It views the physiological characteristics of cardio-cerebral vascular diseases are deficiency of root and excessiveness of appearance,i.e.root being deficiency of Yin,Yang,Qi and blood;the superficiality being blood stasis,sputum and Qi block.The common treatments are to activate blood circulation and get rid of stasis,warmly activate Yang Qi,protect heart Qi,nourish Qi and relief block,induce resuscitation with aromatics,etc.

simple Qi-deficiency syndrome.The symptoms with incidence of over 50% in the Yang-deficiency and accompanied syndromes group were in the following order:precordial pain, oppressed feeling in chest,palpitation,short breath,aversion to cold,cold limbs,weakness,lassitude in loin and knee,polyuria at night.Conclusion:Acute coronary syndrome has complicated pathogenesis,deficiency with excess,and Yang-deficiency,cold accumulation and blood stasis are the main pathogenesis of the disease.

Objective To evaluate the safety and efficacy of adrenal autotransplantation for the treatment of persistent Cushing's disease after transsphenoidal pituitary tumor resection. Methods Four patients were treated by adrenal autotransplantation with attached blood vessels after bilateral adrenalectomy for persistent Cushing's disease from April 1991 to March 2008 in our institute. The four patients were 3 females and 1 male. Their ages ranged from 14 to 36 years, with an average of 30 years. Right adrenalectomy was performed 1 to 3 months before the left adrenalectomy. 30 % ?50 % of the left hyperplastic adrenal was placed in the left inguinal region with the anastomosis of the inferior epigastric artery and the central adrenal vein, and between the left saphenous vein and the incised adrenal envelope with the adrenal middle artery inside. The hormone replacement dosage decreased gradually after operation. They were followed up for 1.0, 1. 5, 8. 0 and 10. 0 years. The patient's symptoms, adrenal hormone (serum cortisol, urinary free cortisol and adrenocorticotroph) levels and the steroid replacement dosages were recorded and analyzed. Results The symptom of the Cushing's disease disappeared completely after operation and there was no Nelson's syndrome except one patient with slight darken skin. Through 4 ways of imaging examination, operation, clinical presentation and endocrine examination, the 4 transplanted adrenals functioned well with less steroid replacement dosage needed after operation. The 4 transplanted adrenal glands functioned steadily 1 year after the auto-transplantation, and no hyperplasia was detected in the transplanted adrenals with the stimulus of high dosage adrenocorticotroph. Conclusions The long-term effects of adrenal autotransplantation with attached blood vessels after bilateral adrenalectomy is effective and safe. Adrenal autotransplantation can be a feasible option for the treatment of persistent Cushing's disease.

Erythropoietin (EPO) is an active glycoprotein synthesized by kidney. The physiological function of regulat?ing the synthesis of erythrocytes by EPO makes it as a clinical drug for treatment of anemia resulted from chronic kidney fail?ure. However, its short biological half-life makes frequent administration, which limits its wide clinical utility since the tough burden and pain on patients. Therefore, the development of EPO derivatives with good efficacy, less adverse reaction and long duration has been a hot spot in the field during several decades. There are currently many different variants of EPO derivatives including erythropoiesis stimulating agents (ESAs) on the market. This article aims to summarize the recent re?search progress in the development of erythropoietin derivatives, specially focusing on EPO mimetic peptides (EMP).

Objective To study a modified method of laparoscopic partial nephrectomy with hypothermic renal artery perfusion in situ.Methods Laparoscopic partial nephrectomy with hypothermic renal artery perfusion in situ was performed in 5 patients from March 2009 to May 2009.There were 3 males and 2 females,with an average age of 49 years (39 to 63 years).There were 3 tumors in the left kidney and 2 in the right kidney,with an average diameter of 5.6 cm (range,3.8 to 7.0 cm).There were 2 cases of chronic renal insufficiency,1 case of solitary kidney,1 case of contralateral renal atrophy and 1 case of larger benign tumor.The procedure of laparoscopic partial nephrectomy with hypothermic renal artery perfusion in situ was as follows:A catheter with balloon was placed in the renal artery with percutaneous approach through the femoral artery preoperatively.During the operation the balloon of the catheter was inflated with water in order to block the renal artery,and renal artery perfusion of about 200ml saline of 4 ℃ was conducted through the catheter under high pressure in order to achieve low temperature in situ kidney.The water of the balloon was extracted after the accomplishment of the laparoscopic partial nephrectomy.Results Laparoscopic partial nephrectomies with hypothermic renal artery perfusion in situ were carried out successfully in 5 cases.The average operative time was 102 min (80 to 120 min),the average renal artery occlusion time was 35 min (range,29 to 39 min),and the average amount of bleeding was 190 ml(50 to 300 ml).The temperature of skin,kidneys,and tumor after hypothermic perfusion dropped by an average of 0.6℃,10.0 ℃,and 9.8℃,respectively.The endogenous creatinine clearance rate was(84.7±16.9),(48.9±14.5),(52.1±12.4),(54.5±13.8),and(54.6±11.7)ml/min before and 1 day,3 days,5 days and 10 days after operation.There was significant difference among the 5 groups in endogenous creatinine clearance rate(P=0.001).There was significant difference between each 2 groups except that between the group at 5 days and 10 days after operaton,The endogenous creatinine clearance rate kept steady in 5 days after operation.Conclusions Laparoscopic partial nephrectomy with hypothermic renal artery perfusion in situ is feasible and safe in favor of the extension of renal ischemic time and the protection of renal function.And it has resolved 2 problems in laparoscopic partial nephrectomy,that is,the laparoscopic artery occlusion and the hypothermic perfusion.

Objective To study the classification and treatment of juxtaglomerular cell tumor of the kidney. Methods Five cases of juxtaglomerular cell tumors of the kidney were diagnosed and treated surgically in our hospital during the last 4 years. Seven large series of cases report of juxtaglomerular cell tumors have been published in the Pubmed. These series of cases report plus 1 case report of static juxtaglomerular cell tumor were incorporated into a review of 71 cases previously published in English literature. The clinical presentation, laboratory examination and imaging study were summarized. The clinical presentation including blood pressure, the laboratory examinations including kalium, plasma renin activity and aldosterone, and renal venous sampling for renin assay, and the imaging study including ultrasonography, CT, excretory urography, and selective renal angiography were studied retrospectively. Results The 71 cases juxtaglomerular cell tumors could be classified into 3 types, that is, typical type, atypical type and static type. The 57 typical cases had the typical characteristics of hypertension, hyperaldosteronism, and hypokalemia secondary to tumor renin secretion.The 12 atypical cases had hypertension with normal kalium, and the 2 static cases had normal blood pressure and kalium. Typical juxtaglomerular cell tumor of the kidney should be considered in hypertensive patients with secondary aldosteronism. Atypical juxtaglomerular cell tumor of the kidney should be considered in patients with hypertension and renal tumor. Static juxtaglomerular cell tumor of the kidney should be considered in patients with benign renal tumor. Conclusions The classification of typical, atypical and static juxtaglomerular cell tumors depends on blood pressure and serum kalium. As a surgically corrected disease, juxtaglomerular cell tumor of the kidney should be considered in patients with benign renal tumor, and nephron-sparing surgery is the first choice.

Severe acute respiratory syndrome is an infectious disease caused by a new type of coronavirus. It belongs to the seasonal febrile diseases in traditional Chinese medicine. The prevention and treatment of severe acute respiratory syndrome (SARS) can be under the guidance of the doctrines for treating febrile diseases of traditional Chinese medicine, treatment based on syndrome differentiation, such as syndrome differentiation of triple energizer, syndrome differentiation according to defensive phase, qi phase, nutrient phase and blood phase. During April and May of 2003, 8 cases of SARS were diagnosed in Shanghai, and 6 patients accepted complementary therapy of traditional Chinese medicine, without death case. The only one patient who didn't take glucocorticoid therapy was complementarily treated with traditional Chinese herbs through the whole treating procedure. Upon the successful treatment of the eight cases of SARS in Shanghai, it is demonstrated that the triple-energizer syndrome differentiation and defensive-qi-nutrient-blood syndrome differentiation in traditional Chinese medicine are of high value in treating SARS patients.

Objective To study the application of proteomics in detecting differentially expressed proteins in renal clear cell carcinoma (RCCC) patient's urine in order to improve the diagnosis rate of RCCC.Methods From Mar.2010 to May.2010,the urine samples of 11 RCCC cases were collected,including 10 males and 1 female with average age of 63 (46-78) years.All patients were finally diagnosed as RCCC by post-operative or biopsy pathology.The normal control urine samples were collected from 10 males with average age of 29 (25-32) years.WCX beads combined with matrix assisted laser desorption ionization time of flighl mass spectrometry (MALDI-TOF MS) technique was applied in detecting differentially expressed proteins in RCCC patient's urine to find out differentially expressed proteins.And genetic algorithm was utilized to establish a diagnosis model.Results 160 differentially expressed proteins in RCCC patient 's urine were detected,and 1 was in significant difference,P=0.0304.ClinProTools 2.2 software was utilized with genetic algorithm to find out 13 differentially expressed proteins to establish a diagnosis model,and the sensitivity and specificity rate was 100％ after cross validation.Conclusions The diagnosis model established by genetic algorithms has high sensitivity and specificity rate,and can improve the diagnosis of RCCC.

Objective To study the diagnosis and surgical treatment of adrenal cavernous hemangi -oma. Methods The data of one case with adrenal cavernous hemangioma was retrospectively reviewed .A 62-year-old female patient admitted in out hospital on 18th June, 2013 due to the paroxysmal hypertension for 10 years and finding the left adrenal mass for 2 months.Her highest blood pressure was 175/55 mmHg and the response for the drug treatment was poor .In recent 6 months, her blood pressure was unstable .Ab-dominal ultrasound showed a hypoechoic mass in left adrenal .Enhanced CT examination showed an irregular mass in the left adrenal gland , with the size of 4.5 cm ×2.5 cm ×3.9 cm,peripherally enhanced in arterial phase , contrast agent filling in portal venous phase , and high density in delay phase .Abdominal MR exami-nation showed a mass before abdominal aortic , with clear and smooth edge .The mass showed low signal in T1WI phase and high signal in T 2WI phase, which was considered as pheochromocytoma .24h urinary cate-cholamines showed that norepinephrine was 103.0 nmol, epinephrine was 9.8 nmol and dopamine was 18.9 nmol.Octreotide (99Tcm-TOC) showed slight high expression of somatostatin receptor .Preoperative diagnosis was left pheochromocytoma . Results After the preoperative medical preparation of phenoxybenzamine for 3 weeks, her blood pressure was maintained at 120-132/50-70 mmHg, with stuffy nose, warm hand and foot, and the weight gain of about 1 kg.The patient was undergone laparoscopic resection of left adrenal tumor under general anesthesia on June 24, 2013.The postoperative blood pressure returned to normal .And the left adrenal pathology was cavernous hemangioma .Following up for 5 months, the patient had normal blood pressure without the tumor recurrence . Conclusions The adrenal cavernous hemangioma is extreme-ly rare with high rate of misdiagnosis .For adrenal tumor with typical hemangioma imaging , the diagnosis of cavernous hemangioma should be considered .For tumors larger than 6 cm, surgery is recommended .The first choice of operative approach is laparoscopic resection of adrenal tumor , and normal adrenal tissue should be retained as far as possible.

Objective To observe the effects of Soyasaponins on inflammatory factors, antioxidant activity and exercise ability in rats with severe heat stroke. Methods Eighty male Sprague-Dawley (SD) rats were randomly divided into normal control group, heat shock model group, saline control group and Soyasaponin group, The rats that died during the experiment or with a low rectal temperature (< 41℃) were excluded, and finally 54 rats were included, 18 rats remaining in each group. The rats in the heat shock model group were placed in the simulated hot climate animal cabin at 30 ℃, and the temperature within 30 minutes was raised to 39 ℃ in the cabin with 65% humidity; in the mean time, the rat models of heat shock were replicated under the following situations: let the rats exercise on a treadmill with running speed set at 15 m/min, slope degree 0°, once running for 8 minutes, interval 2 minutes and the heat shock time was 90 minutes, the rats in the normal control group were fed in an environment with temperature ranging from 23-25 ℃ and relative humidity ranging from 50%-70%. After the establishment of models, the saline control group and Soyasaponin group were given daily saline and Soyasaponin (10 mg/kg) respectively by gavage for 3 consecutive months, while the heat shock model group was not given any treatment. The femoral artery blood was collected 24 hours after the rats left the cabin. The serum levels of interleukins (IL-6, IL-1β), tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), malonaldehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) were measured by enzyme-linked immunosorbent (ELISA) and the contents of serum hemoglobin (Hb), serum urea (BUN), lactate dehydrogenase (LDH) and blood lactic acid (Lac) were measured by automatie biochemical analyzer. Results The levels of IL-6, IL-1β, TNF-α, IFN-γ, MDA, Hb, BUN, LDH, Lac in heat shock model group were significantly higher than those of the normal control group [IL-6 (ng/L): 86.17±4.82 vs. 12.60±3.49, IL-1β (ng/L): 83.00±5.98 vs. 15.70±3.64, TNF-α (ng/L): 72.22±6.93 vs. 13.75±2.69, IFN-γ (ng/L): 36.22±3.02 vs. 7.35±1.60, MDA (nmol/mg): 19.78±4.56 vs. 6.40±1.35, Hb (g/L): 136.22±1.93 vs. 126.75±5.84, BUN (mmol/L):21.06±3.44 vs. 5.65±1.35, LDH (μmoL·s-1·L-1): 9.65±0.83 vs. 2.12±0.17, Lac (mmol/L): 552.56±78.33 vs. 1.32±0.18, all P ＜ 0.05], SOD and GSH-Px were significantly lower than those in normal control group [SOD (kU/L):97.89±10.57 vs. 126.65±11.35, GSH-Px (kU/L): 19.22±2.58 vs. 43.45±4.02]; however, the levels of IL-6, IL-1β, TNF-α, IFN-γ, MDA, BUN, LDH and Lac in Soyasaponin group were significantly lower than those in heat shock model group [IL-6 (ng/L): 45.28±3.54 vs. 86.17±4.82, IL-1β (ng/L): 41.61±2.93 vs. 83.00±5.98, TNF-α (ng/L):37.22±2.46 vs. 72.22±6.93, IFN-γ (ng/L): 19.22±2.60 vs. 36.22±3.02, MDA (nmol/mg): 11.28±1.74 vs. 19.78±4.56, BUN (mmol/L): 11.78±2.13 vs. 21.06±3.44, LDH (μmoL·s-1·L-1): 3.70±0.26 vs. 9.65±0.83, Lac (mmol/L): 274.56±59.08 vs. 552.56±78.33, all P < 0.01], SOD, GSH-Px and Hb were significantly higher than those of heat shock model group [SOD (kU/L): 116.11±11.28 vs. 97.89±10.57, GSH-Px (kU/L): 31.17±2.90 vs. 19.22±2.58, Hb (g/L): 141.33±3.79 vs. 136.22±1.93, all P < 0.01]; there were no significant statistical differences in above indexes between heat shock model group and saline control group (all P > 0.05). Conclusion After heat shock and exercise management, the production and release of inflammatory factors are increased, and the level of lipid peroxidation was elevated in rats. The Soyasaponin can improve the ability to withstand heat shock and strong exercise by reducing the production and release of inflammatory factors and lipid peroxidation in the rats with severe heatstroke.