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.

Objective:To compare biomechanical stabilities between screw-plate fixation and non-cannulated screw fixation for Lisfranc ligament injury by a 3-D finite element analysis.Methods:A 3-D model of a healthy foot was developed from computed tomography images. The 1st and the 2nd dorsal tarsometatarsal ligaments and Lisfranc ligament were cut in the 3-D model of a healthy foot to establish a Lisfranc ligament injury model, in which screw-plate fixation (with 2 locking plates and 8 standard screws and one non-cannulated screw) and non-cannulated screw fixation (with 3 non-cannulated screws) for Lisfranc ligament injury were simulated respectively. Finite element analyses were carried out by Abaqus 6.14 software after loads were added in the 3-D models of screw-plate fixation and non-cannulated screw fixation for Lisfranc ligament injury. The overall stress-strain nephogram, the stress distribution and displacement of the foot bone, and the stress distribution on the internal fixation system were compared between the 2 kinds of models.Results:Under the same load, the stress of the whole screw-plate fixation was concentrated on the fixators, and the stress of the non-cannulated screws was also greater than that of the bones. In both models, the strain of the whole foot led to arch collapse, especially in the medial column. The maximum stress on the screw holes in the medial and middle columns in the screw-plate fixation model was 39.91 MPa, smaller than that in the non-cannulated screw fixation model (53.13 MPa). The relative displacement of the first metatarsal joint in the screw-plate fixation model was 8.515 × 10 -1 mm, much greater than that in the non-cannulated screw fixation model (3.893 × 10 -1 mm). Stress concentration was observed in both models. The stress of the screw-plate system was concentrated on the fibular side of the middle section of the plate used to fix the first tarsometatarsal joint, decreasing towards both ends. The maximum stress of the non-cannulated screws was located in the middle of the medial column screw for fixation of the first tarsometatarsal joint, significantly greater than those of the both ends. The maximum stress of the screw-plate system was 239.5 MPa, smaller than that of the non-cannulated screws (256.8 MPa). Conclusions:Non-cannulated screw fixation demonstrates a greater biomechanical stability for Lisfranc ligament injury than screw-plate fixation. However, the former may have a higher risk of screw breakage because it bears a greater stress.

Objective To evaluate the clinical efficacy of Clostridium butyricum tablets in treatment of diarrhea in patients with hepatitis B-related liver cirrhosis.Methods Eighty-seven patients with hepatitis B-related liver cirrhosis and diarrhea were collected from Pujiang People' s Hospital in Zhejiang province during January 2011 and May 2013.According to random number table,patients were divided into Clostridium butyricum treated group (n =44) and control group (n =43).Both groups were given antiviral,liver support,jaundice-relieving and fluid infusion treatments,while patients in Clostridium butyricum group were given Clostridium butyricum tablets (2 tables per time,3 tables per day for 4 weeks) additionally.Diarrhea remission time,improvements in liver function and the complications were observed.Differences in measurement data were compared with t test,and enumeration data were compared with x2 test or rank-sum test.Results The total effective rate in Clostridium butyricum group was 95.45％ (42/44),while that in control group was 74.4％ (32/43) (Z =2.82,P ＜ 0.05).After 4 weeks of treatment,the improvements of alanine aminotransferase (ALT),aspartate transaminase (AST),total bilirubin (TBil),albumin (Alb) and Child-Pugh (CTP) score in Clostridium butyricum group were more marked than those in control group (t =2.13,2.57,4.83,5.93 and 3.30,P ＜ 0.01).Hepatic encephalopathy occurred in 2 patients in control group and none in Clostridium buayricum group.Conclusion Clostridium butyricum has significant curative effect on diarrhea in patients with hepatitis B-related liver cirrhosis,and it can also improve liver function and reduce the incidence of hepatic encephalopathy.

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.

The construction and amount of fibronectin (Fn), laminin (Ln) and collagen type IV (ColIV) in the extracellular matrix of endothelial cells (EC) co-cultured with vascular smooth muscle cells (VSMC) under shear stress were studied by immuno-fluoro-cytochemistry, laser confocal scanning microscopy and image analysis methods to detect the effect of shear stress on adhesion of EC for vascular tissue engineering. One group of EC was maintained under static conditions as a control. In the control, both Fn and Ln exhibited as a granular pattern in perinuclear area and a fibrillar pattern localized underneath EC, and Col IV exhibited mainly as the granular in the perinuclear area, but the fibrillar was fewer. On exposure of EC to shear stress in physiological range, Fn grouped into fibril tracts, and there was a tendency for some of these tracts of fibrils to align with direction of shear stress. Ln and Col IV also grouped into fibril tracts, which, in contrast to Fn, were randomly oriented, Simultaneously, all contents of the extracellular matrix had different quantitative alterations. These results suggest that the capability of adhesion of EC co-cultured with VSMC may be strengthened under shear stress.
Animals ; Animals, Newborn ; Cattle ; Cell Adhesion ; Cells, Cultured ; Collagen Type IV ; metabolism ; Endothelium, Vascular ; cytology ; metabolism ; Extracellular Matrix ; metabolism ; Extracellular Matrix Proteins ; metabolism ; Fibronectins ; metabolism ; Laminin ; metabolism ; Muscle, Smooth, Vascular ; cytology ; metabolism ; Stress, Mechanical

Objective: To evaluate the clinical application of MBT straight wire. Methods: 41 cases, 11 males and 30 famales aged 12-42 years old, with malocclusion were treated by MBT straight wire appliance in orthodontic clinics, follow-up was carried out. Results: Satisfactory effects were obtained in 11 completely treated cases, preliminary improvement of occlusion was observed in the other 30 cases being still in the treatment. Conclusion: MBT straight wire appliances may be used in the treatment of various malocclusion, but special consideration should be taken according to the type of occlusion in each case.

Objective:To observed the longitudinal changes of the facial growth in vertical dimension in the Chinese adolescents with normal occlusion from 13 to 15 years old.Methods:The subjects were from Beijing area and consisted of 9 males and 14 females aged 12.5-13.5 years with Class I skeletal and dental pattern and without previous orthodontic treatment. Serial 2-year- annual cephalometric radiographs were taken and digitalized. Descriptive statistics for the absolute and incremental changes of the skeletal cephalometric measurements were conducted.Results:Significant gender differences in the changes of facial growth in vertical dimension from 13 to 15 years old were observed. Most of the skeletal measurements in males showed greater value than those in females. The number of the measurements which showed gender difference increased with age. The annual incremental changes of TAFH, TPFH, LAFH, U6-PP in males and those of TPFH and RH in females from 13 to 14 years old were greater than those from 14 to 15 years, However, the average increment of L6-MP in males and that of UI-PP, LI-MP, U6-PP and OB in females from 13 to 14 years old were smaller than those from 14 to 15 years old. There was no significant gender difference in TAFH/TPFH from 13 to 15 years of age. Gender difference from 14 to 15 years old was found in the growth of dental-alveolar height. The main dento-alveolar height changes happened in lower incisors and lower molars in males and in the region of upper molars and upper incisor in females.Conclusion:The skeletal facial growth in vertical dimension from 13 to 14 year old falls into the accelerating period. After 14 years old, the growth velocity is slowed down. There are significant gender differences in the skeletal changes of facial growth in vertical dimension from 13 to 15 years old. From 14 to 15 years old, the gender differences are mainly found in the growth of the dento-alveolar height.

Objective To explore the feasibility of implantation of a composite of tendon, grains of cancellous bone and bone morphogenic protein (BMP) wrapped in antologous periosteum to substitute lunate bone lunatum in the treatment of Kienbock disease. Methods 42 Japanese big ear rabbits were randomly divided into two groups. In group A periostum wrapping a composite of tendon, grains of cancellous bone and bone morphogenic protein (BMP) was implanted. In group B only tendon wrapped by periostum was used. Both of them were respectively implanted into rabbits' suprapatellar bursa, the physiological environment of which seemed to be similar to that of the carpal joint after extirpating the lunate bone in human being. The composites were removed in 1,2,4,8,12,16 and 24 weeks after the operation. X ray imaging, gross, histological and EM changes at varies intervals were observed. And CT value of the composite was statistically analyzed (Stata 4 0). Results Periosteum wrapped BMP/grains of cancellous bone could induce bone and cartilage formation. In group A, newly formed bone could be found at 2 weeks. Rounded bony body with cortex and bone marrow was found to be formed by the implanted composite at 8 weeks. No degenerative changes were observed up to 24 weeks. In group B, the composite didn't form bony body in 24 weeks. In different periods, statistically significant difference in CT value between group A and B was found ( P

Objective The effect of vascular smooth muscle cells (VSMCs) on the PDFG\|B mRNA expression of Co\|cultured endothelial cells (ECs) under shear stress had been studied in order to provide some experimental data for preventing the development of restenosis resulted from VSMCs proliferation in the vascular graft. Methods The level of PDGF\|B mRNA of ECs cultured alone and Co\|cultured with VSMCs exposed to shear stress were investigated by the methods of in situ hybridization and image analysis. Both controls of ECs cultured alone and Co\|cultured with VSMCs were maintained under static conditions. Results In static condition, the content of PDGF\|B mRNA expression of Co\|cultured ECs was lowered in comparison with ECs alone\|cultured. Under shear stress, PDGF\|B mRNA expression of Co\|cultured ECs was increased in transient manner at 1hour after the onset of shear stress and then returned to the level lower than the static level of Co\|cultured ECs at 6hours after being exposed to shear stress. The transient increasing time of PDGF\|B mRNA expression of Co\|cultured ECs reached a maximum earlier than that of ECs cultured alone.Conclusion Under shear stress, PDGF\|B mRNA expression of ECs Co\|cultured with VSMCs is lowered, which may be favor of inhibiting VSMCs proliferation.