Spleen-yin theory was the innovation of doctors in Ming Dynasty for Piwei theory of Dongyuan based on the inheritance of nourishing yin theory of Danxi. But because of rise of stomach yin theory, spleen yin theory was ignored gradually. This article revealed the neutralizing therapeutic conception contained in this theory, which was hoped to be applyed into medical practice and to be deepened furtherly.

Objective To evaluate the safety of central lymph node dissection with total thyroidectomy for papillary thyroid carcinoma. Methods A meta-analysis on the data of suitable seven clinical researches was performed using the Mantel-Haenszel method and the risk difference was calculated.Results Seven studies with a total of 1524 patients were eligible for inclusion, 620 were with totalthyroidectomy plus central lymph node dissection and 904 with thyroidectomy alone. There was a significant increased risk of temporary hypocalcaemia ( P = 0. 03 ) and temporary vocal cord palsy ( P = 0. 01 ) when central lymph node dissection was performed in addition to a thyroidectomy. However, the risk of permanent hypocalcaemia( P = 0. 32 ) and permanent vocal cord palsy (P = 0. 75 ) has no statistical difference between the two groups. Conclusion Central neck dissection added to thyroidectomy does not increase rate of permanent morbidity in thyroid cancer patients.

Objective To clarify the genetic diversity of HIV-1 strains currently circulating in Shanghai and establish the molecular epidemiological database of HIV-1 infection.Methods The samples from 114 newly diagnosed HIV-l-infected individuals between June 2004 and June 2005 were investigated.HIV-1 pol gene(protease 1-99 aa and reverse transcriptase 1-252 aa) from plasma sam- ples were amplified by RT-PCR,sequenced and phylogenetieally analyzed.Protease inhibitors(PRIs) and reverse transcriptase inhibitors (RTIs) resistance-associated mutations in protease (PR) and re- verse transcriptase(RT) regions were analyzed.Results (1)Epidemiological survey showed the exist ence of different modes of transmission of HIV-1 including sexual contacts 51(44.74%),intravenous drug users 43 (37.72%),contaminated blood/blood products transfusion 3(2.63%) and unknown in- fection 17(14.91%);(2)Phylogenetic analysis revealed that 9 of the analyzed sequences were identi- fied as subtype B(7.89%),15 as subtype B'(13.16%),1 as subtype C(0.88%),1 as subtype G (0.88%),38 as CRF01 AE(33.33%),46 as CRF07 BC(40.35%) and4 asCRF08 BC(3.51%); (3)Analysis of drug-resistance associated mutation showed that 21 of 114 (18.42%) persons infected with drug-resistant HIV-1,among which major mutations in PR and RT regions accounted for 2.63 (3/114) and 17.54% (20/114),respectively.The frequencies of major mutation in PR region were M46I(66.67%),M46L(33.33%) and in RT region were M41L(7.69%),A62V (7.69%),T69S (7.69%),V75I/L(15.38%),K103R(25.00%),V118I(23.08%),V179D/E/T(33.33%),G190R (8.33%),L210K/M/X(38.46%),227L/I(16.67%),M230R(8.33%),P236R(8.33%).Conclusions The results revealed the current presence of multiple HIV-1 subtypes and recombinants strains infec- ting residents and migrants living in Shanghai.The broad diversity of HIV-1 has been introduced into Shanghai mainly through drug injection and heterosexual contacts.This study also revealed that HIV-1 strains infecting these newly diagnosed treatment-naive persons have acquired major mutations in both PR gene and RT gene of HIV-1.

Objective To evaluate the safety of performing thyroidectomy together with central lymph node dissection(CLND). Methods Meta analysis was performed on 7 selected clinical papers using MantelHaenszel method and relative risk was calculated. Results A total of 1524 patients were eligible to be included,among whom 904 cases underwent thyroidectomy alone and 620 cases underwent total thyroidectomy combined with CLND. The risk rate of temporary hypocalcemia and temporary vocal cord palsy for CLND was 24. 77% and 9. 12% respectively, which was higher than that in performing thyroidectomy alone. However, the risk of permanent hypocalcemia and permanent vocal cord palsy had no statistic difference between the two groups. Conclusion As there is no increased morbidity of CLND, it is prudently suggested to give a prophylactic CLND for patients with high risk of thyroid papillary carcinoma.

Aortic Aneurysm, Abdominal ; surgery ; Endovascular Procedures ; adverse effects ; Humans ; Intestinal Fistula ; diagnosis ; etiology ; Male ; Middle Aged

Objective To evaluate the effect of different degrees of pubic symphysis diastasis on the stress distribution of posterior pelvic ring. Methods Eight embalmed pelvis and articulated proximal 1/3 of the femurs were harvested for this study. The samples were positioned as both legs standing straight and loaded to 600 N on the on the CSS-44020 biomechanical machine. The strain gages were adhered to 38 sites distributed symmetrically on the two sides of sacroiliac joint, anterior sacrum and posterior ilium. The strain gages were connected to WS3811 digital strainometer to record strain changes of the intact pelvic ring and at 1,2, 2.5 cm of pubic symphysis diastasis. Results Elastic changes occurred in the cortical bone of the pelvis under 600 N load. The symmetrical sites had similar strain changes without significant difference in the intact pelvic ring and at 1,2, 2.5 cm of pubic symphysis diastasis ( P ＞0.05 ). The sites with more strain changes were distributed on the iliofemoral arch in the intact pelvis.The strain changes were increased significantly frona the posterolateral sites to the iliofemoral arch. But the strain changes on the iliofemoral arch were decreased significantly during pubic symphysis diastasis.Conclusion The conduction of vertical load runs along the sacrofemoral arch in the intact pelvic ring and redistributes posterolaterally during pubic symphysis diastasis.

Objective To evaluate the effectiveness of using high-fidelity simulator (HFS) in medical training of cardiopulmonary resuscitation (CPR).Methods The randomized controlled trials (RCTs),quasi-randomized controlled trials (q-RCTs) about comparing HFS with traditional teaching methods in medical training of CPR were searched from Cochrane Library,Pubmed,Web of Knowledge,CNKI,CBM and Wanfang Data.The methodological quality of the included studies was assessed and the valid data were extracted.Meta-analysis was conducted with the Cochrane Collaboration RevMan 5.0.Results Ten q-RCTs and one RCT were included.The quality of the studies were relatively low.Meta-analysis showed that compared with the traditional teaching method,high-fidelity simulation in medical training of CPR had no statistically significant differences in mastering the theoretical knowledge,but had statistically significant differences in mastering the CPR skills.Conclusions HFS in medical training of CPR skills is positive and effective,superior to the traditional teaching methods,but in terms of theoretical knowledge and satisfaction,self-confidence,more researches still need to be further confirmed.

Objective To compare the myocardial protective effects of isoflurane versus sevoflurane in patients undergoing off-pump coronary artery bypass grafting (OPCABG). Methods Forty ASA Ⅱ or Ⅲ patients (NYHA Ⅱ or Ⅲ ) of both sexes, aged 40-55 yr, weighing 55-94 kg, scheduled for elective OPCABG, were randomly divided into 2 groups ( n = 20 each): isoflurane group ( group Ⅰ) and sevoflurane group ( group S). Anesthesia was induced with midazolam, sufentanil and vecuronium. Patients were tracheal intubated and mechanically ventilated. Anesthesia was maintained with inhalation of isoflurane or sevoflurane and infusion of sufentanil and vecuronium. In group Ⅰ, the initial end-tidal concentration of isoflurane was 1.2%. In group S, the initial end-tidal concentration of sevoflurane was 1.7 %. BIS value was maintained at 40-50 by adjusting the end-tidal concentration of isoflurane or sevoflurane. The central venous blood samples were collected immediately before skin incision, at the end of surgery, 2 and 24 h after surgery for determination of plasma creatine kinase-MB (CK-MB) activity and cardiac troponin Ⅰ (cTnI) concentration. The adverse cardiovascular events were recorded. Results The incidences of ventricular premature beat, tachycardia, bradycardia, ventricular fibrillation and S-T segment elevation ( ＞0.1 mV) during surgery and the plasma CK-MB activity and cTnI concentration after surgery were significantly higher in group S than in group Ⅰ ( P ＜ 0.05). Conclusion Isoflurane has better myocardial protective effect than sevoflurane in patients undergoing OPCABG.

Objective To explore the effects of surface modification of PLGA-[ASP-PEG] scaffold with typeⅠcollagen on the adhesion,proliferation and osteogenic differentiation of rabbit bone marrow stromal cells (BMSCs).Methods After PLGA-[ASP-PEG] materials were modified with typeⅠcollagen chemically,the collagen was coated onto the materials physically.The BMSCs obtained from rabbits were cultured on the modified PLGA-[ ASP-PEG] and on the unmodified PLGA-[ ASP-PEG] as control.The adhesion and proliferation behavior of the cells was analyzed and the expressions of osteogenie marker alkaline phosphatase,osteocalcin,osteopontin,typeⅠcollagen and core binding factor al were also detected.Results X-ray photoelectron spectrometry(XPS) confirmed that TypeⅠcollagen was grafted onto the surface of PLGA-[ASP-PEG] successfully and the collagen content on the materials modified chemically and physically was significantly increased.The abilities of adhesion and proliferation and the expressions of osteogenie makers of the BMSCs were significantly greater than those in the control group(P＜0.05).Conclusion Since Type collagen I can improve the biocompatibility of PLGA- [ASP-PEG] scaffold materials,it can be used as a new way to optimize scaffolds in tissue engineering.

In this study, a composite cell model for evaluation of idiosyncratic drug-induced liver injury (IDILI) was established in vitro from the perspective of immune inflammation. And this model was used to evaluate the risk of IDILI for 2,3,5,4'-tetrahydroxy-cis-stilbene-2-O-β-glucoside (Cis-SG) and 2,3,5,4'-tetrahydroxy-trans-stilbene-2-O-β-glucoside (Trans-SG). To determine the low, medium, and high dosage of Cis-SG and Trans-SG, CellTiter-Glo^® 3D Cell Viability Assay was used to detect the effects of Cis-SG and Trans-SG on cell viability of HepG2 cells in three dimensional (3D) culture, and MTT assay was used to detect the effects of Cis-SG and Trans-SG on cell viability of THP-1 derived macrophages. THP-1 derived macrophages were incubated by Cis-SG and Trans-SG directly or supernatants from HepG2 cells incubated with them. Enzyme linked immunosorbent assay (ELISA) was used to detect the levels of interleukin-1β (IL-1β) in the supernatants of the THP-1 derived macrophages. Western blot and reverse transcription-polymerase chain reaction (RT-PCR) were used to determine the expression of apoptosis-associated speck-like protein (ASC), Nod-like receptor protein 3 (NLRP3), cysteinyl aspartate specific proteinase-1 (caspase-1), and IL-1β in THP-1 derived macrophages. The results showed that there was no effect on the secretion of IL-1β in THP-1 derived macrophages incubated by Cis-SG and Trans-SG directly. However, the secretion of IL-1β, the protein and mRNA expression of ASC, NLRP3, caspase-1, and IL-1β significantly increased in THP-1 derived macrophages incubated by supernatants from HepG2 cells incubated with 1, 5, and 25 μmol·L^-1 Cis-SG or 25 μmol·L^-1 Trans-SG. In summary, the composite cell model for evaluation of IDILI established in vitro has been successfully applied in testing Cis-SG and Trans-SG. This composite cell model is helpful to evaluate and screen drugs with IDILI risk in vitro preliminarily, which provides methods for predicting and solving the idiosyncratic liver toxicity of drugs.