Zhisou powder is a famous TCM prescription of Qing dynasty great physician Cheng Zhongling in treating cough caused by exogenous pathogenic factor.Author respects ancient TCM prescriptions,but don't adhere to it.Author believes that with proper modification of the prescription based on correct syndrome differentiation,Zhisou powder is effective for various kinds of cough including acute and chronic cases,and is satisfactory for good clinical result.This article mainly introduces author's experience in treating various kinds of cough which embodies the holism concept and thought of treatment based on syndrome differentiation in TCM.

There are Many gaps of medical psychology on course plans, teaching methods and examination methods in Chinese medicine institutions. Therefore, the teaching of medical psychology must be reformed. By improving course plans, strengthening multiple teaching methods and examination methods used, quality of teaching on medical psychology can be enhanced, and many persons with ability of traditional Chinese medical science can be educated to be abreast of bio-psycho-social medical model.

Objective To observe the protective effect of ghrelin on hippocampal injury induced by global cerebral ischemia/reperfusion (I/R) and explore its effect mechanisms.Methods The male Sprague-Dawley (SD) rats were randomly divided into four groups,namely sham group,I/R group,normal saline (NS)+I/R group and Ghrelin+I/R group,with 42 rats in each group.The model of I/R was reproduced by clipping bilateral carotid artery of rats 15 minutes and then releasing them for 60 minutes.There were no challenges for rats in sham group,just exposed their carotid artery.Ghrelin+I/R group and NS+I/R group were challenged by injecting 1 μ.L ghrelin or NS into lateral ventricle before I/R.Some of brain tissue in the rats was harvested after experiment to determine the levels of malonaldehyele (MDA),myeloperoxidase (MPO) and glutathione (GSH) in hippocampus by using chemical colorimetry and observe infarct sizes and histopathology.Single extracellular neuron discharge in other rats was recorded to observe the activity of glutamic sensitive neurons (Glu-N) and γ-aminobutyric acid (GABA) sensitive neurons (GABA-N) in hippocampus CA1 region of rats suffered I/R.Results Compared with sham group,the levels of MDA and MPO in hippocampus of rats in the I/R group were raised markedly,the level of GSH was decreased significantly,the infarct sizes was increased significantly and pycnosis neurons were increased markedly.All sorts of indexes between NS+I/R group and I/R group showed no significantly statistical significance.Compared with NS+I/R group,the levels of MDA and MPO in hippocampus of rats in the Ghrelin+I/R group were decreased significantly [MDA (nmol/g):16.4 ± 4.2 vs.24.5 ± 6.7,MPO (nmol/g):6.4 ± 1.8 vs.10.2 ± 2.9,both P ＜ 0.05],the activity of GSH was risen remarkably (μmol/g:2.65 ± 0.72 vs.1.66 ± 0.50,P ＜ 0.05),the infarct sizes of hippocampus were reduced markedly [(43.9 ± 9.5)％ vs.(77.0 ± 12.7)％,P ＜ 0.01],the number of pycnosis neuron was reduced markedly (cells:36.2±4.5 vs.47.1 ±6.1,P ＜ 0.01).The results of electrophysiology showed that the discharge frequency of Glu-N and GABA-N in hippocampus CA1 region of rats in I/R group increased markedly as compared with sham group,and no significant difference in the discharge frequency of Glu-N and GABA-N between NS+I/R group and I/R group.Compared with NS+I/R group,injected ghrelin could make the discharge frequency of Glu-N in hippocampus CA1 region of rats decreased markedly (Hz:3.81 ±0.67 vs.4.98±0.33 at ischemia,3.01 ±0.37 vs.3.77 ± 0.41 at reperfusion,both P ＜ 0.05),and the discharge frequency of GABA-N increased markedly (Hz:5.62 ± 0.54 vs.3.62±0.39 at ischemia,4.81±0.48 vs.3.71±0.21 at reperfusion,both P ＜ 0.05).Conclusion Ghrelin might protect hippocampal neuron after I/R iniury,and neuron excitability decrease might be related.

BACKGROUND:Articular cartilage injury is often complicated by subchondral bone damage to form osteochondral defects, and its treatment remains a pressing problem in orthopedics. Osteochondral composite grafts fabricated by tissue engineering technology provide a new way to repair osteochondral defects. OBJECTIVE:To explore the feasibility of fabricating osteochondral composite grafts in an independently designed double-chamber stirring bioreactor. METHODS: Goat bone marrow mesenchymal stem cels were seeded into β-tricalcium phosphate scaffolds. The cel/scaffold constructs were subjected to chondrogenic and osteogenic induction simultaneously in the double-chamber stirring bioreactor. According to the applied shear stress, they were divided into dynamic and static culture groups. The proliferation of bone marrow mesenchymal stem cels was detected by MTT test and scanning electron microscope examination. Osteogenesis and chondrogenesis related genes were detected by RT-PCR for the evaluation of chondrogenic and osteogenic differentiation. RESULTS AND CONCLUSION:The bone marrow mesenchymal stem cels in both dynamic and static culturegroups demonstrated satisfactory proliferation and differentiation. Better proliferation and differentiation ability were found in the dynamic culture group. Fabrication of osteochondral composite grafts in the independently.designed double-chamber stirring bioreactor is feasible, which is better under the mechanical stimulus environment than the static environment.

Objective To study the clinical characteristics of tuberculosis in oral and maxillofacial region,and to provide reference in early diagnosis and early treatment. Methods The clinical data of 132 patients were analyzed retrospectively. ResultsIn all cases, male to female ratio of 1∶1.69, the average age of 38.7 years, the group of 15 ～40year-old had higher incidence. Al1 parts of oral and maxillofacial region could be involved. In all 132 cases,107 cases were treated by surgery and drugs,25 cases by drugs only. Conclusion The local sign of tuberculosis in oral and maxillofacial region was atypical ,so it was likely to misdiagnosis. Definitive diagnosis relied on pathological examination. Operations played an important role in the cases of unifocal lymph nodes tuberculosis,oral mucosal tuberculosis, multifocal concentrated lymph nodes tuberculosis and salivary tuberculosis, while the therapy of multifocal sporadic lymph nodes tuberculosis and osseous tuberculosis should be relied on the medicine.

ObjectiveTo evaluate the efffects dexamethasone (DEX) administration at different times on intestinal ischemia-reperfusion(I/R) injury and inducible nitric oxide synthase(iNOS) activity in mice.Methods Tirty-five healthy male Kunming mice weighing 20-24 g were randomly divided into 5 groups( n =7 each): Sham operation group (group Ⅰ ); intestinal I/R group (group Ⅱ ); DEX administration before ischemia group (group Ⅲ ); DEX administration during ischemia group ( group Ⅳ) and DEX administration at the begining of reperfusion group (group Ⅴ ).Intestinal I/R injury was induced by clamping the superior mesenteric artery for 30 min.Normal saline10 mg/kg,DEX 10 mg/kg was injected iv at 30 min before ischemia in groups Ⅱ and Ⅲ respectively.DEX 10 mg/kg was injected iv at 5 min of ischemia in groupⅣ and immediately at the begining of reperfusion in group Ⅴ.The mice were sacrificed at 3 h of reperfusion,and then the small intestinal tissues were taken for determination of intestinal pathological score( Chiu score),iNOS activity and nitric oxide (NO) content.ResultsChiu score was significantly higher in groups Ⅱ - Ⅴ,and iNOS activity and NO content were sinificantly higher in groups Ⅱ,Ⅳ and Ⅴ than in group Ⅰ ( P ＜ 0.05).Chiu score,iNOS activity and NO content were sinificantly lower in group Ⅲ,and were higher in group Ⅴ than in group Ⅱ ( P ＜ 0.05).There was no significant difference in the indexes mentioned above between groups Ⅱ and Ⅳ ( P ＞ 0.05).ConclusionDEX administration before ischemia can reduce intestinal I/R injury by inhibiting iNOS activity; DEX administration during ischemia has no effcet on intestinal I/R injury and iNOS activity; DEX administration at the begining of reperfusion aggravates intestinal I/R injury by enhancing iNOS activity.

Objective To investigate the effect of hydrogen-rich saline postconditioning on the expression of vascular endothelial growth factor receptor-1 (VEGFR1) during myocardial ischemiareperfusion (I/R) injury in rats.Methods Thirty-six adult male Sprague-Dawley rats,weighing 250-280 g,were randomly divided into 3 groups (n=12 each) using a random number table:sham operation group (group S),group I/R and hydrogen-rich saline group (group H2).Myocardial I/R was induced by 30 min ligation of anterior descending branch of the left coronary artery followed by 2 h reperfusion.In group H2,hydrogen-rich saline 5 ml/kg was injected intravenously at 5 min before reperfusion,while the equal volume of normal saline was given in group I/R.Left ventricular systolic pressure (LVSP),left ventricular enddiastolic pressure (LVEDP) and ± dp/dtmax were measured and recorded during reperfusion and at 120 min of reperfusion.The rats were sacrificed at 120 min of reperfusion,and myocardial specimens were obtained for determination of myocardial infarct size,contents of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) (using ELISA),and expression of VEGFR1 (by Western blot).At 120 min of reperfusion,blood samples were collected from the common carotid artery to measure cardiac troponin I (cTnI) concentrations in serum.Results Compared with group S,LVSP and ± dp/dtmax were significantly decreased,LVEDP was increased,the myocardial infarct size was enlarged,cTnI concentrations in serum and contents of IL-6 and TNF-α were increased,and the expression of VEGFR1 was down-regulated at 120 min of reperfusion in H2 and I/R groups.Compared with group I/R,LVSP and ± dp/dtmax were significantly increased,LVEDP and myocardial infarct size were decreased,cTnI concentrations in serum and contents of IL-6 and TNF-α were decreased,and the expression of VEGFR1 was up-regulated at 120 min of reperfusion in group H2.Conclusion Hydrogen-rich saline postconditioning can reduce myocardial I/R injury possibly by upregulating myocardial VEGFR1 expression and inhibiting inflammatory responses in the myocardium of rats.

OBJECTIVETo construct a three-dimensional finite element model of the upper airway and adjacent structure of an obstructive sleep apnea hypopnea syndrome (OSAHS) patient for biomechanical analysis. And to study the influence of glossopharyngeum of an OSAHS patient with three-dimensional finite element model during titrated mandible advancement.

METHODSDICOM format image information of an OSAHS patient's upper airway was obtained by thin-section CT scanning and digital image processing were utilized to construct a three-dimensional finite element model by Mimics 10.0, Imageware 10.0 and Ansys software. The changes and the law of glossopharyngeum were observed by biomechanics and morphology after loading with titrated mandible advancement.

RESULTSA three-dimensional finite element model of the adjacent upper airway structure of OSAHS was established successfully. After loading, the transverse diameter of epiglottis tip of glossopharyngeum increased significantly, although the sagittal diameter decreased correspondingly. The principal stress was mainly distributed in anterior wall of the upper airway. The location of principal stress concentration did not change significantly with the increasing of distance. The stress of glossopharyngeum increased during titrated mandible advancement.

CONCLUSIONA more precise three-dimensional finite model of upper airway and adjacent structure of an OSAHS patient is established and improved efficiency by Mimics, Imageware and Ansys software. The glossopharyngeum of finite element model of OSAHS is analyzed by titrated mandible advancement and can effectively show the relationship between mandible advancement and the glossopharyngeum.

OBJECTIVE: To study the influence factors on latent values of blink reflex (BR) in normal volunteer. METHOD: BRs of 60 normal volunteers were detected bilaterally with Medtronic Keypoint EMG. RESULT: The normal values of BRs latencies in our research was R1 (10.27 +/- 0.91) ms, R2 (28.79 +/- 4.08) ms and R2' (29.06 +/- 4.35) ms, respectively. There was no statistical difference between left ear and right ear, as far as the latencies of R1, R2 and R2'were concerned respectively (P > 0.05). The latency of R1 in male was more prolonged than female (P < 0.05), as well as the R2 and R2 in male prolonged significantly (P < 0.01). Furthermore, the latency of R1 has a positive relation with age (P < 0.05) in male group, while the latencies of R2 and R2 have no relation with age (P > 0.05). Latencies of BR in female have no relation with age (P > 0.05). CONCLUSION To some extent, age and gender have some influence on the latencies of BR. It is important to establish normal values about BR in different age or gender of people.
Adolescent ; Adult ; Blinking ; Child ; Female ; Humans ; Male ; Middle Aged ; Reference Values ; Young Adult

Objective:To systematically review the barriers encountered by nursing staff in the implementation of early activities in adult ICU units.Methods:A systematic search was conducted on CNKI, Wanfang Database, VIP Database, China Biomedical Database, PumMed, Web of Science, Cochrane Library and EMBASE for the research on the obstacles of early activity nursing implementation in adult ICU from the establishment of the database to July 2020, and the final integrated analysis of the included literature was carried out.Results:A total of 26 articles were included, and 59 obstacles in 5 categories were integrated, including 6 kinds of technical level, 13 kinds of organizational culture level, 7 kinds of personnel level, 4 kinds of structural level, and 29 kinds of 6 sub categories of patients level. The most frequent obstacles were unstable condition of patients, sedation or continuous deep sedation, low staffing level, disturbance of consciousness of patients, insufficient equipment related to early activities, and low willingness or compliance of patients to participate.Conclusion:The nursing staff are facing with many obstacles in guiding and assisting ICU adult patients to carry out early activities. It is necessary to formulate modified policies aiming at changeable factors in order to promote the application of early activities in adult ICU units.