This article discussed the author applied the thought of treatment based on syndrome differentiation that acquisitioned from following the master for many years.The three cases of experience in treating insomnia,welling-abscess of the lung and minor chest bind disease applying classical formulae of Xiaochaihu decoction,Weijing decoction and Xiaoxianxiong decoction separately all get preferable clinical curative effect.

Objective To investigate the clinical efficacy and safety of triclosan in combination with compound glycyrrhizin in the treatment of chronic urticaria. Methods A total of 100 patients with chronic urticaria who were enrolled in our hospital from December 2014 to December 2015 were divided into control group and observation group by random number table method,with 50 cases in each group. The control group was given desloratadine alone, and the observation group was treated with on the basis of the addition of compound glycyrrhizin tablets adjuvant therapy.compare the two groups of patients withThe short-term efficacy,the scores of 7 days urticaria activity,the laboratory indicators and the rate of follow-up recurrence were compared before and after treatment in two groups. Results The total effective rate (96.00％) of the observation group was significantly higher than that of the control group (76.00％) (P <0.05). After the treatment of 7days, the urticaria and itching score in the observation group [(0.79 ± 0.20), (0.65 ± 0.10)] were significantly lower than the control group [(1.54 ± 0.29), (1.29 ± 0.42)] (P<0.05). The levels of IL-4, IFN-γ and IgE in the observation group [(28.16 ± 4.10) pg / mL, (11.95 ± 3.05) pg / mL, (55.21 ± 11.37 g / L) were significantly higher than those in the control group[(35.40 ± 7.92) pg/mL,(7.23 ± 1.89) pg/mL, (73.75 ± 15.09) g/L] (P<0.05). The recurrence rate (10.00％, 18.00％) in the observation group was significantly lower than that in the control group (24.00％, 36.00％) (P<0.05).Conclusion The treatment of chronic urticaria with cisplatin combined with compound glycyrrhizin can alleviate the symptoms of skin lesions, improve the level of related laboratory indicators and help to avoid long-term recurrence.

Teacher Lian Jianwei is good at treating internal diseases,however he is experienced at nose diseases too by differentiating signs and looking into inside from outside;now 3 medical concerned cases are extracted for reference.

Objective To evaluate the clinical feasibility of laparoscopic cool-tip radiofrequency ablation (LCRFA)for renal cell carcinoma. Methods Twelve selected cases of primary renal, ceil carcinoma underwent LCRFA. Of them, 4 cases of left renal carcinomas, 7 cases had right renal carci-nomas and 1 case had bilateral renal carcinomas. The maximum diameter of the tumors was 2.1-8. 5 era. Eleven cases were T, No M0 and the other one was T2 N0 M0. Results The mean operation time was 92±24 min, and the mean blood loss was 50±29 ml. None of the cases need blood transfusion post-operation. No laparoscopic operative complications were observed. Six weeks after operation, complete ablation was achieved in 12 lesions and partial ablation in 1, with a complete ablation rate of 92.3%(12/13). There was no statistic change of Hb. ESR. SCr and GFR after operations (P>0.05). Ten cases underwent CT examination 3 months after the treatment ,9 cases showed complete necrosis of tumor,1 case showed partial necrosis. No recurrence was found. All of the 12 cases remained sur-vived during the follow-up for 1-16 months(median,7.8 months). Conelusions LCRFA for renal cell carcinoma is an accurate and effective intervention with a low incidence of complications, and is more accurate than ultrasound-guided pereutaneous radiofrequency ablation.

Objective To establish and evaluate animal model of adult rats with vitamin D deficient and assess the association of vitamin D deficiency and hypertension .Methods Adult SD rats were divided into 3 groups :normal controls group(feed with ordina-ry forage) ,vitamin D deficient groups(feed without vitamin D)and vitamin D control group(feed with vitamin D) ,which were fed with different diets under 12 h:12 h without ultraviolet light bulb(UV-B) .After treatment for 6 weeks ,Retinal blood was collect-ed ,and Serum vitamin D levels was tested by EIA every 2 weeks .Results After treatment for 10 weeks ,Serum level of vitamin D in vitamin D deficient group were reduced to 2 .07 nmol/L ,while vitamin D group and normal control group were measured as 56 .74 nmol/L and 57 .61 nmol/L ,there was no statistically significant difference between vitamin D group and normal control group (P>0 .05) .hypertension of vitamin D deficient group was significantly higher than other two groups .Conclusion It is feasible to estab-lish model of adult rats with vitamin D by UV-B free light and diets control ,hypertension of rats vitamin D deficiency has a signifi-cant rise compared with the control group .

Background and purpose:Metastatic colorectal cancer (mCRC) patients with K-ras mutation won’t benefit in the anti-epidermal growth factor receptor (EGFR) treatments. Thus K-ras mutation analysis is mandatory before this treatment. There is controversy that K-ras mutation analysis should be performed on primaries or related metastases. The aim of our study was to evaluate the concordance of K-ras status between primary and related metastases tumors, thus investigate the validity and rigorousness of clinical K-ras testing. Methods:Seventy-six patients with confirmed mCRC treated in Fudan University Shanghai Cancer Center were enrolled. After DNA extraction and PCR amplification, tumor specimens with paired primary tumors and related metastatic sites were put into sequencing analysis. And the K-ras mutation status in exon 2 was assessed. Results: K-ras mutation was detected in 31 out of 76 primary tumours (40.8%) and also 40.8%of the metastatic sites. But discordance was found between primary tumor and metastasis in 15 cases (19.7%):8 primary tumors had a K-ras mutation with a wild-type metastasis, meanwhile 7 primary tumors were wild type with a K-ras-mutated metastasis. Conclusion:Our study indicated that quite a few mCRC cases have different K-ras status between primary tumors and related metastatic sites, and it’s not very rigorous to choose the anti-EGFR treatments merely according to the primary tumor-K-ras mutation.Further study and consultation are needed on this problem.

Objective To observe the effects ofTrametes robiniophila Murr and Isatidis Radix bidirectional fermentation products on the migration and invasion of human breast cancer MCF-7 cells and relevant factors; To discuss relevant mechanism of action.Methods Breast carcinoma cell line MCF-7 was used as research subject in this experiment. Control group, Isatidis Radix group,Trametes robiniophila Murr group, andTrametes robiniophila Murr and Isatidis Radix group were included in the experiment. The effects ofTrametes robiniophila Murr and Isatidis Radix bidirectional fermentation products on MCF-7 cell proliferation were measured by MTT method. Cell scratch assay, transwell assay and adhesion assay were used to measure the effects ofTrametes robiniophila Murrand Isatidis Radix bidirectional fermentation products on the migration, invasion and adhesion capability of MCF-7 cells, respectively. The effects ofTrametes robiniophila Murrand Isatidis Radix bidirectional fermentation products on the mRNA expression of MMP-9 and Vimentin were measured by RT-PCR.Results Compared with Isatidis Radix group andTrametes robiniophila Murrgroup, Trametes robiniophila Murr and Isatidis Radix bidirectional fermentation products could significantly inhibit the proliferation, migration, invasion and adhesion capability of MCF-7 cells (P<0.05). Similarly,Trametes robiniophila Murr and Isatidis Radix bidirectional fermentation products reduced the mRNA expression of MMP-9 and Vimentin (P<0.05).ConclusionTrametes robiniophila Murrand Isatidis Radix bidirectional fermentation products may down-regulate the expression of MMP-9 and Vimentin to inhibit the migration, invasion and adhesion capabilities of MCF-7 cells.

Objective To determine the influence of schizophrenia patients with diabetes on cognitive function.Methods Altogether 78 schizophrenia patients with diabetes and 118 patients with schizophrenia were enrolled and Negative and Positive Syndrome Scale,Wechsler Memory Scale-Revised Visual Reproduction Test,Wechsler Adult Intelligence Scale-Revised Digit Symbol Test,Computerized Wisconsin Card Sorting Test,Trail Making Tests,Part A and B,and Wechsler Adult Intelligence Scale-Revised Digit Span Test were used to assess the clinical syndrome and to test the cognitive function.ResultsImpairment of Processing Speed,Attention/Working Memory,Executive Functioning and Visual Memory in schizophrenia patients with diabetes was significantly poorer than that of the schizophrenia patients ( all P ＜ 0.05 ).WAIS-R Digit Symbol Test score and Trail Making Test A and B scores were associated with diabetes duration and age at diabetes onset (P ＜0.01 ).Conclusion The impairment of cognitive function in schizophrenia patients with diabetes is severer than schizophrenia patients,suggesting that the prevention and management of diabetes may improve cognitive outcome in schizophrenia patients.

Objective:To investigate the level of trimethylamine N-oxide (TMAO), one of gut metabolites, in patients undergoing maintenance hemodialysis (MHD) accompanied by congestive heart failure (HF) and its influencing factors.Methods:Those patients of 18-75 years old who received three or more times of hemodialysis sessions per week for three months or longer during Nov 2018 and Mar 2019 were enrolled. Those attended health checkup at the same time without obvious kidney abnormality served as non-kidney disease controls. Serum TMAO concentrations were measured using high-performance liquid chromatography electrospray ionization-tandem mass spectrometry (HPLC-ESI-MS/MS). The levels of TMAO were compared between patients on hemodialysis and controls, between those with heart failure and without heart failure using logrithmically transformed TMAO (lnTMAO). Linear regression analysis was performed to investigate factors influencing TMAO levels.Results:A total of 195 patients undergoing MHD and 40 controls were enrolled. Among them, 30 hemodialysis cases (15.4%) manifested as heart failure symptoms and/or left ventricular ejection fraction less than 50%. Males accounted for 67.2% in patients on hemodialysis and 37.5% in controls ( χ2=12.426, P<0.001) respectively, while the median ages in both groups were 62.0(48.0, 71.0), 45.0(33.3, 55.0) years old respectively ( Z=5.685, P<0.001). TMAO concentrations were significantly higher in patients on hemodialysis than controls [5.54(3.84, 8.91) mg/L vs 0.17(0.11, 0.30) mg/L, after log transformed, t=21.687, P<0.001]. However, there was no statistically significant difference between those with heat failure and those without in male [63.3% vs 67.9%, χ2=0.238, P=0.626], age [64.5(56.8, 71.0) years old vs 61.0(47.0, 72.0) years old, Z=0.894, P=0.372] and TMAO [5.17(3.30, 9.46) mg/L vs 5.57(3.87, 8.95) mg/L, after log transformed, t=-1.537, P=0.135]. Multivariate linear regression analysis demonstrated that in all the participants, serum urea was the main risk factor for TMAO [standardized coefficient ( SB)=0.483]. lnTMAO=0.078×[serum urea(mmol/L)]+0.001×[serum creatinine (μmol/L)]-0.002×[serum uric acid (μmol/L)]-0.003×[platelet (×10 9/L)]+0.014×[age (years old)]+0.344 (if diabetic)-1.266. While in those undergoing MHD, ultrafiltration volume had the most significant effect on TMAO levels ( SB=0.279). lnTMAO=0.249×[ultrafiltration volume(L)]+0.059×[serum albumin (g/L)]+0.008×[age (years old)-0.526 (if heart failure existed)-1.865. Conclusions:MHD patients have gut dysbiosis, while those hemodialysis patients accompanied by heart failure may have peculiar gut microbiota which induces lower serum TMAO levels than those without heart failure after adjusting for multiple related factors. Serum TMAO levels may be associated with ultrafiltration volume and nutrition status etc.

Objective To evaluate traditional Chinese medicine (TCM ) formula granules of clear heat evil and detoxifica‐tion treating hyperuricemia clinical efficacy and safety through randomized ,placebo controlled ,blinded clinical trial .Methods 120 patients with hyperuricemia syndrome of damp heat and blood stasis were selected ,randomly divided into control and treat‐ment groups ,60 cases in each group ,in a period of 4 weeks of treatment and observation .The basic treatment was given to both two groups (diet ,exercise etc);in addition ,the control group had placebo while treatment group was given TCM clean heat evil and detoxifying formula granules .The clinical efficacy of the products was evaluated by compariment of TCM clinical symptoms before and after treatment as well as serum uric acid ,lipids (TC ,TG ,LDL‐C) ,fasting blood sugar ;meanwhile ob‐serving complete blood counts (CBC) ,liver function (ALT ,AST ) ,kidney function (BUN ,Cr) ,electrocardiogram (ECG) and adverse reactions to evaluate its safety .Results After 4 weeks of treatment with TCM clear heat evil and detoxifying formula granules ,the treatment group symptom total efficiency was 84% ,while the placebo control group symptom total efficiency was 25% ,the difference is significant statisticly (P<0 .001);the treatment group of TCM clean heat evil and detoxifying formula granules significantly reduced in the blood uric acid ,compared with before treatment (P<0 .01) ,as well as compared with the placebo control group (P<0 .05);after treatment the TCM clear heat evil and detoxifying formula granules significantly re‐duced in the LDL‐C level (P<0 .05) compared with before treatment .Comparing before treatment with after treatment ,there was no significant difference between the two groups ,in routine blood tests ,liver and kidney functions ,or ECG (P> 0 .05) . There were no side effects or adverse events in either groups in period of treatment and observation .Conclusion TCM clear heat evil and detoxifying formula granules is curative for the hyperuricemia and obviously improve the clinical symptoms for hy‐peruricemia in patients with damp heat and blood stasis .It is a safe and efficient formulation to reduce uric acid .