Liu Baoyi was a famous febrile disease expert in the late Qing Dynasty,who innovated the theory of latent febrile disease.Liu proposed that the deficiency of kidney essence and the deficiency of healthy qi were the prerequisites for the latent cold e-vil,and the exogenous cold evil was the inducement of the disease.He advocated the treatment of latent febrile disease based on the six meridians,with the two ideas of eliminating evil qi and strengthening healthy qi as the outline,and the general principle of treatment was to relieve heat,nourish yin and expel evil qi.He attached importance to the coordination of medicine and food,made good use of fresh medicine,attached importance to drug processing,emphasized the use of herb processed by herb,and adapted the medicine ac-cording to the syndromes.He preferred to use co-processed products for clinical use.The study of Liu's academic thoughts and medi-cation characteristics in treating latent febrile diseases is of great value in guiding the treatment and medication of various infectious and epidemic diseases with fever characteristics nowadays.

Liu Baoyi was a famous febrile disease expert in the late Qing Dynasty,who innovated the theory of latent febrile disease.Liu proposed that the deficiency of kidney essence and the deficiency of healthy qi were the prerequisites for the latent cold e-vil,and the exogenous cold evil was the inducement of the disease.He advocated the treatment of latent febrile disease based on the six meridians,with the two ideas of eliminating evil qi and strengthening healthy qi as the outline,and the general principle of treatment was to relieve heat,nourish yin and expel evil qi.He attached importance to the coordination of medicine and food,made good use of fresh medicine,attached importance to drug processing,emphasized the use of herb processed by herb,and adapted the medicine ac-cording to the syndromes.He preferred to use co-processed products for clinical use.The study of Liu's academic thoughts and medi-cation characteristics in treating latent febrile diseases is of great value in guiding the treatment and medication of various infectious and epidemic diseases with fever characteristics nowadays.

Objective:To compare the chemical composition of decoction and granules of Sangju Decoction; To provide a method for quality evaluation of Sangju Decoction.Methods:HPLC was used to establish fingerprints, and a comprehensive comparative study was conducted on the traditional decoction and formula granules of Sangju Decoction from four aspects: chemical composition type, fingerprint similarity, chemical pattern recognition analysis, and representative index component content.Results:The fingerprint similarity of the 10 batches of traditional decoction was >0.988. 35 peaks were identified and 12 peaks were identified as common peaks (neochlorogenic acid for peak 7, chlorogenic acid for peak 10, cryptochlorogenic acid for peak 11, 1,3-dicaffeoylquinic acid for peak 13, rutin for peak 17, lenoside A for peak 19, lignan for peak 20, isochlorogenic acid B for peak 24, ammonium glycyrrhizate for peak 25). The fingerprint similarity of the formulation pellets was >0.983, and 29 characteristic peaks were identified. Compared with the traditional decoction, some batches of the granules lacked peaks 14, 26, 27, 30, 32 and 34, and clustering analysis (CA), principal component analysis (PCA), and orthogonal partial least squares discriminant analysis (OPLS-DA) could distinguish between the two. The contents of the 10 index components neochlorogenic acid, chlorogenic acid, cryptochlorogenic acid, 1,3-dicaffeoylquinic acid, forsythia ester glycoside A, grass glycosides, isochlorogenic acid B, 3,5-O-dicaffeoylquinic acid, forsythia glycosides, monkshood glycosides in the traditional soup were higher than that in the granules, and the contents of rutin and ammonium glycyrrhizate in the granules were higher than that in traditional decoction.Conclusions:The content and composition of traditional decoction and formula granules of Sangju Decoction are significantly different. The combination of fingerprinting and chemical pattern identification effectively can effectively evaluate the difference between traditional decoction and formula granules of Sangju Decoction, which can lay a foundation for the quality control and rational clinical application of formula granules of Sangju Decoction.

OBJECTIVE To investigate the changes in high performance liquid chromatography （HPLC） fingerprint spectra and nucleoside components between Pinelliae Rhizoma Praeparatum cum Zingibere et Alumine and its processed product Succus bambusae pinella preparata， providing a reference for the quality evaluation of the latter. METHODS HPLC fingerprint was established for 10 batches of Pinelliae Rhizoma Praeparatum cum Zingibere et Alumine and its processed product Succus bambusae pinella preparata following the Similarity Evaluation System of TCM Chromatographic Fingerprints （2012 Edition）. Hierarchical cluster analysis （HCA）， principal component analysis （PCA）， and orthogonal partial least squares-discriminant analysis （OPLS- DA） were conducted on their common peaks. The contents of four nucleoside components， hypoxanthine， uridine， adenine， and guanosine， in both Pinelliae Rhizoma Praeparatum cum Zingibere et Alumine and Succus bambusae pinella preparata were determined. RESULTS The similarity between the fingerprints of the 10 batches of Pinelliae Rhizoma Praeparatum cum Zingibere et Alumine， Succus bambusae pinella preparata， and their corresponding reference fingerprints ranged from 0.851 to 0.990. A total of 10 common peaks were obtained for both samples， and 4 components were identified as hypoxanthine， uridine， adenine， and guanosine. The results of HCA， PCA and OPLS-DA showed that the samples of Pinelliae Rhizoma Praeparatum cum Zingibere et Alumine and Succus bambusae pinella preparata were clustered into separate categories， with OPLS-DA selecting 4 differential components between them， ranked by variable importance projection values as peak 8， peak 1， peak 6 （adenine） and peak 10. The content determination results showed that the average contents of hypoxanthine， uridine， adenine and guanosine in Succus bambusae pinella preparata declined by 15.90%， 12.00%， 26.04% and 22.18% compared to Pinelliae Rhizoma Praeparatum cum Zingibere et Alumine， respectively， with statistically significant differences in the contents of hypoxanthine， adenine and guanosine （P＜0.05 or P＜0.01）. CONCLUSIONS The established fingerprint and content determination methods are simple to operate and have good repeatability， which are suitable for qualitative and quantitative analysis of Pinelliae Rhizoma Praeparatum cum Zingibere et Alumine and Succus bambusae pinella preparata. The average contents of the four nucleoside components decreased after the processing of Succus bambusae pinella preparata.

Objective:To investigate the clinical effect of vascular pressurisation and super reflux on free anterolateral thigh flap (ALTF).Methods:From January 2017 to September 2021, the Department of Hand and Foot Microsurgery, the Second Affiliated Hospital of Hainan Medical College had treated 31 cases of soft tissue defects of the limbs. The patients were 23 males and 8 females, aged 4-76 years old at 40 years old in average. All the patients received transfer of free ALTFs carrying 2 groups of blood vessels of the descending and oblique branches of lateral circumflex femoral artery (LCFA). The vascular pressurisation and super-reflux techniques were applied in wound repair. Soft tissue defect area 7 cm × 5 cm-22 cm × 10 cm. The sizes of flaps were 8 cm×6 cm-23 cm×11 cm. All the donor sites were sutured directly. Fifteen patients had inner flap pressurisation (or super-reflux) and the rest of 16 patients had external flap pressurisation (or super-reflux). After surgery, scheduled follow-ups were conducted through outpatient clinic, telephone and WeChat reviews or home visits to evaluate the efficacy of wound repair.Results:All the 31 flaps survived, except 2 flaps that had mild infection after surgery. The wounds of donor and recipient sites healed completely. The time of follow-up was 3-55 months. The skin of flaps achieved good texture, colour, lustre and appearance. TPD of the flaps ranged 7-12 mm.Conclusion:Vascular pressurisation and super reflux technique are stable and reliable in the clinical application of free ALTF to repair soft tissue defects of limbs.

Objective:To explore the application effect of case-based learning (CBL), teaching mode combined with 3D printing in clinical teaching of sacral tumors.Methods:A total of 108 undergraduate interns and standardized residency training students who studied in our hospital from 2017 to 2018 were divided into the CBL teaching group ( n = 53) and the CBL combined with 3D printing teaching group ( n = 55) according to their study time. The combined teaching group used computer tomography (CT) data to reconstruct and print out a 3D model of sacral tumors based on CBL, and performed preoperative teaching on the invasion of the surrounding tissues of the tumor. The scores of the students in the two groups were evaluated respectively, and the students were surveyed by self-identification questionnaire (learning interest, self-learning ability, teamwork ability, comprehensive analysis ability and clinical thinking ability). The t-test (one-sided) was used for comparison between groups using stata 14.0. Results:The score of CBL teaching group (75.90±6.70) was lower than that of CBL combined with 3D printing teaching group (83.60±7.40). In terms of critical thinking ability evaluation, self-learning ability, learning interest, comprehensive analysis ability and clinical thinking ability, the CBL combined 3D printing teaching group was superior to the CBL teaching group, and the difference was statistically significant ( P<0.001). In terms of teamwork ability, there was no statistical difference between the two groups. Conclusion:The CBL teaching mode combined with 3D printing can improve academic performance, students' learning interest and clinical thinking ability of sacral tumors in the teaching of undergraduate interns and standardized residency training students.

Orthodontically induced tooth root resorption (OIRR) is a serious complication during orthodontic treatment. Stimulating cementum repair is the fundamental approach for the treatment of OIRR. Parathyroid hormone (PTH) might be a potential therapeutic agent for OIRR, but its effects still lack direct evidence, and the underlying mechanisms remain unclear. This study aims to explore the potential involvement of long noncoding RNAs (lncRNAs) in mediating the anabolic effects of intermittent PTH and contributing to cementum repair, as identifying lncRNA-disease associations can provide valuable insights for disease diagnosis and treatment. Here, we showed that intermittent PTH regulates cell proliferation and mineralization in immortalized murine cementoblast OCCM-30 via the regulation of the Wnt pathway. In vivo, daily administration of PTH is sufficient to accelerate root regeneration by locally inhibiting Wnt/β-catenin signaling. Through RNA microarray analysis, lncRNA LITTIP (LGR6 intergenic transcript under intermittent PTH) is identified as a key regulator of cementogenesis under intermittent PTH. Chromatin isolation by RNA purification (ChIRP) and RNA immunoprecipitation (RIP) assays revealed that LITTIP binds to mRNA of leucine-rich repeat-containing G-protein coupled receptor 6 (LGR6) and heterogeneous nuclear ribonucleoprotein K (HnRNPK) protein. Further co-transfection experiments confirmed that LITTIP plays a structural role in the formation of the LITTIP/Lgr6/HnRNPK complex. Moreover, LITTIP is able to promote the expression of LGR6 via the RNA-binding protein HnRNPK. Collectively, our results indicate that the intermittent PTH administration accelerates root regeneration via inhibiting Wnt pathway. The lncRNA LITTIP is identified to negatively regulate cementogenesis, which activates Wnt/β-catenin signaling via high expression of LGR6 promoted by HnRNPK.
Mice ; Animals ; Cementogenesis ; Wnt Signaling Pathway ; beta Catenin/metabolism* ; Heterogeneous-Nuclear Ribonucleoprotein K/metabolism* ; RNA, Long Noncoding/genetics* ; Parathyroid Hormone ; Receptors, G-Protein-Coupled/metabolism*

Objective:To study the HPLC fingerprints of Coptidis Rhizoma- Magnoliae Officmalis Cortex formula granules and the differences of active ingredients in different proportions; To explore the content changes of key components in different proportions of Coptidis Rhizoma- Magnoliae Officmalis Cortex. Methods:HPLC was used to determine the contents of several alkaloids and total phenol of Magnolia officinalis in Coptidis Rhizoma- Magnoliae Officmalis Cortex formula granules and their fingerprints, and the similarity evaluation, cluster analysis and principal component analysis were performed. Results:The similarity of fingerprint of 10 batches of Coptidis Rhizoma- Magnoliae Officmalis Cortex was > 0.950. 17 common peaks were identified, and 6 components were identified. Compared with single medicine, the contents of alkaloids and total phenols in the Coptidis Rhizoma- Magnoliae Officmalis Cortex formula granules were significantly reduced. The contents of multiple alkaloids and total phenols in the Coptidis Rhizoma- Magnoliae Officmalis Cortex formula granules in different proportions were different, and the contents of alkaloids and total phenols were the highest when the proportion of Coptidis Rhizoma- Magnoliae Officmalis Cortex was 2∶1. Conclusion:The contents of main components of Coptidis Rhizoma- Magnoliae Officmalis Cortex formula granules with different proportions are different, which can provide a certain basis for studying the compatibility mechanism of TCM couplet medicines.

Objective:To explore the effect of flipped classroom combined with scenario simulation in the teaching reform on four basic medical puncture techniques of clinical skills training.Methods:A total of 1 275 students majoring in five-year clinical medicine in Guangzhou Medical University were enrolled in the study. The control group (647 cases from Batch 2015) were given the traditional teaching pattern and the experimental group (628 cases from Batch 2016) adopted flipped classroom combined with scenario simulation. At the end of the course, the performance in the tests of four basic medical puncture techniques in the objective structured clinical examination (OSCE) of the two groups were compared. The feedback and evaluation of this teaching mode in the experimental group were investigated by questionnaires. SPSS 19.0 was used for independent samples t test. Results:All the scores of the tests of four basic medical puncture techniques in the experimental group were significantly higher than those in the control group: abdominocentesis [(87.89±7.13) vs. (82.60±10.74) points], thoracocentesis [(85.20±7.39) vs. (81.96±7.76) points], bone marrow aspiration [(88.13±6.00) vs. (83.50±9.63) points], and lumbar puncture [(91.91±7.19) vs. (80.74±12.20) points], with significant differences ( P<0.001). The results about the feedback and evaluation in the experimental group showed that the students gave an average score of 8.4 points to their satisfaction with the new teaching mode. The approval rates of the teaching effect evaluation items such as teaching arrangement, improving learning ability, improving clinical practice ability and school promotion were higher than 90.0%. Conclusion:Flipped classroom combined with scenario simulation, which is worthy to be popularized, can not only improve the students' performance in the tests of four basic medical puncture techniques in the OCSE, but also improve teaching satisfaction and teaching effect.

A 43-year-old female patient received Fuyanshu capsules 1.6 g orally thrice daily for pelvic inflammation. The traditional Chinese medicine decoction was added 1 week later. After 10 days of combination therapy, the patient developed fatigue, which was gradually aggravated, and yellowish skin and sclera appeared. Seven days later, laboratory tests showed alanine aminotransferase (ALT) >1 000 U/L, aspartate aminotransferase (AST) >750 U/L, gamma-glutamyltransferase (γ-GT) 148 U/L, alkaline phosphatase (ALP) 153 U/L, and total bilirubin (TBil) 56.3 μmol//L. After excluding viral hepatitis, autoimmune liver disease, obstructive jaundice, and other causes, liver injury caused by Fuyanshu capsules combined with traditional Chinese medicine decoction was considered. After Fuyanshu capsules and traditional Chinese medicine decoction were discontinued, reduced glutathione, glycyrrhizic acid preparation, and ursodeoxycholic acid were given. Seven days later, the patient′s symptoms were improved obviously and laboratory tests showed ALT 323 U/L, AST 125 U/L, γ-GT 149 U/L, ALP 109 U/L, and TBil 35.8 μmol/L. Twenty-seven days later, the patient′s symptoms disappeared and laboratory tests showed ALT 62 U/L, AST 42 U/L, γ-GT 67 U/L, ALP 67 U/L, and TBil 18.7 μmol/L. There are 7 same components in Fuyanshu capsule and traditional Chinese medicine decoction. It was considered that the liver injury was related to the increase of hepatotoxicity caused by the combination of the two drugs.