Objective To optimize the formative technology for Zhuqi Fugan Granules. Methods By using orthogonal experiment design, and setting parameters of granules as determination standards, concrete density, excipient types and dosage, and consentration of wetting agent were optimized to determine the optimal conditions. Results The optimal forming technology was as follows:The optimal ratio of starch to micrite cellulose was 3∶2;the optimal density of extration was 1.20;the ratio of concrete to excipient was 1∶1;the optimal concentration of wetting agent was 80% of ethyl alcohol. Zhuqi Fugan Granule enjoyed good mobility and with a critical relative humidity of 67%. Conclusion Parameters of Zhuqi Fugan Granules prepared by this method are satisfying, with stable properties and low moisture absorbtion. This preparation technology is simple and feasible.

Objective To investigate the effect of vasoactive intestinal peptide (VIP) and methylprednisolone (MP) on Toll-like receptor (TLR)2/4 mRNA expression in endotoxin (lipopolysaccharide,LPS) induced shock.Methods Ninety Sprague-Dawley rats were randomly divided into LPS group (n =20),LPS + VIP group (n =20),LPS + MP group (n =20),LPS + VIP + MP group (n =20) and control group (n =10).LPS group injected intravenously LPS (E Coli O55B5) 10 mg/kg.LPS + VIP group,LPS + MP group and LPS + VIP + MP group were injected intravenously VIP 5 nmol/kg,MP 3 mg/kg and VIP 5 nmoL/kg + MP 3 mg/kg after LPS 10 mg/kg injection.The control group injected normal saline intravenously instead of LPS.The rats were sacrificed at 6 h and 24 h after injection and the intestine samples were collected.Pathological changes of the intestine were observed by microscopy.RT-PCR was used to detect the intestinal TLR2 mRNA and TLR4 mRNA expressions.Results Intestinal mucosa showed edema or necrotic change with structure of the microvilli disappeared after LPS injection.The inestinal lesions in VIP,MP and VIP + MP groups were milder than LPS group.At 6 h after LPS injection,TLR2 mRNA and TLR4 mRNA expressions were significantly up-regulated in LPS group,LPS + VIP group,LPS + MP group and LPS + VIP + MP group (TLR2 mRNA:1.14 ±0.38,1.17 ±0.42,1.16 ±0.41,0.92 ± 0.29;TLR4 mRNA 1.21 ±0.18,1.04 ± 0.38,1.11 ± 0.34,1.01 ± 0.20) compared with the control group (0.32 ± 0.20,0.24 ± 0.17) (P ＜ 0.01).But there was no significant difference between LPS group,LPS + VIP group,LPS + MP group and LPS + VIP + MP group (P ＞ 0.05).At 24 h after LPS injection,TLR2 mRNA and TLR4 mRNA expressions in LPS + VIP group,LPS + MP group and LPS + VIP + MP group (TLR2 mRNA:0.63 ± 0.12,0.59 ± 0.13,0.52 ±0.19;TLR4 mRNA 0.67 ±0.09,0.64 ±0.09,0.51 ±0.13) were significantly lower than LPS group (1.04 ± 0.38,0.82 ±0.18) (P ＜0.01) (P ＜0.05).Conclusion VIP and/or MP can mitigate intestinal injury induced by LPS shock.The gastrointestinal protection of VIP and glucocorticoids were related to downregulation signaling TLR2 mRNA and TLR4 mRNA expression.But VIP/MP and VIP + MP have no significant effect on expression of intestinal TLR2/4 mRNA until 24 h after LPS shock.

Objective To study the association of peptidylarginine deiminase 4 (PADI4) (padi4_94 and padi4_104) genetic single nucleotide polymorphism (SNP) and rheumatoid arthritis (RA) susceptibility in Han population of Hebei province. Methods This hospital-based case-control study included 115 RA patients and 106 healthy controls. All the individuals were recruited from Han Hebei residents and were randomly selected. The genotype and allele frequencies of PADI4 gene polymorphisms (padi4_94 and padi4_104) were analyzed by PCR-DNA sequencing method. Results The distribution of padi4_94 and padi4_104 genotypes between the two groups was not significantly deviated from that expected by Hardy-Weinberg equilibrium (P>0.05). The combined effect of padi4_94 and padi4_104 SNPs was analyzed and three haplotypos (AA, AG and GG) were found but without GA haplotype. The genotype and allele distribution of padi4_94 and padi4_104 in the patients with RA was not significantly different from that in healthy controls,and the analysis of haplotypes revealed that no haplotypes were risk factors for RA. Conclusion In Han population of Hebei province, the SNPs of PADI4 (padi4_94 or/and padi4_104) is no associated with RA susceptibility. Therefore, it should not be regarded as a genetic risk factor for RA.

Objective To prospectively evaluate the value of diffusion-weighted imaging with background signal suppression (DWIBS) in the detection and diagnoses of metastatic cervical lymph nodes. Methods Twenty patients with head and neck squamous cell carcinomas underwent conventional MRI and DWIBS. The ADC values were measured and compared between metastatic and benign lymph nodes. The abilities of DWIBS and conventional MRI in the evaluation of metastatic cervical lymph nodes were compared. Results Conventional MRI demonstrated 101 lymph nodes, in which 58 were diagnosed as metastatic nodes. When MRI criteria were used for discrimination between metastatic and benign nodes, the obtained sensitivity, specificity, accuracy, positive and negative predictive value were 78% (47/60), 81%(44/54), 80% (91/114), 82% (47/57) and 77% (44/57), respectively. The mean ADC values of metastatic nodes (n =60) and benign nodes (n =54) were (0.945 ±0.122) × 10-3 mm2/s and (1. 210 ±0. 151 ) × 10-3 mm2/s ( t = - 10. 354 ,P ＜0. 01 ). When an ADC value of 1. 090 × 10 -3 mm2/s was used as the threshold for discrimination between metastatic and benign nodes, the obtained sensitivity, specificity,accuracy, positive and negative predictive value were 88% (53/60), 80% (43/54), 84% (96/114), 83%(53/64) and 86% (43/50), respectively. Conclusion DWIBS is helpful in diagnosing metastatic cervical lymph nodes of head and neck squamous cell carcinoma, and is superior to conventional MRI in their detection.

Objective To evaluate the movement function of the left ventricular short-axis with parameters (velocity, acceleration and relatively force) measured with improved anatomical M-mode ultrasound. Methods Sixteen patients with myocardial ischemia coronary heart disease who had taken percutaneous transluminal coronary intervention (PCI) were enrolled. All patients were divided into two groups: group A, single major vascular stenosis (n=8);group B, more major vascular stenosis (n=8). M-mode curves of short-axis sections at mitral valve level, papillary level and apical level were recorded, then the peak myocardial velocities, acceleration and force of the systolic phase, early-diastole phase and end-diastole phase were measured at the post processing station. Results The variety ranges of average velocity and acceleration of the three levels during systolic phase were higher than that during diastole phase. The changing rate of velocity and acceleration in group B was higher than that in group A. Conclusion The new parameters that are measured and calculated with anatomical M-mode ultrasound can reflect the movement functions of coronary heart disease patients taken PCI.

TCM service trades are an inevitable choice for TCM development, and also one of the most important levels in the national development strategy pattern. For the Belt and Road, it is necessary to promote the rapid development of TCM service trades, not only for promoting transformation cross domain development of TCM industry in Gansu, but also for promoting Gansu economic and social development. Based on the analysis of the significance and opportunities of the TCM service trades, this article proposed the specific strategies for promoting the development of TCM service trades in Gansu Province.

Objective To investigate the change of the content of polysaccharides in crude and processed Fructus Corni,thus to approach the process mechanism of Fructus Corni.Methods The content of polysaccharides in the crude and processed Fructus Corni was determined by phenol-sulfuric acid method.Results After processing with wine,the content of polysaccharides of Fructus Corni decreased from 10.12 %(content of total polysaccharidesbeing 51.41 %) to 5.91 %(content of total polysaccharidesbeing 53.10 %),decreased by 41.60 %as compared with that in the crude Fructus Corni.Conclusion After processing with wine,the content of polysaccharides decreases markedly.The results provide certain evidence for approaching the process mechanism of Fructus Corni.

The use of flaps for plastic and reconstructive surgery is very popular today.More and more surgeons have realized that the blood supply plays an important role in the design and survival of flaps.After Ian McGregor and Ian Jackson first introduced the axial flaps into clinics,Mathes divided the flaps into two types in 1981,the fasciocutaneous perforator flaps and musculocutaneous perforator flaps.In 1989,the concept of perforator flap was first brought into clinical practice.With the development of microsurgery and anatomy,the epidermis of human skin is divided into areas based on the vascular anatomy.A new century of musculocutaneous perforator flaps has been established.The terminology,classification,characteristics and application of musculocutaneous perforator flaps are described in this paper.

ObjectiveTo summarize experiences of diagnose and disposal of acute abdomen of patients with spinal cord injury (SCI) in order to raise the successful rate.MethodsThe data of 10 acute abdomen patients with SCI were analyzed retrospectively.ResultsAmong 10 cases, 9 cases were cured, 1 case died.ConclusionDiagnosing and managing acute abdomen of patients with SCI in time can get satisfied outcome.

Objective To explore the prognostic factors of intensive care unit (ICU) patients. Methods A retrospective cohort study was conducted. The clinical data of patients admitted to ICU of Beijing Geriatric Hospital from January 2005 to December 2016 were collected. According to the prognosis, the patients were divided into death group and survival group, and the mortality trend with time and age was observed. Survival and death were treated as dependent variables, while the gender, age, reason of ICU admission, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score, whether undergoing invasive mechanical ventilation (MV), invasive MV reason, duration of invasive MV, whether successful weaning, whether ICU nosocomial infection, hospital acquired pneumonia (HAP), central line-associated bloodstream infection (CLABSI), acute kidney injury (AKI) occurred, whether undergoing continuous blood purification (CBP), whether septic shock occurred, whether undergoing invasive hemodynamic monitoring or blood transfusion and length of ICU stay were used as the independent variables. First, the clinical data was analyzed by univariate analysis. Second, the independent variables influencing the dependent variable were analyzed by logistic regression analysis to screen out prognostic factors of ICU patients. Results During the study period, 1325 patients were treated, 26 patients with missing data, 1299 patients in final group, 865 patients in survival group, and 434 in death group. The proportion of men in the patients was larger (67.7%), and the age span was larger (16-105 years old). The mortality rate in different years showed no significant difference (χ2 = 16.712, P = 0.117), and with the increase of age, the mortality rate of ICU showed an upward trend (χ2 = 16.399, P = 0.022). The univariate analysis showed that ICU deaths were unrelated to gender, but associated with age, APACHE Ⅱ score, invasive MV, invasive MV reason, duration of invasive MV, successful weaning, ICU nosocomial infection, HAP, CLABSI, AKI, septic shock, whether CBP or invasive hemodynamic monitoring, blood transfusion, the reason of ICU admission and the length of ICU stay (all P < 0.05). The relevant factors with statistical difference found in univariate analysis were analyzed in logistic regression analysis, which showed that whether successful weaning [odds ratio (OR) = 0.016, 95% confidence interval (95%CI) = 0.010-0.025], and whether AKI (OR = 3.917, 95%CI = 2.331-6.582) or septic shock occurred (OR = 2.808, 95%CI = 1.604-4.915) were the dependent variables of death or survival (all P = 0.000). Regression coefficient (β value) of successful weaning was -4.155, suggesting that unsuccessful weaning patients were likely to die. The β value of AKI and septic shock was 1.365 and 1.033, suggesting that the patients with AKI or septic shock were more likely to die. Conclusions Whether the success of weaning, whether the occurrence of AKI or septic shock are independent prognostic factors for the prognosis of ICU patients. Measures for the prevention of the above three aspects could improve the prognosis of ICU patients.