"Golden Chamfer"(Jin Gui Yao Lue,Zhongjing Zhang.Han Dynasty),a Chinese medicine-based clinieal classic.believes that the rheumatological disorders are often caused by the interaction of internal and external factors.The internal factors are the lack of Qi and Yang in human body, and the external factors are exogenous wind,cold and dampness evil.According to this theory,the Chinese medicines with the functions of dispelling exogenous wind, cold and dampness can be used to treat rheumatological disorders.In "Golden Chamber",Astragalus root,Aconite,Ephedra,Cassia stem,White atractylodes rhizome and Semen coicis are recommended by the author in the treatment of rheumatological disorders.

Objective To investigate the clinical effect of laparoscopic ovarian surgery combined with gestrinone in the treatment of ovarian cysts and its effect on FSH, LH and E2, for the clinical diagnosis and treatment to provide reference. Methods 60 cases of ovarian cysts from June 2014 to June 2016 in our hospital were selected and randomly divided into control group and treatment group with 30 cases in each group. The treatment group was treated with laparoscopic ovariectomy with gestrinone, two group of patients were treated for 6 months as a course of treatment. FSH, LH and E2 were detected by radioimmunoassay, the number of antral follicles was measured under transvaginal ultrasonography. Results The total effective rate of the treatment group (80%) was significantly higher than that of the control group (40%), the difference was statistically significant (P<0.05), the treatment group and control group after oral administration of gestrinone FSH, LH and E2 levels and the number of antral follicles decreased, however, after oral administration of gestrinone FSH, LH levels and the number of antral follicles were compared with those of the control group, the differences were not statistically significant,E2 levels were compared with those before and after treatment, the difference was statistically significant (P<0.05) There was no significant difference in the incidence of adverse reactions between the two groups. Conclusion Laparoscopic ovariectomy combined with gestrinone treatment of ovarian cysts has significant curative effect, little side effect, safe and reliable, and high cost performance. And the ovarian function has a greater improvement, this method has clinical research value.

OBJECTIVE To review the environment disinfection situation of our hospital operating room in the past three years and to discuss regulatory measurement.METHODS We carried out bacteriological monitoring of air,object surface and hands of medical personnel in operating room and made the advanced bacterial identification to distinct pathogenic bacteria and conditional ones.RESULTS A total of 478 number of times of air,652 number of times of object surface and 284 number of times of hands of medical personnel in the operating room,were detected during the past three years.Total qualification rate was 98.1%,90.2% and 96.5%,respectively,and it reflected an upward trend year by year.Staphylococcus,Escherichia coli,fungi,Acinetobacter baumannii and Pseudomonas aeruginosa were detected from the air and object surface.CONCLUSIONS Strengthening quality management of environmental disinfection,developing and implementing the various management systems,improving the precaution awareness of the operating room staff and strictly managing the people flow and object should become effective measures which guarantee the environment disinfection quality of the operating room and reduce hospital infection during surgery.

[Objective]To observe the curative effect of Wenjing Huayu Decoction for chemotherapy-induced hand-foot syndrome. [Methods]A total of 61 cases of patients with hand-foot syndrome induced by the oral administration of capecitabine were incorporated in the study, and further randomly divided into the treatment group(31 cases) and the control group(30cases). Capecitabine's dosage was 1250mg/m2,twice in one day,from the first day to the fourteen days,7 days of rest,with an observational period of 21 days.In the treatment group, patients were immersed with warm-water diluted Wenjing Huayu Decoction, from the first day of chemotherapy,once in the morning and once at night, 20 minutes a time, with an observational period of 21 days;besides, external application of urea cream was used for patients in the control group;patients in both groups applied corresponding treatment schemes twice a day, once in the morning and once at night, with an observational period of 21 days. The therapeutic effects in both groups were evaluated after 2 cycles of treatment. [Results]The effective rate of HFS was 67.7%in the treatment group and 36.7%in the control group. The results showed that the curative effect in the treatment group was significantly more efficient than that in the control group, with a statistical difference( P<0.05); according to the quality of life(QOL) scoring, there was an obvious difference in improving patients'quality of life between the two groups(P<0.05). [Conclusion]An immersion treatment applying Wenjing Huayu Decoction can be an effective regimen for the treatment of hand-foot syndrome induced by the administration of capecitabine, associated with improvement of patient's life quality.

Objective To investigate the application effect of Kangfuxin Liquid on pain relief saliva SigA and IgG levels in patients with oral ulcer.Methods A total of 98 patients with oral ulcer treated in our hospital from January 2013 to July 2015 were randomly divided into two groups,with 49 cases in each group.The observation group was treated with Kangfuxin oral liquid,the control group was treated with stomatitis spray.The treatment effect, relieve pain, ulcer healing time and saliva SIgA, IgG levels in the two groups were observed,and whether the record of concurrent side effects.Results The effective rate of the treatment group was 89.79% higher than the control group 65.30%(P<0.05).Compared with before treatment, the observation group after treatment, the level of saliva SigA increased, IgG level decreased(P<0.05), the control group after treatment of saliva SIgA, IgG level of improvement is greater than that of the control group, the difference was statistically significant(P<0.05).The pain relief and healing time of the observation group were significantly lower than the control group(P<0.05).Conclusion The clinical effect of Kangfuxin liquid in treatment of oral ulcer in patients with significant clinical effect,reduce local ulcer pain, promote ulcer necrotic cell shedding and granulation tissue of newborn,increase the SIgA, IgG content, strengthen the local immunity response, promote oral ulcer healing, worthy of promotion.

OBJECTIVE:To strengthen the management of dismounting drugs in hospital and improve pharmacist working effi-ciency by designing and mading an oral dispending desk. METHODS:In order to solve the small number of placing dismounting drugs induced by small capacity of the desk and disorder placement of placing medicines in inpatient pharmacy,our pharmacists de-signed a new kind of oral dispensing desk that can solve the above problems,produced it and put it in the daily clinical work. The application effects were evaluated by comparing the number of placing drugs and deployment time of medical orders before and af-ter applying it. RESULTS:The designed oral dispensing desk included square slots in the bench,round slots on the side,operating table,multi-panel drawer and ordinary drawer,in which,the first two parts could be used for placing drugs with different shapes and different sizes,multi-panel drawer could place oral liquid,granules,etc. The total number of placing drugs was increased from 237 to 290,and the average deployment time of each medical order was shortened from(4.55±0.38)s to(3.52±0.16)s. CON-CLUSIONS:Application of new dispensing desk has not only solved the limited capacity of the desk,disorderly placing dismount-ing drugs,being difficult to locate and manage and other problems,but also improved the deployment speed of pharmacists and promoted standardized management of dismounting drugs.

Objective To observe the effect of intrathecal p38 MAPK inhibitor(SB203580) treatment on neuropathic pain and the expression of p38 MAPK and BDNF in dorsal horn of spinal cord in rats with chronic constriction injury(CCI),So as to investigate the possible mechanisms of neuropathic pain.Methods Totally 30 SD rats were evenly randomized into 3 groups(n=10) :sham group receiving intrathecal injection of sodium chloride,control group receiving intrathecal injection of sodium chloride and CCI surgery,and SB203580 group receiving intrathecal injection of SB203580 and CCI surgery.SB203580(0.1 ml/kg) was administered 0.5 h before and 1-14 d after CCI surgery.The mechanical thresholds were tested 24 h before and 4-14 d after CCI surgery.p38 MAPK expression and BDNF release in the dorsal horn were determined using immunohistochemistry method 14 d after CCI surgery.Results The mechanical thresholds in the control and SB203580 groups were significantly lower after CCI surgery compared with that before CCI surgery(P0.05).Compared with the sham operation group,the mechanical thresholds were significantly lower in the other two groups after CCI surgery(P

Objective To screen the Chinese drugs with liver channel tropism acting on the characteristic differential expressed protein of human liver cancer cell protein tyrosine kinase (PTKs) system by protein chip technology, and to analyze the difference in different Chinese drugs with liver channel tropism in relation to PTKs regulation. Methods Forty BALB/C nude mice were chosen; a piece of subcutaneous tumor mass was implanted into the left lobe of liver parenchyma to reduplicate the orthotopically implanted tumor models. After modeling for 10 days, the tumorigenicity was confirmed, and all the nude mice models were divided into four groups; different Chinese medicine extracts were injected intra-peritoneally into corresponding treatment groups respectively, and the methods of treatment in the 4 groups were as follows: In liver channel tropism drug pair of Huayu Xiaozhen group, rhizoma sparganii and curcuma zedoary with dosage containing crude drug 4.5 g·kg-1·d-1 was given, in liver channel tropism drug pair of Gongdu Sanjie group, the extract of centipede and scorpion with dosage containing crude drug 0.3 g·kg-1·d-1 was intra-peritoneally injected, in spleen channel tropism drug pair control group, astragalus and rhizoma atractylodis macrocephalae with dosage containing crude drug 6.3 g·kg-1·d-1 was given, and in the model group, equal amount of 0.9% normal saline was intra-peritoneally injected. After the drug treatment for 3 weeks, the mice were sacrificed and the liver cancer tissue was obtained; after its total protein was extracted, protein chip technology was applied to screen the Chinese drug pair with liver channel tropism acting on differential expressed PTKs of human liver cancer cells, and the results were analyzed by cluster analysis.Results After the end of the experiment, there were 6 animals in Huayu Xiaozhen drug pair group, 5 in Gongdu Sanjie drug pair group, 5 in control drug pair group and 7 in model group. The protein chip screening results showed that the adjusting fold greater > 1.50 or < 0.67 was defined as the difference with statistical significance. Compared with model group, there were 42 up-regulated expressions of PTKs in Huayu Xiaozhen drug pair group, including 29 receptor tyrosine kinases (RTKs) and 13 non-receptor protein tyrosine kinases (nrPTKs) of which the erythropoietin having adjusting fold over 5.0 produced liver cell receptor B1 (EphB1), epidermal growth factor receptor (ErbB2, ErbB4) etc. 3 RTKs; there were 7 RTKs with adjusting fold 3.0 - 5.0 including EphA1, EphA3, EphA7, fibroblast growth factor receptor 2-α (FGFR2-α), hepatocyte growth factor receptor (HGFR), macrophage colony-stimulating factor receptor (M-CSFR) and vascular endothelial growth factor receptor 2 (VEGFR2), and 2 nrPTKs with adjusting fold 3.0 - 5.0 were non-receptor tyrosine kinase BMX (BMX) and Janus kinase 1 (JAK1). In the Gongdu sanjie drug pair group, there were 23 up-regulated expressions: 15 RTKs and 8 nrPTKs, and 6 down-regulated expressions; the RTKs with adjusting fold 3.0 - 5.0 were ErbB4, M-CSFR and 1 nrPTKs that was megakaryocyte-associated tyrosine kinase (MATK). In the control drug pair group, there were 28 up-regulated and 8 down-regulated expressions. The results of cluster analysis showed that in Huayu Xiaozhen drug pair group, there were 17 differential expressed PTKs in accord with the screen criteria of which 9 were RTKs [receptor tyrosine kinase-like orphan receptor 2 (ROR2), stem cell factor receptor (SCFR), anaplasia lymphoma kinase (ALK), platelet-derived growth factor receptor β (PDGFR-β), insulin-like growth factor-IR receptor (IGF-IR), ErbB2, ErbB3, EphB1 and EphA2], 1 nrPTKs [fps/fes related tyrosine kinase (FER)] and 7 PTKs 3 RTKs (M-CSFR, FGFR2-α, EphA3) and 4 nrPTKs [acetate kinase 1 (ACK1), bruton tyrosine kinase (Btk), non-receptor tyrosine kinase ABL1 (ABL1) and BMX]. In Gongdu Sanjie drug pair group, there were 7 differential expressed PTKs in accord with the screen criteria 5 RTKs (M-CSFR, FGFR1, ROR2, EphB1, ErbB2) and 2 nrPTKs [src-related kinase lacking C-terminal regulation and N-terminal myristylation sites (SRMS), FER]. Conclusions The drug pair of centipede and scorpion with Gongdu Sanjie action possesses a more effective anti-HCC role than the drug pair of rhizoma sparganii and curcuma zedoary with Huayu Xiaozhen action, the mechanism is possibly via the regulation of PTKs signal pathway. The liver channel tropism drug pair of rhizoma sparganii and curcuma with action of promoting blood circulation and removing blood stasis possibly has an independent anti-HCC effective pathway outside the PTKs signal system.

Objective To investigate efficient diagnosis and treatment of 17α-hydroxylase (17OHD) deficiency by summarizing clinical characteristics of those patients.Methods From January 1983 to January 2010,48 cases with 17OHD in Peking Union Medical College Hospital were studied retrospectively.Results Among 48 patients with 17OHD,karyotype analysis showed,12 cases with 46,XX and 36 cases with 46,XY.The 46,XX karyotype and 46,XY karyotype with complete 17OHD had typical clinical presentation of amenorrhea [ 12/12,100％ ( 36/36 ) ],no typical spontaneous puberty [ 12/12,13.9％ (5/36) ],Hypertension [ 11/12,100％ ( 36/36 ) ],hypokalemia [ K +:( 2.6 ± 0.7 ),( 2.8 ± 0.7 )mmol/L],hypergonadotropin [ follicle-stimulatinghormone ( FSH ):( 51 ± 35 ),( 79 ± 46 ) U/L,luteinizing hormone( LH ):( 27 ± 14 ),(49 ± 37 ) U/L ],impaired production of sex hormones [ testosterone(T):0.003,0.005 nmol/L; estradiol ( E2 ):26.86,10.64 pmol/L ],hyper-progesterone [ (P):( 32 ± 15 ),( 29 ± 23) nmol/L],impaired production of 17α-hydroxyprogesterone ( 17α-OHP ) [ ( 2.5 ± 1.1 ),( 2.4 ±1.7) nmol/L],ACTH hypersecreation (91.8,114.0 pmol/L).ACTH stimulating test did not elevated in 17α-OHP and cortisol.Conclusion When patients with elevated basal serum levels of progesterone higher than that of ovulation period in addition to clinical symptoms,examination about 17OHD should be warranted.

Objective To investigate the changes in high voltage-activated (HVA) calcium current in dorsal root ganglion (DRG) neurons isolated from rats with neuropathic pain. Methods Pathogen-free male SD rats aged 4-6 weeks weighing 180-220 g were used in this study. The animals were anesthetized with intraperitoneal pentobarbital sodium 50 mg/kg. Neuropathic pain was induced by ligation of L5 spinal nerve between DRG and sciatic nerve. The nerve was transected distal to the ligature. The animals which showed positive signs of neuropathic pain were decapitated on the 14th postoperative day. L5 and L4 DRGs were isolated and the neurons in the ganglia were enzymatically dissociated (group L5 and L4). The control group received no surgery (group C). The HVA Ca2+ current was recorded using whole-cell patch clamp technique. Results Peak calcium current density was significantly lower in group L5 and L4 than in group C, and was significantly lower in group L5 than in group L4 . Halfactivation value (Va 1/2) was also significantly lower in group L5 than in group C and L4 (P ＜ 0.05). The relative contribution of N-type to the total HVA Ca2+ current was significantly greater in group L5 than in group C and L4(P ＜ 0.05). There was no significant difference in the steady-state inactivation curves among the 3 groups. Conclusion In rats with neuropathic pain, the HVA Ca2+ current in the injured DRG neurons may play a key role in the induction of neuropathic pain.