Objective To explore the medication pattern of Chinese medicine practitioner LYU Guoxiong in treating vertigo from the phlegm theory,and to provide diagnostic and therapeutic solutions and scientific basis for the treatment of vertigo by traditional Chinese medicine.Methods To collect the diagnosis and treatment information of patients who attended the outpatient clinic of the Department of Neurology,Affiliated Hospital of Jiangxi University of Chinese Medicine and diagnosed with vertigo from October 2023 to March 2024,to construct a database of the inclusion criteria,and to analyse the frequency of use of traditional Chinese medicines,the four Qi,the flavour of a drug,the attribution of the meridians,the rules of association,and the clustering.Results A total of 150 patients with vertigo who met the criteria were included,and 150 prescriptions were recorded.Involving 114 flavours of traditional Chinese medicine,the total frequency of traditional Chinese medicines using was 1846 times.Among them,16 Chinese medicines were used>30 times,in the order of Huanglian,Fuling,Gancao,Baizhu,Chenpi,Banxia,Zhuru,Yanhusuo,Xiangfu,Niuxi,Gouteng,Zhenzhumu,Huangqin,Chaihu,Shouwuteng etc.The efficacy of high-frequency drugs was based on clearing heat and drying dampness to resolve phlegm,inducing dampness to strengthen the spleen,lowering Qi to resolve phlegm and remove lumps,relieving Qi stagnancy in stomach,activating blood circulation and removing blood stasis,etc.The tastes of the drugs were mostly to be hard and warm,sweet and flat,and bitter and cold,and the attributing meridians were mainly the spleen and liver meridians.The most commonly used drug pairs were Fuling-Zhuru,Huanglian-Fabanxia,Chenpi-Zhuru,Fuling-Gancao,etc.The drug pairs with high association support and confidence level were Huanglian-Chenpi,Fabanxia-Chenpi,Zhishi-Zhuru,Zhuru-Fabanxia,Fuling-Chenpi,Gancao-Chenpi.Conclusion Treating dizziness from the perspective of phlegm,the method of treating dizziness is to clear heat and phlegm,clear the gallbladder and stomach.Commonly used formulas such as Huanglian Wendan decoction are modified and adjusted according to the syndrome.

【Objective】 To investigate the effects of 450 nm diode blue laser on the morphological changes and thermal damage of renal pelvis under different conditions. 【Methods】 An ex vivo study was conducted on a fresh porcine pelvis model (7 cm×5 cm×3 cm). The laser fiber was fixed on the mechanical arm perpendicular to the renal pelvis tissue, and the distance between them was 1-2 mm. The renal pelvis tissue was incised at a speed of 1-2 mm/s and power of 5-30 W. After the incised tissue was fixed in formalin (4%), the morphology, depth, width and coagulation thickness were observed with naked eyes and a microscope. 【Results】 The different powers had different vaporization and incision effects. When the operating distance was 2 mm, the speed was 2 mm/s and power was 5 W, the vaporization depth, width and coagulation thickness were approximately 0 9 mm, 0.25 mm and 0.35 mm, respectively. With the increase of power, the vaporization width and depth increased, and the coagulation thickness was 0.35-0.50 mm. When the power was more than 10 W, the renal pelvis tissue was easily penetrated. When the laser power was 20 W, the section of the renal pelvis showed an irregular shape of vaporization. When the operating distance was 1 mm, the whole renal pelvis tissue was easily vaporized. When it was 2 mm, a wide and safe energy treatment window was produced. 【Conclusion】 The 450 nm diode blue laser can vaporize and incise renal pelvis tissue safely and effectively, with high precision and little thermal damage. It is expected to be a new surgical tool in the treatment of renal pelvis lesions.

Objective:To observe the effects of low intensity pulsed ultrasound(LIPUS) on the osteogenic differentiation of rat bone marrow mesenchymal stem cells(BMSCs) on titanium surface.Methods:BMSCs from Wistar rat bone marrow were respectively cultured on the flat titanium surface and the large grain blast acid etched(SLA) titanium surface,and induced by mineralization medium.Then,the cells were interfered by LIPUS and a control condition.Alkaline phosphatase(ALP) were quantitative determinated after 3 and 7 d mineralization induction respectively,ALP staining were observed after 14 d induction.Alizarin red staining were observed after 21 d mineralization induction.Osteogenic related protein and gene expressions were detected after mineralization induction.Results:ALP in culture medium of LIPUS group was higher than that of the control group after 3 d and 7 d mineralization induction(P＜0.05).LIPUS group showed stronger ALP staining and alizarin staining,and more mineralized nodules than control group.The expression of osteogenic related proteins,including Runx2,BMP2,OPN in LIPUS group increased.Osteogenic related genes expression,including ALP,Runx2,BMP2,OPN,OCN and Col-1 of the LIPUS group increased.Conclusion:The osteogenic differentiation of BMSCs on the fiat titanium surface or SLA titanium surface can be promoted by LIPUS.

BACKGROUND:There are many methods in the clinic to treat pelvic fractures, mainly conservative treatment, internal fixation and external fixation. Conservative treatment often causes complications due to poor reduction after fractures. Fixation has good effects on repair of unstable fractures, but fixation is seldom used for pelvic fractures.
OBJECTIVE:To observe the effects of internal fixation on unstable pelvic fractures, and compare with conservative treatment and external fixation.
METHODS:126 cases of unstable pelvic fractures from Longhua District People’s Hospital of Shenzhen City from January 2008 to June 2014 were divided into three groups:conservative treatment group, external fixation group and internal fixation group (n=42). After treatment, patients received X-ray examination. Lindahl imaging criteria were used as evidence. The quality of fracture reduction was evaluated. Patients were regularly fol owed up after treatment. The recovery of limb function was evaluated according to Majeed standard. Repair effects, the excel ent and good rates of fracture healing and cal us growth were evaluated in the last fol ow-up.
RESULTS AND CONCLUSION:During the last fol ow-up, the total efficiency was 81%in the internal fixation group, 69%in the conservative treatment group, and 71%in the external fixation group, and results were significantly better in the internal fixation group than in the other two groups (P<0.05). The Lindahl and Majeed scores were significantly higher in the internal fixation group than in the other two groups (P<0.05). These results suggest that internal fixation for unstable pelvic fracture obtained better recovery effects and efficiency than conservative treatment and external fixation. Thus, the internal fixation is more suitable for patients with unstable pelvic fractures.

Objective To preliminarily explore the role of serum procalcitonin (PCT) quantization in differntiating coagulase-negative staphylococci (CNS) blood stream infection and contamination derived from blood culture in children. Methods Clinical data of 83 cases of CNS derived from blood culture in People’s Hospital of Changning city, Hunan province between January, 2013 and December, 2013 were retrospectively reviewed. The cases were divided into blood stream infection group and contamination group. The basic demographic characteristics, origins of patients, C reactive protein, time to positivity of blood culture (TP), procalcitonin were compared between the two groups, and the diagnostic performance of PCT according to the ROC curve were analyzed. Results Age, gender, C reactive pretein and TP showed no difference between blood stream infection group (n=38) and contamination group (n=45)(P>0.05), while the proportion of contamination of patients from medical wards was higher than that from surgery wards (P<0.05). PCT was signiifcantly higher in blood stream infection group than that of contamination group (P<0.001). The diagnostic sensitivity, spectivity, accuracy of PCT in differentiating the two groups were 86.8%, 82.2%and 84.3%, respectively, at the best cutoff of 0.195 ng/ml. Conclusions PCT may be a good marker for differentiating CNS blood stream infection and contamination derived from blood culture in children, and may help clinicians make early and reasonable selection of antibiotics.

Objective To investigate the dynamic expressions of CXCL11 and its role in the pathogenesis of acute necrotizing pancreatitis (ANP).Methods Forty-eight SD rats were randomly divided into control group and ANP group,with 24 rats in each group.ANP model was induced by retrograde injection of 4％ sodium taurocholate (1 ml/kg body weight) into the biliary and pancreatic duct.The rats were sacrificed at 1,3,6,12 hours.Serum level of amylase was determined,pathological changes in pancreatic tissue were routinely observed and scored.The expression of CXCL11 mRNA and proteon in pancreas was measured by fluorescence quantitative polymerase chain reaction and immunohistochemical method.The serum levels of CXCL11 were measured by enzyme-linked immunoadsorbent assay.Results The serum levels of amylase in ANP rats were significantly higher than those in control group [(6153 ± 355)U/L vs (185 ± 32)U/L at 6 h,P ＜0.05],pathological changes in pancreatre tisues were more significant in ANP rats,and the pathological score was significantly higher than that in control group [(9.00 ± 0.63) vs (0.33 ± 0.12) points at 6 h,P ＜ 0.05] ; the expressions of CXCL11 mRNA and protein in pancreatic tissue were significantly increased than those in control group (3.13 ± 0.43 vs 0.99 ± 0.24,2.76 ± 0.27 vs 0.33 ± 0.12 at 6 h,P ＜ 0.05).The serum level of CXCL11 was significantly higher than that in control group [(112.1 ± 14.2)ng/L vs (56.8 ±4.3) ng/L at 6 h,P ＜0.05)].Conclusions CXCL11 is an early inflammatory mediator in acute pancreatitis,and involved in the pathogenesis of ANP in rats.

Objective To observe the substance P(SP) and calcitonin gene-related peptide(CGRP) expressions in the temporomandibular joints(TM J) of the rats undergone emotional stress and explore the relationship between emotional stress and temporomandibular joint disorder(TMD). Methods Ninety SD rats were averagely randomly divided into emotional stress ( ES ) group( n = 30 ), electric foot-shocked (FS) group ( n = 30 ) and control (CON) group( n = 30). The emotional stress was induced by communication box. The TMJ tissues in ES and CON groups were removed after 1, 3 and 5 weeks of emotional stress for scanning electron microscope ( SEM ) test and immunohistochemistry test. The SP and CGRP expressions were examined with SABC immunohistochemistry and then analyzed by image analysis system. Results The expressions of SP and CGRP had significant difference after 1 ,3 and 5 weeks emotional stress ( SP: 124.5 ± 16.9,185.6 ± 1.8 and 193.5 ± 3.5, respectively; CGRP: 185.9 ±5.3, 112.5 ±5.2 and 174.3 ±5.3 ,respectively) (P＜0. 05 ). The SEM results showed that there was a series of structural change on the condylar surface after emotional stress. Conclusion The SP and CGRP energy nerve fibers take part in the TMJ pathological process undergone emotional stress.

Objective To investigate the role of psychological intervention in the prevention of the temporomandibular joint disease (TMD) , through the observation of the relative changes in the rat TMJ under psychological stress after psychological intervention. Methods The rat model of communication box was built to exert the psychological stress. The antianxiety agent was applied before stress, and the stressor was removed after stress. The expression of the proinflammatory cytokines IL-1 and TNF-α in the mandibular condylar chondrocytes in rat TMJ was detected by ELISA and RT-PCR. Results The RT-PCR results showed that the expression of IL-1 mR-NA increased into the peak in the 1st week, weakened in the 3rd week, and returned to normal in the 5th week, while the TNF-αmRNA peaked in the 1st week, returned to normal in the 3rd week. The ELISA results showed that there was no significant difference of the OD value of the serum IL-1 and TNF-α(0. 095 ±0. 006,0. 077 ± 0.007,0.069 ±0.009 ;0.079 ±0.010,0.075 ±0. 009,0.079 ± 0.012) in the antianxiety agent group (0. 107 ± 0.024,0. 101 ±0.005,0.088 ±0.010)and the stressor removal group(0. 090 ±0.016,0. 088 ±0.005,0.089 ± 0.011) , compared with the control group(0.087 ±0.004,0.090 ±0.009,0.089 ±0.010;0.074 ±0.008,0.069 ±0.015,0.068 ±0.011) (P>0.05), while significant differences were observed when compared with the psychological stress group(0.282 ±0.045,0.226 ±0.021,0.092 ±0.002;0. 164 ±0.009,0.123 ±0.013,0.091 ± 0.006) (P<0.05 ). Conclusion Application of the antianxiety agent and stressor removal could effectively counter the influence of psychological stress to TMJ, which provides good experience for the clinical prevention of TMD.

Objective To investigate the possible mechanisms of the attribution of psychological stress to the temporomandibular joint disorder(TMD) ,through the evaluation of the animal model and detection of the proinflammatory cytokines in the TMJ.Methods The animal models of communication box were built to mimic the psychological stress.The concentration of the serum Cor and ACTH was detected in the control group, Psychological Stress group ( PS group), and diazepam ( anti-anxiety drug) group ( PS + DI group).The expression of the proinflammatory cytokines IL-1 and IL-6 in the rat TMJ in the different phases of psychologicalstress was detected by RT-PCR.Results The results of the serum concen- tration of Cor and ACTH showed that there was significant difference between the control group and the PS group(P＜0.01 ) ,while no significant difference between the control group and the PS + DI group(P＞0.05).The expressions of IL-1 and IL-6 were comapared in all group.The expressions of IL-1 in CON group were (0.453± 0.021 ) mg/L, (0.439 ± 0.028 ) mg/L and (0.454 ± 0.023 )mg/L.These values were markedly increased compared with those of the PS group(0.981 ±0.024)mg/L, (0.746±0.017)mg/L and (0.510 ±0.016)mg/L respectively, P＜0.01 ) ,but no significant differences compared with PS + DI group(0.549 ± 0.014 ) mg/L, ( 0.498 ± 0.014 ) mg/L and ( 0.444 ± 0.022 ) mg/L respectively, P ＞ 0.05).Similar changes were observed in expressions of IL-6.The expressions of IL-6 in the CON rats were (0.525 ±0.028)mg/L,(0.515 ±0.028)mg/L and (0.518 ±0.022)mg/L,respectively,while those of PS group were(0.820 ± 0.023 ) mg/L, (0.694 ± 0.019 ) mg/L and (0.579 ± 0.015 ) mg/L, respectively, which were significan- tly higher in the PS groups(P＜ 0.05 ).But there were no significant differences between CON group and PS + DI group( (0.599 ±0.015)mg/L, (0.541 ±0.015)mg/L, (0.487 ±0.008)mg/L respectively, P＞0.05).Conclusion The psychological stress can play important role in the formation of TMD.

Objective To observe the influence of psychological stress and countermeasure implementation upon the temporomandibular joint ( TMJ ) articular disc and external pterygoid muscle in rats,providing experimental and theoretical evidence for clinical treatment of psychological stress-induced temporomandibular disorders (TMD).Methods The animal models treated by psychological stress induced by alternating current box were established.Before and after subjected to psychological stress,rats were given anxiolytic drugs to eliminate stressors.For all the rats in control group,psychological stress group ( PS group),and psychological stress plus anxiolytic drug injection group ( ( PS + DI) group),the microstructure of TMJ articular disc and external pterygoid muscle the changes in RNA expression of interleukin-1 ( 1L-1 ) were investigated by using transmission electron microscope (TEM),scanning electron microscope ( SEM ) and RT-PCR methods,respectively.Statistical analysis was performed upon the obtained test results.Results The TEM showed pathlogical changes in rats'pterygoid muscles of PS group at 1,3 and 5 weeks,including edema,reduction of substrate density and microchondrial cristae.Instead,these structures were all showed normal in the group of PS + DI and recovering group after removal of stressor.For the rats in PS group,SEM observation revealed that partial synovium of articular disc began to disintegrate 1 week after psychological stress.Strip-like wear degenerations were shown in the surface collagenous fiber in articular disc 3 weeks later,and the surface collagenous fibers in articular disc were arrayed in disorder 5 weeks following stress treatment.No significant microstructural changes in articular disc were observed in all stressor-eliminating groups and ( PS + DI) group 1,3,and 5 weeks following stress treatment.Statistical significance was noted in RNA expression level of IL-1 between PS group and PS + DI group (P＜0.05).In addition,there was significant difference in IL-1 expression between PS group and all stressor-eliminating groups.Conclusion The implementation of countermeasures effectively counteracted the influence upon TMJ induced by psychological stress,and provided possible resolutions for the clinical treatment of TMD induced by psychological stress.