Objective]To explore the essence of doubts differentiation from‘Neiwaishangbianhuolun’,the monumental work of the medical practitioner Dongyuan Li in Jin and Yuan Dynasties, and relativity between internal damage and exogenous diseases.[Methods] By means of researching the background of‘Neiwaishangbianhuolun’, analyzing the 13 main differentiations, think about the essence of doubts differentiation; meanwhile, by connecting to the explicate of mechanism of ascending yangqi belonging to exterior-releasing medicine(wind-expel ing drugs) in his representative work‘Piweilun’, discuss the contrary and transforming relationships between exogenous wind-cold and internal damage of the stomach and spleen, comparing to academic thoughts of Zhongjing Zhang’s‘Shanghanlun’. [Results]Realize essence of doubts differentiation from ‘Neiwaishangbianhuolun’ is not exterior or interior of disease location,but deficiency and excess of disease character.By analyzing the functional mechanism of wind-expel ing drugs and relationship among exogenous diseases,wind-expel ing drugs and the stomach and spleen, raise the relativity between internal damage and exogenous diseases. [Conclusions] The revealing of the essence of deficiency and excess differentiations from‘Neiwaishangbianhuolun’, together with knowledge of the functional essence of wind-expel ing drugs and the relevance of internal damage and exogenous diseases, may open the mind partly for syndrome differentiation and medications in the clinic.

Objective To investigate the relationship of serum uric acid level with carotid atherosclerosis and intracranial stenosis in patients with cerebral ischemic stroke.Methods 186 patients checked by Color Doppler Flow Imaging (CDFI) and Transcranial Doppler (TCD) were enrolled.According to the degree of carotid intima-media thickness (IMT), patients were divided into normal group, and intima thicken group, the plaque shaping group and the vascular stenosis group.According to the degree of intracranial stenosis, patients were divided into stenosis group and nonstenosis group.The serum levels of uric acid (UA), triglycerides (TG), total cholesterol (TC), highdensity lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) were detected.The relative factors for carotid atherosclerosis and intracranial stenosis were analyzed by multiple logistic regression analysis.Results Compared with normal group and intima thicken group, the percentage of patients with hypertension, coronary heart disease and serum TC level were increased in plaque shaping group and vascular stenosis group (P＜0.05 for all).With the increase of carotid IMT, serum UA level was also gradually increased (F=11.386, P =0.000).Logistic regression analysis showed that serum UA level was the independent risk factor for carotid atherosclerosis (OR=3.486, P=0.013).Among 186 patients, 43 cases (23.1％) had intracranial vascular stenosis.The UA level was higher in stenosis group than in non stenosis group (t=9.372, P=0.013).Logistic regression analysis showed that serum UA level were the independent risk factors for intracranial arterial stenosis (OR =1.914, P=0.022).Conclusions The occurrence of carotid atherosclerosis and intracranial stenosis are closely related with hyperuricemia in patients with cerebral ischemic stroke, which indicates serum uric acid level may reflect the degree of carotid artery atherosclerosis.

Objective To study the difference between the mRNA expressions of hyaluronan synthase in the epithelial cells of endolymphatic sac and renal tubules with the oligonucleotide probe. Methods The oligonucleotide probe of hyaluronan synthase was designed and synthesized, the mRNA expressions of hyaluronan synthase in the epithelial cells of endolymphatic sac and renal tubules were detected with hybridization in situ. Results mRNA of hyaluronan synthases were strongly expressed in some epithelial cells of endolymphatic sac and renal tubules. Conclusion It is confirmed that a dual regulatory system for hyaluronan /hyaluronidase exists in the epithelial cells of endolymphatic sac and renal tubules at the level of molecular biology.

A method was developed for the determination of nicotinamide(NA) in rice by prE-column derivatization and high performance liquid chromatography/electrospray ionization mass spectrometry(HPLC/ESI-MS). After extraction with water, NA was derivatized by 9-fluorenylmethoxycarbonyl(FMOC-Cl). In order to enhance the sensitivity, the derivatization was optimized regarding organic solvent content and amount of FMOC-Cl. The best HPLC conditions for the separation of NA in real samples were achieved using a C18 column and mobile phase which contained 0.1% formic acid. The MS experiments were performed in selected ion monitoring mode(SIM). The method shows good linearity over the range of 0.1-5 mg/L for NA with a correlation coefficient of 0.9983. The limit of determination(LOD) was 0.05 mg/kg. Precision and recovery studies were evaluated at three concentration levels for rice root, stem, leaf and unpolished rice. The recovery(n=5) ranged from 72.0% to 89.2% with relative standard deviations from 2.3% to 9.6%. The method is simple, highly selective and reliable, and can be used to determine NA in rice at physiological level.

Objective] To explore core thought of Li Dongyuan’s spleen and gastric theory, grasp the basic spirit of Dongyuan theory, and better guide the clinic. [Method]Basing on some relevant theories from NeiJing, the eminent physician in Jin and Yuan Dynasties established the academic thought centering on regulating the spleen and stomach in treatment of the deficiencies. [Result]The thought revealed the cooperative function between invigorating Yang and tonifying middle-energizer and Qi. It also proposed the concept of “ Yin-fire” and the method of relieving high fever with drugs of sweet flavor and warm nature, creating a series of prescriptions of invigorating Yang and tonifying middle-energizer, which broadening the clinical treatment of traditional Chinese medicine. [Conclusion]The academic thought centered on adjusting spleen and stomach by raising Yang and tonifying Qi, broadens the TCM clinical therapy, today still effectively guides clinical practice.

Congenital Hypothyroidism ; diagnosis ; Diagnostic Errors ; Humans ; Infant, Newborn ; Male ; Water-Electrolyte Imbalance ; complications

Objective To evaluate the management strategy for gallbladder carcinoma found during the procedure of intended laparoscopic cholecystectomy (LC) Methods Twenty one cases of primary gallbladder carcinoma were incidently found during a period of 1996-2003, among them 17 cases of Nevin stage Ⅱ、Ⅲ and Ⅳ were divided into group A (6 cases) converted to open radical resection, and group B (11 cases) treated by LC ? 2 test and Kaplan Meier analysis were used to analyze postoperative survival rates Results (1) Two Nevin stage Ⅰ cases are still alive for 6 and 47 months at a follow up after LC; (2) For stage Ⅱ、 Ⅲ and Ⅳ patients, open surgery resulted a much longer survival ( ? 2=4 55, P =0 0328) Conclusion (1) For Nevin stage Ⅰ patients, simple LC is enough; (2) Patients of Nevin stage Ⅱ、 Ⅲ and Ⅳ should be coverted to open radical resection

Objective To summarize our experience in the management of stones impacted at cystic duct during laparoscopic cholecystectomy(LC). Methods There were 58 patients with stones impacted at cystic duct during LC from July 1997 to June 2001.Cystic duct was incised to remove stones first,then intraoperative cholangiography was performed.If stones were found in common bile duct,they would be taken out by intraoperative endoscopic sphincterotomy or open operation. Results All the impacted stones in 58 patients were removed successfully.51 coses underwent LC.Intraoperative cholangiography showed there were common bile duct stones in 7 cases.For these 7 coses,5 cases were treated by LC combined with intraoperative endoscopic sphincterotomy and other 2 cases were converted into open operation.No Severe complication occurred. Conclusions Nearly all cases with stones impacted at cystic duct can receive LC by removing impacted stones through incising the cystic duct and intraoperative cholangiography.If there are any stones in common bile duct,they can be removed by endoscopic sphincterotomy.

Anthrax is a fatal infectious disease of human and livestock and is caused by Bacillus anthracis. To establish a simple and specific assay for the clinical diagnosis of B. Anthracis infection, two oligonucleotide primers specific for the cap region of plasmid pXO2 and two specific for the pag region of plasmid pXO1 were designed and synthesised for polymerase chain reaction (PCR). The fluorescence dye SYBR Green I incorporated into the double strands was used to quantitate, and the specificity of PCR product was confirmed by the melting curve. The results showed that 0.8?mol/L primers and 3.0mmol/L Mg 2+ were optimal for this quantitative PCR assay. The sensitivity of this assay was 10 3 copies per millitier B. anthracis could be specifically distinguished from other B. cereus group of bacteria. with this assay. SYBR Green I real-time PCR appeared to be a rapid, accurate and specific methad for quantitative analysis of B. anthracis.