Objective To provide references for the clinical application of Dunhuang prescriptions for treating internal medicine diseases by analyzing medication rules of Dunhuang manuscriptsFu Xing Jue based on data mining method.Methods TCM prescriptions for internal medicine diseases in the Dunhuang manuscriptsFu Xing Jue were input computer. Excel 2003 software was used to establish relevant database. Data mining method was used to analyze the medication rules.Results There were 61 TCM prescriptions in the Dunhuang manuscriptsFu Xing Jue, including66 kinds of Chinese herbal medicine and 336 times of total frequency of usage. The used core single herbs were as follows: Glycyrrhizae Radix et Rhizoma, Paeoniae Radix Alba, Zingiberis Rhizoma,Zingiberis Rhizoma Recens, Scuteliariae Radix, Inulae Flos, Ginseng Radix et Rhizoma, Jujubae Fructus, Lophatheri Herba, Schisandrae Chinensis Fructus, and Cinnamomi Ramulus; medicine types were tonifying-deficiency medicine, heat-clearing medicine, relieving exterior syndrome medicine, interior-warming medicine and antitussive and antiasthmatic medicine, with the cumulative frequency of 80.66%; medicine flavors were bitterness, sweetness and pungentness, with the cumulative frequency of 83.91%; medicine properties were coldness, warmness and peace, with the cumulative frequency of 87.95%; channel tropisms were stomach, lung, spleen, heart, kidney and liver, with the cumulative frequency of 86.15%. Clinical compatibility of medicines for treating internal medicine diseases in Dunhuang medical prescriptions were mainly qi-tonifying medicines (Glycyrrhizae Radix et Rhizoma, Ginseng Radix et Rhizoma and Jujubae Fructus), blood-replenishing medicine (Paeoniae Radix Alba), and nourishing medicines (Ophiopogonis Radix), supplemented by heat-clearing medicine (Lophatheri Herba andScuteliariae Radix),with relieving exterior syndrome medicines (Zingiberis Rhizoma Recens andCinnamomi Ramulus),interior-warming medicine (Zingiberis Rhizoma), antitussive and antiasthmatic medicine (Inulae Flos), inducing astringency medicine (Schisandrae Chinensis Fructus) as characteristic medication. High-frequency medicines constitute Dunhuang medical prescription of Xiaoyindan Decoction, which can be used to treat epidemic. Conclusion This article concluded the compatibility rules of Dunhuang manuscripts Fu Xing Jue, provide references for clinical medication and research and development of new medicine.

Objective To study the medication rule of traditional Chinese medicine treatment of urinary stone disease data mining. Methods Clinical study literature in China Journal Full-text Database 1985-2012 on Chinese medicine prescription of urinary stone disease were retrieved, database was established and analyzed by SPSS12.0 statistical software. Results There were 209 literatures meeting the inclusion criteria of Chinese medicine for urinary lithiasis, including 209 oral administration compound, 234 kinds of traditional Chinese medicine, 1843 times of frequency. The traditional Chinese medicine mainly for diuresis and diffusing dampness, restoring vital energy, blood-activating and removing stasis, regulating qi, clearing heat, promoting digestion and purgation, counted for 86.43%;with flavour of sweet, bitter, spicy, fresh, counted for 86.67%;nature of cold, plain, warm, counted for 93.08%;meridian tropism of liver, bladder, spleen, stomach, kidney, lung, heart, counted for 83.67%. Conclusion Trditional Chinese medicine of diuresis and diffusing dampness, restoring vital energy, blood-activating and removing stasis, regulating qi, clearing heat were commonly used. The core single medicine are Lysimachiae Herba, Glycyrrhizae Radix, Talcum, Lygodii Spora, Plantaginis Semen, Pyrrosiae Folium, Cyathulae Radix, Malvae Fructus, Galli Gigerii Endothelium Corneum, Akebiae caulis, etc.

Objective To investigate the effects of co-exposure to LPS and heat on plasma tumor necrosis factor-? (TNF-?), interleukin-6 (IL-6), malondialdehyde (MDA) and activity of superoxide dismutase (SOD) in rats. Methods Male pathogen-free Wistar rats were randomly assigned to the following groups: saline-injected normothermic control (Group C), saline-injected heat exposure (Group H), LPS-injected normothermic control (Group L), LPS-injected heat exposure (Group HL). Mean arterial pressure (MAP) was continually monitored. Plasma levels of TNF-?, IL-6, MDA and SOD were determined at 0, 40, 80, 120 min. Results The rats in Group HL displayed much lower MAP, higher MDA and lower SOD than the other 3 groups. The rats in Group HL displayed an early rise in plasma TNF-?, IL-6 at 40 min, the peak values of both at 80 min significantly higher than the other three groups at the same time piont. Conclusion Co-exposure to LPS and heat primes the rats to advance and augment systemic inflammatory response syndrome.

Objective To provide a strategy for open heart surgical procedures of reducing allogeneic transfusion in the perioperative periods.Methods A comprehensive blood conservation program and new transfusion criteria[haemoglobin(Hb)were0.05).The Hct was down after operation in both groups.In the test group the Hct decreased in to 30% at day7 postoperation and regained gradually after 14 days of operation.Conclusion The dininishing allogeneic transfusion can be achieved by application of comprehensive blood conservation techniques and new transfusion criterion during the perioperative periods of open heart surgical procedures.The operative curative effect is not influence thereby.

Objective To investigate the operative technique and efficacy of PPH for severe hemorrhoids. Methods The clinical data of 153 cases of severe hemorrhoids treated by PPH, individualized according to size and nature of the piles, concomitant morbidities and conditions at the dentate line, and analysis of the relevance between operative technique and clinical efficacy as well as postoperative complications, were revieuled retropectively. Results All of the prolapsed tissue retracted immediately. Bleeding at the anastomotic site occurred in 49 cases, pulsatile bleeding in 12 cases, all of which were sutured under direct vision with cessation of bleeding. The width of excised-tissue was 2.1~4.6cm(average 3.5cm). The main symptoms of patients on the 1st post-operation day were abdominal distention caused by dysuria, pain, and tenesmus and burning sensation. At followup of 1-40 months, there was no stenosis of stoma, anal incontinence or recurrence of prolapse. After operation, a very satistactory result was achieved in 87 cases, satisfactory in 63 cases and mostly satisfactory in 3 cases. Conclusions In order to achieve ideal results with good retraction of tissues, avoidance of complications and improve patient satisfactory rate, the use of PPH for severe hemorrhords must be individualized and technical skill during operation are important.

BACKGROUND:Increasing reports have focused on the application of tranexamic acid to reduce bleeding during total knee arthroplasty, but its usage method remains controversial.
OBJECTIVE:To explore the impact of topical articular application of tranexamic acid and intravenous application of tranexamic acid on blood loss during primary unilateral total knee arthroplasty.
METHODS:According to randomized control ed principle, 90 patients who received unilateral total knee arthroplasty in the Tengzhou Central People’s Hospital from October 2013 to December 2014 were enrol ed in this study, and randomly assigned to intravenous injection group and topical injection group (n=45). Patients in the intravenous injection group were given tranexamic acid by intravenous injection (10 mg/kg, maximum 1.2 g) during the induction of anaesthesia. Patients in the topical injection group were given intraarticularly tranexamic acid (2 g dissolved in 50 mL physiological saline) before articular capsule suture and after prosthesis fixation. Drainage amount after replacement, hemoglobin and hematocrit on the next day after replacement, and the number of blood transfusion population were compared between the two groups. Simultaneously, clinical symptoms of pulmonary embolism and deep vein thrombosis in the lower limb were observed. If necessary, lower extremity vascular Doppler ultrasound was conducted.
RESULTS AND CONCLUSION:No significant differences in drainage amount after replacement, hemoglobin and hematocrit on the next day after replacement, the number of blood transfusion population, and the proportion of blood transfusion were detected between the two groups (P>0.05). No deep vein thrombosis was found in the lower limbs at 14 days after replacement in both groups. These findings confirm that compared with intravenous systemic application, periarticular topical application of tranexamic acid during total knee replacement could obtain identical effects on reducing blood loss and blood transfusion after surgery, and could avoid relevant complications of intravenous application of tranexamic acid.

The cDNA encoding the rabbit metallothionein-I was amplified by RT-PCR from the rabbit liver induced by cadmium and cloned into prokaryotic fusion expression vector pQE40. Then it was transformed into Escherichia coli M15. Positive expression clones were detected by colony blotting. Target protein solubility was determined by Western blotting analysis. The optimal induction condition of the level of protein expression with IPTG induction was established by SDS-PAGE electrophoresis and ImageMaster VDS software analysis. The fusion protein can be purified from lysates with Ni-NTA agarose. We found that the fusion protein with apparent molecular weight 32 KD existed in two ways: soluble and insoluble in Escherichia coli. After 1 mM IPTG induction, the level of expression of the fusion protein increased with the prolongation of induction time and reached a peak in 9 h by ImageMaster VDS software analysis, accounting for 57.4% of all the insoluble protein. The purified fusion protein was obtained by Ni-NTA affinity chromatography. This fusion protein can be used in further studies on the preparation of MT-I protein and development of protein product.
Animals ; Cloning, Molecular ; DNA, Complementary ; genetics ; Escherichia coli ; genetics ; metabolism ; Genetic Vectors ; Metallothionein ; genetics ; metabolism ; Rabbits ; Recombinant Fusion Proteins ; biosynthesis ; genetics ; isolation & purification ; Transformation, Bacterial

Hiatal hernia (HH) is a prevalent medical condition characterized by the protrusion of abdominal contents into the thoracic cavity through an enlarged diaphragmatic esophageal hiatus. The most common clinical manifestations of HH include acid reflux, heartburn, belching, coughing, and chest pain. Currently, there is a lack of standardized comprehensive treatment protocols for different types of HH, presenting significant challenges in their clinical management. In light of this, individualized treatment approaches should be followed by surgical practitioners when dealing with HH, in order to formulate the most appropriate clinical treatment plan tailored to each patient′s specific circumstances.

To summarize the experience in treating reverse psoriasis based on location-based syndrome differentiation. It is believed that the main pathological factors in the onset of reverse psoriasis are dampness， heat， stasis， and toxins. In clinical practice， treatment is tailored based on the location-based syndrome differentiation and treatment according to the presence of dampness， heat， stasis， and toxins. For cases that manifest predominantly in the upper body with wind-heat attacking the surface， the treatment focuses on clearing heat， dispersing wind， and relieving itching， and a self-designed Sanhua Decoction （三花汤） is used. Alternatively， for cases with blood heat accumulating and stagnation， the treatment emphasizes on clearing heat and toxins， and cooling blood to eliminate skin lesions， and self-designed Sancao Decoction （三草汤） is employed. For cases that mainly affect the middle part of the body with damp-heat stagnating in the spleen， the treatment focuses on clearing heat， resolving toxins， and drying dampness while invigorating the spleen， and a self-designed Sanhuang Decoction （三黄汤） is applied. For cases with stasis and heat intertwining， the treatment aims to resolve stasis， clear heat， and activate collaterals while detoxifying， and a self-designed Santeng Decoction （三藤汤） is used. For cases that predominantly affect the lower part of the body with damp-heat descending， the treatment focuses on detoxification， eliminating dampness， and clearing and promoting the lower jiao， and a self-made Sanling Decoction （三苓汤） is used. For cases with cold and dampness accumulating and toxins， the treatment emphasizes on warming yang， supplementing qi， and detoxification while eliminating dampness， and a self-made Sanshen Decoction （三参汤） is prescribed.

Objective:To investigate the application value of Clavien-Dindo classification in evaluation of postoperative short-term complications of Da Vinci robotic-assisted or laparoscopic-assisted total gastrectomy with D 2 lymphadenectomy. Methods:The retrospective cohort study was conducted. The clinicopathological data of 262 patients with gastric cancer who were admitted to the 940th Hospital of Joint Logistic Support Force of Chinese People′s Liberation Army from January 2016 to January 2019 were collected. There were 214 males and 48 females, aged (58±11) years, with a range from 17 to 81 years. Of 262 patients, 120 cases undergoing Da Vinci robotic-assisted total gastrectomy + D 2 lymphadenectomy + Roux-en-Y anastomosis were divided into robotic group, and 142 cases undergoing laparoscopic-assisted total gastrectomy + D 2 lymphadenectomy + Roux-en-Y anastomosis were divided into laparoscopic group. Observation indicators: (1) intraoperative and postoperative situations; (2) postoperative pathological examination; (3)complications; (4) stratified analysis; (5) follow-up. Follow-up using outpatient examination and telephone interview was performed to detect complications, tumor recurrence and survival of patients within postoperative 2 months. The follow-up was up to May 2019. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the t test. Measurement data with skewed distribution were represented as M (range), and comparison between groups was analyzed using the Mann-Whitney U test. Count data were described as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test or Fisher exact probability. Comparison of ranked data between groups was analyzed using the rank sum test. Results:(1) Intraoperative and postoperative situations: cases undergoing conversion to open surgery, the operation time, volume of intraoperative blood loss, the number of lymph node dissected, time to first flatus, time to initial fluid diet intake, duration of postoperative hospital stay of the robotic group were 1, (243±42)minutes, 100 mL(range, 100-150 mL), 38±15, (2.8±1.0)days, 3 days(range, 3-4 days), 11 days(range, 9-13 days), respectively. The above indicators of the laparoscopic group were 2, (244±38)minutes, 100 mL(range, 100-150 mL), 34±14, (3.2±1.0)days, 4 days(range, 3-5 days), 10 days(range, 9-13 days), respectively. There were significant differences in the number of lymph node dissected, time to first flatus, time to initial fluid diet intake between the two groups ( t=2.068, -3.030, Z=-3.370, P<0.05), and there was no significant difference in cases undergoing conversion to open surgery, the operation time, volume of intraoperative blood loss, duration of postoperative hospital stay between the two groups ( χ2=0.000, t=-0.158, Z=-1.824, -0.088, P>0.05). (2) Postoperative pathological examination: cases with well differentiated tumor, moderately differentiated tumor, poorly differentiated tumor, signet ring cell carcinoma or other types of tumor, cases in stage T1b, T2, T3 or T4a (pT staging), cases in stage N0, N1, N2, N3a or N3b (pN staging), cases in stage ⅠB, ⅡA, ⅡB, ⅢA, ⅢB or ⅢC (pTNM staging) of the robotic group were 6, 50, 55, 9, 10, 22, 63, 25, 42, 19, 19, 24, 16, 17, 22, 23, 20, 23, 15, respectively. The above indicators of the laparoscopic group were 4, 42, 84, 12, 6, 18, 81, 37, 39, 27, 32, 19, 25, 13, 19, 28, 39, 16, 27, respectively. There was no significant difference in the above indicators between the two groups ( Z=-1.880, -1.827, -0.140, -1.460, P>0.05). (3) Complications: cases with complication classified as grade Ⅰ, grade Ⅱ, grade Ⅲa, grade Ⅲb, grade Ⅳa, grade Ⅳb of Clavien-Dindo classification, cases with death, cases with overall complications, cases with severe complications of the robotic group were 9, 6, 3, 2, 2, 0, 0, 22, 7, respectively. The above indicators of the laparoscopic group were 12, 15, 9, 6, 3, 1, 1, 47, 20, respectively. There were significant differences in cases with overall complications, cases with severe complications between the two groups ( χ2=7.309, 4.790, P<0.05), and there was no significant difference in cases with complication classified as grade Ⅰ, grade Ⅱ, grade Ⅲa, grade Ⅲb, grade Ⅳa, grade Ⅳb of Clavien-Dindo classification, cases with death between the two groups ( χ2=0.080, 2.730, 1.042, 0.704, 0.000, 0.000, 0.000, P>0.05). (4) Stratified analysis: of the patients with overall complications in robotic group, cases of male or female, cases aged ≥65 years or <65 years, cases with body mass index (BMI) ≥24 kg/m 2 or <24 kg/m 2, cases with tumor diameter ≥5 cm or <5 cm, cases with or without abdominal surgery, cases with tumor located at upper stomach or middle stomach, cases in Ⅰ-Ⅱ grade or Ⅲ grade of American Society of Anesthesiologists (ASA) classification, cases with well differentiated tumor or undifferentiated tumor, cases in stage Ⅰ-Ⅱ or stage Ⅲ (pTNM staging), cases with operation time ≥250 minutes or <250 minutes, cases with volume of intraoperative blood loss ≥150 mL or <150 mL, cases with the number of lymph node dissected ≥25 or <25 were 15, 7, 14, 8, 11, 11, 16, 6, 4, 18, 19, 3, 15, 7, 7, 15, 8, 14, 12, 10, 12, 10, 14, 8, respectively. The above indicators of patients with overall complications in the laparoscopic group were 33, 14, 17, 30, 16, 31, 36, 11, 11, 36, 27, 20, 31, 16, 13, 34, 14, 33, 24, 23, respectively. Of the patients with overall complication, there were significant differences in cases of male, cases aged ≥65 years or <65 years, cases with BMI<24 kg/m 2, cases with tumor diameter≥5 cm, cases without abdominal surgery, cases with tumor located at middle stomach, cases in Ⅰ-Ⅱ grade or Ⅲ grade of ASA classification, cases with well differentiated tumor, cases in stage Ⅲ (pTNM staging), cases with operation time ≥250 minutes, cases with volume of intraoperative blood loss <150 mL, cases with the number of lymph node dissected ≥25 between the two groups ( χ2=6.683, 4.207, 6.761, 7.438, 4.297, 6.325, 9.433, 3.970, 4.850, 4.911, 3.952, 3.915, 6.865, 4.128, P<0.05) and there was no significant difference in cases of female, cases with BMI≥24 kg/m 2, cases with tumor diameter <5 cm, cases with abdominal surgery, cases with tumor located at upper stomach, cases with undifferentiated tumor, cases in stage Ⅰ-Ⅱ (pTNM staging), cases with operation time < 250 minutes, cases with volume of intraoperative blood loss ≥150 mL, cases with the number of lymph node dissected <25 between the two groups ( χ2=0.277, 1.052, 1.996, 1.552, 2.172, 2.594, 2.244, 3.771, 1.627, 3.223, P>0.05). (5) Follow-up: 262 patients were followed up postoperatively for 2 months. During the follow-up, no patient was diagnosed with tumor recurrence, and one patient in the laparoscopic group died of severe infection. Conclusions:The Clavien-Dindo classification can be used in evaluating postoperative short-term complications of Da Vinci robotic-assisted or laparoscopic-assisted total gastrectomy with D 2 lymphadenectomy. Compared with laparoscopic-assisted total gastrectomy with D 2 lymphadenectomy, Da Vinci robotic-assisted total gastrectomy with D 2 lymphadenectomy has the advantages of minimally invasiveness, low incidence of overall and severe complication.