Objective]This paper is for the theoretical formation of clear livering factors development process . [Method]Adopt the method of literature investigation, explore the meaning of liver governing smoothing and dispersing Qi. [Result]It has three meanings: Like smooth doesn't like depression;dredge(The ascending and descending of Qi);spread. The support theory behind it is:Five elements theory;The movement theory of Qi;Zhu Zhenheng ’ s theory of“Liver Governs Smoothing and Dispersing”. Relationships between three meanings and support theory is:With five elements theory explaining the function of the liver governing smoothing and dispersing Qi ,it eventual y uses the movement theory of Qi; With Zhu Zhenheng ’s theory of“Liver Governs Smoothing and Dispersing”, explain the function of the liver governing smoothing and dispersing Qi is different from the the movement theory of Qi. [Conclusion]Liver governing smoothing and dispersing Qi is a new theory of reconstruction by modern scientific theories and methods.

Gastroesophageal reflux disease (GERD) is a common gastrointestinal disease and its incidence is increased in recent years in China.As the main treatment of GERD, proton pump inhibitors (PPI) has stable effects and high safety in long-term application.However, around 30% GERD patients had poor symptom control under standard PPI treatment, even developed into refractory GERD, seriously affecting the quality of life.Therefore, the treatment of GERD is a difficult clinical problem and multiple therapeutic modalities have emerged, including drug therapy, endoscopic treatment and surgery.In this paper, we reviewed the advances in study on treatment of refractory GERD.

Objective To study the dynamic imaging changes of the uterine leiomyomas before and after uterine arterial embolization (UAE) treatment and to discuss its therapeutic mechanism. Methods Color Doppler senography and both plain and enhanced MR[scanning were performed in 45 patients with uterine leiomyomas before and after UAE. Plain CT scan was performed in all patients after UAE. All the patients were followed up for 3-16 months (average 10±3.5 months). Results In 41 of the total 45 cases, the color Doppler senography showed rich blood flow signals in leiomyomas and myometrium before UAE and no or less blood flow signals in both leiomyomas and myometrium on the first day after UAE. On the seventh day, the blood flow signal was still absent in leiomyomas while it was restored in myometrium, and the same phenomena remained in the first, the third and the twelfth month after UAE. In the other four eases, color Doppler sonography demonstrated blood flow signals inside leiomyomas on the seventh day after UAE and it remained till twelve months after embolization. The embolic agent (Lipiodol) was found in both leiomyomas and myometrium on CT scan for 45 cases on the first day of UAE. CT scan also showed the deposit of the Lipiodol in myometrium, but Lipiodol gradually vanished in leiomyomas at one, three and the twelve months after UAE. The enhancement was apparent in leiomyomas and myometrium on MRI scan in all 45 cases before UAE. The enhancement was found in the myometrium, but not in leiomyomas, on MRI scan in 39 cases 3 months after UAE. The other six cases demonstrated different degrees of enhancement in leinmyomas after embolization. In two cases the detachment of the leiomyomas were observed after embolization and the desquamating materials were pathologicallyproved to be necrotic tissue. The difference in the measuring data about leiomyoma volume between MPI and color Doppler sonography was of no statistical significance (P > 0.05). Conclusion The therapeutic mechanism of UAE for uterine leiomyomas is selectively embolizing the vascular bed of uterus, leading to subsequent necrosis of leiomyomas. The color Doppler sonography should be the fast choice for the dynamic imaging follow-up after UAE.

Objective To explore the impact of nucleos(t)ide analogue antiviral therapy on anxiety and depression of patients with chronic hepatitis B (CHB),and analyze the related factors.Methods Before nucleos(t)ide analogue antiviral therapy,1 year and 2 years after antiviral therapy,120 CHB patients were investigated with self-rating anxiety scale (SAS) and self-rating depression scale (SDS).The demography data of patients were collected.Serum levels of alanine transaminase (ALT) and hepatitis B virus (HBV) DNA and other biochemical indicators were measured regularly.Results Before nucleos(t)ide analogue antiviral therapy,1 year and 2 years after antiviral therapy,both the mean scores of SAS and SDS became lower gradually (F=12.661 and 22.395,respectively;both P＜0.01).The percentage of patients with SAS and SDS scores more than 50 were 5.8％,4.2％,1.7％ and 13.3％,7.5％,5.0％,respectively.After 2 years of therapy,the anxiety improvement rate of the patients obtained HBV DNA＜1000 copy/mL was 69.0％,while those with HBV DNA≥1000 copy/mL was 22.2％ (x2 =22.325,P＜0.01).Meanwhile,after 2 years of therapy,the depression improvement rate of the patients obtained HBV DNA＜1000 copy/mL was 77.4％,while those with HBV DNA≥1000 copy/mL was 22.2％ (x2 =32.179,P＜0.01).Multiple factors Logistic regression analysis indicated that the odds ratios (OR) of improvement of anxiety and depression in patients with HBV DNA＜1000 copy/mL were 7.751 (95％ CI:3.026-19.853) and 15.069(95％ CI:5.309-42.770),respectively,compared with those with HBV DNA≥1000 copy/mL; and OR of improvement of depression in patients with ALT≤40 U/L waa 4.103 (95％ CI: 1.376 - 12.238).Conclusions Nucleos(t) ide analogue antiviral therapy could improve the anxiety and depression of CHB patients.The HBV DNA negativity is the independent impact factor of improvement of anxiety and depression in CHB the patients.

Objective To predict the target genes and function of has-miR-26b,has-miR-1972,has-miR4485,has-miR-4498,and has-miR-4743 by bioinformatics analysis,and provide the theoretical basis for the further research.Methods The targets of the five microRNAs were predicted by Target Scan,miRBD,and DIANA-microT-CDS,and the result were analyzed by gene ontology and pathway analysis using FunNet.Results 734 predicted targets were obtained by finding the intersected genes of Target Scan,miRBD,and DIANA-microT-CDS.GO analysis showed that biological processes regulated by the differentially expressed microRNAs included diverse terms,among which some terms (e.g.,central nervous system development,neuron differentiation,axonogenesis,synaptic transmission,learning,and memory,etc.) had direct relationship with the central nervous system and brain functions.The pathway analysis showed that a significant enrichment in several pathways related to neuronal brain function,such as axon guidance,glutamatergic synapse,Wnt signaling pathway,mTOR signaling pathway,VEGF signaling pathway,etc.Among the five microRNAs,has-miR-26b,has-miR-1972,has-miR-4498 might have more important regulatory functions.Conclusion Bioinformatic analysis indicates that has-miR-26b,has-miR-1972,has-miR-4485,has-miR-4498,and has-miR-4743 are closely related to the mechanism and pathogenesis of major depressive disorder.

BACKGROUND: The uterine arterial embolization which is a major method to treat hysteromyoma has bean widely used in clinic and achieved a satisfactory therapeutic efficacy. The study addressing the effect of trisacryl gelatin microspheres on uterine arterial embolization in a hysteromyoma guinea pig model has less bean reported yet. OBJECTIVE: To vedfy the feesibility of trisacryl gelatin microspheres to uterine arterial embolization in hysteromyoma guinea pig models. METHODS: A total of 30 adult female guinea pigs were randomly divided into two groups: pelvic cavity artery moulding group (n=10) was performed pelvic vascular casting mould to demonstrate the anatomical characteristics, such as source, running shape, length, diameter and branches; arterial embolization group (n=20) was induced hysteromyoma model using astrogen-progestogen replacement therapy and performed technical research and pathological analysis by bilateral uterine arterial embolization. RESULTS AND CONCLUSION: The trunks of uterine arteries were erupted from internal iliac arteries. The diameter of the trunks and its arcuate branches were (0.350±0.022) mm and (0.160±0.012) mm, respectively. The 20 guinea pigs of the arterial embolization group were succeeded in operating bilateral arterial embolization. The dosage of 40-120 pm and 100-300 μm trisacryl gelatin microspheras were (0.040t±0.005) mL and (0.017±0.002) mL respectively during the operation. The achievement ratio of establishing model was 75% in the arterial embolization group. On the pathological section, the microspheres could be found in the uterine arterial arcuate branches and second branches within the subsercsa and third branches. The myometrium Was thickening. The cells of the leiomyoma nodules arranged in palisade or weaving shapes. Ischemia and necrosis were evidently present in leiomyomas of guinea pigs after embolization, but the myometria and endometria had no pathological change of ischemia and necrosis. It is feasible to use trisacryl gelatin microspheres to operate uterine arterial embolization for hysteromyoma of guinea pigs and the embolization effects are satisfactory.

Objective To synthesize 18F-AlF-NOTA-G-TMTP1 and evaluate its potential for PET imaging on nude mice bearing high-metastatic potential hepatoma cells.Methods NOTA-G-TMTP1 was synthesized by the standard Fmoc-solid phase synthetic protocols and radiolabeled with 18F using NOTA-AlF chelation method.The nude mice models bearing low-metastatic potential HCC97L and high-metastatic potential HCCLM3 xenografts were established separately.The tumor-targeting characteristics of 18F-AlF-NOTA-G-TMTP1 were assessed by microPET/CT and biodistribution assay.Results NOTA-G-TMTP1 was labeled with 18F in one step with (25±6)％ labeling yield (n=5).The radiochemical purity of 18F-AlF-NOTA-G-TMTP1 was more than 95％ with a specific activity more than 11.1 GBq/μmol.The octanol/water partition coefficient (logP) for 18F-AlF-NOTA-G-TMTP1 was-3.166±0.022.The tumor to muscle ratios were 1.8± 0.4 and 4.7±0.2 at 35 min post injection for HCC97L and HCCLM3,respectively.The uptake of 18F-AlF-NOTA-G-TMTP1 in HCCLM3 tumor was inhibited (61.4％) by unlabeled G-TMTP1.Conclusion 18F-AlF-NOTA-G-TMTP1 has been successfully synthesized.It shows specific uptake by tumor induced by the high-metastatic potential hepatoma cells.

Objective To investigate the effects of Guiqi polysaccharide (GQP) on the telomerase activity in premature senescence of WI-38 cells;To discuss its mechanism of action.Methods MTT assay was used to observe the effects of different concentrations of H2O2 on the proliferation of WI-38 cells and screened the best concentration of H2O2 to induce premature senescence cellular model in WI-38 cells. ELISA and chemical staining method were used to evaluate the protection of GQP in telomerase activity and senescence-associated β-galactosidase activity in premature cellular senescence.Results 200μmol/L H2O2 treatment could induce premature senescence in WI-38 cells. There were no significant differences in senescence-associated β-galactosidase and telomerase activity between GQP group and normal control group (P>0.05), but had significant difference with model group (P<0.01).Conclusion GQP can increase the telomerase activity and inhibit the senescence-associated β-galactosidase activity in premature senescence of WI-38 cells.

Objective To discuss the operative strategies for cervical spine fracture combined with ankylosing spondylitis and the deformity of cervicothoracic kyphosis.Methods Retrospectively analyzed 21 cases of cervical spine fracture combined with ankylosing spondylitis and the deformity of cervicothoracic kyphosis,who underwent surgeries from January,2007 to August,2014.Twenty males and 1 female were included.Mean age was (48.6±7.5) years (range,36-65 years).The preoperative American Spine Injury Association (ASIA) classification distribution:2 cases of Grade A,6 cases of Grade B,7 cases of Grade C,5 cases of Grade D,and 1 case of of Grade E.The investigative surgical methods including posterior cervical open reduction,internal fixation and bone graft fusion;posterior cervical open reduction/decompression,internal fixation and bone graft fusion;or combined posterior and anterior cervical decompression,bone graft fusion and instrumentation.The operative time and blood loss were recorded,the clinical therapeutic effect was evaluated by visual analogue scale (VAS) score,ASIA grade improvement,cervical curvature (the angle between a line drawn parallel to the inferior endplate of C2 and a line drawn parallel to the inferior endplate of C7 in the lateral plane of an X-ray image) and radiological assessment (including bone graft fusion condition and internal fixation position).Results One case died from severe pulmonary infection and respiratory failure at the 45th day after operation.All the other 20 patients obtained complete follow-up with a mean time of (39.4±8.76) months (range,25-59 months).7 cases received posterior cervical open reduction,internal fixation and bone graft fusion,average operative time was (92.1±5.4) minutes and average blood loss was (96.1+23.7) ml.9 cases received the posterior cervical open reduction and decompression,internal fixation and bone graft fusion,mean operation time was (121.4± 14.0) minutes and blood loss was (250.0±38.9) ml.3 cases experienced combined posterior and anterior cervical decompression,bone graft fusion and fixation,average operative time was (222.4± 14.9) minutes and average blood loss was (354.3+46.7) ml.Mean of VAS scores at the 3th month postoperatively was 2.76±0.46,significantly lower than the preoperatively VAS scores (8.95±0.36).Mean of VAS scores at the 24th month postoperatively was 1.77±0.39,significantly lower than those at the 3th month postoperatively.The neurological function of spinal cord achieved significant improvement after operations and continued recovered gradually in the subsequent follow up.ASIA Classification distribution at the 24th month postoperatively was:0 case of Grade A,0 case of Grade B,3 cases of Grade C,8 cases of Grade D,9 case of Grade E.Mean of the cervical curvature after operation was-7.1°± 1.9°,significantly higher than preoperatively(-13.4°±3.3°) and did not have any loss of Cobb's angles at 24th month after operation.All the surviving cases achieved solid bone graft fusion.Mean bone graft fusion time was 5.8 months (range,4-9 months).There was no internal fixation loose,fracture and dislocation occurred during follow up.Conclusion All procedures can significantly relieve the painful symptoms,effectively restore the normal cervical alignment and stability,and remarkably improve the neural function of the patients suffering cervical spine fracture combined with ankylosing spondylitis and the deformity of cervicothoracic junction kyphosis.

Objective To assess clinical and urodynamic results of augmentation enterocystoplasty (AE) in patients with ncurogcnic hladdcr dysfunction (NBD).Methods Retrospectively reviewed our database between 2005-2011 to identify 77 patients who underwent AE ( sigmoid 74 patients,ileum 3 patients).Postoperativc complications,renal function,urodynamics parameters and quality of daily life were evaluated.Results The mean follow-up length was 24 months.Compared with pre-operative condition,the mean bladder capacity significantly increased from (160.6 ± 128.3) to (468.5 ± 60.6) ml (P ＜0.001 ) and the maximum detrusor pressure decreased from ( 31.1 ± 26.4) to ( 10.9 ± 4.5 ) cm H2O ( P =0.002 ).Serum creatinine level decreased from (270.3 ± 113.6 ) to ( 174.4 ± 81.3 ) μmol/(l) ( P =0.00 1 ).There were significant decrease on mean number of incontinence episodes and pads used per day ( P ＜0.01 ).Post-operative complications included metabolic acidosis in two patients (2.6％),adhesive intestinal obstruction in four patients (5.2％),deteriorating renal function in one patients ( 1.2％ ) and recurrence of vesicoureteral reflux in three patients (3.9％).Conclusions The results suggest that AE is safe and effective in treating patients with NBD.Concomitant URI is considerèd on patients with long illness history,vesicoureteral reflux at low intravesical pressures and upper urinary tract dilation.Patients with moderate and severe upper urinary tract deteriorations benefit from this procedure and the benefit can maintain a long time.