Objective: To observe the clinical therapeutic effect of Pyretic Arthralgia granules in treating rheumatoid arthritis of moist heat arthralgia spasm syndrome,so as to provide scientific evidence in clinical Medication.Methods: Adopted random and positive parallel contrast methods,60 cases of active stage rheumatoid arthritis(RA) patients whom were differentiated of symptoms and signs as moist heat arthralgia spasm syndrome were divided into groups.Experimental group took Pyretic Arthralgia granules 2.0 g every time and 3 times a day orally;control group took Loxonin orally,60 mg every time and 3 times a day.Both course of treatment in two sets were 4 weeks.Results: Experimental group and control group all could improve present symptoms,physical signs and physical-chemical index.There was not significance variance in two groups comparing the disease therapeutic effect with the therapeutic effect of syndrome of traditional Chinese medicine.Conclusion: Pyretic Arthralgia granules has the effects of detumescence,alleviating pain and improving Joint function,and has not obvious poison and side reaction.It is good for further generalizing and applying.

Subintimal angioplasty had been widely used in the intervention of lower extremity arterial obliterans disease in recent years.True lumen re-entry is the key to subintimal angioplasty.This comprehensive exposition of the true lumen re-entry can improve the chances of ultrasound and subintimal arterial flossing with antegraderetrograde intervention and catheter systems and other emerging technologies in the application of subintimal angioplasty,and various types of technology advantages and disadvantages.

With the progress of minimally invasive surgical techniques,the vast majority of general surgery can be safely carried out laparoscopically.But the development of the pancreas laparoscopic surgery is lagging behind.Initially laparoscopy was used only as a diagnostic and staging tool.Nevertheless with more and more successful launch of laparoscopic surgery.Surgeons devoted a great deal of energy to this field in order to benefit more patients.This review focused on the literature of laparoscopic pancreatic surgery in resent years,although the majority of literature suggests that the minimally invasive pancreatic surgery has advantages of rapid recovery,low complication rate compared to traditional open surgery.However,most studies are limited to a small sample and a single institution results.The promotion of this emerging technology still needs more rigorous evidence based medicine.

Objective To study the correlation of heart rate variability(HRV) and autonomic nervous function in patients with anxiety neurosis, and provide evidence for prevention and treatment of anxiety disorder. Methods 90 patients with generalized anxiety disorder(GAD) and panic disorder(PD) and 90 healthy persons were tested by psychological questionnaire,the anxiety and depression were assessed by HAMA and HAMD. The average heart rate and HRV index were monitored by 24-hour ambulatory ECG. Results The average heart rate of the anxiety group was higher than the control group, compared with the control group the difference was significant ( P < 0. 05 ); The HRV parameters of the anxiety group were lower than the control group, compared with the control group the difference was significant( P < 0. 05 ) ;The HRV parameters of the GAD group were lower than the control group, the HRV parameters of the PD group were lower than the GAD group, the difference was significant ( P < 0. 05 ). Conclusion The patients with anxiety neurosis had high sympathetic nerve activity function and autonomic dysfunction, the PD patients had higher sympathetic nerve activity function and autonomic dysfunction than the GAD patients.

Objective To observe the apoptosis and expression of Toll-like receptor (TLR)-4's mRNA in ischemia-reperfusion injured rat renal tubular epithelia cells (NRK-52E) in vitro, and effect of Cordyceps Sinensis (CS) extractant.Methods Cultured NRK-52E cells were divided into a control group, a model group, and a CS preincubated group. All first removed media and incubated with antimycin A for 1 h, and then recovered the media to simulate the ischemia-reperfusion injury in vitro. We detected the apoptosis ratio of cells by flow cytometer and the mRNA expression of TLR-4, Bax, Bcl-2 gene by reverse transcription-polymerase chain reaction at different time points.Results In ischemia-reperfusion injured NRK-52E, the apoptosis ratio rose as time passed (P＜0.05). We also observed increased mRNA expression of TLR-4, Bax (P＜0.05) and deceased expression of Bcl-2 (P＜0.05). Compared with the model grpup, the CS preincubated NRK-52E cells showed apparent tolerance to ischemia-reperfusion injury, which manifestated lower apoptosis ratio (P＜0.05), decreased expression of mRNA of TLR-4, Bax and increased expression of Bcl-2 (All Ps＜0.05). Conclusion The number of apoptosis cells and the expression of TLR-4 mRNA inceased with ischemia-reperfusion injury of NRK-52E in vitro. CS can prevent the NRK-52E cells from ischemia-reperfusion injury by downregulating TLR-4 gene.

According to TCM theory of the wholistic concept and the principles of syndrome differentiation and treatment, the characteristics of the pathogenesis of aplastic anemia (AA) were summarized and corresponding treatment was put forward on the basis of clinical observation and the study of literature. In the pathogenesis of AA, the deficiency of spleen and kidney is the primary aspect, fire attacking blood vessels is the secondary aspect and there is change because of blood stasis. In treatment, the method of invigorating spleen and tonifying kidney is adopted in order to get at the root, and releasing fire to stop bleeding is adopted in order to bring about a temporary solution, and activating blood circulation to dissipate blood stasis is adopted in order to produce blood. The outline should be caught hold of that consumption is primary aspect and fire is secondary aspect and there is change because of blood stasis in order to obtain satisfactory curative effect.

Objective To study comprehensive methods for senile hypertension and compared with conven-tional western medicine treatment,and provide reference to guide clinical hypertension treatment for the future. Methods 162 cases with senile hypertension were selected in our hospital,according to the order of treatment and the principle of informed consent,they were randomly divided into observation group and control group.The control group was given conventional western medicine treatment,the Nifedipine sustained release tablets joint irbesartan tab-lets.Based on the thinkings of health management,we established health records for observation group firstly,then as-sessed cardiovascular risk among patients.The patients with low,moderate risk were conducted the continuous monito-ring of blood pressure,health education,the key intervention in their way of life,established a good mentality.If the blood pressure was still unstable and out of control,we began to consider the use of drug.For patients with high risk or very high risk,besides the treatment considered,they needed immediate medical treatment supplemented by traditional Chinese medicine.Observation group was followed up for 1 time,and lasting for 6 months,then their blood pressure was measured again,the treatment effect and adverse reactions were evaluated.Results The total effective rate of ob-servation group was 96.7% (89 /92),which was significantly higher than that of control group 82.8% (58 /70),χ2 =9.12,P <0.01,the difference was statistically significant.After following up for 6 months,the systolic blood pressure of observation group fell to (126.1 ±21.5 )mmHg,t =7.548,P <0.01;diastolic blood pressure fell to (79.5 ±9.5)mmHg,t =10.703,P <0.01,the change was significantly different than before.The systolic blood pres-sure of control group fell to (145.3 ±26.7)mmHg,t =1.979,P <0.05,there was markedly reduced,diastolic blood pressure decreased too,but there was no statistical difference (P >0.05).So the effect of observation group was better than control group.Meanwhile,some adverse reaction occurred in both groups,but there was no significant difference. Conclusion With the thinking of health management for aged patients with hypertension,offer full -course treatment for them in order to increase the awareness of hypertension and establish healthy lifestyle,guide scientific and rational drug use.The integrated use of these methods can effectively improve the effect of the treatment of senile hyperten-sion,which is worthy of popularization and application.

Objective Health education provided by medical staffs can promote the patients 'abilities of self management . This article explored the teaching mode of health education course for nursing students of college to undergraduate level . Methods Reform took place in the course of health education for nursing students of Grade 2009 to 2012 who studied in the medical school of col-lege to undergraduate in Nanjing Genernal Hospital .The unidirectional teaching method was replaced by trinity teaching method which included cases , situational analogue training and clinical situation experience .In their clinical internship , the same questionnaire was used by designated personnel to survey the satisfaction degree of the patients , the clinical teachers and the nurses themselves .Analysis and comparison were conducted on the materials of satisfaction degree from 2009 to 2011 . Results Significant difference was found in the satisfaction degree of the patients , the clinical teachers and the nurses before and after the application of trinity teaching model (93.4%vs 56.9%, 91.6%vs 59.7%, 99.3% vs 78.1%). Conclusion The trinity teaching model is of high practical value , which is worth popularizing .

Objective To investigate the effects of 1,25-dihydroxyvitamin D3 in the prevention of corneal allograft rejection. Methods Forty-five SD rats (only right eyes) were used as recipients,and 15 Wistar rats (double eyes) were used as donors. SD rats were randomly divided into 3 groups: the autograft control group,the allograft control group (receiving peanut oil as placebo),and the allograft group were treated with 1,25-dihydroxyvitamin D3 (1.0 ?g.kg-1.d-1,3 times/d for 13 d,i.p.). Drugs were injected intraperitoneally for 14 d after transplantation. Routine antibiotic eye drops were used. Grafts were observed by operating microscopy everyday after transplantation. Five SD rats in each group were killed respectively at the 14,21,and 30 d postoperatively. Neovascularization and inflammation were evaluated with HE staining. ELISA was used to detect the contents of IL-1?,IL-2,IL-8,and IL-10 in the peripheral blood. Results The mean survival time (MST) of the graft was (21.7?6.8) d in the autograft control group,(11.2?2.5) d in the allograft control group,and (19.3?5.2) d in the allograft group. There was statistically significance between the latter 2 groups (P