Based on the study of four diagnostic methods in Treatise on Exogenous Febrile Diseases,this dissertation analysed the cause of differentiation of syndrome unavailable,and indicated that:differentiation of syndrome unavailable resulted from multi-reasons.The patients who had symptoms and signs but all the modern physics and chemistry index were normal,the data get from traditional four diagnostic methods were useful to discriminate and estimate diseases.Modern physics and chemistry index can help in improving exactitude,but we cannot ignore traditional diagnostic methods.

China ; Gastroesophageal Reflux ; therapy ; Humans ; Integrative Medicine ; Medicine, Chinese Traditional ; methods

Objective To explore the risk factors of lower limb deep vein thrombosis (DVT) in patients with traumatic fractures so as to provide references for prevention of DVT. Methods A total of 1 068 patients with traumatic fractures were involved in the study to analyze the incidence of DVT under 43 risk factors including general state, injury type, fracture condition and operation and screen significant factors for multiple factor analysis. Results The total incidence rate of DVT in 1 068 patients was 12.0%. The univariate analysis showed that male patients at age ＞60 years, with BMI≥25 kg/m2, history of smoking, lack of exercises, history of diabetes, hypertension, coronary artery disease and cerebrovascular disease had higher incidence rate of DVT. In different injury types, the fall injury caused the highest incidence rate of DVT (45.6%). There were different DVT rates for different fracture position,with the highest incidence rate of DVT for femur shaft fracture (20.5%). The incidence rate of DVT was 51.7% for fractures of more than three parts, 14.2% for fractures of two parts and only 3.7% for sole part. The incidence rate of DVT for comminuted fractures was higher than the overall rate. The operation duration, massive transfusion during operation and epidural anesthesia were related with the increase of incidence of DVT. Multivariate analysis found nine independent risk factors and showed that the more risk factors were, the higher incidence of DVT was. Conclusions The risk factors of DVT for traumatic fractures include age ＞60 years, BMI≥25 kg/m2, history of smoking, fall injury, more than three parts of fractures, comminuted fractures, operation duration ＞ 2 hours, massive transfusion during operation and epidural anesthesia.

Objective To comparethe effects of four different emergency fixation methods for the open tibiofibular fractures on the treatment and prognosis of the multiple trauma patients. Methods A comparative study was carried out on the effect offour different early fixation methods on the fracture and the multiple trauma in aspects of the short-term indicators including mortality rate,acute respiratory distress syndrome(ARDS),fat embolism syndrome(FES),multiple organ dysfunction syndrome (MODS),ICU stay and the long-term indicators including wound healing time,fracture healing time,rate of joint function recovery and fracture complications in 43 multiple trauma patients. Results The locked intramedullary nail wag better than the other fLxation methods including the calcaneal traction,the gypsum external fixation and the internal fixation with steel plate and extemal fixation support in most indexes(P<0.05,0.01). Conclusion The locked intramedullary nail can significantly decrease the incidence rate of complications and obtain sound fracture healing for the patients with multiple trauma combined with open tibiofibular fractures(types Gnstilo Ⅰ,Ⅱ and Ⅲa).

Objective:To evaluate the expression of vascular endothelial growth factor C(VEGF-C),Epstein-Barr virus(EBV) latent membrane protein 1(LMP1),cyclooxygenase-2 (COX-2) in nasopharyngeal carcinoma(NPC).Method:LMP1, COX-2 and VEGF-C were detects by immunohistochemical staining for 57 case NPC tissue.Result:The positives rates of LMP1,COX-2 and VEGF-C detected by immunohistochemical staining were 49.1%(28/57), 75.4%(43/57)and 59.6%(34/57), respectively. The expression of LMP1, COX-2 and VEGF-C were correlated to each1 other in NPC(P<0.05).Conclusion:LMP1 and COX-2 may induce expression of VEGF-C directly or LMP1 induce expression of VEGF-C by induce COX-2 expression, may contribute to lymph metastasis and develop NPC.

Objective To investigate the clinical value of contrast-enhanced ultrasound (CEUS) in the diagnosis of postoperative complications after pancreas transplantation.Methods Eighty-six post pancreastransplantation patients were examined by CEUS to observe the perfusion of contrast agent,plot timeintensity curve (TIC),and compare to the results of enhanced CT,MRI and pathology.Results Eleven cases of thrombosis,13 cases of rejection and 13 cases of pancreatitis were observed among 86 patients.Result from CEUS showed that:① Distribution of normal pancreatic grafts vascular and parenchyma was even,TIC follows positive skewed distribution.②Thrombosis:there was no perfusion in the embolic vessels and no enhancement or low uneven enhancement in the parenchyma.③ Rejection:perfusion of the parenchyma was slow,peak value was decreased,rising and falling slope of the TIC was reduced with blunt peak.④Pancreatitis:perfusion of the parenchyma was uneven,the regional low enhanced area was visible,clear of the contrast agent was relatively slow,rising slope of TIC was reduced and the peak value was decreased.Conclusions CEUS can monitor the perfusion of the pancreatic grafts vascular and parenchyma,and get useful perfusion parameters.It has been proven as an effective method to definitely diagnose postoperative complications after pancreas transplantation.

Objective To study the changes of clonality of T cell receptor (TCR) and complementarity determinative region 3(CDR3) before and after autologous peripheral blood CD34+ stem cell transplantation(auto-PBSCT) for severe/refractory connective tissue disease(CTD). Methods Thirteen patients with severe/refractory CTD were enrolled for auto-PBSCT in Peking Union Medical College Hospital, including systemic lupus erythematosus (8 cases), rheumatoid arthritis(4 cases), and primary Sjogren’s Syndrome(1 case). Blood samples were collected before/after mobilization, 2 weeks, 1, 3, 6, 12 and 18 months post-transplantation. Diversity of TCRBV and CDR3 were showed by reverse transcription-polymerase chain reaction(RT-PCR) and genescan. Results The TCR BV usage and CDR3 spectral pattern of pre-auto-PBSCT CTD patients were revealed skewed pattern and oligoclonality, Which developed severe oligoclonality within 1 months after auto-PBSCT. However, they showed diversity andpoly-clonality 3～6 months after auto-PBSCT. Conclusion Skewed pattern and oligoclonality of TCRBV and CDR3 which implied auto-reactive were depressed after auto-PBSCT, and inclined to change to normal pattern.

Objective To explore the effects of ultraviolet, magnetic field and drug therapy on chemotherapeutic phlebitis(CP) in rabbits. Methods CP models were established by injecting vinorelbine into ear-edge veins of rabbits, and resulting in red swelling and fever of the skin. Twelve Japanese albino rabbits were randomly divided into four groups: a control group(C group), an ultraviolet therapy group (UT group), a magnetic field therapy group (MF group) and a drug group (D group). Twenty-four rabbit ears were observed by use of naked eyes and pathohistological examination after correspond treatment. Results Compared with those in C group, inflammation symptoms and edema in UT and MF groups were mitigated significantly by using of naked eyes and pathohistological examination (P 0.05) . In addition, the effects of inhibiting fibrous tissue hyperplasia were observed in magnetic field group (P

Objective To investigate the value of combined detection of serum CA125 ,VEGF‐C andβ2‐MG levels on early diag‐nosis of retroperitoneal lymph node metastasis in the patients with ovarian cancer .Methods Fifty‐one patients with ovarian cancer undergoing retroperitoneal lymph node cleaning operation were included as the experimental group ,including 29 cases of positive retroperitoneal lymph node metastasis .Contemporaneous 32 cases of benign ovarian tumor were selected as the control group .The serum CA125 level was detected by using electricity chemiluminescence (electrocheminescence) ,serum VEGF‐C level by using en‐zyme‐linked immunosorbent assay (ELISA) and serumβ2‐MG level by using the latex enhanced immune turbidimetric method .The serum CA125 ,VEGF‐C andβ2‐MG levels were compared among various groups .Results The serum CA125 ,VEGF‐C andβ2‐MG levels in the experimental group were (1 682 .5 ± 261 .5)μg/mL ,(2 125 .6 ± 96 .7)pg/mL and (2 .52 ± 0 .61)mg/L respectively , which in the control group were (30 .5 ± 6 .3)μg/mL ,(1 738 .0 ± 79 .8)pg/mL and (1 .87 ± 0 .56)mg/L respectively ,the difference between them was statistically significant (P< 0 .01) .The serum CA125、VEGF‐C、β2‐MG levels in 29 cases of retroperitoneal lymph node metastasis were more significantly higher ,which were (1 997 .3 ± 376 .8)μg/mL ,(2 895 .2 ± 126 .8)pg/mL and (4 .95 ± 0 .69)mg/L respectively ,and the difference was statistically significant compared with the control group (P<0 .01) .The sensitivity ,specificity and accuracy rate of the combined detection of serum VEGF‐C ,β2‐MG and CA125 for diagnosing ovarian cancer retroperitoneal lymph node metastasis were 95 .8% ,97 .3% and 98 .5% respectively .Conclusion The combined detection of serum VEFG‐C ,β2‐MG and CA125 has an important clinical value in early diagnosing retroperitoneal lymph node metastasis of o‐varian cancer .

Objective To investigate the value of acoustic radiation force impulse (ARFI)and color Doppler flow imaging (CDFI)in the diagnostic of acute rejection (AR)after liver transplantation.Methods B mode ultrasound,CDFI and ARFI exams were performed on fifty-eight patients who was diagnosed with AR through liver biopsy in our hospital.The liver allograft size,mean velocity of portal vein,hepatic vein spectrum waveform and shear-wave velocity were obtained and compared with the results of 30 healthy subjects as control group.Results Compare to control group,the AR group had a significant increase in liver allograft,decrease in mean velocity of portal vein,the elimination of triphasic wave of hepatic vein,and a significant increase in shear-wave velocity (P =0.000,0.000,0.007,0.000,respectively).The correlation coefficient between four criteria and grouping was 0.478,0.557,0.286,0.483,respectively.The area under ROC curves for diagnosing AR using the four criterias mentioned above was 0.914.Conclusions Combination of CDFI and ARFI in diagnosing of AR after liver transplantation has higher sensitivity and accuracy.