Objective This report investigate the intervention effect of the water extract of Alpinia oxyphylla Miq. fruit (AOF)on memory impairment and the mechanism in cerebral ischemia rats. Methods 48 Rats were randomly divided into sham-operated group(n=12), ischemia group(n=12), AOF group Ⅰ( n= 12)and AOF group Ⅱ (n= 12). The model of transient cerebral ischemic/reperfusion was made by bilateral occlusion of common carotid arteries in rats and combination with reducing blood pressure with an abdominal injection of so-dium nitroprusside. Learning-memory ability was observed by step through test. The content of NO and the activi-ties of NOS were measured in hippocampus. Results In step through test,the latency in ischemia group[(143.8±65.2)s]significantly decreased, the number of errors (8.9±4.2 ) significantly increased compared with sham-operated group [latency: (257.2±67.1 ) s; number of errors: (1.7±1.1 ), P<0.01 ]. The latency in AOF group Ⅰ and AOF group Ⅱ[(186.5±46.2) s, (193.4±43.7 ) s ] significantly increased, the number of errors (6.1±2.9,5.2±2.1 ) significantly decreased compared with ischemia group(P<0.05, P<0.01). In hippocampus, the content of NO and the activities of NOS in ischemia group [(56.53±27.42) nmol/mg prot, (17.23±5.64) nmol/mg prot] significantly increased compared with sham-operated group[ (40.02±17.9 ) nmol/mg prot, ( 10.46±6.15)nmol/mg prot], and in AOF group Ⅰ and AOF group Ⅱ [content of NO:group Ⅰ (46.60 ±20. 26)nmol/mg prot,group Ⅱ (42.38±21.23) nmol/mg prot ;activities of NOS:group Ⅰ (13.98±5.13 ) nmol/mg pint,group Ⅱ(13.61±5.27) nmol/mg prot] significantly decreased compared with ischemia group(P<0.05). Conclu-sion AOF could significantly ameliorate the memory impairment in cerebral ischemic rats. Its effects may be in-volved in the decrease of content of NO and activities of NOS in hippocampus.

Objective To improve recognition of posterior reversible encephalopathy syndrome (PRES) in children. Methods Two children with PRES admitted to children's hospital were included. Clinical data were retrospectively studied and related literatures were reviewed. Results The primary diseases of the two patients are systemic lupus erythematosus and nephritic syndrome, respectively. They all developed an acute onset of headache, visual changes, consciousness disturbance, hypertension and seizures. Cranial MRI showed bilateral parietal, temporal and occipital cortical or subcortical lesions with hypointensity on Tl-weighted imaging and hyperintensity on T2-weighted imaging. Clinical symptoms resolved soon and radiographic recovery occurred within 14 to 21 days with prompt anti-hypertension treatment and supportive care. Among the mechanisms which might contribute to the development of PRES, acute elevated blood pressure seems to be the most important factors in these two cases. Prompt anti-hypertension treatment usually can reverse the PRES lesion. Conclusions It is important to improve cognition of PRES in children. Delayed treatment can cause permanent neurological impairment. Doctors should be alert to this syndrome. Early diagnosis and prompt treatment are very important. (J Clin Pediatr,2010,28(2):168-170)

OBJECTIVE:To investigate the effects of TanshinoneⅡA sodium sulfonate injection on levels of P-selectin,glial fi-brillary acidic protein (GFAP),vascular endothelial growth factor (VEGF) and neurological function in patients with acute cere-bral infarction. METHODS:A total of 114 patients with acute cerebral infarction selected from Lianyungang First People's Hospi-tal during Apr. 2013-Apr. 2016 were divided into control group and observation group according to random number table,with 57 cases in each group. Control group was given routine treatment. Observation group was additionally given Tanshinone ⅡA sodium sulfonate injection 40 mg 0.9％ sodium chlonride injection 250 mL,ivgtt,qd. A treatment course lasted for 7 d,and both received 2 courses of treatment. NIHSS scores,the levels of serum P-selectin,GFAP and VEGF were compared between 2 groups before treatment and after 7,14 d of treatment. The occurrence of ADR was also compared. RESULTS:Before treatment,there was no statistical significance in above indexes between 2 groups(P>0.05). Compared to before treatment,NIHSS score,the levels of se-rum P-selectin and GFAP in 2 groups were decreased significantly after 7,14 d of treatment,while the serum level of VEGF was increased significantly. These indexes of 2 groups after 14 d of treatment were significantly better than 7 d of treatment,except for NIHSS score. Above indexes of observation group was significantly better than those of control group during corresponding period, with statistical significance (P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:For acute cerebral infarction, Tanshinone ⅡA sodium sulfonate injection can significantly reduce the levels of serum P-selectin and GFAP,improve VEGF level and promote the recovery of neurological damage with good safety.

Objective:To discuss clinical effect of Zhuyu Zhixuetang to chronic endometritis （CE） with syndrome of Qi deficiency and blood stasis and to study improvement effect to pregnancy outcome. Method:One hundred and forty-four patients were randomly divided into two groups， patients in control group were 72 cases and in observation group were 72 cases. In control group， 66 patients completed the therapy because of 4 falling off or missing visit and 2 eliminated， and in observation group， 65 patients completed the therapy because of 3 falling off or missing visit and 5 eliminated. In two groups. anti-infection treatment was gicen to patients. Patients in control group got Fuke Qianjin Pian， 6 tablets/time， 3 times/day. Patients in observation group got Zhuyu Zhixuetang， 1 dose/day. The treatment was continued for 3 months and the follow up was recorded for 6 months. Before and after treatment， changes of menstrual volume， period and cycle were recorded. And hysteroscopy and color Doppler ultrasound of vagina were made， and endometrial morphology and endometrial receptivity were evaluated ［endometrial thickness， resistance index （RI）， pulsation index （PI） and blood flow index （FI）］ were evaluated， and pathology of endometrial were tested. And scores of syndrome of Qi deficiency and blood stasis were graded， levels of interleukin-1 β （IL-1 β）， IL-6 and tumor necrosis factor-α （TNF-α） and T-lymphoid subsets （CD3⁺， CD4⁺， CD8⁺） in peripheral blood were measured. Pregnancy and miscarriage were recorded and the safety was evaluated. Result:After treatment， menstrual volume， menstrual period， cycle and complete normal rate of menstruation in observation group were all higher than those in control group （P<0.05）. Endometrial thickness and FI were more than those in control group （P<0.01）， RI and PI were lower than RI and PI in control group （P<0.01）. And compared with control group， levels of IL-1β， IL-6， TNF-α and CD8⁺ were less （P<0.01）. And levels of CD3⁺， CD4⁺ and CD4⁺/ CD8⁺ were higher than the data in control group （P<0.01）. During 6 months follow-up， pregnancy rate in observation group was 46.97% （31/66） was higher than 27.69% （18/65） in control group （χ²=5.197， P<0.05）. Total effective rate of endometrial morphology was 96.97% （64/66） higher than 86.15% （56/65） in control group （χ²=4.981， P<0.05）. Total effective rate endometrial pathology was 95.45% （63/66） higher than 84.62% （55/65） in control group （χ²=4.304， P<0.05）. Total effective rate of comprehensive clinical effect was 93.94% （62/66） higher than 81.54% （55/65） in control group （χ²=4.696， P<0.05）. There was no adverse reactions related to traditional Chinese medicine. Conclusion:Zhuyu Zhixuetang can regulate menstruation， relieve clinical symptoms， improve endometrial morphology under hysteroscopy， regulate systemic and local immune inflammatory response， improve CP， thus improve pregnancy outcome， with better comprehensive effect and safety.

Objective To evaluate the locating effects of a portable ultrasound for leg perforator flaps,and the clinical effects of leg perforator flaps for the wounds of the extremities.Methods Since December 2009 to March 2011,thirty-one cases of soft tissue defects of the extremities were treated with free vascularized leg perforator flaps in our center.A portable ultrasound were used for the locating of the perforator arteries of the leg before the operations.These flaps include 24 cases of the fibular artery perforator flaps (4 with simultaneous fibula transfer),three cases of the posterior tibia artery perforator flap,two cases of the medial gastrocnemius artery perforator flap,and 2 cases of the lateral gastrocnemius artery perforator flap.The flap size ranged from 15.0 cm × 8.0 cm to 1.0 cm × 1.5 cm.The caliber diameter of the perforator artery ranged from 0.2 mm to 1.8 mm.The wounds included 21 cases of the hand,five cases of the forearm,and 5 cases of the leg.Results The coincidence rate intraoperatively of the portable ultrasound was 96.8％.All the flaps survived and the wounds healed uneventfully.The donor site of the flaps were either closed directly or closed with partial split-thickness skin graft.Conclusion The portable ultrasound is an effective,reliable and accurate instrument for locating the leg perforator flaps.The leg perforator flaps have the advantages of convenient harvest,satisfactory thickness,less donor site morbidity,and high survival rate.

Objective To investigate the effects and mechanisms of Alpinia oxyphylla fructus (AOF) on learning and memory in D-galactose induced brain aging mice. Methods The brain aging model was induced by s. c D-galactose. Learning-memory ability was tested by passive avoidance test and Morris water maze test, and the expression of synapsin ( Syn), mitogen-activated protein kinase (MAPK) and protein kinase ( PKC ) in hippocampus were examined by Western blot. Results ① Passive avoidance test:the latency in brain aging group( ( 119.80 ±101.80)s) significantly decreased,and the number of errors (4.4 ± 1.3 ) significantly increased compared with the control group( latency: (279.30 ± 31.64) s; number of errors: ( 1. 8 ±0.9), P＜0. 01 ) ). The latency in low dose, middle dose and high dose AOF group( ( 170.25 ± 68.31 ) s, (226.31 ± 73.25 ) s, (263.20 ± 70.55 ) s) significantly increased, and the number of errors in middle dose and high dose AOF group ( ( 2.8 ± 1.2 ), ( 2.3 ±0. 9 ) ) significantly decreased compared with brain aging group (P ＜ 0. 05, P ＜ 0. 0 1 ). ② Morris water maze test:the escape latency in brain aging group was significantly longer, and the time spent in the original quadrant that previously contained the platform was significantly shorter compared with the control group (P＜0. 01 ). The escape latency in 3 AOF groups was significantly shorter (P＜ 0. 05 ), and the time spent in the original quadrant that previously contained the platform in middle and high dose AOF groups was significantly longer compared with brain aging group (P＜0. 05, P＜0. 01 ). ③ Western blot test:the expression of Syn,MAPK and PKC in hippocampus of brain aging group was significantly weakened than that of the control group. In contrast, the expression of Syn,MAPK, PKC were significantly enhanced in all AOF groups. Conclusion AOF could significantly improve the ability of learning and memory in brain aging mice. Its effects might be related to the increase of the expression of Syn, MAPK and PKC in hippocampus.

Brachytherapy is a key part of radical radiotherapy for cervical cancer. Along with the persistent development of radiotherapy techniques, the combined application of brachytherapy and intensity-modulated radiotherapy ( IMRT) has been proposed by scholars for cervical cancer patients presenting with large residual tumors accompanied by parametrial infiltration after IMRT. In this article, recent research progress on IMRT combined with brachytherapy applied in the treatment of cervical cancer was reviewed.

Primary sclerosing cholangitis(PSC)is a cholestatic disease characterized by chronic progressive bile duct inflammation and has a low incidence rate and poor prognosis in China.There is still no drug therapy that can change the course of PSC,and liver transplantation is the only effective treatment for PSC,with a 5-year survival rate of 85%after transplantation.Drug therapy for PSC is facing great challenges based on the current status of PSC.At present,drugs for the treatment of PSC are in the stage of clinical trials and have shown certain application prospect,among which ursodeoxycholic acid is the most widely studied and commonly used drug.In addition,there are many emerging drugs in the pipeline.This article summarizes the latest advances in drug therapy for PSC.

This article delves into the insights of civilized mutual learning in the development of tradition-al Chinese medicine,emphasizing the importance of life science characteristics in the construction of this discipline.It also discusses the dynamic adjustment of the disciplinary system.Civilized mutual learning is an inevitable phenomenon in history.Researchers in traditional Chinese medicine should focus on the commonalities between Eastern and Western civilizations.They should adhere to the principles of tradi-tional Chinese culture,preserve its creative nature,and be open to incorporating the achievements of sci-ence and humanities from both ancient and modern China and foreign countries.The construction of tradi-tional Chinese medicine should accentuate its life science features,allowing the philosophy of Chinese civilization to play a guiding role in the preventive treatment of diseases.Furthermore,traditional Chinese medicine should be responsive to the impact of new findings in areas such as the information conservation law and quantum mechanics on the discipline's development.It should also reinforce research on the quality and efficacy of Chinese medicinals and dynamically update the disciplinary system that fosters tal-ent training.In conclusion,this article highlights the significance of civilized mutual learning in the devel-opment of traditional Chinese medicine.It proposes that the construction of the discipline should empha-size its life science characteristics and explores the dynamic adjustment and improvement of the discipli-nary system.Through ongoing exploration and innovation,traditional Chinese medicine will contribute significantly to the global life science field.

Objective:To evaluate the optimization effect of transcutaneous electrical acupoint stimulation (TEAS) combined with moderate sedation with propofol (TEAS-propofol balanced anesthesia) for gastrointestinal endoscopy.Methods:This was a single-blind randomized controlled trial. American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅲ patients, aged 18-64 yr, undergoing elective gastrointestinal endoscopy at the Endoscopic Diagnosis and Treatment Center of the Affiliated Hospital of Qingdao University from May to August 2022, were divided into 2 groups using the block random allocation method: conventional anesthesia group (group C) and TEAS-propofol balanced anesthesia group (group TPB). Patients received moderate sedation with propofol plus routine anesthesia with fentanyl 50 μg in group C. In TPB group, TEAS was performed at bilateral Neiguan, Hegu and Zusanli acupoints before surgery until the end of surgery, and patients received propofol for moderate sedation (Modified Observer′s Assessment of Alertness/Sedation scale score was 3). The efficacy and safety of anesthesia and parameters related to outcomes were observed and recorded.Results:In this study, 66 patients were recruited, with 33 in each group, the failure rate of anesthesia in both groups was 3%, and no reflux or aspiration was found. Compared with group C, no significant changes were found in the patients′ satisfaction on the same day, intraoperative pain response score, incidence of intraoperative adverse reactions (tachycardia, hypertension, bucking and body movement), awake time, consumption of propofol, rate of intraoperative awareness and rate of patients hoping to receive the same anesthesia method again postoperatively ( P>0.05), the patients′ satisfaction was significantly increased on the next day ( P<0.05), the incidence of intraoperative respiratory depression, physician satisfaction, and degree of postoperative dizziness and nausea were significantly reduced ( P<0.05), and the discharge time and time to the complete recovery of normal behavior function was significantly shortened in group TPB ( P<0.05). Conclusions:The combination of TEAS at bilateral Neiguan, Hegu and Zusanli acupoints with moderate sedation using propofol for gastrointestinal endoscopy is not only safe and effective, but also beneficial to the postoperative outcome of patients, and the effect is better than that of conventional anesthesia with propofol and fentanyl.