The standardization of syndrome differentiation based on the diseases of WM has become an important academic guidance,which,however,has induced lots of problems.The logical contradiction was analyzed between the results of standardization of syndrome differentiation based on the diseases of TCM and WM,between the results of two large-scale standardizations of syndrome differentiation based on WM and between the results of syndrome differentiation of related diseases of WM.In this paper,the author studied on the origin of symptoms and signs of syndrome differentiation of the diseases of WM and the effect of standardization of syndrome differentiation of the diseases of WM on the nature and location of disease in TCM,and pointed out some important unresolved academic problems.

To investigate the relationship between diabetes and its names in ancient times by analytical method of medical theory,comparison of medication rules and statistical analysis method.And then foundation will be established for exploring the ancient treatment rules of diabetes.The comparison and mutual reference of the above three methods can reveal disease essence and their mutual relationship in the different levels,which had an important technology signifi cance.

Objective To investigate the diagnosis and disease assessment of serum pancreatic stone protein(PSP/reg) in ventilator-associated pneumonia(VAP) by a prospective study.Methods The blood sample was collected in patients with mechanical ventilation(MV) from September 2012 to October 2015.Then the concentration of PSP/reg was detected by ELISA method and the time of MV and the outcome of VAP were recorded,while the patients who did not have VAP occurred in the same period regarded as control group.Results Compared with the control group,there was no significant difference in the serum concentration of PSP/reg in VAP group(P>0.05).From continuous monitoring,compared with the start time of MV,there was a significant increase in the concentration of PSP/reg in VAP group(P<0.05),and reached the highest peak in the fourth day.That of the seventh day was significantly decreased,but still higher than the first day(P<0.05).It decreased further in the fourteenth day,but compared to the start time of MV was still higher(P<0.05).In this study,38 cases were successfully evacuated in VAP group.Compared with the fourth day,the concentration of PSP/reg in the 38 cases in the stop of MV had significantly decreased(P<0.05),close to that of in the start of MV,but still a difference between them(P<0.05),and higher than that of the control group in the stop of MV(P<0.05).By Spearman analysis,we found that PSP/reg concentration in the first day had a significant correlation with CRP(r=0.570,P<0.05),but WBC and PCT were not(P>0.05).Conclusion PSP/reg can be used as one of the indicators for diagnosis of VAP,and may be related to the severity of VAP.

Conditional forebrain-specific presenilin-1 and presenilin-2 double knockout mice (dKO mice) exhibit several neurodegenerative phenotypes of Alzheimer's disease (AD) pathology, such as tau hyperphosphorylation, neuron loss, forebrain cortical shrinkage and memory impairment. By using capillary electrophoresis assay, monoamine neurotransmitters in forebrain cortex, hippocampus and other forebrain region of dKO mice aged at 6, 9 and 12 months were measured to illustrate the relationship among presenilins function deficiency, neurodegenerative phenotypes and monoamine neurotransmitters. Data showed that levels of monoamine neurotransmitters in forebrain cortex of dKO mice were significantly decreased at 6 months when compared to controls, while as mice getting older, levels of monoamine neurotransmitters increased to that of controls, or even higher. In hippocampus, 5-hydroxytryptamin and epinephrine in dKO mice had a significant increase at 6 months, followed with a significant increase of each monoamine neurotransmitter at 12 months age. In other forebrain region, 5-hydroxytryptamin and dopamine had a similar level between control and dKO mice at 6 and 9 months but a significant decrease at 12 months; however, level of norepinephrine and epinephrine were significantly decreased at 6 and 12 months except epinephrine of 6 months. These results demonstrated that knockout of presenilins genes could lead to the variation of monoamine neurotransmitters, and the variation profiles were different among forebrain cortex, hippocampus and other forebrain region. However, whether presenilins deficiency caused the variation of monoamine neurotransmitter directly or not, and how about the effects of variation of monoamine neurotransmitters on AD-like pathology need to be further analyzed.

Objective To investigate the diagnosis and prognosis evaluation value of neutrophil elastase (NE) in ventilator-associated pneumonia (VAP).Methods A retrospective analysis was conducted.The data of patients undergoing mechanical ventilation admitted to Department of Central Intensive Care Unit (ICU) of Boai Hospital of Zhongshan City Affiliated to Southern Medical University from September 2012 to October 2015 were enrolled.The patients were divided into two groups according to whether they suffered from VAP or not.The content of NE in serum and bronchoalveolar lavage fluid (BALF) at the time of mechanical ventilation start,VAP diagnosis (the worst value from 48 hours after mechanical ventilation start to weaning in non-VAP patients),and at the time before mechanical ventilation weaning,as well as inflammation parameters,clinical pulmonary infection score (CPIS),duration of mechanical ventilation and prognosis were recorded.Receiver operating characteristic curve (ROC) was used to analyze the predictive value of NE on VAP diagnosis and prognosis.Results Finally 38 patients were enrolled in the VAP group,and 40 in non-VAP group,and baseline data was similar between the two groups.There was no significant difference in the content of NE in serum and BALF between VAP group and non-VAP group [serum NE (μg/L):67.04 (63.00,75.75) vs.69.00 (63.75,75.00),BALF NE (μg/L):96.26 (85.26,176.01) vs.95.26 (86.76,107.11),both P ＞ 0.05].From continuous monitoring,no significant change in the content of NE in serum and BALF during mechanical ventilation was found in the non-VAP group,but the content of NE in serum and BALF at the time of VAP diagnosis in VAP group was significantly higher than that at mechanical ventilation start [μg/L:157.00 (153.04,165.75) vs.67.04 (63.00,75.75),178.04 (153.00,188.25) vs.96.26 (85.26,176.01),both P ＜ 0.05],and NE content in serum and BALF was significantly decreased at the time after VAP clinical recovery and before mechanical ventilation weaning [μg/L:75.67 (64.51,110.55) vs.157.00 (153.04,165.79),95.50 (66.56,183.02) vs.178.04 (153.00,188.25),both P ＜ 0.05].The NE in the start time of VAP in VAP group was divided into four groups according to quartile,it was found that with the increase of NE content in serum and BALF,the CPIS was increased,the duration of mechanical ventilation was prolonged,and the prognosis was poor (all P ＜ 0.01).Compared with non-VAP group,white blood cell count (WBC),neutrocyte proportion,C-reactive protein (CRP),and procalcitonin (PCT) in VAP group were significantly increased (all P ＜ 0.01).NE in BALF was significantly positively correlated with WBC,neutrocyte proportion,CRP and PCT (r value was 0.507,0.432,0.779,and 0.519,respectively,all P =0.000),among which the highest correlation was CRP.NE in BALF used for VAP diagnosis has good accuracy,with sensitivity of 87.4％,and specificity of 90.6％,and sensitivity and specificity of NE in serum for VAP diagnosis was 78.6％ and 79.2％ respectively.Conclusion NE can be used as one of the indicators for VAP diagnosis,and it is related to the prognosis of VAP.

Objective To analyze the current situation and influencing factors of job satisfaction of advanced practice nurses ( APN ) in military hospital after training, and provide scientific basis for further research on the rational use of APN. Methods Self-designed general information questionnaire and Spector′s job satisfaction questionnaire were used to survey the job satisfaction and influencing factors of 338 cardiovascular APN in military hospital ( cluster sampling method ) . Results The total score of job satisfaction of 338 cardiovascular disease nurses was (130. 79 ± 22. 06), which was lower than that of the American norm(t= -2. 300,P<0. 05). Multiple linear regression analysis showed that the time of certification, category of personnel and work position affected the nurses′job satisfaction. Conclusions The job satisfaction of APN in the military cardiovascular disease should be strengthened. Hospital managers should be according to the influencing factors, change the management mode to realize the transition from identity management to postmanagement, and provide APN better work environment, so as to exert the positive role of clinical nurse specialist.

Objective:To evaluate the effects of bosutinib on acute lung injury in mice with endotoxemia.Methods:Sixty clean-grade healthy male C57BL/6 mice, aged 8-12 weeks, weighing 20-25 g, were divided into 4 groups ( n=15 each) using a random number table method: control group (group C), bosutinib group (group B), endotoxemia group (group lipopolysaccharide [LPS]) and bosutinib plus endotoxemia group (group B+ LPS). Septic acute lung injury model was developed by intraperitoneal injection of LPS.Bosutinib 5 mg/kg was injected via the tail vein at 0.5 h before establishing the model in group B+ LPS and at the corresponding time point in group B. At 24 h after developing the model, the mice were sacrificed for microscopic examination of the pathological results of lung tissues which were scored for calculation of the lung coefficient (LI) and wet/dry lung weight (W/D) ratio, and for determination of the content of Evans blue in lung tissues (by Evans blue staining), expression of vascular endothelial cadherin (VE-cadherin), vascular cell adhesion molecule 1 (VCAM-1), phosphorylated nuclear transcription factor κB p65 (p-NF-κB p65), phosphorylated nuclear factor κB inhibitory protein α (pIκB-α) (by Western blot) and expression of interleukin-1beta (IL-1β), IL-6 and tumor necrosis factor-alpha (TNF-α) mRNA (using real-time polymerase chain reaction). Results:Compared with group C, the LI, W/D ratio, Evans blue content in lung tissues and lung injury score were significantly increased, and the expression of IL-1β mRNA, TNF-α mRNA, IL-6 mRNA, VCAM-1, p-NF-κB p65 and pIKB-α was up-regulated, and the expression of VE-cadherin was down-regulated in group LPS ( P<0.05), and no significant change was found in the parameters mentioned above in group B ( P>0.05). Compared with group B, the LI, W/D ratio, Evans blue content in lung tissues and lung injury score were significantly decreased, and the expression of IL-1β mRNA, TNF-α mRNA, IL-6 mRNA, VCAM-1, p-NF-κB p65 and pIKB-α was down-regulated, and the expression of VE-cadherin was up-regulated in group LPS ( P<0.05). Conclusions:Bosutinib can ameliorate the acute lung injury in mice with endotoxemia.

Lemierre syndrome is a rare, potentially fatal condition characterized by internal jugular vein thrombosis following an acute oropharyngeal infection, often accompanied with cervical necrotizing fasciitis. This paper reviews 5 cases of Lemierre syndrome with cervical necrotizing fasciitis, extensive cervical drainage and sufficient antibiotics is crucial treatment for Lemierre syndrome, anticoagulation combined with antibiotics is safe and effective for propagation or nonresolution of the thrombus.

Objective: To summarize the experience of applying cervical double parallel incision combined with mediastinoscope or thoracoscope in the treatment of cervical necrotizing fasciitis (CNF) accompanied with descending necrotizing mediastinitis (DNM), so as to provide a reference for clinical practice. Methods: The clinical data of six patients with CNF accompanied with DNM who were admitted to the Department of Stomatology and the Department of Otolaryngology Head and Neck Surgery, The First People′s Hospital of Changzhou from September 2014 to September 2018 were retrospectively analyzed. All of the six patients were confirmed by CT of neck and chest, among whom there were two males and four females aged from 48 to 73. Three patients were treated with cervical double parallel incision combined with mediastinoscope to be combined with cervical and thoracic drainage under general anesthesia while the other three with cervical double parallel incision combined with thoracoscope to be combined cervical and thoracic drainage under general anesthesia. The CT of neck and chest as well as infectious indicators including hematology, C-reactive protein (CRP) and procalcitonin (PCT) were reexamined during the postoperative period. Results: The cervical and thoracic combined drainage was unobstructed in all of the six patients, no secondary surgery was performed, and the infectious indicators gradually decreased. All patients had off-bed activities on the first day after the operation, were all cured and discharged after an average of 21 days (16 to 36 days) in hospital and followed up for an average of 18 months (4 to 30 months) after the operation. None of them experienced infection relapse, and they were all satisfied with the appearance of the cervical incision. Conclusions Cervical double parallel incision combined with mediastinoscope or thoracoscope for the treatment of CNF accompanied with DNM has the advantages of complete drainage, small trauma, excellent efficacy and aesthetic operative area, thus being deserved to be clinically popularized.

Objective To investigate the inhibitory effect and mechanism of lentinan on colitis-associated colorectal cancer (CAC) induced by azomethane (AOM)/dextran sulfate sodium salt (DSS) through the IL-6/ STAT3 pathway. Methods C57BL/6 mice were randomly divided into a control group, a model group, a low-dose group (0.865 mg/kg lentinan), a medium-dose group (1.73 mg/kg lentinan), and a high-dose group (3.46 mg/kg lentinan). Except the control group, CAC was induced by AOM/DSS in the other groups, and corresponding drugs were injected intraperitoneally during the modeling process. Body mass, disease activity index (DAI) score, colon length, and tumor number were compared among all groups. Hematoxylin–eosin staining was used to observe the pathological morphology of colon. ELISA was utilized to detect the IL-6, IL-1β, and IL-18 contents in serum. Western blot analysis was conducted to detect the expression levels of IL-6, p-STAT3, and c-Myc in colon tissues. Results The tumor number, DAI score, serum IL-6, IL-1β, and IL-18 contents and the expression levels of IL-6, p-STAT3, and c-Myc in the colon tissue of the model group were higher than those of the control group, while the body mass and colon length were lower than those of the control group (P<0.05). The pathological morphology of colon tissues showed adenocarcinoma formation. After different doses of lentinan intervention, the tumor number, DAI score, serum IL-6, IL-1β, and IL-18 contents and the expression levels of IL-6, p-STAT3, and c-Myc in colon tissues were all lower than those in the model group, while body mass and colon length were higher than those in the model group (P<0.05). The pathological morphology of colon tissues showed adenomas of different grades but no adenocarcinoma was found. Conclusion Lentinan inhibits CAC formation, and its anticancer effect is related to the inhibition of the IL-6/STAT3 pathway.