After analyzing texts of ShangHanLun in this article,the author believes that ZHANG Zhong-jing's theory of treatment by di erentiation of syndrome is featured as:①Di erent treatments are given to the same disease based on the patient's speci c conditions such as cold,heat,de ciency and excess.②The illness develops in di erent way based on constitutional di erences.③Distinction must be done based on the location and character of illness.④The treatment must be changed based on the di erentiation of syndrome.ZHANG's treatment by di erentiation of syndrome is not only a great inspiration to the physicians in later generations but also provides great guidance to treatment by TCM.

Objective Selected three different birth years of cases in Beijing Sijiqing Hospital,to analyze the rate of vaginal delivery and the change of vaginal delivery rate in different factors with the changing time,put forward in a new era measures to increase the rate of vaginal delivery.Methods Chose three different time(1997.10.1 -2000.9.10),(2004.10.1 -2007.9.30) and (2011.10.1 -2014.9.30) in Beijing Sijiqing Hospital obstetric patients hospitalized term delivery into groups A,B and C.The three groups of patients were retrospectively analyzed to study the change of the vaginal delivery rate.Results In different age,different factors in the vaginal births,with the development of the society,the change of national policy,the hospital vaginal births to fall after A rise trend,group A and group B,group C vaginal births were 83.45%,54.27% and 83.45% respectively,but still vaginal births in group C was lower than that of group A.There was significant difference in the rate of vaginal delivery among the three groups(χ2 =6.448,P <0.05).Conclusion As protect the majority of maternal health,increase the vaginal delivery rate by strengthening health education to improve midwifery skills,improve environmental conditions and other delivery methods.

Objective To investigate the serum levels of anti-BRAF antibody in patients with rheumatoid arthritis (RA) and its clinical significance.Methods Blood samples from 129 patients with RA,71 patients with other rheumatic diseases and 68 healthy controls were measured by enzyme-linked immunosorbent assays (ELISA).The serum levels of anti-BRAF antibody in patients with RA were divided into high,medium and low groups,each group had 43 cases.The clinical symptoms,immunological findings and related imaging data of all cases were recorded.We investigated the relationship between the serum levels of anti-BRAF antibody and the clinical symptoms,immunological findings and related imaging changes of the RA group.Chi-square test,Mann-Whitney U test,Spearman's correlation test were used for statistical analysis.Results ① The serum levels of anti-BRAF antibody were significantly higher in RA group [A:1.093 (0.150-3.210)] than in other rheumatic diseases group [A:0.278 (0.093-0.455)] and healthy controls [A:0.202 (0.121-0.443)] (Z=-11.223,P=0.021 ; Z=-7.839,P=0.008 7).The serum levels of anti-BRAF antibody was not significantly different between patients with other rheumatic diseases group and healthy controls (Z=-0.905,P=0.445).② The difference in positive rate of rheumatoid factor (RF) in different groups of anti-BRAF antibody levels was statistically significant (λx2=10.14,P=0.006),namely the positive rate was significantlyhigher in the low-level group (88％) than in the high-level group (58％) (x2=10.03,P=0.002).Thepositive rate of anti-cyclic citrullinated peptide antibody and anti-keratin antibody of the three groups was not significantly different (x2=0.721,P=0.697; x2=1.735,P=0.188).③ There was significant negative correlation between the levels of anti-BRAF antibody and the course of disease (r=-0.233,P=0.047),RF(r=-2.84,P=0.039),IgM (r=-0.234,P=0.038),and hemoglobin (r=-0.287,P=0.032).There was no significant correlation between the level of anti-BRAF antibody and the joint swelling index (r=-0.133,P=0.230),joint pain index (r=-0.173,P=0.100),other clinical and laboratory parameters.There was significantly negative correlation between the ESR and hemoglobin level.④ There was no significant difference of the level of anti-BRAF antibody between the normal group and patients with bone destruction in the RA group (Z=-0.642,P=0.521).⑤ There was no significant difference in the level of anti-BRAF antibody between the normal group and patients with interstitial pulmonary fibrosis group in the RA group (Z=-0.121,P=0.904).Conclusion The anti-BRAF antibody can be used for the diagnosis of RA as a new autoantibody,and it can also be used in the diagnosis of early or RF-negative RA.There is no correlation between the level of anti-BRAF antibody and bone destruction and interstitial pulmonary fibrosis.

The Book of Huo You Xin Shu was written by Zeng Shirong,a famous pediatrics doctor in Yuan Dynasty.Based on his ancestors' experiences,together with his own long-term clinical practices,this book discussed critically on issues of how to nurture children and the treatment based on syndrome differentiation. He promoted the concept of scientific nurture and criticized the problems associated with in bringing up children.He suggested that every aspect of the children's daily life must be taken care of under the guidance of scientific recommendations in order to allow children to growth up healthily.Prophylaxis should go ahead of treatment.He mentioned the importance to carefully investigate in the causes and origins of diseases and to accurately distinguish between the exterior signs and interior causes.For an acute case,symptoms should be dealt with first,while for a chronic one the root cause is treated.He pointed out this principle to remind us a dire consequence may be caused due to misdiagnosis and rash treatment.Before the treatment,we have to differentiate between exterior and interior,cold and heat,deficiency and excess,and follow the principle of simultaneous treatment of both exterior and interior,elimination and reinforcement.Moreover,he paid special attention to the effect of Spleen and Stomach functions in developing pediatrics diseases,emphasizing the importance of regulating them in pediatrics treatment.He was the first person to initiate the concept of "four causes of infantile convulsion(Si Zheng)"and "eight syndromes in infantile convulsion(Ba Hou)".He thought that we ought to investigate the causes of disease,catch the key of pathogenesis,pay great attention to the Qi activity,and the most importantly,regulate Qi activity in treatment.

AIM To investigate the effect of urapidil on NO, ET, ANF and AngⅡ of spontaneously hypertensive rats. METHODS The content of nitric oxide (NO), endothelin (ET), atrial natriuretic factor (ANF) and angiotensin Ⅱ (AngⅡ) were determined by spectrophotometry and radioimmunoassay of spontaneously hypertensive rat (SHR) during the process of decreasing blood pressure with urapidil. RESULTS\ They were as follows: compared with the same aged normal blood pressure WKY rats, in the SHR, the content of serum NO decreased, the level of ET and ANF in the plasma increased. Whereas the level of AngⅡ has no difference in any group. Compared with the control of SHR,urapidil can increase the contents of serum NO, decrease the level of ET and ANF in the plasma. CONCLUSION \ It is suggested that urapidil may adjust the imbalance of cardiovasco-active substances by increasing the release of endogenous vasodilators and reducing the release of endogenous vasocontrictors to antihypertention.

To meet with the new problems of curriculum design about prevention medicine field to undergraduate in medical college,based on our teaching practice,we tried to explore some teaching measures about fieldwork of health education,in term of updating teaching methods and skills so as to enhance our students' integrated quality,cultivate and bring up more and more capable new-pattern preventive medical students fit for the public requirements.

Objective:To investigate the activated state of TH1/TH2 cytokines and T lymphocytes and to explore the pathogenesis of ankylosing sondylitis.Methods:Cytokine levels of Th1(IFN-?、TNF-?、IL-2)and Th2(IL-10、IL-5、IL-4) in plasma, percentages of CD3 +、CD4 +、CD8 + T cells、B cells(CD19 +) NK cells(CD16 +56 +)and CD3 +HLA-DR +、CD4 +HLA-DR +、CD8 +HLA-DR + T cells in peripheral blood lymphocytes were detected by Flow Cytometry.Results:In patients with AS ,plasma levels of TNF-?、IL-2 were significantly lower than that of healthy controls. IL-10 were significantly higher than that of healthy controls. In AS patients, percentages of CD3 +and CD8 + T cell from peripheral blood lymphocytes were significantly lower than that of healthy controls. Percentages of CD8 +HLA-DR + T cell were significantly lower than that of healthy controls. CD4 +HLA-DR +T cell was significantly highter than that of healthy controls.Conclusion:In patients with AS , lower levels of TNF-?、 IL-2 and higher level IL-10 at plasma indicate an inclination between TH1 and TH2, such as an impaired TH1 cytokine profile and an activated TH2 cytokine profile, especially in TNF-?.

According to the characteristics of clinical probation teaching of endocrinology,we established the stage-separated echelon teaching mode that accorded with cognitive law.By inspiring,guiding and other methods,medical students’learning enthusiasm were greatly stimulated,and their understanding and grasping degree to the clinical specialty content was deepened.We focused on training clinical skills and thinking ability of medical students,and achieved satisfactory teaching results.

Objective To find the cells in myocardium controlling in cardiomyogenic differentiation of marrow derived-mesenchymal stem cells(MSCs).Methods Rat marrow derived-MSCs,cardiomyocytes(CM)and endothelial cells(EC)were isolated and cultured,then MSCs were incubated with the CM or EC or cultured alone after labeled by 5-Bromo-2-deoxyuridine(BrdU)for 72 hours.The cells were identified by morphology,immunocytochemistry and double immunocytochemistry.Results More than 95% of the cells isolated and cultured belonged to MSCs,CM or EC.Incubated with CM,most MSCs labeled by BrdU showed cardiomyocyte-like morphology.After 4 weeks of cultivation,positive staining of double immunocytochemistry of BrdU and Sarcomeric Actin or Connexin-43(CX-43)were observed in 44% cells.However,there was no obvious change in morphology and no positive staining of double immunocytochemistry was recorded in MSCs incubated with EC or cultured alone after 1、2、3 and 4 weeks of cultivation.Conclusion MSCs can differentiate into cardiomyogenic cells in cardiomyocyte microenvironment and cardiomyocytes may play a crucial role in the differentiation.

Adult ; Esophageal Neoplasms ; diagnosis ; Humans ; Hypopharyngeal Neoplasms ; diagnosis ; Male ; Sarcoma, Synovial ; diagnosis