Objective] To study the transmission of the Ishinpo versions ,understand the prevailing version of Ishinpo. [Method] With the research methods of the Chinese traditional history and philology,collect and sort historical cited references of the Ishinpo, by paying attention to three main emendation in the transmission history of Ishinpo. [Result] Ishinpo of Nakarai is the golden version for document research. The prevailing Ansei Ishinpo version of contemporary China is based on Nakarai version,which consists of twenty seven scrolls of Hei era and three scrolls of Edo Era. Ishinpo Versions have been divided into Emperor Nakarai versions,Uji versions and Family tradition versions. There are big differences in utilization and completeness of the three version system. The Emperor Nakarai versions are relatively good, of which the Nakarai version preserves best. The Uji versions are widespread, of which the RenHe Temple version is better preserved but lacuna. There are lots of lacunas in the family tradition versions, owing to circulateed copies. [Conclusion] In the three main emendation, of Ishinpo, mostly, the Nakarai version is the source edition, the Uji version is primary edition, and the family tradition version is the secondary edition. The paper, which is useful in the transmission of the Ishinpo and thus historical process of medical exchange between China and Japan, has established the system of Ishinpo versions, defined the golden version and the prevailing version.

The ghrelin is an endogenous ligand of the growth hormone (GH) secretagogue receptor,which can regulate the secretion of GH,stimulate the appetite,adjust the energy metabolism,and improve the cardiovascular function.Children with congenital heart disease (CHD) usually suffered from malnutrition and growth retardation,which were connected with insufficiency of energy intake,poor absorption,and increase of nutritional requirement,anatomy and the changes of hemodynamics.Many infants with CHD gradually present ventricular dysfunction and growth restriction in their early childhood,which consequently lead to severe complications.Ghrelin is valuable in the early detection of potential CHD,plays an important role in improving the state of malnutrition and protecting the cardiac function,and provides an important reference to explore the new drug therapy for CHD.This review summarized the effects and significances of ghrelin on growth and cardiac function in infants with CHD.

OBJECTIVETo compare the difference among the combined method of oral administration of forlaxand acupoint embedding therapy, the simple acupoint embedding therapy and the simple oral administration of for-lax in the clinical efficacy on diabetic constipation.

METHODSOne hundred and fifty patients were randomized intoa comprehensive group, an acupoint embedding group and a forlax group, 50 cases in each one. In the acupointembedding group, the embedding therapy was applied to bilateral Tianshu (ST 25), Daheng (SP 15), Shangjuxu(ST 37) and Dachangshu (BL 25), once a week. In the forlax group, forlax (polyethylene glycol) was prescribedfor oral administration, once a day, 10 g each time. In the comprehensive group, the acupoint embedding therapyand forlax were combined and the methods were the same as the first two groups. The treatment for 4 weeks wasas one session, and 2 sessions were required in the three groups. Separately, in 4 weeks, 8 weeks of treatment and2 months after treatment, the constipation symptom scores were compared among the three groups. At the end of2 sessions of treatment, the clinical efficacy and adverse reactions were compared among the three groups. In2 months after treatment, the recurrence rate was compared among the three groups.

RESULTSThe total effectiverate was 98. 0% (49/50) in the comprehensive group, better than 86. 0% (43/50) in the acupoint embeddinggroup and 78. 0% (11/50) in the forlax group (both P<0. 01). In the 4 weeks and 8 weeks of treatment, the con-stipation symptom scores were reduced significantly as compared with those before treatment in the three groups(all P<0. 05). The results in the comprehensive group were lower than those in the other two groups (all P<0. 05). In the 4 weeks of treatment, the scores were not different significantly between the acupoint embedding group and the forlax group (P>0.05). In 8 weeks of treatment and 2 months after treatment, the scores in the acupoint embedding group were better tan those in the forlax group (all p<0.05). There were 2 cases of drug adverse reaction in the comprehensive group, 6 cases in the forlax group and 0 case in the acupoint embedding group. The recurrence rate was 8.1% (4/49) in the comprehensive group, lower than 32.6% (14/43) in the acupoint embedding group and 59.0% (23/39) in the forlax group (both P<0.01).

CONCLUSIONthe combined therapy of acupoint embedding and forlax achieves the better clinical efficacy on diabetic constipation and constipation symptom scores as compared with the simple acupoint embedding therapy and the oral administration of forlax the short-term efficacy of the simple acupoint embedding therapy is not different significantly from the simple forlax medication, but the long-term efficacy and safety are better than those of simple forlax medicaiton.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Combined Modality Therapy ; Constipation ; drug therapy ; etiology ; physiopathology ; therapy ; Defecation ; Diabetes Complications ; complications ; physiopathology ; Female ; Humans ; Laxatives ; administration & dosage ; Male ; Middle Aged ; Polyethylene Glycols ; administration & dosage ; Treatment Outcome

Objective To study the ultrasonographic changes and blood flow characteristic ofthromboangiitis obliterans (TAO) by two-dimensional ultrasound and color Doppler imaging MethodForty-seven vessels of 40 patients with clinically suspected TAO vascular detected with two-dimensionalultrasound and color Doppler,and comparison with CT imagmg.Results Color Doppler imaging couldvisualize the arterial wall and blood flow echo filling case,and the spectrum showed the hemodynamicchanges.Conclusions Color Doppler is the first choice for the secondary check to the noninvasivethromboangiitis obliterans,close to the result by an angiography that is usually regarded as a sensitive,accurate and convenient diagnostic method.

Objective To observe the effects of ganglioside and piracetam in improving the neurological function in patients with hypertensive cerebral hemorrhage.Methods Ninety-six patients with hypertensive cerebral hemorrhage Were randomly divided into 2 groups,ganglioside group(48 patients)and piracetam group(48 patients).Ganglioside group used the amount 40mg ganglioside mixed with sodium chloride injection(100ml,concentration 0.9%),and the piracetam group uesd piracetam(20g)mixed with the same injection.Both the patients of the 2 groups were given intravenous drip once a day,then after continuous 3 weeks,the general information and the improvement of nerve were observed.Results The effective rate and excellent rate of ganglioside group were remarkably higher than piracetam group,there was significant difference between the two groups(P＜0.05).Conclusion Ganglioside was better than pimcetam in improving clinical symptoms and the neurological deficit of the patients with hypertensive cerebral hemorrhage.

Objective To determine whether pancreatic ductal preservation(pancreatic ductal injection of sparing TIUW solution at the time of pancreas procurement)can improve islet yield and function after cold preservation of pancreas.Methods Pancreases were classified into five groups:fresh pancreases(group1 ,n= 10);preserved for 6 hr in TIUW solution without and with pancreatic ductal preservation by TIUW solution(group2, n=10 and group3, n = 10);preserved for 24 hr in TIUW solution without and with pancreatic ductal preservation by TIUW solution(group4 ,n= 10 and group5,n= 10).Dithizon(DTZ)staining was used to identify islet morphous and yield, trypan blue uptake(TBU)was used to assess the nonviability of islets, the insulin secretory response to glucose was used to evaluate islet function in vitro, islet transplantation was used to determine islet function in vivo.Results Islet yields per pancreas after purification in group 1 to 5 were 590± 127, 272 ± 50,454 ± 65, 253± 56, 447 ± 66(islet equivalent ± SD), respectively.Percentage of nonviable islets in grouplto5were(5.7±4.2)%,(18.3±6.5)%,(11.7±4.2)%,(26.3±5.6)%,(15.0±5.3)%.Stimulation index in group 1 to 5 were 7.32±2.32, 4.81±1.17, 7.56±2.44, 2.88±1.00, 5.71±1.90.Cure rates in group 1 to 5 were 100%, 0%, 100%, 0%, 70%.In this study, the differences were significant between control groups and experimental groups(P＜0.05, group 2 vs.group3 and group4 vs.group5).Conclusion The pancreatic ductal preservation can improve islet yield and function.

Nucleated red blood cells (nRBCs) are immature red blood cells, which are rarely in circulating blood in elder children, but often present in neonatal blood. The clinical significance in neonates is unclear. Numerous studies have shown that many kinds of acute and chronic stimuli can lead to an increase in the number of nRBCs in circulating blood. This article reviews various pathological processes related to the production and release of nRBCs, and emphasizes the effects of acute and chronic hypoxia and immune regulation on it.

Objective To compare the efficacy of aspirin and rivaroxaban on prevention of deep vein thrombosis after total knee repalcement.Methods Patients (200 cases) who were given total knee replacement were selected,and the patients in aspirin group (98 cases) were administered with asprin after 12 h treatment,and the patients in rivaroxaban group (102 cases) were administered with rivaroxaban after 12 h treatment.The efficacy of aspirin and rivaroxaban to prevent deep vein thrombosis after total knee repalcement was evaluated by blood coagulation indexes,D-dimer level,and complication during perioperative period.Results Before surgery,there was no statistically significant difference on coagulation indexes between two groups.After 3 d of operation,there was no statistically significant difference in Plt,APTT,and PT between two groups.The FIB level of aspirin group was improved significantly and higher than that of rivaroxaban group (P ＜ 0.05).While the FIB level of rivaroxaban group was close to the normal level.Before operation,there was no statistically significant difference in D-dimer between two groups.After 1,3,and 7 d of operation,the D-dimer levels in two groups were increased.But the D-dimer levels of 3 and 7 d after operation began to decline.After 1,3,and 7 d of operation,the D-dimer ofrivaroxaban group was lower than that of aspirin group (P ＜ 0.05).During perioperative period,there was no statistically significant difference on DVT between two groups.Conclusion Rivaroxaban could prevent the formation of DVT effectively and reduce the D-dimer with good anticoagulation and high safety.It is worthy of clinical application.

The author has analysed the current employment situation for clinical medicine graduates,the reasons for the difficulty of employment and solutions,so that the basis and the reference can be provided for us to carry out guiding work of clinical medicine graduates.

Because of the short education system,active and effective entrance education will produce a great impact on both the life of the medical college students and their long-term development.We should not only understand and analyze the views and cognition of the students but put forward a proposal to their entrance education as well,which will provide basic and reference that can develop the entrance and the political thought education better.