Through tracing to the source of syndrome differentiation according to meridian and collateral theory, Lingshu: Jingmai (Miraculous Pivot * Meridians) is studied in this article. Considered the requirement and concept of treatment according to syndrome differentiation, the application of proper syndrome differentiation methods based on meridian and collateral theory in acupuncture clinic is discussed. Theories, key factors as well as historical relations of syndrome differentiation according to meridian and collateral are also analyzed. The feature and origin of syndrome differentiation according to meridian and collateral, which are considered to be more important, are also discussed. Focuses of explanation are put on the functions, significances, connotations, relationship and clinical application of two major factors of syndrome differentiation, namely the running course of meridian and collateral and signs.
Acupuncture Therapy ; Diagnosis, Differential ; Humans ; Meridians ; Syndrome

Iron overload is a metabolic disorder characterized by excessive iron deposition in the liver,pancreas,heart,endocrine organs, etc.,resulting in structural damage and dysfunction.The liver is the primary organ for iron storage,and excessive iron deposition induces liver inflammation and fibrosis,which may progress to cirrhosis and even liver cancer,with a poor prognosis.Accurate evaluation and effec-tive treatment can reduce liver injury caused by iron overload and improve patients′survival.

Objective To optimize the extraction conditions for Yuemu eye drops.Methods The extraction conditions were studied with orthogonal test L_9(3~4),the content of caffeic acid was determined by HPLC as index.Results Alcohol concentration and frequency of extraction were remarkable factors in the test. Conclusion The optimum extraction technology for Yuemu eye drops was to reflux and extract the materials for 2 times in 80% alcohol,the volume of which was 6 times the weight of herbal medicine,with 1 hour for each time.

To synthesize 3-nicotinamide-1, 2, 4-benzotriazine-1, 4-dioxide and to determine its anti-tumor activity in vitro. METHODS: Cyanogenamide and benzofuroxan were used as starting materials to prepare the intermediate (3-amino-1, 2, 4-benzotriazine-1, 4-dioxide, Tirapazamine). The objective substance was obtained from the reaction of the intermediate and nicotinic acyl chloride. The in vitro antitumor activities of the synthesized compounds were determined by MTT method using MCF-7 and HepG2 cells. RESULTS: The obtained compounds were identified by 1H-NMR, MS and IR. The purity of the objective substance determined by HPLC was 99.24%. CONCLUSION: The anti-tumor activity of 3-nicotinamide-1, 2, 4-benzotriazine-1, 4-dioxide is much better than tirapazamine. Copyright 2012 by the Chinese Pharmaceutical Association.

Objective To investigate the effectiveness of laparoscopic mesh repair of parastomal hernia. Methods Laparoscopic mesh repair was performed in 7 patients with parasromal hernia from September 2004 to December 2005 in this hospital.Results Laparoscopic mesh herniorrhaphy was successfully performed in 6 patients, while a conversion to open herniorrhaphy was required in 1 patient because of extensive intraperitoneal adhesion. The operating time was 45~180 mi (mean, 109 min), and the hernial diameter was 4~6 cm (mean, 5.6 cm). Transient abdominal distention happened in 2 patients. Five patients complained of a pain in operative area within 3 weeks. Seroma occurred in 4 patients and was cured by needle aspiration and pressure bandaging for 2~ 4 times. No hematoma or surgery-related infection was seen. The length of postoperative hospital stay was 3~8 d (mean, 5.1 d). Postoperative follow-up for 2~15 months (mean, 8.3 months) revealed no recurrence. Conclusions Laparoscopic mesh repair of parastomal hernia is safe, effective, and feasible.

Objective To explore the causes and treatments for complications of laparoscopic incisional hernia repair.Methods A total of 110 patients with incisional hernia(42 men and 68 women,aged 33 to 89 years with a mean of 65)were treated with laparoscopic mesh repair in our hospital from March 2004 to May 2007.The clinical records of the patients were analyzed retrospectively.Results The laparoscopic repair was completed in all of the patients expect in one,who was converted to open surgery because of intraperitoneal adhesion.After the operation,15(13.6%)patients developed abdominal distension,86(78.2%)had severe pain in the operative area(not less than 6 weeks in 2 cases),23(20.9%)had seroma,6(5.4%)had urinary retention,2(1.8%)had acute gastric dilation,2(1.8%)had intestinal fistula,2(1.8%)had respiratory dysfunction,and 2(1.8%)showed recurrence of the hernia.Conclusion Most of the complications of laparoscopic incisional hernia repair are caused by insufficient preoperative preparation,intraperitoneal adhesion,difficulty in exposure of the visual field,improper use of electrocoagulation,small-sized masses,or weak fixation.

Objective To evaluate the efficacy of gasless laparoscopy for totally extraperitoneal(TEP) hernia repair.Methods Between April and August 2007,totally 82 patients with inguinal hernia received TEP in our hospital,in 30 of them the surgery was completed with gasless laparoscopy,while in the other 52,pneumoperitoneum was used for the operation.The operation time,medical cost,hospital stay,complications,and follow-up data of the two groups were compared.Results The gasless group had a longer operation time [(65.3?19.4) min vs(43.6?21.9) min,t=4.501,P=0.000],but less medical cost [(6186.7?1283.7) RMB vs(8391.8?850.8) RMB,t=-9.347,P=0.000].No significantly difference was observed in the hospital stay and rate of complications between the two groups [(2.1?0.8) d vs(1.8?0.9) d,t=1.513,P=0.134;and 6.7%(2/30) vs 5.8%(3/52),?2=0.027,P=0.870].Conclusion Gasless laparoscopy is effective and safe for totally extraperitoneal(TEP) hernia repair.

Eleven elderly patients undergoing maintenance hemodialysis without ARB or ACEI within 4 weeks were enrolled. Anti-hypertensive agents were replaced by telmisartan gradually to maintain stable blood pressure. Before and after 6 or 12 weeks of treatment, blood biochemical profiles, fasting blood glucose, fasting plasma insulin, insulin resistance index(HOMA-IR), blood pressure, and body weight were recorded. Our results showed that telmisartan did not affect body weight, high-density lipoprotein (HDL), triglyceride (TG), SCr, BUN, Alb, K+ , and PTH, although led to a significant decrease in TC and low-density lipoprotein (LDL). Following telmisartan treatment, FPG did not change significantly, but fasting insulin decreased from 13.9±3.6 mU/ml to 9.9±2.7 or 9.1±2.3 mU/ml at 6 and 12 week (P<0.01), and HOMA-IR decreased from 3.5±1.4 to 2.4±0.8 or 2.2±0.8 at 6 and 12 week (P<0.05). These results suggest that insulin resistance in elderly patients with MHD may be improved by telmisartan.

Objective To investigate the effect of lectin like oxidized low density lipoprotein receptor 1 ( LOX-1 ) in NRK52E intaking lipid induced by oxidized low density lipoprotein ( ox-LDL). Methods NRK-52E was incubated with ox-LDL (0,25,50, and 100 g/ml ) for 24 hours or pre-treated with the chemical blocker of LOX-1 receptor- polyI or carrageenan, and then exposed to 50 μg/ml of ox-LDL. LOX-Ⅰ mRNA was examined by real-time PGR. LOX-1 protein was assessed by Western blot analysis. Lipid deposit was examined by oil red O. Results LOX-1 mRNA expression in 25,50,100 μg/ml ox-LDL group was 2. 13, 10. 14, 20. 81 times of that in 0 g/ml ox-LDL group ( P <0. 05 ,respectively). LOX-1 protein expression in 25,50,100 μg/ml ox-LDL group was 2. 53,12. 18,21.45 times of that in 0 μg/ml ox-LDL group( P <0. 05 ,respectively). Following the increased LOX-1, lipid intake increased. Pre-treatment with Poly Ⅰ or carrageenan, LOX-1 mRNA expression deceased by 48% or 47%, LOX-1 protein deceased by 72% or 65%, lipid intake induced by 41% or 49% ( P <0.05 ,respectively). Lipid had a close relationship with LOX-1 ( r = 0. 87, P < 0. 05). Conclusion Ox-LDL induced NRK52E to express LOX-1 and promoted NRK52E to intake lipid, and this effect could be partly blocked by LOX-1 blocker.

Due to unknown onset time, patients with wake-up stroke and unknown onset stroke areoften excluded from thrombolytic therapy. However, many clinical studies have shown that multimodal imaging techniques can effectively guide wake-up stroke and unknown onset stroke for intravenous thrombolysis. Its endovascular treatment has also made some progress. This article mainly reviews the imaging findings, intravenous thrombolysis, and endovascular therapy in patients with wake-up stroke and unknown onset stroke.