Diagnostic methods play important role in theoretical system of Inner Canon of Huangdi.There are 74 articles about diagnostic methods,which contains near 50 kinds of TCM diagnostic methods referred to pulse diagnosis,colour inspection and so on.This paper analyze the connotation and extension of the term "diagnostic method",establish a theoretical framework of dynamic whole concept,bi-directional discrimination,characteristics of triple pathogens and four kinds of methods.The diagnostic model of"shape-spirit-transporting qi"and the modern language"nature-biology-psychology-society" four-dimensional diagnostic method are constructed.

Objective To investigate the evaluation of different levels of QRS-T angle in patients with acute myocardial infarction (AMI).Methods A total of 186 AMI patients from January 2010 to May 2016 in our hospital as the research object.The review method was used to analyze the clinical and followup data of the patients.The left ventricular ejection fraction (LVEF),plane QRS-T angle,white blood cell (WBC) and isoenzyme count and creatine (CK-MB) were evaluated and compared.Results (1) The age of the patients with heart failure was larger than that in the patients with normal heart function,and the proportion of myocardial infarction and hypertension and diabetes distributionthe in two groups had statistically significant difference (P ＜ 0.05);(2) The WBC and CK-MB levels of patients with normal cardiac function were lower than those in patients with heart failure.The planar QRS-T angle ＜ 50 degrees,between 90 degrees and 100 degrees and more than 100 degrees were statistically significant between normal heart function patients and failure heart function patients (P ＜ 0.05),and with the decrease of LVEF the levels of QRS-T angle increased;(3) The sensitivity and specificity of 90 degrees ≤ QRS-T angle ＜ 100 degrees and QRS-T angle greater than 100 degrees were 96.32％ and 95.98％,95.02％ and 94.68％,and those were different with the sensitivity and specificity of WBC,CK-MB and other QRS-T angle(P ＜ 0.05).Conclusions Different planar QRS-T angle on the evaluation of cardiac function insufficiency has certain clinical value,but when the 90°≤ QRS-T angle ＜ 100° and QRS-T angle ≥ 100° have better sensitivity and specificity with no difference between two QRS-T angles.The QRS-T angle≥ 90° can be used as one of the indicators for the evaluation of cardiac function insuffieiency.

[ABSTRACT]OBJECTIVETo study the clinical effect of CO2 laser in the treatment of hypertrophic ventricular dysphonia.METHODSFrom December 2011 to December 2013, 40 patients with hypertrophic ventricular dysphonia were treated in our department. Conservative treatment had no valid for all of them. All the patients were examined with strobolaryngoscope and voice analysis (including fundamental frequency, jitter, shimmer and harmonic to noise). After general anesthesia, the hypertrophic ventricular cords were excised with CO2 laser under suspension laryngoscope.RESULTS The Hoarseness were better in all the patients after operation. The ventricular cord and mucosal waves of the vocal cord were normal. The jitter and shimmer were lower than that before operation, but the fundamental frequency and harmonic to noise were higher than that before operation. There were no complications. CONCLUSIONThe treatment of hypertrophic ventricular dysphonia with CO2 laser under suspension laryngoscope is safe, reliable and practical.

Enzyme-linked immunosorbent assay ( ELISA) was applied to detect the antibody against CoxA16 and EV71 among 0~14 age groups. In 1 000 cases of children, the total positive rate of anti-EV71 IgM was 19. 9%, the total positive rate of anti-EV71 IgG was 47. 7%, the total positive rate of anti-CoxA16 IgM was 22. 8%, the to-tal positive rate of anti-CoxA16 IgG was 51. 3%. There was a negative correlation between positivity for EV71 IgM and positivity for CoxA16 IgM(χ2 =2. 794,P>0. 05). There was also a negative correlation between positivity for EV71 IgG and positivity for CoxA16 IgG(χ2 =2. 793,P>0. 05). The positive rate of IgG antibody against CoxA16 and EV71 was higher in neonatal group in which anti-EV71 IgG was 41 . 5% and anti-CoxA16 IgG was 49 . 5%. The lowest positive rate of IgG antibody against CoxA16 and EV71 was in infant group in which anti-EV71 IgG was 38. 0% and anti-CoxA16 IgG was 43. 5%. Except for neonatal group,the positive rate of IgG antibody against Cox-A16 and EV71 increased gradually with the age growth, there were statistical differences among the age groups (χ2=27. 04 and 19. 98,P<0. 01). With the age growth,the positive rate of IgM antibody against EV71 and CoxA16 increased,there were statistical differences among the age groups(χ2 =41. 12 and 37. 13,P<0. 01). There were not statistical differences between gender groups (χ2 =0. 51,1. 77,0. 36 and 2. 12,P>0. 05).

Objective To explore the evidences of the humoral factor involved in the liver allograft rejection, and to explore better monitoring methods and therapy of the humoral liver rejection. Methods After the humoral liver rejection, liver puncture biopsies were performed. Immunohistochemical examinations of C4d, CD20+ B lymphocytes and CD138+ plasma cells were performed to judge whether humoral factor was involved in liver rejection. The dosage of tacrolimus was increased first when rejection was identified. The patients with severe liver function damage were treated with methyllprednisolone, and the steroid-insensitive cases were treated with antithymocyte globulins (ATG) and rapamycin. Results 25 biopsies were performed in 16 patients. Humoral rejection was diagnosed for 15 times in 10 patients, cellular rejection was diagnosed for 6 times in 4 patients, and the both kinds of rejection occurred in the last 2 patients. The effect of methylprednisolone was obviously lower in the humoral rejection cases (29.4%, 5/17) than that of the cellular rejection cases (7/8). Steroid-insensitive humoral rejections were diagnosed in 12 biopsies from 7 patients receiving liver transplantation. One patient was cured with ATG and 5 patients were cured with addition of rapamycin. The case whose blood type was AB receiving a liver transplant from the donor of O blood type died of liver function failure even after an extensive treatment. Conclusions Humoral immune factors maybe involved in some acute and chronic liver allograft rejection. ATG and rapamycin are more effective for the patients with humoral liver rejection.

Objective To prepare a harmine hydrochloride liposome formulation with high encapsulation efficiency. Methods Preformulation investigation was carried out to obtain the drug physicochemical properties such as solubility and lgD in buffers of different pH value. Harmine hydrochloride was encapsulated into liposomes by active loading method. Encapsulation efficiency of liposomes was determined after the free drug was separated from liposome by ultrafiltration. The influence factors on the encapsulation efficiency including drug-lipid weight ratio, incubation temperature, pH value of external water phase were investigated. Results As the pH value increasing, the solubility of harmine hydrochloride was decreased, while the apparent oil-water distribution coefficient was increased. By active loading method, the encapsulation efficiency could be over 80% when the drug to lipid weight ratio was under 1∶5. The pH gradient between intervesicle and intravesicle obviously influenced the encapsulation efficiency, while incubation temperature had little effect on encapsulation efficiency. Conclusion Active loading is suitable for preparing harmine hydrochloride liposome with high encapsulation efficiency.

Objective To evaluate the application of artificial liver support system (ALSS) in severe hepatitis patients before liver transplantation. Methods Double lumen catheters were inserted into the femoralvein to construct the blood conduit in patients receiving ALSS. The blood purification apparatus was applied for plasma replacement and blood perfusion with PIS separator and HA hemoperfusion apparatus. The plasma replacement capacity was 3000ml-4000ml (average 3200 ml) with albumin 20g. The average dosages of both heparin and protamine were 25 mg. The separation speed was 26 ml/min. The replacement blood flow was 100-150 ml/min, and the average treatment time was 120 min. Results The liver function markers, including TB, DB, ALT, AST and NH 3, were improved in patients with ALSS. Conclusion ALSS could correct the imbalance of homeostasis of the patients, eliminate the toxic substances effectively and provide valuable support for liver transplantation.

Objective To explore causative factors, and prevention and treatment of nonanastomotic biliary stricture (NABS) after orthotopic liver transplantation. Methods The donor’s liver together with celiac artery and its branches were havvested rapidly without injury to reduce heat ischemia time and artery loss, then the bilinary duct was flushed to clean out residual bile. During operation, when the portal vein was opened, the hepatic artery of the donor liver was flushed with heparin saline. Post-operatively, acute or chronic rejection and cytomegalovirus infection should be prevented. When NABS occurred, it was treated with bilinary balloon dilatation. Results Of 36 patients with liver transplantation, 4 patients (11.1%, 4/36) were found to suffer from NABS. Two patients were cured, in one patient it was improved after dilatation, and one patient died. Conclusion NABS is mainly related to artery loss, cold/warm ischemia injury, ischemia/reperfusion injury, bile toxicity injury, immune injury and cytomegalovirus infection etc. Biliary balloon dilatation is the major treatment for NABS. Retransplantation is necessary for some severe cases.