Senior citizens have many diseases related to blood stasis, which was often overlooked by clinicians, and thus affected the treatment of the disease. Through analyzing and summarizing of related literature in recent five years of senile constipation treated from blood stasis, we found that the blood stasis is closely linked to senile constipation. Blood stasis in the gut forms constipation, and constipation with the passing of time forms blood stasis in returen. Blood stasis and constipation often influence each other.

This paper introduced the definition of case management, the application of case management model in China and abroad, analyzed the necessity of the implementation of colostomy case management in the field of patients with colostomy, and then discussed the challenges and solving strategies in the delivery of colostomy case management in China in order to provide a theoretical basis for the establishment and promotion of colostomy case management model.

OBJECTIVE To study the protective effect of Orychophragmus violaceus(OV)seed against acute hepatotoxicity induced by the traditional Chinese Medicine Cortex Dictamni in mice. METHODS Twenty-five mice were randomly divided into 5 groups:control group,Cortex Dictamni group(70 g · kg-1)and OV seed groups(36,54 and 72 g · kg-1). OV Seed groups were orally adminis?tered with the aqueous extract of OV seed for 4 consecutive days while the other groups were ig given water. On the 4th day,Cortex Dictamni group and OV seed groups were ig given the aqueous extract of Cortex Dictamni,and normal control group was ig given water. Twenty-four hours later,all the mice had their blood and liver samples taken after anesthesia. The serum chemical parameters were measured, including glutamic oxaloacetic transaminase (GOT),glutamate pyruvate transaminase (GPT) and lactate dehydrogenase(LDH),as well as malondialdehyde(MDA),glutathione(GSH)and oxidized glutathione(GSSG)levels in the liver. GSH/GSSG ratio was calculated. Histopathologic changes in the liver were observed and the area was calculated after HE staining. RESULTS Compared with normal control group,Cortex Dictamni(70 g · kg-1)increased the serum GOT,GPT and LDH levels by 500, 140 and 40 fold(P<0.01). OV seed reduced serum GOT,GPT and LDH levels increased by Cortex Dictamni(P<0.05,P<0.01),by as much as 62%,75% and 99% for GPT,70%,82% and 98% for GOT,and 55%,75%and 96%for LDH,respectively. The level of MDA and the ratio of GSH/GSSG in Cortex Dictamni group were 1.39 ± 0.58 and(3.53 ± 1.27)μmol · g-1,a 10-fold increase and 40%decline compared with normal control group(P<0.01). OV seed of 72 g·kg-1 lowered the level of MDA by 22%(P<0.05),and OV seed(36,54 and 72 g · kg-1)increased the GSH/GSSG ratio by 47%,42%and 54%(P<0.05). Histopathologic results showed that OV seed alleviated the liver damage induced by Cortex Dictamni from(64.1±8.5)%to(37.5±7.1)%and (20.0±0.8)%(P<0.01). CONCLUSION OV seed can effectively protect mice from the acute hepatotoxicity induced by Cortex Dictamni.

ObjectiveTo evaluate the clinical efficacy and safety of Huaban Jiedu Formulation （化斑解毒方， HJF） in treating psoriasis vulgaris with blood-heat syndrome. MethodsA randomized， double-blind， placebo-controlled study was conducted with 60 patients diagnosed with psoriasis vulgaris of blood-heat syndrome. Patients were randomly assigned to either a treatment group or a control group， with 30 cases in each. The treatment group received HJF granules orally， one dose a day， combined with topical Qingshi Zhiyang Ointment （青石止痒软膏）， while the control group received placebo granules， one dose a day， combined with the same topical ointment. Both groups were topically treated twice daily of 28 days treatment cours. Psoriasis area and severity index （PASI）， visual analogue scale for pruritus （VAS）， traditional Chinese medicine （TCM） syndrome scores， dermatology life quality index （DLQI）， and psoriasis life stress inventory （PLSI） were assessed before treatment and on day 14 and day 28. Response rates for PASI 50 （≥50% reduction） and PASI 75 （≥75% reduction）， as well as overall clinical efficacy， were compared between groups. Serum levels of interleukin-6 （IL-6） and interleukin-17 （IL-17） were measured before and after 28 days of treatment. Adverse reactions during treatment were recorded. ResultsAfter 28 days of treatment， both groups showed significant reductions in PASI total score， lesion area score， erythema， scaling， and infiltration scores， pruritus VAS score， TCM syndrome score， DLQI， PLSI， and serum IL-6 and IL-17 levels （P＜0.05）. Compared to the control group， the treatment group had significantly greater improvements in PASI total score and erythema score， TCM syndrome score， serum IL-6 and IL-17 levels， and PASI 50 response rate after 28 days （P＜0.05）. Between-group comparisons of score differences before and after 28-day treatment revealed that the treatment group showed significantly better improvements in PASI total， lesion area score， erythema score， TCM syndrome score， DLQI， PLSI， and inflammatory markers （P＜0.05 or P＜0.01）. The total effective rate on day 14 and day 28 was 40.00% （12/30） and 83.33% （25/30） in the treatment group， versus 6.90% （2/29） and 41.38% （12/29） in the control group， respectively. The clinical efficacy in the treatment group was significantly superior to that in the control group （P＜0.05）. Mild gastric discomfort occurred in 3 patients in the treatment group and 1 in the control group. ConclusionHJF can effectively improve skin lesions and TCM symptoms relieve pruritus， enhance quality of life， and reduce inflammatory markers IL-6 and IL-17， in patients with blood-heat syndrome of psoriasis vulgaris， with a good safety profile.