As the core vehicle for preserving and transmitting traditional Chinese medicine（TCM） academic thought and clinical experience， the establishment of a robust quality evaluation system for TCM clinical case reports is a crucial component in the current standardization and modernization of TCM. Based on the practical experience of constructing the China Clinical Cases Library of Traditional Chinese Medicine by the China Association of Chinese Medicine， this study conducted a comprehensive analysis of critical challenges， including insufficient authenticity and unfocused evaluation criteria. It proposed a three-dimensional evaluation framework grounded in the structure-process-outcome logic， encompassing three dimensions of authenticity and standardization， characteristics and advantages， application and translational impact. This framework integrated 12 key evaluation indicators in a systematic manner. The model preserved the academic characteristics of TCM syndrome differentiation and treatment， while aligning with modern scientific research standards， achieving a balance between individualized TCM experience and standardized evaluation. Concurrently， this study provided theoretical foundations and methodological guidance for evaluating the quality of TCM clinical cases， contributing significantly to the inheritance of TCM knowledge， evidence-based practice， and the reform of talent evaluation mechanisms.

In the treatment of diabetic gastroparesis(DGP),traditional Chinese medicine has conventionally focused on therapies such as ascending clear and descending turbid,pungent-opening and bitter-descending methods,aiming to regulate the ascending and descending of the spleen and stomach's Qi mechanism and to restore the middle-jiao's transformation as the ultimate goal.By explo-ring the physiological relationship between gallbladder and spleen-stomach and its pathological relationship with DGP,this article sug-gests that the gallbladder also participates in the regulation of blood sugar and digestive activities in the body,which is closely related to the onset of the disease.As the Shao Yang pivot,the gallbladder stores essential fluid,harbors ministerial fire,primarily governs the upward movement and dispersion,and is responsible for decision-making and emotions.The normal flow of Qi,blood,and body flu-ids,as well as the functional activities of the channels and collateral vessels,are closely associated with the gallbladder.When the gallbladder's function becomes abnormal,the body may also exhibit imbalances in the intestinal microbiota,disarray of gastrointestinal hormones,delayed gastric emptying,and elevated blood sugar levels,which aligns with the modern medical understanding of the onset of gastroparesis diabeticorum.Therefore,this article proposes the treatment principle of"venting the wood constraint"and the treatment of DGP according to symptoms,offering a reference for clinical treatment.

Objective To explore the relationship between serum retinol binding protein 4 and serum Lipasin levels and vascular complications in gestational diabetes mellitus(GDM).Methods From Jan.2016 to Jan.2018,80 pregnant women with gestational diabetes diagnosed as GDM in Wenzhou Central Hospital of Zhejiang Province were selected as the study group.They were divided into two groups according to whether they had vascular lesions.Group A included patients with gestational diabetes mellitus complicated with vascular complications and group B included patients without vascular complications.Forty healthy pregnant women were selected as the control group(group C).The levels of fasting plasma glucose (FPG),fasting serum insulin (FINS),homeostatic model assessment of insulin resistance (HOMA-IR),serum retinol binding protein 4 (RBP4) and serum Lipasin were compared among three groups of pregnant women.The vascular complications of GDM were analyzed.Results The levels of FPG,FINS and HOMA-IR in gestational diabetes mellitus pregnant women were higher than those in healthy pregnant women (P＜0.05),and those in group A were higher than those in group B (P＜0.05).The levels of RBP4 and Lipasin in serum of pregnant women with GDM were higher than those of healthy pregnant women (P＜0.05),and those of group A were higher than those of group B (P＜0.05).Spearman univariate correlation analysis showed that serum RBP4 levels were positively correlated with FPG and FINS(P＜0.05),and serum Lipasin levels were positively correlated with FPG and FINS (P＜0.05).Logistic regression analysis showed that the levels of FPG,FINS,RBP4 and Lipasin increased,which were independent risk factors for diabetic retinopathy (P＜0.05).Conclusion In GDM with vascular complications,the serum RBP4 and Lipasin levels are higher,which are independent risk factors for vascular complications in GDM,and may participate in the occurrence and development of vascular complications in gestational diabetes mellitus.

Objective To explore the clinical features of congenital hepatic fibrosis (CHF) in children.MethodsA total of 111 patients diagnosed with CHF during January 2002 to June 2015 were included and divided into children group and adult group according to the age at diagnosis. The clinical data including gender, age, clinical symptoms, signs, laboratory examinations, and imaging characteristics were retrospectively analyzed and compared between two groups.ResultsThere were high incidences of splenomegaly and liver cirrhosis in both children and adult groups, and no difference was found between two groups (P>?0.05). The fatigue, jaundice, and hepatosplenomegaly were more common in children group while the renal cyst and liver cyst were more common in adult group, and the differences were statistically signiifcant (P all?

ObjectiveTo observe the role of Sijunzi decoction on the gut barrier protection and immunity regulation in spleen-qi deficiency type patients with persistent inflammation-immunosuppression catabolism syndrome (PICS).Methods A prospective study was conducted, and according to random number table, 46 patients with PICS accompanied by spleen-qi deficiency admitted to Department of Critical Care Medicine of Beijing Shijitan Hospital of Capital Medical University were randomly divided into two groups: control group and Sijunzi decoction group(each 23 cases). Conventional therapy was given to both groups, and the patients in Sijunzi decoction group were additionally treated with modified Sijunzi decoction 100 mL by nasal feeding, while those in the control group were treated with an equal amount of warm boiled water by nasal feeding. The course of treatment was 2 weeks in both groups. The improvement in traditional Chinese medicine(TCM) syndrome and gastrointestinal function was observed in two groups before and after treatment. At the same time, the changes of lymphocyte subsets including total T cells(CD3+ cells),helper/inducer T cells(CD3+/CD4+T cells), suppressor/cytotoxic T cells(CD3+/CD8+ T cells), CD4/CD8, total natural killer cells(NK cell,CD3-/CD16+CD56+ cells),natural killer like T cells(NK T cell,CD3+/CD16+CD56+ T cells),total B cells(CD19+ cells),regulatory T cells(Treg T cells, CD4+/CD25+ T cells),suppressor T cells(CD8+/CD28- T cells) and cytotoxic T cells(CD8+/CD28+ T cells)were analyzed.Results① There were no differences in the acute physiology and chronic health evaluationⅡ(APACHEⅡ)score,acute gastrointestinal injury(AGI)grades and peripheral blood lymphocyte subsets between Sijunzi decoction group and control group before treatment( allP>0.05).② After 2 weeks of treatment, all the patients' clinical symptoms of spleen-qi deficiencywere improved, and there was no difference in effect between the Sijunzi decoction and control group(valid:11 cases vs. 6 cases, invalid:12 cases vs.17 cases, bothP>0.05) . In both groups, the patients' AGI condition was improved, but the improvement in treatment group was more significant than that in the control group(valid: 14 cases vs. 7 cases, P<0.05) .③ In the control group,the numbers of CD3+, CD3+/CD8+,CD8+/CD28- T cells after treatment were increased significantly〔CD3+:(62.37±7.83)% vs.(54.08±11.65)%, CD3+/CD8+:(31.52±10.55)% vs. (23.94±9.22)%, CD8+/CD28-:(24.97±10.25)% vs.(16.78±10.55)%〕 and CD19+ number was decreased obviously〔(5.78±5.33)% vs.(9.73±8.02)%〕 at the same time(allP<0.05). After treatment, in the Sijunzi decoction group, the numbers of CD3+,CD3+/CD4+, CD3+/CD8+, CD8+/CD28-, CD8+/CD28+ T cells were increased significantly compared with those before treatment〔CD3+:(74.53±7.64)% vs.(52.98±10.05)%, CD3+/CD4+:(36.27±12.08)% vs.(30.00±8.60)%, CD3+/CD8+:(37.33±12.56)% vs.(22.88±9.97)%, CD8+/CD28-:(26.89±10.80)% vs.(17.01±9.48)%, CD8+/CD28+:(12.08±5.50)% vs.(8.47±4.29)%〕, and total CD19+ number was decreased remarkably at the same time〔(4.60±4.28)% vs.(9.86±8.61)%,P<0.05〕. In the Sijunzi decoction group, after 2 weeks of treatment, the number of CD3+ T cells was increased more significantly than that in the control group〔(8.29±9.28)% vs.(5.80±5.33)%,P<0.05〕.ConclusionUsing Sijunzi decoction combined with conventional therapy can improve the clinical symptoms of patients with PICS accompanied by spleen-qi deficiency and gastrointestinal dysfunction, the mechanism is possibly via enhancing immunity by regulating the numbers of B and T lymphocytes, and maybe the cell-mediated immunity plays a more prominent role.

LZ-8 protein, isolated from a well known Chinese traditional medicinal fungus Ganoderma lucidum, is the first member of fungal immunomodulatory protein, members of which have been isolated from a variety of medicinal and edible mushrooms in the last two decades. The protein plays a multifunctional and important role in modulating immune system. In this report, in order to get LZ-8 protein crystals, the LZ-8 gene was expressed and purified by affinity chromatography, gel filtration chromatography and anion exchange chromatography subsequently. The protein was then crystallized using the hanging-drop vapour-diffusion method. The LZ-8 crystals were obtained and the phase information was calculated by X-ray diffraction. The resolution of LZ-8 crystals is 3.2A. This study will provide an insight into the structure of fungal immunomodulatory proteins.
Animals ; Crystallography ; Fungal Proteins ; biosynthesis ; genetics ; immunology ; Ganoderma ; genetics ; metabolism ; Genetic Vectors ; genetics ; Immunologic Factors ; biosynthesis ; genetics ; Mice ; Recombinant Proteins ; biosynthesis ; genetics ; immunology

Objective To investigate the relationship between estrogen levels and tenosynovitis in postm-enopausal women. Methods 74 cases of postmenopausal women,including 32 cases of tenesynovitis (group A),42 cases healthy postrnenopausal women for the control group (group B) were observed. 42 cases of normal menstruation women were taken as control group (group C). Results The estrogen level was (89.7066±126.7458) pmol/L in group A,(45.6768±30.6342) pmol/L in group B,and (626.7384±361.5348)pmol/L in group C,There is statistical difference between group A and group C (P<0.05). Conclusions Tenosynovitis incidence in postmeno-pausal women has no significant relationship with the level of estrogen change.

Objective:To investigate the effect of Yiqi Huoxue Jiedu on diabetic peripheral neuropathy.Methods: 60 patients were randomly divided into treatment group receiving Yiqi Huoxue Jiedu treatment,control group receiving vitamin B and routine treatment to improve neural microcirculation.The conduction velocity of all patients’sensory and motor nerves and the scores of the symptoms had been observed.Results: Symptoms and nerve conduction velocity of treatment group and control group had been improved respectively,and the treatment group was superior to control group in clinic symptoms,clinical obvious effective rate and total effective rate.Conclusion: Yiqi Huoxue Jiedu method can improve conduction velocity of sensory and motor nerves,symptoms of anesthesia and pain of limbs of patients with diabetes peripheral neuropathy,and have good effect on diabetes peripheral neuropathy.