The concept of "three-yin and three-yang" in Shanghan Lun (Treatise on Cold Pathogenic Diseases), a classic written by Zhang Zhongjing in Han Dynasty, has been always the focus of dispute in successive dynasties. The essence of "three-yin and three-yang" has not been fully revealed up till now. Through studying the six divisions of day and night, the six diseases, the combination of syndromes, the complicated diseases, the complete recovery time and the space division of "three-yin and three-yang", the authors draw a conclusion that the "three-yin and three-yang" in Shanghan Lun is a concept of time-sequence, which is associated with the location of disease in space. So it is suggested that the "six diseases" in Shanghan Lun is a categorization for exogenous febrile diseases, and this categorization reveals a sort of inner relationship between the emergence, development, transformation of the febrile diseases and the time.

BACKGROUND: The femoral neck fracture is a common skeletal injury, with high mortality and disability rate. Nonunion and avascular necrosis in femoral head are the main problems in treatment of femoral neck fracture. Up to now, the guidelines for its management continue to be unsolved and are stil evolving.
OBJECTIVE:This study aims to summarize the incidence of two femoral neck fracture complications, as wel as the advance in prevention and treatment. This work can help to better understand the mechanism of non-union and avascular necrosis, and to choose the optimal management of this fracture.
METHODS:Papers in terms of femoral neck fracture published in core periodicals were reviewed. Studies which are not directly related to femoral neck fracture or articles regarding poly-trauma were excluded. Literatures concerning non-union and avascular necrosis after femoral neck fracture were preferred.
RESULTS AND CONCLUSION:A total of 241 articles were screened out, and those were mainly published in the last five to ten years. 182 unrelated papers were excluded, and 59 papers were included in the analysis. The femoral neck fracture has a high incidence. Nowadays, there are a variety of treatments for this fracture, but the stability and healing result of fractures depend on many factors, such as age, classification of fracture, general condition of patient, and accompanying diseases. Up to now, the choice of management is stil controversial. Imaging representation and patient’s age are not the main factors for the selection of treatment. Hence, a comprehensive assessment of the risk factors that influence fracture healing is necessary for surgeons to choose an optimal treatment of this fracture. Femoral neck fractures, therefore, represent an enormous socio-economic and medical problem and chal enge surgeons to find the cheapest and most effective way to treat them. Internal fixation of the fracture in combination with the use of osteo-inductive materials may be a new way to further improve the treatment effects of femoral neck fracture.

BACKGROUND:As a lightweight metal with mechanical properties similar to natural bone, a natural ionic presence with significant functional roles in biological systems, and in vivo degradation via corrosion in the electrolytic environment of the body, magnesium (Mg)-based implants have the potential to serve as biocompatible, osteoconductive, degradable implants for load-bearing applications. On the other hand, Mg, as a critical mediator of cellular growth and activities regulation, is the second most abundant intracellular cation where it plays an important role in enzyme function and trans-membrane ion transport.
OBJECTIVE:To retrospectively summarize the application progress, physiological role and mechanism of Mg, and to review its regulation of bone metabolism.
METHODS:Papers addressing application, physiological and bone metabolism regulation of Mg published in core periodicals were reviewed. Studies in which Mg were used as an assistance materials, or articles regarding cellphysiology in which Mg were not the main research object were excluded. Literatures concerning the regulation of bone turnover by Mg were given special attention.
RESULTS AND CONCLUSION:Mg al oys are cytocompatible materials with adjustable mechanical and corrosion properties and show their potential as biodegradable implant materials. Moreover, Mg is abundantly distributed among the body and essential for maintaining physiological function of the cells. Mg deficiency has been associated with a number of clinical disorders including osteoporosis. But it remains to be determined what specific biochemical process is activated by Mg2+to regulate cellular activity and bone turnover. Further investigations of the precise mechanism are valuable to the clinical application of Mg.

Objective To understand morphological characteristics of sinoatrial node cells(SNCs) by taking purified isolation and culture of neonatal rat's SNCs in vitro and to understand the expression characteristics of surface antigens hyperpolarization activated cyclic nucleotide gated cation channel 4(HCN4) and connexin 45(Cx45) on SNCs.Methods The SNCs were isolated from sinus node tissues removed from neonatal rats by trypsin and purified cultured with differential attachment and 5'-bromodeoxyuridine(BrdU) treatment.Results Three different types of cells were observed among the purified cultured SNCs: spindle,triangular and irregular cells.The spindle cells took up the greatest proportion,had the fastest beats,and had less developed organelle and scarce muscular fibrils.Immunofluorescence staining was positive against HCN4 and Cx45 on the spindle cells.Small amounts of HCN4 was observed on triangular cells.Conclusion ① Isolation by trypsin combined with differential attachment and BrdU treatment is a reliable approach to culturing sinoatrial node cells.② The spindle cells with the fastest beats and positive expressions of HCN4 and Cx45 may be the sinus node pacemaker cells.

AIM: To investigate the effects of losartan on myocardial fibrosis and left ventricular hypertrophy in hypertensive patients. METHODS: 35 essential hypertensive patients with left ventricular hypertrophy were treated with losartan 50-100 mg for 6 mon. Before and after the treatment, serum procollagen typeⅢ (PCⅢ), laminin (LN), and hyaluronic acid (HA) were measured by radioimmunoassay; and left ventricular mass index (LVMI) was determined with ultrasonic cardiogram. RESULTS: After treatment with losartan: the serum levels of PCⅢ, LN, HA, and LVMI were all decreased (P

BACKGROUND:The main factors that influence revision of acetabular bone defects include evaluation of acetabular bone defects,reconstruction of acetabulum and appropriate acetabular cups used in revision.OBJECTIVE:The review from the three aspects will help to choose an appropriate cup in revision and to formulate the best revision protocols.METHODS:A computer-based online search of PubMed was performed for English articles published from January 1900 to June 2009 with the key words of acetabulum,revision,bone defect,in English and Chinese.Clinical studies published in core periodicals of the latest twenty years were reviewed.Articles regarding primary joint replacement,femoral prosthesis revision and animal experiments were excluded.RESULTS AND CONCLUSION:A total of 61 articles were analyzed,31 were excluded,and 30 mainly published in 5 years,were included.Reconstruction of acetabular bone structure,restoration of original rotation center of hip joint are key factors for repair.Moreover,appropriate prosthesis further benefits the repair effect.Bone transplantation for bone defect and cementedless prosthesis have become favorable methods for revision of acetabular bone defects.

Objective To evaluate the therapeutic effect and toxicities of low dose Gemcitabine combined with Oxaliplatin in the treatment of advanced or metastatic uroedthelial carcinoma.Methods A total of 42 patients pathologically confirmed advanced or metastatic urothelial carcinoma (23 bladder cancer cases,11 ureteral carcinoma cases,and 8 renal pelvic carcinoma cases) were reviewed.Karnofsky score for each patient before treatment was more than 60.Combined treatment with Gemcitabine and Oxaliplatin regimen was as follows:Gemcitabine 700 mg/m2,iv infusion at day 1,8 and day 15,Oxaliplatin 100 mg/m2,iv infusion at day 2.The regimen was administered for more than 2 cycles (every 4 weeks) and the response rate was evaluated.The regimen was used in palliative chemotherapy and adjuvant chemotherapy,respectively.Results According to WHO evaluation criteria on therapeutic effectiveness,7 patients (16.7％) had complete response,13 patients (30.9％) had partial response,14 cases (33.3％) remained stable status,and 8 cases (19.1％) had progression.The overall response rate was 47.6％.The main side effects included thrombocytopenia,leucopenia,nausea,vomiting and alopecia,which were mild to moderate and disappeared when the chemotherapy was ceased.No chemotherapy related death occurred.Conclusions Combined treatment with low dose Gemcitabine and Oxaliplatin is effective for advanced or metastatic urothelial carcinoma,with mild and tolerable toxicities.

OBJECTIVE To investigate the pertinency between acute physiology and chronic health evaluation Ⅱ scores(APACHEⅡ)and nosocomial infection.METHODS The clinical data from 1 007 ICU patients were evaluated with APACHEⅡ scores system,and made a prospective survey of nosocomial infection.RESULTS Along with the increase in APACHEⅡ scores,nosocomial infection rate and mortality showed rising trend and they were in linear relationship.CONCLUSIONS APACHEⅡ scores system not only can appraise the degrees of severity of illness,evaluate medical treatment,and estimate the prognosis,but also forecast nosocomial infection.

OBJECTIVE To focus on the diagnosis,treatment and prevention of central venous catheter(CVC)-related bloodstream infections(CRBSI)in clinical practice.METHODS The related articles within the nearest 10 years were reviewed,which published in the domestiec and foreign academic journals,at the same time,the related monitoring data of the hospital were analyzed.RESULTS Highlights on the diagnosis,treatment and prevention of CRBSI:for the patients with CVC,the possibility of the CRBSI should be considered,as soon as a high fever was found,and it could not be explained with the non-infectious causes.Infection occurring time and pathogen were different between the general catheters and the anti-infective catheters.The effect of the anti-infective catheters was limited.To pull out the catheters was one of the most effective treatment measures.CONCLUSIONS Prevention of CRBSI:the indications of CVC intubation should be undisputed.Silicone catheter should be used.When the catheter is predicted to be indwelling more than 5 days,anti-infective catheters should be chosen.To insert CVC at the subclavian vein instead of the femoral vein.To care the hub and keep the puncture point dry and do disinfection well.The health care workers should be trained.

The medical student should learn the knowledge and skill for NI control.Nosocomiology subject should be set up in higher medical education as early as possible to meet the needs of medical science development.