Objective: This study explores the applicability of a multi-attribute decision-making method in assessing Guizhi Decoction (GZD) and its varieties as noted in the Shanghanlun. Methods: A known multi-attribute decision-making method, the analytic hierarchy process (AHP), was adopted to transform the clinical challenge of selecting optional decoction for a given combination of symptoms or signs into multiple criteria decision-making problem. Results: A normative model based on the AHP was realized for indications of GZD and its varieties. The indications of sub-family GZD-f (indications of GZD itself) were exterior illness; the indications of GZD-vf1 (indications of GZD's variants which consist of fine adjustments to the ingredients or content on the basis of GZD) were exterior illness with interior excess, suggesting that GZD-vf1 consisted of most conservative variants of GZD; the indications of both GZD-vf2 (indications of Guizhi Qu Shaoyao Decoction and its derivative variants) and GZD-vf3 (indications of Guizhi Gancao Decoction and its derivative variants) showed evolution from exterior illness to interior deficiency in 2 directions. As to efficacy evaluation of the decoction, GZD and its varieties (restricted to those comparable ones) were of equal efficacy on 3 popular signs or symptoms indicating exterior illness: floating pulse, aversion to wind and spontaneous sweating, which were the common ground of indications for the GZD family. Conclusion: Modeling of diagnostic procedure based on the AHP is proved practicable to analyze the clinical judgment system of traditional Chinese medicine. Quantification research on syndrome differentiation and decoction evaluation system focused on signs and symptoms is suggested as a feasible and reliable model.

BACKGROUND: Vascular complications usually occur in diseases related to obesity such as primary hypertension or diabetes. Treating obesity with the method of promoting blood circulation to remove blood stasis gains a curative effect, so we presume that obesity may be correlated to blood stasis syndrome.OBJECTIVE: Analyzing the relationship between leptin(Lep) and insulinmetabolism of sugar and fat,endothelin(ET),blood pressure,body mass index(BMI), etc. Comparison of the differences in Lep and BMI between the blood stasis syndrome group and the non-blood stasis syndrome group was conducted to explore the correlation between obesity and the blood stasis syndrome.DESIGN: An observatory and controlled study based on patients with hypertension or diabetes.SETTING: Wards of the department of dardiovascular dedicine and the department of dndocrinology of a university of traditional Chinese medicine.PARTICIPANTS: All the patients in the present study were hospitalized at the Department of Internal Medicine of the Second Affiliated Hospital(Jinan City, Shangdong Province) of Shandong University of Traditional Chinese Medicine from September 2000 to January 2001.Among them, 126 cases with hypertension were at the Department of Cardiovascular Medicine, and 133 cases with type 2 diabetes were at the Department of Endocrinology. Inclusion criteria: ① The diagnosis of diabetes followed the diagnostic criteria for diabetes that was formulated by the WHO in 1980; ② The diagnosis of hypertension followed the diagnostic criteria in"China' s Guidebook for Hypertension Prevention and Treatment." The patients were aged between 45-76 years. Exclusion criteria: ① Secondary hypertension,diabetics; ②Complicated with severe diseases; ③ Complicated with severe disfunction of the heart,lung,liver, kidney or severe primary diseases in hematopoietic system; ④ Patients with mental disorder or pregnant women or in the state of lactation; ⑤ Patients aged <45'years old or>76 years old; ⑥ Patients who refused to participant in the study. Eighty-four cases with primary hypertension and 85 diabetics met the inclusion criteria, with a total of 169 cases including 73 male cases and 96 female cases. The cases were divided into blood stasis syndrome group and non-blood stasis syndrome group according to the clinical symptoms. There were 23 male cases and 37 female cases in the blood stasis syndrome group.METHODS: Drawing vein blood at the state of empty stomach for making plasma and serum. ET was detected with the radioimmuoassay(RIA) kit of ET by the method of RIA(the Arithmometer of Amma5500γ) . Lep and Ins were detected with the radioimmuoassay(RIA) kit of Lep and the radioimmuoassay(RIA) kit of Isu. The fasting blood sugar, total cholesterol(TC),triamid-glycerin(TG), high dense lipoprotein-cholesterol(HDL) and low dense lipoprrotein-cholesterol(LDL) were detected by the full-automatic bio-chemical analytical instrument of AMS-SaBa/8.MAIN OUTCOME MEASURES: Comparing the difference of Lep,Ins,ET between different diseases,syndromes; analyzing the relationship between Lep and Ins,BMI,blood sugar,blood lipid,blood pressure,etc.RESULTS: The detectable rate of the blood stasis syndrome in the diabetes group was higher than that in the hypertension group (P<0.05) . The ET density,Lep density,BMI,the percentage of fat of the blood stasis syndrome group were higher than those of the non- blood stasis syndrome group (P<0.05 ). The Ins density of the blood stasis syndrome group was lower than that of the non-blood stasis syndrome group(P<0.01 ). There was a positive correlation between Lep and BMI,the percentage of fat,ET,systolic pressure (SP),pulse pressure(PP) (P<0.05 or P<0. 01).CONCLUSION: There was a positive correlation between obesity and the blood stasis syndrome. Lep of patients with type 2 diabetes or hypertension was positively correlated to BMI,the percentage of fat and the level of ET.

AIM: To study the effects of Shenghua Decoction on the expression of adhesion molecules in vascular endothelial cells (VECs) of blood-stasis rats. METHODS: The expression of VCAM-1, ICAM-1, PECAM-1, iNOS and their corresponding mRNA in VECs were assayed by immunohistochemistry, image analysis and RT-PCR under the function of different Shenghua Decoction doses (high, middle, low). RESULTS: Immunohistochemistry and image analysis indicated: the expression of VCAM-1, ICAM-1, PECAM-1 and iNOS were higher in the model group than in the control group, Shenghua Decoction could decrease the expression of VCAM-1, ICAM-1, PECAM-1 and iNOS in the model group, moreover as the dose decreased, the expression of these molecules increase, it was of dose-effect relation. CONCLUSION: Shenghua Decoction can downregulate the expression of adhesion molecules in vascular endothelial cells of blood-stasis rats, and the dose-effect relation is obvious.

To construct a protein-protein interaction (PPI) network in hypertension patients with blood-stasis syndrome (BSS) by using digital gene expression (DGE) sequencing and database mining techniques.

Objective To compare the efficacy of laparoscopy versus traditional surgery for elderly patients undergoing nephrectomy.Methods Totally 134 elderly patients undergoing nephrectomy diagnosed by CT or PET-CT were divided into the laparoscopy group and the traditional surgery group (n=67,each).Clinical symptoms,operation time,bleeding volume,analgesic use,the duration of drainage,exhaust time,length of hospital stay,adverse reactions and death rate were recorded.All patients were followed-up for 2 years.Results There were significant differences in the bleeding volume,operation time,analgesic use,duration of drainage and exhaust time between the laparoscopy group and the traditional surgery group [(141.2 ± 23.3) ml vs.(175.7 ± 31.7) ml,(162.4±13.1) min vs.(177.6±13.1) min,(60.7±15.1) mgvs.(89.2±17.7) mg,(2.4±0.9) d vs.(4.0±1.1) d,t=2.92,5.21,15.94,10.5,respectively,all P＜0.05].The incidence of postoperation complications was lower in the laparoscopy group than in the traditional group [4 cases (6.0％) vs.15 cases (22.4％),x2=11.03,P=0.001].Tumor relapse was found in 2 cases in the laparoscopy group and 3 patients in the traditional group.1 patient died in laparoscopy group and 2 patients in traditional group,respectively.There were no significant differences in tumor relapse and death rate between groups (both P＞ 0.05).Conclusions Laparoscopy is safe and effective for elderly patients undergoing nephrectomy and it can reduce the complications and adverse reactions,which can be the first choice for elderly patients undergoing nephrectomy.

AIM: To research the effect of serum from patients with blood stasis syndrome(BSS) associated with hypertension disease on vWF、TM、EPCR excreted by ECV-304 and Tanshinone Ⅱ_A's intervention. METHODS: Cultivated human umbilical vein endothelial cells(CRL-1730) were divided into four groups,according to different serum of patients with BSS associated with hypertension disease,BSS(model) group,non-blood stasis group,health group and control group.The incubation time was 24 h.Tanshinone Ⅱ_A was of different concentrations(40、20、10、5 ?g/mL),all Tanshinone Ⅱ_A groups' cells were incubated by patients' serum and Tanshinone Ⅱ_A for 24 h.vWF,TM and EPCR were assayed by enzyme-linked immunosorbent assay(ELISA). RESULTS: vWF,TM and EPCR secreted were higher in the model group,the non-blood stasis group and the health group than those in the control group;vWF,TM and EPCR secreted were higher in the model group,the non-blood stasis group than those in the health group;Thereinto,the difference was distinct between the model group and the health group(P

Objective To explore the change of the red blood cell(RBC) immunoadhensive function in children with asthma and the effect of glucocorticoid on RBC immunoadhensive function.Methods The rosette rate of RBC-C3b receptor(RBC-C3bRR) and rosette rate of RBC-Immunocomplex(RBC-ICR) were measured by using yeast rosette method in 42 children with asthma,20 healthy children(control group),and 28 asthmatic children in remission period were measured also by the same methods after one month and six months of glucocorticoid inhalation therapy.Results The levels of RBC-C3bRR were lower in asthma group than that in remission group and control group(P0 05).Conclusions RBC immunoadhensive function has shown significant decrease in asthmatic children;and it may be improved by using glucocorticoid inhalation therapy in asthmatic children at remission period.

Objective To evaluate the short-term effects of methotrexate (MTX) injection by hysteroscopic tubal catheterization for unruptured tubal pregnancy, and to investigate factors influencing curative effects of such approach. Methods A total of 82 patients with unruptured tubal pregnancy underwent injection of MTX 20 mg (10ml) by hysteroscopic tubal catheterization from October 2000 to September 2002. Clinical efficiency and side effects were recorded. After administration for 72 hours, in case serum ?-HCG level had dropped less than 50 percent, a second injection of MTX was given. Results The total cure rate was 82.9% (68/82), and 72.0% (59/82) of the patients were cured clinically with the first administration of MTX, with the length of hospitalization being (10?4.9) days. Statistically, the drug reflux at injection, the declining level of ?-HCG after administration, and the serum level of ?-HCG ≥ 4000 mIu/ml before administration significantly influenced the curative effects (P=0.000, P=0.001, P=0.032, respectively). No side effects were found in this study. Out of the 65 cured patients followed up for 2 months,57 (87.7%) got normal menstruation. Conclusions MTX injection by hysteroscopic tubal catheterization for unruptured tubal pregnancy is effective, simple, minimally invasive and safe.

AIM: To observe the efficacy of Huangdanyishen Capsule (HDC)(Radix Astragali, Radix Salviae Miltiorr hizae) on renal lesions in diabetic nephropathy(DN) rat induced by Streptozocin(STZ). METHODS: The murine model with DN induced by STZ was made from Wistar rats with insulin resistance after being fed with feedingstuff of hypersugar, hyperlipid, hypercholesterol. These rats were randomly divided into five groups, and all rats were successively administrated corresponding drugs for 10 weeks. The general state and blood sugar were observed during the period. Serum urea nitrogen and creatinine content, the excretory rate of urinary micro-protein and renal pathological features were determined after 10 weeks. RESULTS: HDC could obviously ameliorate psychic status and renal function of rats with diabetes mellitus Ⅱ, and increase DN rats' weight. HDC could reduce the content of DN rats' serum urea. nitrogen and creatinine and urinary micro-protein. The ultramicropathologic histopathologic results indicated that the glomerular basement membrane thickening, synapse displaying foul-up and amalgamation, and mitochondrial swelling were alleviated to a certain extent in HDC groups. The content of murine blood sugar in HDC groups was significantly lower than those in model group. CONCLUSION: HDC has an obvious effect on Ⅱ DN treatment and decrease the content of blood sugar at the same time.

Objective To study the mechanism of the hyperuricemia among the middle and elderly populations. Methods Serum uric acid, creatinine (Cr), blood urea nitrogen (BUN), fasting gluose (FG), total cholesterol (TC), triglyceride (TG) were detected in 1073 subjects with hyperuricemia and 1235 subjects with normal serum uric acid as control of middle and elder groups. Results The means of Cr, BUN, FG, TG ,TC in hyperuricemia were significantly higher than those in the control group,respectively (males: t′ =7. 508,P ＜0.05;t′ =9. 484,P ＜0.05;t=6.208,P＜0.05;t′ =7.055,P ＜0.05;t = 5. 097,P ＜0.05;females;t′ = 11.221,P ＜0.05;t′= 8.314,P ＜0.05 ;t =5. 641 ,P ＜0.05 ;t′ =8. 328 ,P ＜0.05 ;t =7. 227 ,P ＜ 0.05). In males,the mean of the BUN; FG and TG were significant different among the different age groups (the control group: F = 3. 500, P ＜ 0.05; F = 5. 607, P ＜0.05 ;F =3. 378,P ＜0.05 ;the hyperuricemia group: F= 15.400,P ＜0.05 ;F =5. 111 ,P ＜0.05 ;F = 11. 143 ,P ＜0.05), the positive rate of BUN, Cr, FG and TG were significant different among the different age groups (control group:χ2 = 17. 112,P ＜ 0.05;χ2 =7. 807,P ＜0.05 ;χ2 = 17. 829,P ＜0.05;χ2=8.433,P ＜0.05; hyperuricemia group:χ2 =35. 587,P ＜0.05 ;χ2 =83. 005 ,P ＜0.05 ;χ2 =41. 639,P ＜0.05 ;χ2 =31. 466,P ＜0.05). In the same age group,the mean and the positive rate of BUN and Cr were significantly higher in the hyperuricemia group than in the control group(P ＜ 0.05). The mean of TG was significantly higher in every age group of the hyperuricemia group than controls (P ＜ 0.05), but the positive rate had no significant differences in the age group of ≥ 70 years (P ＞0.05). The mean and the positive rate of FG and TC were significant differences in middle age group between the hyperuricemia and the control group (P ＜ 0.05), but were no differences in elder age group(P ＞ 0.05). In females,the mean and positive rate of Cr, BUN, FG,TG and TC were significant different in different age groups of the controls(BUN:F = 13. 759,P ＜0.05;χ2 = 19. 491 ,P ＜0.05; FG: F = 13. 554,P ＜0.05;χ2 = 33. 438,P ＜0.05;TG:F= 18. 160,P ＜0.05;χ2 = 16. 978,P ＜0.05;TC: F = 37. 647,P ＜0.05;χ2 =60.547,P ＜0.05) ,but in the hyperuricemia group that were only significant difference in BUN, Cr and TC (BUN:F = 5. 830, P ＜ 0.05; χ2 =11.941,P＜0.05;Cr:F=4.057,P ＜0.05;χ2 =20.097,P＜0.05;TC:F=7.934,P ＜0.05;χ2 = 16.405,P ＜0.05). In same age group compared of all the indices were similar with male. Conclusions The mechanism of serum uric acid increasing are different in middle age and elderly age. In middle age, it is metabolic disturbance. However,in elderly age it is descending of the kidney function.