Nuanjian Jian(Decoction for Warming Liver Meridian),originating from Jing Yue Quan Shu(Jingyue's Complete Works)written by Zhang Jingyue,is composed of Angelicae Sinensis Radix(Danggui),Lycii Fructus(Gouqizi),Poria(Fuling),Fructus Foeniculi(Xiaohuixiang),Cinnamomi Cortex(Rougui),Linderae Radix(Wuyao),and Aquilariae Lignum Resinatumd(Chenxiang)or Aucklandiae Radix(Muxiang).Nuanjian Jian is a widely-used classical formula for warming the liver and kidneys,promoting qi circulation and alleviating pain.It was included in the Ancient Classical Formulas Catalog(First Batch)published by the National Administration of Traditional Chinese Medicine in 2018,and was primarily used to treat lower abdominal pain,hernia,and other disorders differentiated as the syndrome of cold stagnation in the liver and kidneys.Based on the principles of key information verification for classical formulas,this article systematically reviewed the ancient and modern literature on Nuangan Jian,and conducted a comprehensive textual research and analysis of its origin,composition,dosage,method of making a decoction and taking medicines,processing,modifications,historical and modern applications,and experimental studies.The study concluded that the composition and dosage of this formula are relatively clear.The contemporary single-dose equivalents are calculated as Danggui 9.33 g,Gouqizi 11.19 g,Fuling 7.46 g,Xiaohuixiang 7.46 g,Rougui 5.60 g,Wuyao 7.46 g,and Chenxiang 3.73 g.The decoction is prepared by adding 300 mL of water and 4 g of ginger,boiling until reduced to 140 mL,and taken 2-3 times daily,2 hours after meals.Modern practitioners have expanded the indications of this formula,extending its use from hernia and lower abdominal pain to various disorders in andrology,gynecology,and gastroenterology.The indications have the core pathogenesis of cold stagnation in the liver meridian,and usually affect the liver while also involve the spleen,kidneys,and lower energizer.Diseases of the lower abdomen,genitals,and breasts belonging to the region of the liver-meridian route,are also commonly treated with Nuangan Jian.The findings of this study provide a reference for the further development of this classical formula.

This article introduced the experience of physician Chen Shiduo of the Qing Dynasty in treating hyperhidrosis as documented in Bian Zheng Lu.Chen Shiduo proposed several syndromes for hyperhidrosis,including insufficient lung qi,imbalance between the heart and kidney,depletion of kidney yin,excessive stomach fire,and deficiency of heart blood.In terms of treatment,he advocated for methods that focus on reinforcing deficiency and consolidating the exterior while also nourishing yin,clearing heart heat and nourishing kidney water,replenishing true yin to harmonize yin and yang,nourishing stomach yin to reduce fire and stop sweating,and nourishing the heart to enrich blood and drain fire.His medication approach emphasizes harmonizing the internal organs,with a particular expertise in using Mori Folium.His diagnosis and treatment of hyperhidrosis have been remarkably effective and serve as a reference for later generations.

This article introduced the experience of physician Chen Shiduo of the Qing Dynasty in treating hyperhidrosis as documented in Bian Zheng Lu.Chen Shiduo proposed several syndromes for hyperhidrosis,including insufficient lung qi,imbalance between the heart and kidney,depletion of kidney yin,excessive stomach fire,and deficiency of heart blood.In terms of treatment,he advocated for methods that focus on reinforcing deficiency and consolidating the exterior while also nourishing yin,clearing heart heat and nourishing kidney water,replenishing true yin to harmonize yin and yang,nourishing stomach yin to reduce fire and stop sweating,and nourishing the heart to enrich blood and drain fire.His medication approach emphasizes harmonizing the internal organs,with a particular expertise in using Mori Folium.His diagnosis and treatment of hyperhidrosis have been remarkably effective and serve as a reference for later generations.

Objective:To summarize the nursing experience of liver transplantation in a patient with acute liver failure, renal injury, shock, hepatic encephalopathy and hyperlactic acidemia caused by K-amine poisoning.Methods:A case of severe K-amine poisoning admitted to the First Affiliated Hospital of Zhejiang University Medical College on June 29, 2022 was treated by multidisciplinary team cooperation. The treatment scheme of blood purification combined with liver transplantation was adopted, individualized nursing measures were implemented, including fluid resuscitation, blood purification, prevention and treatment of complications such as brain edema and infection of hepatic encephalopathy, immunosuppressive treatment after liver transplantation, occupational protection, health education and follow-up management.Results:After careful treatment and nursing, the liver and kidney function of the patient recovered smoothly and was discharged on the 33rd day after liver transplantation.Conclusions:In view of the rapid progress of acute liver failure caused by K-amine poisoning and the involvement of multiple organs, blood purification combined with liver transplantation successfully saved the lives of patients under the cooperation of multidisciplinary teams. Do a good job in disease monitoring and individualized nursing to improve the long-term survival rate of patients.

Psoriasis vulgaris is a recurrent inflammatory skin disease. A variety of factors, such as trauma and infection, can destroy the skin barrier function, thereby breaking the balance of immune homeostasis and tolerance, causing abnormalities in function and/or number of various immune-related cells in local skin, resulting in psoriasis-like skin changes such as abnormal proliferation of keratinocytes and excessive inflammatory reactions in skin lesions. Various immune cells in skin lesions can sense changes in the surrounding environment (autocrine or paracrine) through surface molecules, and then express and secrete a variety of inflammation-related factors; if maintenance mechanisms for immune homeostasis and tolerance become invalid, the positive feedback network of inflammation mediated by inflammation-related factors will be formed locally, leading to the occurrence of psoriasis vulgaris. This review summarizes research progress in the role of immune-related cells in skin lesions in the immunopathological mechanism of psoriasis vulgaris, especially innate immune cells such as γδT cells.

OBJECTIVETo investigate the expression pattern of resistin (RSTN) in skeletal muscle tissue and its influence on glycometabolism in rats with traumatic brain injury (TBI).

METHODSSeventy-eight SD rats were randomly divided into traumatic group (n=36), RSTN group (n=36) and sham operation group (n=6). Fluid percussion TBI model was developed in traumatic and RSTN groups and the latter received additional 1 mg RSTN antibody treatment for each rat. At respectively 12 h, 24 h, 72 h, 1 w, 2 w, and 4 w after operation, venous blood was collected and the right hind leg skeletal muscle tissue was sampled. We used real-time PCR to determine mRNA expression of RSTN in skeletal muscles, western blot to determine RSTN protein expression and ELISA to assess serum insulin as well as fasting blood glucose (FBG) levels. Calculation of the quantitative insulin sensitivity check index (Q value) was also conducted. The above mentioned indicators and their correction were statistically analyzed.

RESULTSCompared with sham operation group, the RSTN expression in the skeletal muscle as well as serum insulin and FBG levels revealed significant elevation (P<0.05), and reduced Q value (P<0.05) in traumatic group. Single factor linear correlation analysis showed a significant negative correlation between RSTN expression and Q values (P<0.001) in traumatic group.

CONCLUSIONThe expression of RSTN has been greatly increased in the muscular tissue of TBI rats and it was closely related to the index of glycometabolism. RSTN may play an important role in the process of insulin resistance after TBI.

Animals ; Brain Injuries ; metabolism ; Glucose ; metabolism ; Insulin Resistance ; Male ; Muscle, Skeletal ; chemistry ; metabolism ; Rats, Sprague-Dawley ; Resistin ; analysis

Objective To detect the epidemiologic features of pediatric patients with fall from height injury in an effort to provide a reference for prevention and scientific treatment.Methods Data of pediatric patients with fall from height injury treated from January 2011 to December 2012 were collected in the form of questionnaires.Epidemiologic features and relationship of associated factors were measured.Results Pediatric fall injury occurred very often in warmer season,namely on April and May,and in a day,it was more likely to happen when parents slacked at noon and night.Stairs and balconies were the most common sites of falls and head was most vulnerable to the injury.Falling height was the primary factor to the severity of injury.Conclusion To strengthen the protection reform in key areas,the supervision in peak time for falls and the care to children of the migrant workers can reduce fall injury in a certain extent.

Objective To determine the coagulation status as well as circulating levels of complement and inflammation markers in patients with chronic urticaria (CU) during acute attack and in remission,and to estimate the relationship of coagulant and anticoagulant factors as well as fibrinolytic markers with the development of chronic urticaira.Methods This study included 40 patients with CU (22 during acute attack and 18 in remission) and 40 healthy blood donors from the Guangzhou Blood Center.Venous blood samples were obtained from these subjects,and enzyme-linked immunosorbent assay (ELISA) was performed to measure the plasma levels of prothrombin fragrnent 1 +2 (F1 +2),tissue factor (TF),thrombomodulin (TM),high molecular weight kininogen (HMWK),tissue-type plasminogen activator (t-PA),C5a and serum levels of C3,C4,antistreptolysin O antibodies (ASO),rheumatoid factor (RF) and C-reactive protein (CRP).Erythrocyte sedimentation rate (ESR) was also determined in these patients.Comparisons of these parameters were carried out by using t test,and the correlation of these factors with CU was evaluated by using Spearman correlation coefficient.Results Compared with the healthy controls,the patients with CU showed significantly higher plasma levels of F1+2 and HMWK (both P ＜ 0.01),but lower levels of TF,TM and t-PA (all P ＜ 0.01).The plasma levels of F1 +2,HMWK,t-PA were significantly correlated with the symptom scores in patients with CU (r =0.81,P ＜ 0.01; r =-0.39,P ＜ 0.05; r =0.35,P ＜ 0.05).A significant increase was observed in the plasma concentration of F1 +2 in patients during acute attack compared with those in remission (P ＜ 0.01),whereas no significant differences were noted in the plasma levels of TF,TM,HMWK,t-PA,C5a,serum levels of C3,C4,ASO,RF and CRP or ESR between the two groups of patients (all P ＞ 0.05).Conclusions It seems that coagulation,anti-coagulation and fibrinolysis are all involved in the development of urticaria.There is an obvious difference in the plasma level of prothrombin F1 +2 between patients with CU during acute attack and in remission,suggesting that coagulation factors play a certain role in the initiation and progression of CU.

Objective To analyze the injury features of the wounded in the bullet train crash in July 23,2011 in Wenzhou of Zhejiang and explore treatment experience.Methods A total of 177 cases who were injured or died in the 7.23 Wenzhou bullet train crash were involved in the study.The age,gender,injury types,injury regions and injury severity were analyzed by using Trauma Database System V3.0 ( produced by China Trauma Data Center of Third Military Medical University). Results A total of 137 cases were admitted to our hospital within 24 hours after the bullet train crash in Wenzhou.There were 76 males and 61 females,with no significant difference.Of the 137 cases,136 survived and one died after medical treatment.The major injury types included impact injury,crush injury and heavy weight falling injury.Among the 136 survivors,108 cases were with multiple injuries,accounting for 79.4％.The most common injury region of the survivors was the chest,followed by the head and limb.The minimum trauma index (TI) was 5 points and the maximum 27 points.There were 4 cases(3.7％ )with TI ≤9 points,86 (79.6％) with 10-16 points and 18 (16.7％) with ≥ 17 points.Of all,78 cases (72.2％) had ISS score ＜ 16 points and 30 (27.8％) had ≥16 points.The minimum ISS was 3 points and maximum 75 points.There were 40 deaths including the one died after medical treatment,who were all with multiple injuries,with head injury the main cause.ConclusionsThe causes of the bullet train crashes are complicated,with high incidence of multiple injuries.The injury severity is varied,but the overall situation is not serious.Distribution of common injury regions is significantly different between the wounded and the dead.Injury triage,patient transfer and specialist treatment of the wounded should be carried out appropriately during the initial stage of medical rescue based on those injury features after the bullet train crashes.

Objective To compare the sensitivity and specificity of venereal disease research laboratory (VDRL) test versus several other laboratory tests in the diagnosis of neurosyphilis. Methods Lumber puncture was conducted to obtain cerebrospinal fluid (CSF) from untreated outpatients with latent syphilis (LS) or serofast outpatients with LS. Then, VDRL test, rapid plasma regain (RPR) test, Treponema pallidum particle agglutination (TPPA) assay, fluorescent treponemal antibody-absorption (FTA-ABS) test and protein quantification were performed on these CSF samples. The sensitivity, specificity, positive predictive value and negative predictive value were compared between VDRL test and four other laboratory tests in the diagnosis of neurosyphilis. Results Totally, 61 cases of latent syphilis were included in this study. The sensitivity, specificity,positive predictive value and negative predictive value were 93.44% (57/61), 99.32%(293/295), 96.61%(57/59), 98.65% (293/297)for CSF-RPR, respectively, 91.80% (56/61), 82.71% (244/295), 52.34% (56/107),97.99 (244/249) for CSF-TPPA, respectively, 93.44% (57/61), 82.71% (244/295), 52.78%(57/108), 98.39%(244/248) for CSF-FTA-ABS, respectively, and 49.18%(30/61), 97.29% (287/295), 78.95% (30/38),90.25% (287/318) for CSF protein quantification, respectively. Conclusions CSF-VDRL cannot be replaced by CSF-RPR, -TPPA, -FTA-ABS, or CSF protein quantification in the diagnosis of neurosyphilis. CSF-RPR shows a high sensitivity and specificity in the diagnosis of neurosyphilis, with an increased diagnostic capability (area under the receiver operating characteristic curve) compared with CSF-TPPA, CSF-FTA-ABS or CSF protein quantification.