In recent years, many versions of international standard terminologies on TCM have been established and enacted by different authoritative organizations worldwide. However, infantile tuina acupoints have never been included in them. The article illustrated the necessity of including infantile tuina acupoints in the international standard terminologies on TCM from the aspects of history, present state and specificity of these points. It also pointed out some problems of infantile tuina acupoints, such as different records of acupoints numbers, applications in the clinic and strategies applied in their English translation, and suggestions were provided accordingly, hoping that the infantile tuina acupoints can be included in the further revised versions of international standard terminologies on TCM.

Objective] To explore a new method of synthesis of resveratrol oligmer induced by photosensitizers, further analyze its free radical scavenging activity and analgesic activity. [Method] Resveratrol was dispersed in pH 7.4 phosphate buffer solution, mixed with pheophorbide, then illuminated by laser at 630nm. The oligmers in the filtrate were analyzed by HPLC-MS and isolated by preparative liquid chromatography. Free radical scavenging activity was determined by DPPH and ABTS method, and the analgesic effect was measured by hot plate test and acetic acid writhing test in mice. [Result] A new peak occurred and reached stable in reactive solution after 20 min illumination. It was identified as the dimer of resveratrol with conversion of 35%. Its concentrations on inhibition of 50% DPPH and ABTS radical were respectively 230 μg·mL-1 and 273 μg·mL-1. It reached maximum pain threshold at 180 min, and the inhibition rate of writhing number was 62.6% with better effects than resveratrol. [Conclusion] Reseratrol can be polymerized to the dimer after pheophorbide excited by red light, the resveratrol and its dimer both have the ability of eliminating free radicals and analgesic effects, but the dimer has the stronger activity.

Teaching of clinical skills is an important bridging phase from preclinical medicine to clinical practice.It is also an important element of medical students'clinical skills training.According to the character of internal medical cardiology,we should enhance the training of their clinical thinking ability,medical communication competence,and clinical operating ability to get satisfactory teaching effect.

p38 signaling pathway is an important branch of mitogen-activated protein kinase（MAPK)-mediated signal transduction pathway. It plays pivotal roles in various physiological and pathological events, such as inflammation, cell stress, apoptosis, cell cycle and growth. Previous research in osteoarthritis, p38 participation was found in the inflammatory factors activate, cartilage cell apoptosis etc. Disc degeneration, also associated with inflammatory response, apoptosis and pathological changes which p38 MAPK signaling pathways role is not clear. Some reports about this area are reviewed in this article.

OBJECTIVE To analyze the profile of the pathogens and their drug resistance isolated from children with lower respiratory tract infection in Wenzhou area from Jan 2004 to Dec 2006.METHODS Lower respiratory tract secretions were obtained from children with lower respiratory tract infection for bacterial culture.The K-B method was applied for the antibiotic susceptibility test.RESULTS Total 1605 strains were isolated.The isolating rates of Gram-positive cocci,Gram-negative bacilli and fungi were 24.9%,61.2% and 14.0%,respectively.60.5%,and 54.6% of the isolates of Escherichia coli and Klebsiella pneumoniae produced extended-spectrum beta-lactamases(ESBLs).The rate of Penicillin-resistant Streptococcus pnenmoniae(PRSPN)was 30.6%.20.5% isolates of Staphylococcus aureus were MRSA.All isolates of Enterobacteriaceae and Gram-positive cocci were susceptible to imipenem and vancomycin in vitro.CONCLUSIONS Gram-negative bacilli are still the primary pathogens resulting in lower respiratory tract infection in children.Fungi and muti-drug-resistant bacteria are on the rise trend.

Objective:To optimize the extraction conditions of gallic acid inWudang pineneedle tea and establish the assay meth-od. Methods:The content of gallic acid was determined by RP-HPLC-DAD. Orthogonal test was used to optimize the extraction condi-tions of gallic acid in Wudang pineneedle tea on the base of single factor tests. The optimal extraction conditions were as follows:adding 50-fold amount of water, and ultrasonic extracting for 60 min under 200W ultrasound power. Results:The linear range of gallic acid was 5. 10-51. 00 mg ·L-1(r=0. 9993), and the average recovery was 98. 7% (RSD=1. 93%, n=6). The average content of gallic acid in the samples was 0. 35 mg·g-1 . Conclusion: The optimal extraction conditions are simple and feasible, and the assay method is stable and reliable, which can be used for the extraction and content determination of gallic acid in Wudang pineneedle tea.

Objective To investigate endplate shape in low lumbar spine in patients with herniated nucleus pulposus, and analyze the relationshipbetween endplate shape and herniation of intervertebral disc, Modic changes. Methods The preoperative MRI of 110 patients wasreviewed. The endplate shape was divided into 3 types. Disc degeneration was classified with the Pfirrmann's way. Results Concave typewas the most common in the lower lumbar spine. Flat was more prevalent in lower than in upper. The L5~S1 segment was flat in most cases.Irregular type was the least and mainly appeared at the L5~S1 segment. Disc degeneration worsened from concave, flat, to irregular. Herniatedintervertebral disc dominated with flat and irregular endplates, and no-herniated ones dominated with concave. Modic changes more associatedwith irregular endplates. Conclusion Endplate shape may respond to the disc degeneration. Modic changes associate with irregularendplate.

Objective: To explore the significance of Th17 in hepatocellular carcinoma, expecially with HBV infection.Methods:Cytometric bead array(CBA) was employed to detect 5 cytokines(IL-2,IL-4,IL-6,IFN-γ,IL-17A)from 39 tumor and non-tumor tissues of HCC and combined clinical data for comparative statistic analysis.Results:The expression of IL-2,IL-4,IFN-γin liver cancer tissue[(4.61±0.28),(3.37±0.58),(3.08±1.08)pg/ml,respectively] was significant lower than non-cancer tissue [(5.57±0.59),(3.77±0.70),(3.69±1.20)pg/ml,respectively].Otherwise,the expression of IL-6,IL-17A in cancer tissue [(280.09±254.68), (2.66±1.66) pg/ml, respectively] was higher than non-cancer [(6.58 ±1.92), (1.49 ±0.98) pg/ml, respectively].And,whatever cancer or non-cancer tissue,the expression of IL-17A in tissue[(3.45±1.86)pg/ml] with high HBV load (>1 000 U/ml) was significant higher than tissue with low HBV load[(1.97±1.16)pg/ml].Conclusion: IL-17A was highly expressed in HCC,and IL-2,IL-4,IFN-γmay inhibit its expression,and IL-6 may promote it.Hepatitis B virus infection may promote Th17 expression,thereby reducing patient′s prognosis.

Objective To evaluate the clinical application value of real-time three-dimensional transesophageal echocardiography (RT-3D-TEE) in diagnosis of mitral valve prolapse(MVP).Methods Twenty patients with MVP with more than moderate mitral regurgitation referred for mitral valve repair (MVR) were studied.All patients underwent RT-3D-TEE and mitral valve quantification(MVQ) before MVR.The location of scallop lesions and ruptured mitral chordae tendineae for mitral valve were evaluated,and compared with surgical findings.Carpentier's nomenclature was applied to the mitral valve anatomic localization either RT-3D-TEE or surgery.There were three anterior leaflet scallops defined as A1,A2 and A3,and three posterior leaflet scallops defined as P1,P2 and P3.Results ① The shape and spatial structure of the scallop lesions and ruptured mitral chordae tendineae of mitral valve were clearly displayed by RT-3D-TEE,also could be observed through left atrium view and left ventricular view.② Compaired with surgical findings,RT-3D-TEE was of high sensitivity (100 ％),higher specificity (95.46 ％) and crude agreement (95.83％) in the location of P2,the positive likelihood ratio of location of P2 (22.03) was the biggest,the negative likelihood ratio (0) was the smallest.③ RT-3D-TEE had lower sensitivity (66.67％),specificity (83.76 ％) and crude agreement (83.33 ％) in the diagnosis of location of P1 than other locations,the positive likelihood ratio(4.11) was the smallest,the negative likelihood ratio (0.40) was the biggest.④ The sensitivity,specificity,crude agreement,positive likelihood ratio and negative likelihood ratio of RT-3D-TEE in diagnosis of ruptured mitral chordae tendineae accompanied by MVP were 100％,91.67％,95.00％,12.00,0 respectively.Conclusions RT-3D-TEE could clearly display the three-dimensional structure of the lesions of mitral valve.It was of better accuracy in diagnosis of the location of scallop lesions of mitral valve and the rupture of chordae tendineae,and was of important clinical application value in MVR.

OBJECTIVE: To establish HPLC method for the determination of thioguanosine in human red blood cells. METHODS: The determination was performed on Hypersil ODS colum. The mobile phase consisted of methanol-water (10∶90) with detection wavelength at 342nm. 6-Thioguanine(6-TG)was generated from thioguanosine through heating and hydrolyzing. 6-TG was extracted into 0.1mol/L hydrochloric acid for sample injection assay with external reference method for the quantification. RESULTS: The linear range of 6-TG was 30～1 200pmol/8?108RBCs. Its optimum hydrolyzing time was 1 hour and optimal extraction pH value ranged from 11 to 12. The content of phenyl mercury acetate in the extraction solution was 1.3mmol/L. CONCLUSION: Under optimized conditions, HPLC method for the determination of thioguanosine is fast, accurate and sensitive.