AIM: The differentiation theory on kidney turbidity is used to recognize the relevant characters of Alzheimer disease. METHODS: The analysis is carried on the interrelationship between kidney turbidity and Alzheimer disease in the aspects of pathology, pathogenesis and clinical manifestations. RESULTS: It was discovered in modern neural pathological examination that in the patients with Alzheimer disease, the cerebral cortex was atrophic, the convolution becomes flat, the cerebral groove was widened, the ventricle was extended, brain weight was declined and cortical nerve cells were de creased in various degrees. All of those changes were the manifestations of kidney essence deficiency in Chinese medicine. The main mechanism on neuron loss caused by Alzheimer disease was that oxygenic free radical works on nerve neurons and induces the increased Ca2+ inner-flow. Con cerning to the theory of Chinese medicine, oxygenic free radical was taken as "kidney turbidity". In the patients with Alzheimer disease, insufficient kid ney essence resulted in malnourishment of heart. In addition, upward dis turbance of kidney turbidity and abnormality of heart mind projected the brain and affected brain function, resulting in recent memory disturbance that was the initial symptom of Alzheimer disease. CONCLUSION: Concerning to the treatment of Alzheimer disease, Chinese medicine emphasizes not only on reinforcing kidney and filling-up essence, but also rather on eliminating kidney turbidity, for which, the method of re solving turbidity and damp is applied specially.

Objective To explore the clinical effect of budesonide inhalation combined with psychological intervention in the treatment of chronic obstructive pulmonary disease (COPD).MethodsSelected in Zhuji city center hospital from July 2012 to April 2017 year to receive treatment in patients with chronic obstructive pulmonary disease in 80 cases as the research object, after the patient related clinical data, all patients were randomly divided into treatment group and control group two groups, each group of 40 cases of patients in the study group of patients with a doctor inhaled budesonide combined with psychological intervention treatment, inhalation therapy on the comparison group of patients treated with budesonide, observe the changes of two groups, serum blood gas index change and remodeling index sputum viscous indicators clinical statistics.ResultsAfter treatment the corresponding treatment after the intervention, the study group of serum basic fibroblast growth factor Xian (b-FGF), nerve growth factor (NGF) and tissue inhibitor of metalloproteinase-1 (TIMP-1), sputum interleukin-8, tumor necrosis factor alpha and PaO2, PaCO2 and other aspects of the statistical index is obviously better than the contrast group;the study group of patients treatment effect is much higher than that of contrast group patients.ConclusionBudesonide inhalation combined with psychological intervention in the treatment of chronic obstructive pulmonary disease is more effective than conventional treatment, which is worthy of popularization and application in clinical medicine.

[Objective]To contrast the influence of using the electro-needling machine on the Zusanli(ST36) or Shangjuxu(ST37) ,or on the two points both to treat the postoperative distension of the abdomen.And simultaneously to obverse whether using the two points together has the coordination effect or antagonistic effect.[Method] Adopting the stochastic grouping contrastive technique,dividing the 100 patients into the Zusanli group,the Shangjuxu group,the cooperative group and the blank group. To contrastively observe each situation,including the abdominal rumbles sound,the abdominal pain,the transformation of the incidental symptoms and the first time of exhaust,before and after the acupuncture treatment in each group.[Result]The treatment group has the therapeutic effect,with the blank group comparison,having the significant difference(P0.05)with each other.There's no obvious coordination effect or antagonistic effect during the treatment in the cooperative group. [Conclusion] Using the electro-acupunture on Zusanli,Shangjuxu can play an important part in improving the recuperation of the gastrointestinal function after surgical treatment. It also can obviously relieve uncomfortable postoperative symptoms.

This paper discussed the methods of developing clinical thinking ability and the key emphasis on the related main medical and teaching activity.

Standardized patients for interview has been widely used in medical education and examinations.Nevertheless the standard training of SP is still not widely used in China up to the present.Referring to the character of SP working as "the people providing case history","the assessor" and"the teacher",we have described how to write scenarioes,establish the score criteria,institute the training steps,form the measures of examination and supervision in detail in this article,and resummarized the experiences we got during the training period.

OBJECTIVE:To study the inhibitory effects of berberine on EA.hy926 human umbilical vein endothelial cells (EA. hy926 cells) injury induced by particulates with no more than 2.5 μm air aerodynamic diameter in atmospheric (PM2.5),and its p38 mitogen-activated protein kinase(MAPK)signal pathway mechanism. METHODS:PM2.5 samples were collected and hatched EA.hy926 cells with concentrations of 0(blank control),20,200 and 400 mg/L for 24 h. The survival rate and apoptosis rate of cells,contents of IL-6,TNF-α and MDA,activities of SOD and LDH,protein levels of p-p38 MAPK,Bcl-2 and Bcl-2 associated X protein (Bax) were detected. The above indexes of EA.hy926 cells in blank control group,PM2.5 group (200 mg/L PM2.5), p38 MAPK pathway-specific blocker SB203580 group (20 μmol/L SB203580+200 mg/L PM2.5),berberine low-,medium- and high-concentrations groups(5,10,20 μmol/L berberine+200 mg/L PM2.5)were also determined. RESULTS:Compared with blank control,survival rate of cells,SOD activity and Bcl protein decreased after 200,400 mg/L PM2.5 hatched;apoptosis rate of cells, contents of IL-6,TNF-α and MDA,LDH activity,protein levels of p-p38 MAPK and Bax increased (P<0.05),in concentra-tion-dependent manner. Compared with PM2.5 group,survival rate of cells,SOD activity and Bcl-2 protein increased in berberine medium-,high-concentrations groups and SB203580 group;apoptosis rate of cells,contents of IL-6,TNF-α and MDA,LDH ac-tivity,protein levels of p-p38 MAPK and Bax decreased (P<0.05). CONCLUSIONS:Berberine attenuates PM2.5-induced EA. hy926 cells injury via the inhibition of p38 MAPK pathway.

Objective To investigate risk factors for neonatal clavicular fracture,to provide a reference for clinical treatment.Methods A retrospective analysis was performed towards 3 025 live births,47 cases had neonatal clavicular fracture.The birth weight,mode of delivery,maternal age,parity,gestational age,clavicle second stage of labor,the fundus height plus abdominal circumference,cord around neck,and other fracture potential risk factors were analyzed through univariate and multivariate analysis,and the risk factors were summarized.Results 3 025 cases of live births,of which 47 cases had neonatal clavicular fracture,clavicle fracture rate was 1.55%;univariate results sug-gested that the mode of delivery,birth weight,the second stage of labor,maternal age,gestational age,nuchal cord,ma-ternal weight's clinical data index had statistically significant differences between the fracture group and non -fracture group (χ2 =37.514,34.997,28.647,19.847,18.847,16.694,all P <0.05 );multivariate analysis showed that mode of delivery,birth weight,the second stage of labor,gestational age,nuchal cord,maternal body mass index were a newborn children collarbone fracture independent risk factors.Conclusion Mode of delivery,birth weight,the second stage of labor,gestational age,nuchal cord,maternal body mass index are independent risk factors for neonatal clavicu-lar fracture,obstetric should continue to improve midwifery skills,to develop prevention strategies to reduce the inci-dence of neonatal clavicular fracture.

Objective To investigate the etiology of papular urticaria: is it caused only by arthropod-like insects-bite allergy, or by multiple factors such as food allergy, disturbance of gastrointestinal function and infection? Methods We searched, by computer and manually, the foreign and domestic literature related to the etiology of papular urticaria published since 1950s, and according to the methods of evidence-based medicine, systematically evaluated the evidence supporting either the insect-bite theory or the multiple factor theory. Results Twenty-nine articles ( 22 English and 7 Chinese ) supported the theory of hypersensitivity to bites from certain insects such as mosquitoes, gnats, fleas, mites, bedbugs etc. Two articles in Chinese mentioned the possibilities other than insect-bite, but the reliability was unconvincing, because the authors did not present the source of data or statistical methods used in the articles. The evidence from epidemiology, histopathology, laboratory and clinical researches all supported the insects-bite theory. No proven evidence was found supporting other aetiological hypotheses. Conclusion Our results suggest that papular urticaria is caused only by the allergy to stings or bites of arthropods, and other hypotheses still lack convincing evidence.

Objective: To study the adjustment amplitude of blood pressure in patients with hypertensive intracerebral hemorrhage and the guiding significance in clinical practice in monitoring the changes of cerebral hemodynamics by transcranial Doppler (TCD). Methods: The blood pressures of sixty-four hospitalized patients with intracerebral hemorrhage were monitored dynamically within 10 hours after the onset. Among them, 38 patients had intracranial hematoma puncture and tube drainage within 24 hours of hospitalization (operation group), and 18 patients had conservative treatment (conservative group). Patients were monitored with TCD at the time of hospitalization on day 1, 4, 7, and 14. Another 8 unoperated patients (antihypertensive group) were monitored with TCD before and after antihypertensive treatment, and they were compared with the TCD parameters of 26 simple hypertensive patients (control group) before and after antihypertensive treatment. Results: There was no significant difference in TCD parameters in the control group before and after antihypertensive treatment, however, the blood flow velocity of bilateral middle cerebral arteries (MCA) decreased, and the pulsatility index (PI) increased after antihypertensive treatment in the antihypertensive group. The blood pressure in patients with intracerebral hemorrhage decreased gradually during the treatment, while the blood flow velocity of bilateral MCA decreased first, and then increased. The PI values of bilateral MCA increased first, and then decreased. The blood flow velocity in the conservative group decreased within the first week of the onset. It began to increase at week two and the changes of PI values were contrary to it. The blood flow velocity of MCA increased on day 7 and PI values decreased in the operation group, and there was significant difference between the 2 groups on day 14. The blood pressure decreased more significant in the operation group than that in the conservative group, and there were significant differences in systolic pressure between the 2 groups on day 14 (P

Objective To identify the effect of using modified 99 type China hemp service shoes and socks on preventing servicemen from skin superficial fungal infection during the drill.Methods A double-blinded control study was carried on in 2 months test with 16 testees who wore the modified 99 type China hemp service shoes and socks.Every testee was dispensed 1 pair of shoes and 3 pairs of socks.The left socks were produced in different material and way from the right one in each pair.Clinical examination of feet skin primary lesions and fungal test on each individual testee were done at the beginning of this research,as well as in the middle and the end.Results The clinical symptoms of 16 testees' feet skin were obviously relived during the 2 months test.4 of 16 testees claimed that there were more obviously relieving of feet symptoms on left than right.8 of 16 testees which were positive of fungal test at the beginning of the research claimed that their feet symptoms were lessened,and 2 of the above 8 were turned to negative of fungal test after 8 weeks,however the other 6 were positive yet.And the fungi culture was done on these 6 above testees who were still positive on fungal test.2 cases were Trichophyyon gypseum,while other 4 cases were Trichophyyon rubrum.Conclusion The modified 99 type China hemp service shoes and socks can relieve the clinical symptoms and prevent fungal infection that occurs during the drill.