By clinical observing and summarizing a large amount of data, we found that the regularity of tongue presentation in stroke patient has important clinical significance. In the acute stage, the tongue coating and body of tongue should be observed carefully to tell the seriousness and the tendency of a disease; in the stable stage, the tongue coating and the texture of tongue should be observed carefully to tell progress of diseases; and in the recovery stage the texture of tongue should be observed carefully to judge the changes of Qi and Xue in viscera and prevent the relapse prevention of disease.

Objective To observe the therapeutic effect of ultrasonic microbubble combined with bevacizumab (Avastin) on choroidal neovascularization induced by photocoagulation in rabbits.Methods CNV was induced by photocoagulation with argon laser in 30 rabbits (60 eyes).All of the rabbits underwent fundus fluorecein angiography (FFA) 21 days after photocoagulation;6-8 hours later,3 rabbits were randomly chosen to be executed to having the immunohistochemical examination.Twenty-one days after photocoagulation,27 rabbits were divided randomly into 3 groups:bevacizumb,ultrasonic microbubble+bevacizumb,and control group;each group has 9 rabbits (18 eyes).The rabbits in control group had no interference treatment;while the rats in bevacizumb and ultrasonic microbubble+bevacizumb group underwent injection with bevacizumb or ultrasonic microbubble+bevacizumb respectively.FFA was performed on all of the rabbits 7,14,and 28 days after photocoagulation to observe the inhibition of CNV;immunofluorecence and Western blot were used to detect the expression of VEGF in retina and choroid.Twenty-eight days is the time point to determine the therapeutic efficacy.The expression of VEGF and the results of FFA were the sdandards of the judgement of therapeutic efficacy.Results Proliferaion of CNV to the retinal inner layer and the obvious leakage of fluoresein in the photocoagulation area indicated that the model of CNV was set up successfully.Twenty-eight days after injection,obvious fluorescent leakage was found in the control group,and the average fluorescent leakage in bevacizumab group differed much from the control group(t=16.2952,P<0.05);while the difference between ultrasonic microbubble+bevacizumb group and bevacizumab group was also significant (t=4.7955,P<0.05).At the same time point,the expression of VEGF in bevacizumab group detected by immunofluorecent assay and Western blot differed much from the control group (t=7.0327,9.2596;P<0.05),and the difference of VEGF between ultrasonic microbubble+bevacizumb group and bevacizumab group was significant (t=2.9724,17.1937;P<0.05).this experiment show that ultrasound combined bevacizumab intravitreal injection of the therapeutic effect of CNV superior to other groups(P<0.01).Conclusion Ultrasound microbubble combined with bevacizumab injection may improve the therapeutic effect on CNV by inhibiting the expression of VEGF.

BACKGROUND: The repair and functional reconstruction of peripheral traumatic nerves depend, on posttraumatic operation time and operative techniques which have certain referential value.OBJECTIVE: To explore the effects of related factors on the repair and functional reconstruction of common peroneal nerve (CPN) after injuries.DESIGN: A case analysis.SETTING: Department of Orthopaedics, Fourth Hospital Affiliated to China Medical University.PARTICIPANTS: Eighteen patients diagnosed with simple CPN injury received treatment in the Department of Orthopedic Surgery of the Fourth Affiliated Hospital, Chinese Medical University, between January 1991 and January 2001. There were 15 males and 3 females aged 12-61 years old with the mean age of 26.5 years; there were 9 cases of complete transection, 3 cases of incomplete transection, 1 case of compression, 4 cases of contusion, and 1 case of irreversible injury. Posttraumatic treatment at hospital was obtained 0.5 hour to 6 months after injury.METHODS: All patients were subjected to CPN explorative operation;neuroanastomosis was performed on 12 cases, neurolysis on 2 cases, tendon graft on 1 case and conservative treatment on 3 cases. Antibiotics were administered after operation together with blood activating medicine and neurotrophic medicine. Moreover, the patients were required to do passive functional exercise in order to avoid arkylosis and myoatrophy.MAIN OUTCOME MEASURES: Functional recovery of CPN was assessed at postoperative 6 months based on the myodynamia of the same side anterior tibia muscles (excellent: above grade 4; good: grade 3; passable: grade 2; poor: grade 1 or grade 0).RESULTS: All the 18 patients entered the results analysis; their outcomes were assessed as excellent in 10 cases, good in 6 cases, and passable in 2cases, with the excellent rate being 89% (16/18).CONCLUSION: Patients diagnosed with CPN injury should be treated with primary repair of traumatic nerves as early as possible, which will benefit the functional recovery of limbs.

Objective To investigate the clinical features and pathogenic characteristics of different types of deep sternal wound infection in dif?ferent types after cardiac surgery. Methods A retrospective study was performed. From January 2012 to December 2014,84 patients with sec?ondary DSWI after cardiac surgery underwent the pectoralis major muscle flap transposition in our department were recruited for the study. Re?sults The average age of 84 patients with DSWI was 54.6 ± 14.8 years old,of which typeⅡDSWI patients were the most common(49/84, 58.3%). Both typeⅠand typeⅡDSWI patients showed typical clinical manifestations and early chest X?ray or Computerized tomography(CT) showed mediastinal widening(P<0.01). Some patients with typeⅢDSWI showed only local symptoms of surgery. The organisms most common?ly isolated in patients with DSWI were gram gram?negative bacilli(GNB,54.8%). Although there was no significant difference between the 3 types of DSWI patients(P>0.05),but the pathogenic results of the 3 types of those DSWI patients showed such a trend:typeⅠDSWI patients with GNB is was more common,and typeⅡDSWI patients was more prone to complicated infection. Conclusion Different types of DSWI may dis?play different features,the prevention and treatment of DSWI should be closely combined with the clinical manifestations and local pathogenic char?acteristics.

Objective To understand the trend of the constituent ratio of atrial fibrillation(AF)and primary etiology in hospitalized cases with chronic heart failure(CHF)and complicated with AF in late 20 years.Methods 1 180 patients with CHF(thereinto,440 complicated with AF)were selected from the hospitalized cases during the past 20 years(1983—2002),and a retrospective analysis was performed with every 5 years interval.Results The constituent ratio of AF in the general cases with CHF was 37.3%,and it was higher in females than in males(41.3% vs 33.4%,P

Objective To analyze the change of the proportions of the hospitalization causes in patients with chronic heart failure(CHF) in a single-central hospital in late 20 years.Methods 1 259 hospitalized cases diagnosed primarily as chronic heart failure were selected from the First Central Hospital of Tianjin during 1983-2002,and divided into two groups with a decade interval.A comparative analysis was performed to explore the proportions of the primary,concomitant and multiple causes of hospitalization for CHF patients between two groups.Results(1) The most common primary causes in general cases was coronary artery disease(CAD,56.6%),rheumatic heart disease(RHD,20.9%) and pulmonary heart disease(PHD,9.2%).During the latter decade,the proportions of CAD and dilated cardiomyopathy(DCM) increased,while RHD,PHD,congenital heart disease(CHD) decreased.(2) The causes of concomitant disease for CHF was essential hypertension(EHT,44.0%),diabetes mellitus(DM,16.4%),chronic obstructive pulmonary disease(COPD,14.3%),cerebral-vascular disease(CVD,11.4%) and anemia(5.2%).All proportions of these concomitant diseases except COPD increased during the latter decade(P

Objective:To compare the effect of Rain Classroom and traditional teaching model on the academic achievement of domestic medical undergraduates by Meta-analysis.Methods:All literature were retrieved from CNKI, Wanfang Med Online, VIP, and CBM databases, and the retrieval time limited from the establishment of the database to October 2019. Randomized controlled trials (RTCs) for the evaluation of the effects of Rain Classroom method in undergraduate medical education were selected. Literature were screened according to the established inclusion and exclusion criteria. Data was extracted and the quality of the literature was assessed using the Jadad scale. All analyses were performed by Stata 12.0 software.Results:A total of 3 662 medical undergraduates in 20 RCTs were included. Meta-analysis results showed that student's theoretical and practical scores of the Rain Classroom teaching group were significantly higher than those of the traditional teaching group (theoretical scores: WMD = 8.52, 95%CI = 7.30 -9.74, P < 0.001; practical scores: WMD = 8.95, 95%CI = 5.42 -12.49, P < 0.001). Conclusion:The Rain Classroom teaching method can effectively improve the theoretical and practical academic achievement among medical undergraduates and enhance the teaching effect. This study has also provided the evidence -based basis for the promotion and application of the Rain Classroom teaching method in medical undergraduate courses.

Objective To investigate the role of endothelial progenitor cells ( EPCs ) transplantation in rats with sepsis induced by endotoxin ( lipopolysaccharides, LPS ). Methods Sixty clean grade Sprague-Dawley ( SD ) rats with genetic background were divided into three groups according to random number table method:control group, model group, and EPCs transplantation group, with 20 rats in each group. The sepsis model was reproduced by intravenous delivery of LPS 5 mg/kg. Rats in control group were injected with the same amount of normal saline. EPCs were isolated, and cultured and identified were fluorescently labeled with the green fluorescent protein ( GFP ) adenoviral transfection method. The EPC transplantation group was injected with LPS, then a fluorescently labeled EPCs suspension was injected via the tail vein 1 hour later. The expression of fluorescent markers of EPCs was detected with both small animal in vivo imaging instrument and frozen section. Seven days after transplantation, abdominal aorta blood was collected to determine interleukins ( IL-6 and IL-10 ) in peripheral blood with enzyme linked immunosorbent assay ( ELISA ), and the lung, liver, and kidney tissues were harvested, the wet/dry ratio of the lung ( W/D ) was calculated, and hematoxylin and eosin ( HE ) staining was performed to observe, the change in histopathology. Toll-like receptor 4 ( TLR4 ) mRNA expression in lung, liver, and kidney tissues was determined with real-time reverse transcription-polymerase chain reaction ( RT-PCR ). Results The positive rate of EPCs cells with double marking of CD133 and CD34 was 99.0% at the 5th generation of subculture by using flow cytometry. After the transplantation of EPCs labeled with the green fluorescent protein, the appearance of fluorescence indicated that EPCs were mainly localized in the chest, and a stronger fluorescence was observed near the blood vessels. EPCs transplantation could significantly reduce the inflammatory cell infiltration and cell damage in lung, liver, and kidney tissue in septic rats. Compared with control group, the expression of IL-6 and IL-10 in the peripheral blood, W/D ratio, and TLR4 mRNA in lung, liver, and kidney were increased significantly in the model group. Compared with model group, the expressions of IL-6 and IL-10 in the peripheral blood were significantly reduced after EPCs transplantation [ IL-6 (μg/L ):2.127±0.118 vs. 2.664±0.438, IL-10 ( ng/L ): 24.5±3.9 vs. 31.5±3.8, both P < 0.01 ]. EPCs transplantation reduced the W/D ratio of lung, liver and kidney tissues ( lung: 4.68±0.24 vs. 5.48±0.15, liver: 3.33±0.11 vs. 3.94±0.09, kidney: 4.08±0.20 vs. 4.84±0.21, all P < 0.05 ], and down-regulated the expression of TLR4 mRNA ( ×103, lung: 782±131 vs. 1 136±126, liver: 39.1±14.0 vs. 69.2±8.7, kidney: 52.2±15.2 vs. 83.5±17.1, all P < 0.01 ). Conclusions EPCs can enter the lung, liver and kidney tissues of the rat successfully after transplantation of EPCs via vein. EPCs transplantation can down-regulate pro-inflammatory process, help to recover the balance of pro-and anti-inflammatory processes, alleviate the damage to the lung, liver, and kidney tissue significantly.

Objective To evaluate the relationship between mRNA and protein expression of HtrA and Streptococcus mutans i-solated from the children with different caries experience and to provide the theoretical and experimental basis on prediction of dent-al caries in deciduous teeth .Methods The strains of Streptococcus mutans isolated from children with different carious experiences in the preliminary experiments were divided into three groups :high caries-susceptible group ,middle caries-susceptible group ,caries-free group .All strains were reanimated on the agar plate of MS ,and after smear pure culture examination ,typical bacteria were in-cubated in BHI ,then purified nucleic acid and extracted all the RNA of streptococcus mutans by reverse transcription PCR and de-tected it by agarose gel electrophoresis integrality .Synthetic cDNA and take further PCR amplification with cDNA products .Ob-serve records results by Gel imaging system .HtrA of target gene and electrophoresis image were gray scan by Gel quantitative soft-ware Gel-Pro analyzer 4 .0 was used to analyze relative expression value of gene .After purifying protein ,collected total protein of Streptococcus mutans strains by Western Blot method ,then tested the concentration of total protein sample .The results of Chemilu-minescence imaging were scanned into computer by Bio-Rad analyzing system ,calculated the gray value by software Quantity One 4 .4 .0 which showed the relative expression level of protein .Results There were significant differences in HtrA mRNA and protein expression of different Streptococcus mutans isolated from the children with different caries susceptibility .high caries-susceptible group> middle caries-susceptible group> caries-free group (P< 0 .05) .Conclusion There were significant differences in HtrA mRNA and protein expression of different Streptococcus mutans isolated from the children with different caries susceptibility .The higher caries susceptibility the group was ,the more HtrA mRNA and protein the strain express .

Objective To prospectively study the relation between transforming growth factor beta-1 (TGF-?_1), V_(20) and lung function (PFTs) and radiation pneumonia (RP), as well as to set up a prediction model of RP. Methods From Jan 2004 to Dec 2005, 121 valid patients with esophageal carcinoma or lung cancer were treated with conventional thorax radiotherapy(RT) by 15 MV X-ray beams to a total D_T 60-68 Gy over 30-34 fractions in 42-46 days. All patients received chest CT scanning before RT. Dose volume his- togram(DVH) and V_(20) were obtained through 3-dimensional TPS. Serum TGF-?_1 and PFTs of the patients were measured both before and after RT as well as on the 20th day after the beginning of RT. RP was diag- nosed basing on contrasted CT and clinical symptoms. Results RP was diagnosed in 32 of all 121 pa- tients. The results of Logistic Regression Statistic showed that V_(20) and TGF-?_1 ratio (after RT/before RT) significantly influenced the incidence of RP. Patients with V_(20)≥30% had more RP than patients with V_(20)