The apprentice system is the principal succession method of ancient Chinese medicine. Masters pass down knowledge via verbal instructions as well as personal deeds, and apprentices are unconsciously influenced deeply within by what they see and hear from masters. That is where the strong point of the system. However, at the same time, apprentices are confined by their master’s instructions and learn only a part of the knowledge. It is the profound meaning rather than the form, that truly represents the modern value of the system. Traditional Chinese medicine stresses the cultivation of medical ethics, purification of learning motivation, study of classic works, solid foundation of basic skills and clinical practice. It also advocates that apprentices should be led and taught in accordance to his aptitude.

Objective:This article has summarized the second generation cognitive screening exam(NCSE) about it's subtests,methods of use,applicability,characteristics and flaws.

Child ; Electroacupuncture ; adverse effects ; instrumentation ; Electrolysis ; Equipment Failure ; Equipment and Supplies ; adverse effects ; Humans ; Male

Coccidioides ; Coccidioidomycosis ; pathology ; Humans ; Infant ; Male

Objective To observe the protective effect of Erigeron Breviscapus(Vant.)Hand-Mazz(EBHM) on retinal ganglion cells(RGCs) and optic nerve in rabbits with elevated intraocular pressure(IOP). Methods Twenty rabbits with chronic elevated IOP were divided into two groups randomly: EBHM treated group(the ocular hypertension with EBHM treated subgroup and the normal IOP with EBHM treated subgroup) and untreated group(the simple ocular hypertension subgroup and the simple normal IOP subgroup). EBHM was irrigated into the stomachs to the treated group after IOP elevated continuously for 7 d.For light and electron microscopy studies,the rabbits' eyes were made into eyeball samples and optic nerve samples after 60 d.The density of RGCs,thickness of retinal nerve fiber layer(RNFL),and optic nerve axons were observed and quantitated by computer image analysis system.The ultra-microstructure changes of RGCs and optic nerve axons were observed by electron microscope.Results(①The RNFL) thickness,RGCs density and number of axons of the two ocular hypertension subgroups were decreased,compared with those of the two normal IOP subgroups(P

OBJECTIVE: To investigate the feasibility and results of laryngeal functional preservation surgery for piriform sinus carcinoma with paraglottic space involvement. METHOD: Fourteen cases of piriform sinus carcinoma with paraglottic space involvement were reviewed. Laryngoplasty was performed after tumor was resected, bilater al selective neck dissections were performed at the same stage. Postoperative chemoradiotherapy was applied to 11 patients while the other 3 patients did not receive chemotherapy nor radiotherapy. The follow-up time ranged from 6 months to 5 years, and the mean follow-up time was three and a half years. RESULT: Twelve cases healed primarily while 2 cases experienced delayed heal because of pharyngeal fistula. Postoperative swallow bucking occurred in all patients, the longest gastric feeding time was 2 months. For the patients underwent postoperative chemoradiotherapy, the tumor did not recur in ten cases during the 3 years follow-up, while recurred in another case and the patient died without further treatment. Among those 3 cases without postoperative radiotherapy or chemotherapy, the tumor recurred in 2 cases during the following 6 months and chemoradiotherapy was applied, no recurrence presented in one patient, another one lost of follow-up. For the patient with recurred tumor 8 months after surgery, total laryngectomy was employed with postoperative chemoradiotherapy, the case died of tumor recurrence one and half year after the first surgery. The 3-year survival rate was 78.6%. For the vocal cord at lesion side, the mobility was noticeable in 6 patients, and visible anatomic landmark was lost in the other 8 patients. CONCLUSION Laryngeal function preservated surgery could be performed in selected cases of piriform sinus carcinoma with para-glottic space involvement in order to achieve better clinical results and quality of life.
Aged ; Carcinoma ; surgery ; Female ; Follow-Up Studies ; Glottis ; Humans ; Hypopharyngeal Neoplasms ; surgery ; Larynx ; physiology ; Male ; Middle Aged ; Organ Sparing Treatments ; Pyriform Sinus ; pathology ; Retrospective Studies ; Treatment Outcome

In order to assess the effect of long-term versus short-term intravesical chemotherapy in preventing the recurrence of patients with non-muscle-invasive bladder cancer, we searched several databases with words as mesh terms and free text words to find all eligible randomized clinical trials (RCTs) for the comparison of the two strategies of instillation durations. "Observed-Expected events research (O-E)" and "Variance (V)" for calculating hazard ratio (HR) were used in Revman 5.2 software recommended by Cochrane Collabration for data analysis. Sensitivity and subgroup analysis were selected to minish heterogeneity. GRADEpro 3.6 profile recommended by Cochrane Collabration was employed for quality assessment of analyses. Finally, 13 eligible RCTs with 4216 patients were included in this review and 16 comparisons from 13 trials were involved for analysis. The pooled analysis revealed no significant difference between long-term and short-term duration [HR=0.99, 95% CI (0.89, 1.11), P=0.89]. Within the subgroup analysis, patients benefited from long-term instillations with a start regimen of one immediate instillation [HR=0.83, 95% CI (0.69, 1.00), P=0.05]. But patients were not suitable to receive long-term instillations with epirubicin (EPI) [HR=1.01, 95% CI (0.91, 1.13), P=0.78]. The progression rate was not reduced after long-term instillations [HR=0.96, 95% CI (0.66, 1.39), P=0.82]. From our results, patients should not receive introvesical chemotherapy more than half a year. In contrast, patients with one immediate instillation are preferred to have a long-term duration at least one year. Long-term instillations can not reduce the progression rate.

Objective To observe the sensitivity of stroke volume variation (SVV) for assessing volume change during induction period of general anesthesia.
Methods Patients who underwent orthopaedic surgery under general anesthesia and mechanical ventilation were divided into two groups randomly. Patients in the groupⅠwere subjected to progressive central hypovolemia and correction of hypovolemia sequentially;patients in the Group Ⅱ were exposed to hypervolemia alone. Each step was implemented after 5 minutes when the hemodynamics was stable. SVV and cardiac index (CI) were recorded, and Pearson’s product-moment correlation was used to analyze correlation between SVV and CI.
Results Forty patients were included in this study, 20 cases in each group. For group Ⅰpatients, SVV was increased significantly along with blood volume reduction, and changes in CI were negatively correlated with changes in SVV (r=-0.605, P<0.01);SVV decreased significantly along with correction of blood volume;changes in CI were negatively correlated with changes in SVV (r=-0.651, P<0.01). For groupⅡpatients, along with blood volume increase, SVV did not change significantly;changes in CI revealed no significant correlation with changes in SVV (r=0.067, P>0.05).
Conclusion SVV is a useful indicator for hypovolemia, but not for hypervolemia.

Carotid Body Tumor ; complications ; Female ; Glomus Jugulare Tumor ; complications ; Humans ; Middle Aged ; Paraganglioma ; complications

The chemical consitituents from cytotoxic fraction of the Callicarpa nudiflora extract were isolated and purified by a combination of HP-20 macroporous resin, silica gel and Sephadex LH-20 column chromatographies. The structures were elucidated on the basis of the spectroscopic data and comparison of their spectroscopic data with reported data. The cytotoxicity was evaluated by the MTT assay. The 50% and 70% EtOH elutions of EtOH-extract showed significant cytotoxic activities, leading to the isolation of twelve compounds, which were identified as luteoloside(1), lutedin-4'-O-β-D-glucoside(2), 6-hydroxyluteolin-7-O-β-glucoside(3), lutedin-7-O-neohesperidoside(4), rhoifolin (5), luteolin-7, 4'-di-O-glucoside (6), forsythoside B (7), acteoside (8), alyssonoside (9), catalpol(10), nudifloside(11), and leonuride(12). Compounds 3-6, 10 and 12 were isolated from this genus for the first time, and compound 9 was isolated from this plant for the first time. The cytotoxicity assay demonstrated that flavonoids 1-6, in various concentrations, showed monolithic proliferation inhibitory activities against Hela, A549 and MCF-7 cell lines. Compounds 3, 5 and iridoid glycoside 11 possessed higher cytotoxicacivities. In short, flavonoids are the main components of cytotoxic extract from C. nudiflora, while phenylethanoid glycosides are the predominant ingredient but inactive to cancer cell lines. In addition, the minor iridoid glycoside expressed weak cytotoxic activity.
Callicarpa ; chemistry ; Cell Proliferation ; drug effects ; Cytotoxins ; chemistry ; isolation & purification ; pharmacology ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; pharmacology ; Humans ; MCF-7 Cells ; Molecular Structure