Objective To study the metabolic parameters in health checkup people with dark red tongue and light red tongue,with different coating nature,coating color or liguliform,to understand the relationship between dark red tongue and human metabolic state.Methods Clinical data of 2 891 individuals who underwent health checkup in our center between Dec.2013 and Aug.2014 were collected,including body mass index,blood pressure,blood glucose,lipid and uric acid.Tongue diagnosis was made by Chinese Medicine practitioners.Results The dark red tongue was more common in males,it was found in 61.58％ males and 38.42％ females in the dark red tongue group.The average level including body mass index,systolic blood pressure,diastolic blood pressure,blood glucose,total cholesterol,triglyceride,low-density lipoprotein cholesterol and blood uric acid in dark red tongue group were higher than those in light red tongue group (P＜0.01).When the dark red tongue had yellow fur-like or thick and greasy coat,the average level of body mass index,blood glucose,total cholesterol,low-density lipoprotein cholesterol and blood uric acid were higher than those of the normal dark red tongue group,the level of high-density lipoprotein cholesterol was lower than that of the normal dark red tongue group.Conclusions Dark red tongue has homogeneous relations with abnormal metabolic parameters,it may be the external expression of metabolic abnormalities;tongue is the external macro manifestation of human body health state.

This study was aimed to discuss the connotation of congenital constitution in medical books before Qing dynasty. By searching the character Bing as a keyword in the Encyclopedia of Traditional Chinese Medicine (TCM), 6 480 articles were retrieved. Through reading each of the articles, 9 congenital constitution terms were con-cluded. A total of 1 041 valid entries involved in 165 medical books were retrieved. The results showed that congen-ital constitution was affected by parent heredity and region factors. Parent heredity factor includes the influence of both parents and the influence of mother during pregnancy where the influence of both parents includes both parents' habits and conditions when having sex; the influence from the mother includes habits and medication during her pregnancy. Congenital constitution embodiment includes the body's growth and development, body structure and vis-cera, qi and blood, pulse and forefinger blood vessels (of young children), mental state and life span. In three other factors of congenital constitution (i.e. qi and blood, body structure and life span), both body structure and life span depend on the endowment of qi and blood. It was concluded that TCM practitioners before Qing dynasty judged one's congenital constitution through observing the speed of its growth and development, appearance, mental state, strength of visceral functions, condition of its mind, forefinger blood vessels, pulse, susceptible to types of disease and etc. Therefore, body structure is an important factor of congenital constitution judgment. TCM practitioners before Qing dynasty paid attention to the effect on mother to her offspring's health.

Objective To investigate the correlation between body mass index (BMI) and features of tongue manifestation.Methods A total of 1 655 physical examination individuals were selected,and height and body weight were measured to calculate BMI.Traditional Chinese Medicine tongue inspection was performed,and map of tongue manifestation was photographed by a digital camera.Results Among the 1 655 physical examination individuals,prevalences of normal weight,overweight/obesity and low weight were 50.94％,43.74％ and 5.32％,respectively.The prevalences of individuals had dark red tongue (37.98％ vs.24.56％;x2=40.883,P＜0.001),purplish tongue (5.94％ vs.3.44％;x2=8.133,P=0.017),dark purplish tongue (2.35％ vs.0.59％;x2=10.398,P=0.006),yellow fur (63.95％ vs.58.84％;x2=9.570,P=0.008),thick greasy fur (24.86％ vs.17.20％;x2=18.698,P＜0.001) in the overweight/obesity group were significantly higher than those in the normal weight group,and the prevalence of individuals had exfoliative fur/little fur/less fur in the overweight/obesity group was significantly higher than that in the normal weight group (1.93％ vs.3.91％;x2=6.454,P=0.040).The prevalences of individuals had red or deep red tongue (48.86％ vs.24.72％;x2=24.608,P＜0.001),red dot tongue (7.95％ vs.1.93％;x2=12.254,P=0.002),thin whitish fur (22.73％ vs.9.53％;x2=14.030,P=0.001) in the low weight group were significantly higher than those in the normal weight group.Binary logistic regression analysis showed positive correlation between dark red tongue (OR 1.830,95％ CI 1.515-2.211;P＜0.001),purplish tongue (OR 1.874,95％ CI 1.211-2.901;P=0.005),dark purplish tongue (OR 4.259,95％ CI 1.610-11.266;P=0.003),yellow fur (OR 1.294,95％ CI 1.093-1.531;P=0.003),gray-black fur (OR 6.147,95％ CI 1.816-20.811;P=0.004),thick greasy fur (OR 1.597,95％ CI 1.289-1.978;P＜0.001) and BMI,and negative correlation between pink tongue (OR 0.766,95％ CI 0.637-0.920;P=0.004),red or deep red tongue (OR 0.659,95％ CI 0.549-0.789;P＜0.001),red dot tongue (OR 0.548,95％ CI 0.326-0.921;P=0.023),thin whitish fur (OR 0.695,95％ CI 0.536-0.900;P=0.006),whitish fur (OR 0.821,95％ CI 0.683-0.986;P=0.035) and BMI.Conclusions There is some correlation between BMI and features of tongue manifestation.Abnormal tongue color is mainly dark red tongue in the overweight/obesity individuals,and red or deep red tongue in low weight individuals.Abnormal tongue fur is mainly thick yellow fur.The tongue shape is normal in different body weight groups.

Objective To measure the chromatic differences of the tongue tip and tongue side and provide quantitative evidence for tongue color diagnosis. Methods Totally 683 healthy people were recruited, and their tongue photos were taken. Then ICC specific documents were used for the correction of all tongue photos, and chromatic values (L*, a*, b*, C*and h°) of tongue tip and tongue side were obtained for further statistical analysis. CIEDE2000 was used for calculating the color differences. Results The average color difference of tongue tip and tongue side in normal pink tongue was 5.4. When pink tongue has abnormal red tongue tip, the average color difference of tongue tip and tongue side was 10.85. Compared with normal tongue tip, the average color difference of tongue tip and tongue side in abnormal color tongue with abnormal red tongue tip increased from 5.4-7.0 to 11.23. Conclusion Red tongue tip is a sensitive sign indicating abnormal heat in the body. Tongue tip quantitative diagnosis is valuable in the determination of heat sign in TCM preventive treatment of disease, and reveal the diagnosis meaning and scientific connotation of red tongue tip.

Objective To form the in vitro diagnostic reagents(IVD)selection and optimization management plan and management database,and optimize the IVD management work.Methods Through the analysis of the policy background and the current management status of the IVD clinical laboratory in Beijing Hospital,the selection and optimization management plan for existing and newly applied laboratory IVD was formulated based on clinical needs.The IVD of the whole hospital was selected and optimized by combing projects,open bidding,innovative quotation methods,on-site review and other steps.The IVD management database and qualification database of Beijing Hospital was formed,and the effect from the aspects of compliance,work efficiency and cost control was evaluated.Results The selection and optimization of 1 737 IVDs in the whole hospital were completed according to the formulated IVD selection and optimization management plan.The implementation of management plan improved the work efficiency.The content of review in an average meeting was increased by more than 10 times,and the frequency of new applications for IVD access was accelerated,while the IVD cost was reduced,and the average purchase amount of the whole hospital was reduced by about 15％.The prices of key IVD products were lower after selection than before selection,and the difference was significant(t=2.493,P=0.034).Conclusion The management scheme of IVD selection and optimization was feasible,and it could achieve the goal of ensuring compliance,improving efficiency and reducing costs.

Objective To explore the effect of Willis circle variation and hemodynamic forces alteration arised from vascular structural abnormity on intracranial aneurysm (IA) rupture using 3D-digital subtraction angiography (DSA) and transcranial color Doppler (TCCD) detection.Methods Two hundred and twenty-three patients with IA,admitted to and conformed by DSA in our hospital from November 2010 to November 2011,were divided into ruptured IA group (n=182) and un-ruptured IA group (n=41).The 3D-DSA was applied in all patients to carefully evaluate the aneurysm sizes,locations,and morphous features,and to confirm the presence of A1 dominance and Willis circle variation.Moreover,aneurysmal neck area,diameter of parent artery,angle between A2 segments of bilateral anterior cerebral artery,angle between aneurysmal longitudinal axis and parent artery,aortic diameter (AD) and aspect ratio (AR) were measured with assistance of 3D-DSA images.Besides,TCCD was applied to all patients,and the hemodynamic parameters were recorded to calculate wall shear stress (WSS) and mechanical stretch.The risk factors of IA rupture were analyzed by receiver operating characteristic (ROC) curve and multivariate Logistic regression with emphasis on Willis circle variation and hemodynamic forces alteration.Results Whether it was in ruptured IA group or in un-ruptured IA group,the incidence rate of variation of anterior Willis circle was higher than that of variation of posterior Willis circle.A1 dominance on the left side was the most common asymmetry.As compared with those in un-ruptured IA group,statistically elder age,smaller AD,larger angle between aneurysmal longitudinal axis and parent artery,decreased WSS and increased mechanical stretch in the ruptured IA group were noted (P＜0.05).ROC curve indicated that angle between aneurysmal longitudinal axis and parent artery,AD,WSS and mechanical stretch could be used to evaluate IA rupture (area under the curve:0.606、0.618、0.396、0.637).Age (OR=8.618,95％CI:2.866-25.917,P=0.000),hypertension (grade Ⅲ OR=16.320,95％CI:1.628-163.556,P=0.018),angle between aneurysmal longitudinal axis and parent artery (OR=3.053,95％CI:1.131-8.242,P=0.028),AD (OR=5.638,95％CI:1.507-20.251,P=0.008) and mechanical stretch (OR=4.230,95％CI:1.554-11.516,P=0.000) were risk factors of IA rupture.A1 dominance (OR=0.242,95％CI:0.074-0.785,P=0.018),small aneurysms (2-5 mm,OR=0.207,95％CI:0.054-0.788,P=0.002) and WSS (OR=0.021,95％CI:0.060-0.672,P=0.009) were identified as protective factors.Conclusions Willis circle variation exists in IA patients.Age,hypertension (grade ⅢD,angle between aneurysmal longitudinal axis and parent artery,AD and mechanical stretch are risk factors of IA rupture,while A1 dominance,small aneurysm (2-5 mm) and WSS are identified as protective factors.Accurate assessment of these factors is of great clinical significance for the prevention and treatment of IA in the future.