD500(P=0.003), IT(P=0.012), IC(P=0.043), TPCD(P=0.015), the position of iris insertion(P=0.024) were correlative factors of positive results.In multiple-factor analysis, only IT(P=0.011), TPCD(P=0.009), iris root attachment points(P=0.02) were independent risk factors of positive results.CONCLUSION:A certain proportion of patients with PACS after LPI appeared positional angle closure in a dark room.Peripheral iris hypertrophy, anterior displacement of the ciliary body and iris root attachment points are vital risk factors.Long-term follow-up study and intervention treatment are required in these patients after LPI.

Background As the only active component in final treatment phase of Tip-Edge Plus technique,the activation of nickel-titanium orthodontic archwires is one of the factors that affect the torque expression.It is necessary to evaluate the mechanical properties of the nickel-titanium wire used in the final treatment phase in simulated oral environments to forecast the treatment outcomes.Methods The mechanical properties of 171 thermal nickel-titanium wires of 0.35 mm (0.014-in) in diameters with different deflection of 40 mm in length were investigated with three-point bending test.The samples were divided into 2 groups:as-received and bended groups.In the bended group,samples were divided into 7 subgroups according to the amounts of deflection and named by the canine angulations (-25°,-19°,-13°,-7°,-1°,+5°,+11°).The deflection of wires was made by inserting the wires into the deep tunnel of Tip-Edge Plus brackets positioned in plaster casts with different canine angulations to mimic the use of nickel-titanium wires in the final treatment phase.Immersed the bended group in artificial saliva (pH 6.8) and preserved at 37.0°C.Eight durations of incubation were tested:1 to 8 weeks.Three analogous samples of each group and subgroups were tested per week.Stiffness (YS:E) and the load-deflection characteristics of unloading plateau section were obtained.Results Significant changes in specific mechanical properties were observed in long-term immersed and large deflected wires compared with as-received groups.Both immersion time and deflection affected the mechanical properties of wires in the simulated oral environment,and the two factors had synergistic effect.In groups-25°,-19° and -13°,stiffness (YS:E) increased then decreased and average plateau force and ratio of variance decreased then increased correspondingly at specific time.Conclusions In the final treatment phase of Tip-Edge Plus technique,the mechanical properties of nickel-titanium wire are associated with the using time and amounts of deflection and it may affect treatment outcomes.As the main reason for wire deflection,canine crown angulation plays an important role in the wire performance.It may be wise to focus on the canine crown angulations and using time in clinic with Tip-Edge Plus technique and make proper adjustment to help to make sure the treatment outcomes.

Child, Preschool ; Epilepsy, Rolandic ; diagnosis ; drug therapy ; physiopathology ; Humans ; Male ; Prognosis ; Steroids ; therapeutic use ; Treatment Outcome

AIM: To observe the effects of porous polyethylene ( Medpor) as a spacer graft in the reconstruction of large areas eyelid defect after the operation of malignant tumors of lower eyelids.
METHODS: Nineteen cases ( 19 eyes ) of malignant tumors of lower eyelid underwent the eyelid reconstruction were selected. Medpor lower eyelid inserts implantation were used to replace tarsal joint sliding conjunctival flap and pedicle flap, and repaired full -thickness lower eyelid defects then underwent eyelid reconstruction.
RESULTS: Appearance of eyelids and functional improvements were satisfactory with no stimulation on the eyeball and no effect on the visual function. Implants is with no absorption, shift, exclusion or infection and no tumor recurrence in all cases during the follow up for 6-36mo.
CONCLUSION: Medpor lower eyelid inserts implantation can instead tarsal plate for the reconstruction of medium to large areas lower eyelid defect, which is easy performing with rare complications. It is an ideal alternatives of tarsal plate.

We investigated the roles of the crude antigen(CA) of Clonorchis sinensis and excretory secretory products (ESPs) in the polarization of Th1 and Th2 cells.Bone marrow-derived cells were generated from BALB/c mice and isolated into immature DCs;immature DCs were then treated with either CA (CA stimulated group),ESPs (ESPs stimulated group),LPS (positive control group) or PBS (negative control group) for 24 hours.Then the CD4+T cells were isolated from mouse spleen by using anti mouse-CD4 Microbeads,and further cocultured with stimulated DCs for another 72 hours.The purities of DCs and CD4+ T cells were evaluated by flow cytometry and the expressing levels of T-bet mRNA and GATA-3 mRNA were detected by real-time PCR.ELISA was used to detect the levels of IFN-γ and IL-4 cytokines in the supernatant.mRNA levels of T-bet and GATA-3 in the ESPs group were higher than those in PBS-stimulated group (P＜0.05).The concentrations of IFN-γ and IL-4 cytokines in the culture were increased in the ESPs group,compared with PBS stimulated group(P＜0.05).IFN-γ but not IL-4 was increased in CA group (P＜0.05).The results implied that CA might play a role in Th1 type immune response,and ESPs likely play roles in both Th1 and Th2 immune responses.

Objective To determine the effect of induction of immune tolerance by intrathymic injection of myelin basic protein (MBP) for treatment of surgical brain injury (SBI) in rats.Methods Twenty-four male SD rats were divided into experimental group,control group and sham group with 8 rats each,according to the random number table.SBI model was established in experimental group and control group.Thymuses were exposed and injected with MBP (experimental group) or saline (control group) respectively.Sham group received craniotomy without durotomy and thymus paracentesis.Modified neurological severity score (MNSS),cerebral edema volume,levels of peripheral blood proinflammatory cytokine interleukin (IL)-2 and anti-inflammatory cytokine IL-4,and CD4 +/CD8 + T-cell ratio were measured at postoperative 1,3,7,14 and 21 d.Results MNSS between control and experimental groups differed significantly at each time point (P ＜ 0.05).Compared to sham group,MNSS in experimental group was recovered the same value at 21 d (P ＞ 0.05),but in control group remained high over the study (P ＜ 0.05).Less cerebral edema was observed in control and experimental groups than in control group at each time point (P ＜ 0.05),but all were lower than these in sham group (P ＜ 0.05).Lower IL-2 concentrations and higher IL-4 concentrations were observed in experimental group than in control group at 3,7 and 14 d (P ＜0.05).Compared to sham group,IL-2 concentrations in experimental group and IL-4 concentrations in control group revealed no significant differences at each time point (P ＞0.05).CD4 +/CD8 + T-cell ratio between experimental group and control group revealed significant difference at 1,7 and 14 d (P ＜0.05).CD4 +/CD8 + T-cell ratio in experimental group and control group recovered to the same level in sham group at 7 and 21 d(P ＞ 0.05).Conclusion Induction of immune tolerance through intrathymic injection of MBP can reduce neurological deficit and brain edema and facilitate the recovery of function from SBI.