Objective To observe the clinical effect of self-made Jingxuan decoction in treating vertebroarterial vertigo of cervical vertebra disease. Methods Sixty five patients were randomly recurited into a control group (30 cases) and a treatment group (35 cases). The contol group received safflor yellow and sodium chloride injection, deproteinised calf blood serum injection, flunarizini, and metroclopramidum; While the treatment group received self-made Jingxuan decoction besides the treatments in the control group. 7 days constituted a course of treatment. The curative effects were assessed after two courses of treatment. Results The effective rate was 94.29% in the treatment group and 76.67% in the control group, showing significant difference (P<0.05). Conclusion Self-made Jingxuan decoction is an effective drug for vertebroarterial vertebroarterial vertigo of cervical vertebra disease.

Objective To control the quality of Shujin Jiegu tablets by determining the content of dracorhodin in the preparation by HPLC.Method With dracorhodin as index,the content of dracorhodin in the preparation was determined by HPLC.Results Dracorhodin showed a good linear relationship in the range of 1.53～7.66 ?g,r =0.999 9.The average recovery was 98.64%,RSD=1.12%.Conclusion This method is simple,rapid,repeatable,and applicable to the quality control of the preparation.

Objective To design a model of the content structure of websites of large scale modern hospitals which is in keeping with Chinas realities. Methods The First Hospital affiliated to the Fourth Military Medical University was selected as a representative of large scale modern Chinese hospitals and on the spot investigations were carried out. Investigations were also made via the Internet on ten famous domestic websites of hospitals affiliated to medical universities and the first ten American hospital websites as chosen by the American News Website in 2000. The opinions of 20 experts were collected and analyzed by means of expert consultation. Results The basic features of the websites of large scale modern hospitals were summed up and a content structure of websites of large scale modern hospitals, both advanced and in keeping with Chinas realities, was designed. Conclusion There is some regularity to follow in the website contents of large scale modern hospitals and the website contents of hospitals in China are turning from the stage of information to the stage of interaction.

Objective To investigate the clinical efficacy for different treatments of stage Ⅳ right colorectal cancer and its prognostic factors.Methods The clinical data of 106 patients with stage Ⅳ right colorectal cancer who were admitted to the First People's Hospital of Chenzhou from January 2008 to December 2013 were retrospectively analyzed.Among the 106 patients,42 patients receiving palliative resection were allocated to the palliative resection group,30 patients receiving colostomy were allocated to the colostomy group,20 patients receiving bypass surgery were allocated to the bypass group and 14 patients without treatment were allocated to the non-treatment group.Fluorouracil + leucovorin (5-FU/LV) were used as postoperative chemotherapeutics,and the time of chemotherapy was 2 to 6 months.The follow-up was applied to the patients by outpatient examination and telephone interview till February 2014.The non-normal distribution data were described as median and range.The survival curve was drawn by Kaplan-Meier method,and the survival rate was analyzed using the Log-rank test.The continuous variables were cut into the categorical variables.The univariate analysis of categorical variables was done using chi-square test,and the multivariate analysis was done using the COX regression model.Results The incidences of postoperative complications in the palliative resection group,in the colostomy group and in the bypass group were 47.6％ (20/42),40.0％ (12/30) and 65.0％ (13/20),respectively,with no significant difference (x2=3.053,P ＞ 0.05).One-hundred patients were followed up for 14.0 months (range,3.0-40.0 months),with overall median survival time of 10.3 months (range,2.6-27.0 months) and the 1-,2-year survival rates of 36.8％ and 6.7％.The median survival time and 1-,2-year survival rates were 11.5 months (range,4.3-27.0 months),47.6％,16.7％ in the palliative resection group,8.5 months (range,3.5-18.0 months),20.0％,0 in the colostomy group,9.0 months (range,3.0-13.0 months),15.0％,0 in the bypass surgery and 5.0 months (range,2.6-10.0 months),0,0 in the non-treatment group,showing a significant difference in the prognosis of patients among the 4 groups (x2 =42.395,P ＜ 0.05).The prognosis of patients in the palliative resection group were significantly different from those in the other 3 groups (x2 =5.786,6.178,10.378,P ＜0.05),there was no significant difference in the prognosis of patients between the colostomy group and the bypass surgery group (x2 =0.203,P ＞ 0.05).The results of univariate analysis showed that T stage,N stage,tumor differentiation,preoperative obstruction,peritoneal implantation,methods of treatment,chemotherapy and postoperative complications were related factors affecting the prognosis of patients with stage Ⅳ right colorectal cancer (x2=37.428,48.586,32.550,22.739,33.562,42.395,21.517,11.530,P＜0.05).T4 stage,N2 stage,poor-differentiated tumors and peritoneal implantation were independent risk factors affecting the poor prognosis of patients with stage Ⅳ right colorectal cancer (RR =2.336,2.945,2.182,3.500,95％ confidence interval:1.102-4.953,1.156-7.501,1.003-4.749,1.573-7.787,P ＜0.05).The postoperative chemotherapy was an independent factor affecting the good prognosis of patients with stage Ⅳ right colorectal cancer (RR =0.495,95％ confidence interval:0.271-0.904,P ＜ 0.05).Conclusion Palliative resection can improve the prognosis of patients with stage Ⅳ right colorectal cancer.T4 stage,N2 stage,poor-differentiated tumor,and peritoneal implantation were independent risk factors affecting the poor prognosis of patients with stage Ⅳ right colorectal cancer,while postoperative chemotherapy was an independent factor affecting the good prognosis of patients with stage Ⅳ right colorectal cancer.

Objective To summarize the experience in the perioperative nursing of one-stage bilateral total hip arthroplaaty (THA) for the systemic lupus erythematosus (SLE) patients with avascular necrosis of the femoral head (ANFH).Methods From June 1998 to April 2007,17 cases of patients who were diagnosed as SLE with bilateral ANFH were treated by one-stage bilateral THA.Perioperative nursing included psychological support,diet control,observation and nursing of various complications,correct functional exercise and health education.Harris score and SF-36 score were evaluated before and after operation.Results There were 2 cases with delayed incision healing,1 with early prosthesis dislocation,1 with thigh pain for 10 months and 1 with acute renal failure postoperatively,which were improved and recovered after proper treatments.Asymptomatic deep vein thrombosis (DVT) in low extremities were detected by color Doppler ultrasonography in 6 cases.There were no pulmonary embolism and no deep infection around prosthesis.There was no Addisonian crisis postoperatively.The pain was relieved and the motion of joint was improved during follow-up.There was no radiological evidence of implant loosening.The Harris hip score and SF-36 score greatly alleviated after operation.All patients were followed up and the mean follow-up time was 28 months.Conclusions One-stage bilateral THA has good results for the patients with SLE and AVNH.Strengthening of perioperative nursing contributed to improvement of success rate of surgery and reduction of complication.

Objective:To assess the preventive and therapeutic effects and primary mechanisms of Danshen injections in the treat-ment of hepatic encephalopathy ( HE) . Methods:The acute ammonia poisoning model induced by ammonium chloride was established in mice, and HE model with liver injury induced by carbon tetrachlorie and high blood ammonia induced by thioacetamide was made in rats. The time of death was detected in the first model, and the histamine levels in blood and brain, liver function and liver pathologi-cal histology changes were detected respectively in the other model. Results:In the acute ammonia poisoning experiment, the time of death in Danshen injections group was longer than that in the control group. Furthermore, Danshen injections could notably decrease the histamine levels in blood and brain, reduce the levels of ALT, AST, ALP and Tbil in serum and improve the function of liver to show the preventive and therapeutic effects on HE. Conclusion:Danshen injections exhibit promising preventive and therapeutic effects on HE, which may be related to decreasing histamine levels in blood and brain.

Objective To investigate the role of methylation of genomic DNA and connective tissue growth factor (CTGF) gene promoter in the pathogenesis of diabetic nephropathy (DN). Methods According to the WHO 1999 guideline for diabetes mellitus diagnosis and classification standard,90 patients diagnosed as diabetes mellitus and 30 healthy volunteers were enrolled in this study.All the participants were divided into diabetes mellitus without DN (DM) group (n=48),DN group (n=42) and healthy control group (n=30) accordingly.DNA was extracted from the peripheral blood and high pressure liquid chromatography (HPLC) was used to measure the overall methylation level of genomic DNA.The methylation status of CTGF gene promoter was determined by PCR and sequencing analysis.Serum CTGF protein level was measured by ELISA.Results The overall methylation level of genomic DNA was 5.23％±0.09％ for DN group,4.71％ ±0.03％ for DM group,and 4.37％±0.01％ for healthy control group,with no significant differences among three groups (all P＞0.05).The CTGF promoter methylation level in DN group (22.02％± 12.90％) was significantly decreased,compared to DM group (49.18％±8.01％,P=0.019) or healthy control group (72.18％±19.30％,P=0.000).Moreover,the serum CTGF protein level in DN group [(193.44±11.90) mg/L] was significantly increased,compared to DM group [(127.65±10.30) mg/L,P=0.031] and healthy control group [(95.84±5.10) mg/L,P=0.001]. Conclusion In DN patients,CTGF gene promoter methylation level is significantly decreased,but CTGF protein level is higher as compared to non-DN patients,which indicates that CTGF gene promoter demethylation may be involved in the pathogenesis of diabetic nephropathy.

Objective To investigate the association between Bsml polymorphism in vitamin D receptor (VDR) gene and diabetic nephropathy in Chinese Han population. Methods PCR-restriction fragment length polymorphism (PCR-RFLP) was used to test the genotype and allele frequency of Bsml in 304 patients with type 2 diabetes mellitus (DM group) and 100 healthy individuals (NC group).The DM group was further divided into non-diabetic nephropathy group (DN0 group,122 cases),minimal albuminuria group (DN1 group,87 cases),and mass albuminuria group (DN2 group,95 cases).Eighty-three DM patients without nephropathy for over 5 years were L-NDN subgroup,and 64 DM patients with nephropathy occurring within the first year were EDN subgroup. Results Genotype and allele frequency of BsmI polymorphism were significantly different between DM and NC group (x2=7.088,P=0.008;x2=5.865,P=0.015).BB+Bb genotype and B allele frequency were significantly higher in DN2 group than those in NC group (x2=14.287,P=0.000;x2=12.621,P=0.000) and DN0 group (x2=8.063,P=0.005;x2=8.173,P=0.004).BB+Bb genotype and B allele frequency were significantly higher in EDN group than those in L-NDN group (x2=7.228,P=0.007; x2=5.853,P=0.016).DN patients with allele B (BB and Bb genotypes)presented higher urinary albumin excretion rates compared with patients without allele B (bb genotype,P＜0.01).The genotype of BsmI was correlated with DN,and allele B was risk factor of DN occurrence and early onset (OR=2.004; OR=2.394). Conclusion VDR gene BsmI polymorphism is associated with DN,and the patients carrying allele B are more involved in mass albuminuria and eady onset of nephropathy.

OBJECTIVE: To explore the composition characteristics of traditional Chinese medicine (TCM) syndromes in patients with acute ischemic stroke of yin or yang syndrome by investigating the characteristics of TCM syndromes at different periods after onset. METHODS: One thousand two hundred and forty-six patients with acute ischemic stroke were admitted in twenty hospitals. According to the "diagnostic criteria of syndrome differentiation of stroke", the characteristics of syndromes in the patients were investigated at the periods of 1-3 days, 4-10 days and 11-30 days after they had ischemic stroke. General distribution of six basic syndromes was compared between the patients with yin syndrome and the patients with yang syndrome at the three periods. The six basic syndromes were wind syndrome, pathogenic fire syndrome, phlegm syndrome, blood stasis syndrome, qi deficiency syndrome, and syndrome of yin deficiency and yang hyperactivity. RESULTS: The percentages of wind, pathogenic fire, and phlegm syndromes in the patients were decreased at the period of 11-30 days as compared with the period of 1-3 days (87.1% vs 79.3%, 52.1% vs 38.7% and 67.1% vs 57.4% respectively, P<0.01). However, the percentages of the syndromes of blood stasis, qi deficiency, and yin deficiency and yang hyperactivity were similar at the three periods (P>0.05). There were no differences in the distribution of yin and yang syndromes among the three periods (P>0.05). The percentages of syndromes of wind, pathogenic fire, phlegm, and yin deficiency and yang hyperactivity were higher (P<0.01), and the percentages of syndromes of blood stasis and qi deficiency were lower (P<0.05, P<0.01) in patients with yang syndrome than in patients with yin syndrome. The complex of three syndromes was the most frequent composition pattern in the patients at the three periods. The percentages of complex syndromes of four or five syndromes were higher, and the percentages of single-syndromes and complex syndromes of two syndromes were lower in patients with yang syndrome than in patients with yin syndrome (P<0.05, P<0.01). The most frequent complex syndromes in patients with yin syndrome were complex syndrome of wind, phlegm, blood stasis and qi deficiency, and complex syndrome of wind, phlegm and qi deficiency; while the most frequent complex syndromes in patients with yang syndrome were complex syndrome of wind, pathogenic fire, phlegm and qi deficiency, and complex syndrome of wind, pathogenic fire and phlegm. CONCLUSION: The main discrimination between the yin and yang syndromes is that the yang syndrome is characterized by pathogenic fire. The syndromes of phlegm, qi deficiency, and blood stasis are not associated with the diagnosis of yin or yang syndrome.

OBJECTIVE: To explore the clinical evaluation system reflecting the superiority and characteristics of comprehensive traditional Chinese medicine (TCM) therapy for acute stroke. METHODS: A randomized controlled trial with single blind in various therapeutic centers was applied on the patients with the acute stage of hemorrhagic stroke due to hypertension, who were allocated to the trial group and the control group. The trial group accepted the general Western medicine therapy and differential treatment of traditional Chinese medicine based on stage classification. Patients in the control group were treated with the general Western medicine and the placebo of traditional Chinese herbal medicine. The treatment effect was assessed at the 7th day, 14th day, 21st day, and 28th day of post-treatment and after 3-month follow-up. The clinical evaluation system included the syndromes of TCM (ZH), Glasgow coma standard (GCS), nerve functional failure (NF), activity of daily living (ADL), Barther index (BI), quality of life index (QLI) and functional activities questionnaire (FAQ). RESULTS: Four hundred and four patients with acute stroke were included. There were 178 cases with yang-syndrome and 21 cases with yin-syndrome in the trial group (n=199), and there were 165 cases with yang-syndrome and 40 cases with yin-syndrome in the control group (n=205). The rates of recovery and obvious improvement after 3-month treatment in the trial group and the control group were 86.5% and 73.6% respectively. There was significant difference between the two groups (P<0.01). The response sensitivity of the effect items indicated that the sensitivity of GCS began to increase from the 7th day and was high at the 14th day and the 21st day for all patients. The response sensitivity of the NF scale was high for all patients at the 14th day, the 21st day and the 28th day. The BI scale and the QLI scale were sensitive to the patients with light and middle stage of stroke at the 21st day, and were sensitive to the patients with light stage of stroke after 3-month follow-up. The FAQ scale was sensitive to the light stroke at the 21st day and after 3-month follow-up. The ADL scale was sensitive to all patients at the 28th day and the patients with light stage of stroke after 3-month follow-up. The ZH scale was sensitive to all patients from 0 to 7d, the 14th day, and the 28th day. The principle components analysis indicated these 7 items could reflect the condition of stroke from 0-7d, the 21st day and after 3-month follow-up, and could be used to evaluate the therapeutic effect of hemorrhagic stroke. ZH scale and FAQ scale were more sensitive than other effect items at the 28th day. CONCLUSION: The seven items (GCSbNFbBIbQLIbFAQbADLbZH) have high sensibility to all patients in the acute stage of hemorrhage stroke especially at the 21st day. The ZH score will change in accord with the condition of stroke, and is appropriate to reflect the condition of stroke. It is believed that the seven items can form the system of effect evaluation in different stages of stroke, and the ZH scale is a very important item.