Severe acute pancreatitis （SAP） is closely related to dysfunction of the spleen-stomach ascent and descent. Due to the influence of modern lifestyle and dietary factors， Qi deficiency in the spleen and stomach has become the pathological basis of SAP. Its pathogenesis is characterized by dampness， heat， pathogenic factors， stasis， stagnation， obstruction， Fu-organs Qi obstruction， pathogenic excess， and healthy Qi deficiency. At different stages of the disease course of SAP， there is a focus on both pathogenic excess and healthy Qi deficiency. It is specifically manifested as Fu-organs stagnation and heat accumulation， as well as pathogenic excess and healthy Qi deficiency， during the systemic inflammatory response phase， intermingling of blood stasis and pathogenic factors， as well as Qi deficiency and blood stasis， during the infection period， and weakness of the spleen and stomach， as well as healthy Qi deficiency and lingering pathogenic factors， during the residual infection period. Based on the theory that "the spleen and stomach are the acquired foundation"， a staged treatment method centered on the core principle of "strengthening healthy Qi to eliminate pathogenic factors" was developed. The staged treatment method included "clearing the Fu-organs to expel turbidity， replenishing Qi to harmonize the stomach， activating blood circulation to expel pathogenic factors， replenishing Qi to relieve pain， promoting digestion to stimulate appetite， and replenishing Qi to invigorate the spleen". In clinical practice， Hewei Tongxie mixture， Yikang mixture， and Shiwei Jianpi Xiaoshi powder were selected for staged treatment of SAP. This article systematically summarized the theoretical basis of traditional Chinese medicine， Western medicine foundation， modern pharmacological mechanisms， and clinical application experience of the staged treatment of SAP with "strengthening the healthy Qi to eliminate pathogenic factors"， providing new ideas for the treatment of SAP with traditional Chinese medicine.

Objective:To explore whether the muscarinic acetylcholine receptor M1(M1 AChR)regulate the expression of ionotropic glutamate receptor AMP A type subunit 1(GluA1)and ionotropic glutamate receptor AMP A type subunit 2(GluA2),thus participating in the effects of plateau hypoxia on learning and memory in rats.Methods:Rats were randomly divided into normoxic group(Control),plateau hypoxia group(Hypoxia)and plateau hypoxia+TAK-071(an agonist of M1AChR)group.Morris water maze was utilized to detect the learning and memory ability of rats.Immunohistochemistry was utilized to determine the distribution and expression levels of M1 AChR,GluA1,and GluA2 in hippocampal CA1 and CA3 areas of rats.Western Blot was utilized to determine the expression levels of M1 AChR,GluA1,p-GluA1(Ser845),GluA2 and p-GluA2(Ser880)in hippocampus of rats.RT-qPCR was utilized to determine the mRNA expression levels of M1 AChR,GluA1,GluA2,ionotropic glutamate receptor NMDA type subunit 2A(NR2A),tau and amyloid β-protein(Aβ)in hippocampus of rats.Results:Plateau hypoxia could significantly increase the escape latency of rats in the spatial navigation test and shorten the stay time of rats in the target quadrant in the spatial probe test,while TAK-071 treatment could significantly improve the memory status of rats damaged by plateau hypoxia in the spatial probe test.There was a good correlation between the expression of GluA1,GluA2 and M1 AChR in CA1 and CA3 regions of hippocampus.In hippocampus,the expressions of GluA1 and GluA2 were synchro-nized with their corresponding phosphorylated proteins,and the correlativity between GluA1 and GluA2 and M1 AChR changed due to plateau hypoxia was reversed after TAK-071 treatment.TAK-071 could significantly reduce(P＜0.05)the expression levels of M1 AChR,GluA1,GluA2,NR2A,tau and Aβ mRNA increased due to plateau hypoxia.Conclusion:Activating M1 AChR can improve the memory impairment of rats caused by plateau hypoxia by regulating the expression of GluA1,GluA2 and their phosphorylated proteins.

Objective:To explore whether the muscarinic acetylcholine receptor M1(M1 AChR)regulate the expression of ionotropic glutamate receptor AMP A type subunit 1(GluA1)and ionotropic glutamate receptor AMP A type subunit 2(GluA2),thus participating in the effects of plateau hypoxia on learning and memory in rats.Methods:Rats were randomly divided into normoxic group(Control),plateau hypoxia group(Hypoxia)and plateau hypoxia+TAK-071(an agonist of M1AChR)group.Morris water maze was utilized to detect the learning and memory ability of rats.Immunohistochemistry was utilized to determine the distribution and expression levels of M1 AChR,GluA1,and GluA2 in hippocampal CA1 and CA3 areas of rats.Western Blot was utilized to determine the expression levels of M1 AChR,GluA1,p-GluA1(Ser845),GluA2 and p-GluA2(Ser880)in hippocampus of rats.RT-qPCR was utilized to determine the mRNA expression levels of M1 AChR,GluA1,GluA2,ionotropic glutamate receptor NMDA type subunit 2A(NR2A),tau and amyloid β-protein(Aβ)in hippocampus of rats.Results:Plateau hypoxia could significantly increase the escape latency of rats in the spatial navigation test and shorten the stay time of rats in the target quadrant in the spatial probe test,while TAK-071 treatment could significantly improve the memory status of rats damaged by plateau hypoxia in the spatial probe test.There was a good correlation between the expression of GluA1,GluA2 and M1 AChR in CA1 and CA3 regions of hippocampus.In hippocampus,the expressions of GluA1 and GluA2 were synchro-nized with their corresponding phosphorylated proteins,and the correlativity between GluA1 and GluA2 and M1 AChR changed due to plateau hypoxia was reversed after TAK-071 treatment.TAK-071 could significantly reduce(P＜0.05)the expression levels of M1 AChR,GluA1,GluA2,NR2A,tau and Aβ mRNA increased due to plateau hypoxia.Conclusion:Activating M1 AChR can improve the memory impairment of rats caused by plateau hypoxia by regulating the expression of GluA1,GluA2 and their phosphorylated proteins.

Idiopathic pulmonary fibrosis(IPF)is a chronic and fatal interstitial lung disease that poses a serious threat to human health and life,and currently there is no specific treatment for it except lung transplantation.The theory of traditional Chinese medicine(TCM)holds that Qi deficiency and blood stasis are the critical pathogenesis of IPF,so the therapy of invigorating Qi and activating blood circulation is established as the important method for the treatment of IPF.Studies have found that the prescriptions for invigorating Qi and activating blood have definite efficacy in improving the clinical symptoms of patients with IPF and delaying the progression of the disease.Based on its clinical effectiveness,a large number of researches have been carried out on the relevant mechanism of invigorating Qi and activating blood circulation in the treatment of IPF in recent years.In this paper,we systematically reviewed the relevant literature,and made a review on the mechanism of Qi-invigorating and blood-activating therapy in the treatment of IPF from the aspects inhibiting inflammation,improving the metabolism of extracellular matrix,intervening epithelial/endothelial-mesenchymal transformation,resisting oxidative stress,reducing angiogenesis,activating cellular autophagy,regulating immune balance and fibrinolytic activity,so as to reveal the scientific connotation of Qi-invigorating and blood-activating therapy and provide a theoretical basis for the clinical application of this therapy in the treatment of IPF.

ObjectiveTo evaluate the effect and safety of Buyang Huanwutang in treatment of connective tissue disease-associated pulmonary fibrosis in the patients with syndrome of Qi deficiency and blood stasis and explore the possible anti-fibrosis mechanism of Buyang Huanwutang. MethodSixty-six patients with connective tissue disease-associated pulmonary fibrosis with syndrome of Qi deficiency and blood stasis were randomized to receive either Buyang Huanwutang combined with routine therapy or routine therapy for 4 weeks. The primary outcome indicator was change in forced vital capacity （FVC） from the baseline， and the secondary outcome indicators included the changes in percentage of predicted forced vital capacity （FVC%pred）， percentage of forced expiratory volume in first second to predicted value （FEV₁%pred）， King's Brief Interstitial Lung Disease （K-BILD） total score， 6 minute walking distance （6MWD）， hydroxyproline （HYP）， matrix metalloproteinase （MMP）， tissue inhibitor of metalloproteinase-1 （TIMP-1）， and transforming growth factor-β （TGF-β） from baseline. Patients in line with the inclusion criteria were included in the primary analysis， and sensitivity analysis was performed after multiple imputation of missing data. Safety set was adopted for safety analysis. ResultThe 66 patients （included in the sensitivity analysis） meeting the inclusion criteria included 34 in the observation group and 32 in the control group， and 60 patients finally received the whole trial intervention （included for primary analysis）. Compared with the baseline， the FVC increased in the observation group and decreased in the control group after intervention （P<0.01）， which was consistent between the sensitivity analysis and the primary analysis. The changes in FVC%pred， FEV₁%pred， 6MWD， and K-BILD total score from baseline in the observation group were superior to those in the control group （P<0.01）， with consistent results between the sensitivity analysis and the primary analysis. TIMP-1 in the observation group decreased compared with baseline （P<0.05）， while TIMP-1 in the two groups showed no significant changes from the baseline The observation group outperformed the control group in the changes in HYP， MMP-9， and TGF-β from baseline （P<0.05）. The common adverse events were cough， diarrhea， nausea， rash， and upper gastrointestinal tract infection， the incidence of which showed no statistical difference between the two groups. ConclusionBuyang Huanwutang can improve lung function， motor function， and quality of life in patients with connective tissue disease-associated pulmonary fibrosis and has good safety. The mechanism may be related to the reduction of TGF-β， MMP-9， and TIMP-1 levels and maintaining of MMP-9/TIMP-1 balance.

With the rapid development of modern biomedicine, subjective factors such as human emotion and disease experience are diluted. Accurate data, programmed diagnosis and treatment process and other objective factors cut off the effective communication between doctors and patients, aggravating the already tense doctor-patient relationship and intensifying various conflicts in the clinic. In order to improve clinical humanistic care, medical and nursing workers have launched reflections and explorations. Narrative medicine is a new form of medical humanistic practice, while parallel chart, as an important way of its practice, records patients’ subjective experiences and painful feelings. It is of great theoretical significance and clinical value to sinicize narrative medicine and construct and promote parallel chart in Traditional Chinese Medicine (TCM) by studying the research progress of parallel chart in China and its application in TCM.

Objective This study explored whether EPAS1 gene is involved in the proliferation of pulmonary arterial smooth muscle cells (PASMCs) during hypoxia when EPAS1 gene expression was interfered by small interfering RNA (siRNA).Methods The rat primary pulmonary artery smooth muscle cells were cultured and identified by immunofluorescence.The specific lipidosomes of EPAS1 siRNA were constructed and transfected into PASMCs,and the best targets were selected from the three interfering targets.The transfected PASMCs were cultured in hypoxia (37℃,5％ CO2,2％ O2) or normoxia (37℃,5％ CO2,20％ O2) for 24h,48h and 72h,respectively.The PASMCs proliferation was detected by CCK-8 assay.The protein expression of EPAS 1 and vascular endothelial growth factor (VEGF) were determined by Western blotting to investigate the effect of silencing EPAS1 gene expression on the proliferation of PASMCs under hypoxic condition.Results The specific liposomes ofEPAS1 siRNA were successfully constructed and transfected into PASMCs,and the best interfering target were selected from the three interference targets.The proliferation of PASMCs was increased and the protein expression of VEGF was up-regulated in the PASMCs under hypoxic condition.Under hypoxic or normoxic condition,PASMCs proliferation and VEGF protein expression of PASMCs were suppressed by EPAS 1 siRNA.Conclusion EPAS 1 gene might be involved in the proliferation of rat PASMCs by regulating VEGF protein level under hypoxic condition.

200 papers on nerve root type cervical spondylosis treated with Chinese medicine were retrieved and 38 papers with complete diagnostic criteria and medical statistics were included for study. The results showed acupuncture, massage, and herbal therapy were three common methods and have their own advantage, but systemic, standardized and normative treatment program was lack. In the meantime of treating nerve root type cervical spondylosis, prevention should also be paid attention. The treatment, prevention and exercise on the whole therapeutic idea should be established, which has far-reaching significance.

Objective To design and implement a dynamic simulation system for medical treatments on hospital ship, the application of which can provide evidence for the tactical and technical index of the equipment and the research on medical treatments. Methods Queuing theory and discrete events imitation methods were applied to make research on how to simulate random arrival of the sick and wounded of corresponding various random pattern, organizing of medical resources and medical treatments as well as procedures and rules of medical treatments by means of establishing overall system mathematics model on condition that the amount of the wounded and different distribution of wound type was given. Results The process data and outcome data of medical treatments such as passing ratio were achieved under different running circumstances in the given time. Conclusions The system can imitate the large-scale medical treatment process which can rarely implement many times in reality, meet different needs flexibly, and provide optimization foundation to medical resources configuration on medical ships.