The Simultaneous Treatment of Pulse and Syndrome of Water Qi Disease chapter of Synopsis of Golden Chamber is regarded as one of its most challenging sections. Although nominally focused on water qi disease, this chapter also discusses yellowish sweating disease, qifen disease, and other diseases. This multiplicity of topics led to the misconception that all these diseases are water qi diseases, complicating the diagnosis and treatment strategies. By distinguishing water qi as both a pathogenic factor and a disease entity, this paper redefines the concept, linking it to the abnormal accumulation of liquid and gaseous water in the body, akin to the disrupted water cycle of the nature. It demonstrates that ZHANG Zhongjing recognizes the primary syndrome, pathogenesis, and therapeutic principles of water qi disease from the generation, aggregation, and dissipation of vaporous water. The study further differentiates water qi disease, yellowish sweating disease, and qifen disease as distinct entities. An analysis of their etiology, pathogenesis, syndromes, and treatment approaches establishes their independence while exploring their interrelations. Moreover, the relationships among the qifen, xuefen, and water phase diseases are clarified. ZHANG Zhongjing′s discussion in the Simultaneous Treatment of Pulse and Syndrome of Water Qi Disease identifies the three diseases around the three " disease of water phase." The clarification of the concepts and relationships of the diseases in the Simultaneous Treatment of Pulse and Syndrome of Water Qi Disease will help to systematically and thoroughly elucidate ZHANG Zhongjing′s principles and thoughts on identifying and treating water qi disease.

Objective To establish a noninvasive diagnostic model for liver fibrosis in chronic hepatitis B(CHB)patients with normal alanine aminotransferase(ALT)and an age of≤30 years by selecting specific indicators from the commonly used noninvasive indicators such as clinical,biochemical,and imaging indicators,to avoid invasive liver biopsy in such patients to some extent,and to guide the timing of antiviral therapy.Methods A total of 251 CHB patients with normal ALT and an age of≤30 years who underwent liver biopsy in Shenzhen Third People's Hospital and The First Hospital of Changsha from January 2019 to January 2022 were enrolled,with 175 patients in the model group and 76 patients in the validation group,and commonly used clinical indicators were obtained based on clinical experience and related articles.The two-independent-samples t test or the two-independent-samples Mann-Whitney U rank sum test was used for comparison of continuous data between groups,and the chi-square test was used for comparison of categorical data between groups.A Spearman rank correlation analysis was used to investigate the correlation between each indicator and liver fibrosis and identify the indicators with correlation(P<0.01,r>0.200);a Logistic regression analysis was used to establish a noninvasive diagnostic model,and the receiver operating characteristic(ROC)curve was used to evaluate its performance and perform validation of the model;this model was then compared with the widely used models of aspartate aminotransferase-to-platelet ratio index(APRI)and fibrosis-4(FIB-4).The Kappa consistency test was used to investigate the consistency of pathological results.Results A total of 17 commonly used clinical indicators were obtained,among which 9 indicators(ALT,aspartate aminotransferase[AST],gamma-glutamyl transpeptidase[GGT],ferritin[FERR],platelet count[PLT],procollagen type Ⅲ amino-terminal peptide[PⅢP],collagen Ⅳ[CⅣ],HBV DNA,and spleen thickness)were correlated with liver fibrosis(P<0.01,r>0.232).Based on the above indicators,the predictive model was established as P=1/(1+e-γ),γ=-1.902+0.106×AST-0.011×PLT-0.265×HBV DNA+0.059×PⅢP,in which P was the probability for predicting≥S2 liver fibrosis and γ was the predictive index.The comparison between each indicator and the model showed that the model had the largest area under the ROC curve of 0.852,with a sensitivity of 92.7%and a specificity of 76.9%.The model was validated in 76 patients and showed an accuracy of 77.600%.The model was compared with APRI and FIB-4,and the results showed that the model has good accuracy.Conclusion Compared with the models of APRI and FIB-4 commonly used in the world,this model can more accurately judge the degree of liver fibrosis in such patients,thereby replacing liver biopsy to some extent and guiding the timing of antiviral therapy.

The relationship between dosage form and efficacy is an important aspect of traditional Chinese medicine pharmacy research.However,there is a lack of systematic analysis of how ancient physicians understood the functional characteristics of decoction.By analyzing the advantages and effects of using decoction in the Jingui Yuhan Jing,it can be observed that ancient people's understanding of the therapeutic effect of decoction did not solely stem from medical practice,but also understood and elaborated on the function of decoction through the characteristics of water.This article starts with a discussion on the application of decoction in Jingui Yuhan Jing and uses metaphorical cognitive theory to analyze how ancient physicians understood and constructed the cleansing,opening,guiding,dispersing,nourishing,and moisturizing effects of decoction in the aspects of water cleanliness,connectivity,fluidity,impact,and moisturizing.This has formed a relatively complete set of explanations on the functional characteristics of decoction based on the"water metaphor".This has affected the widespread application of decoction and selection of solvents and has developed a new thinking system for the understanding and research of ancient dosage forms.

Purpose: Patients with advanced biliary tract cancer (BTC) have a poor survival. We aim to evaluate the efficacy and safety of nab-paclitaxel plus gemcitabine and cisplatin regimen in Chinese advanced BTC patients. Materials and Methods: Eligible patients with locally advanced or metastatic BTC administrated intravenous 100 mg/m2 nab-paclitaxel, 800 mg/m2 gemcitabine, and 25 mg/m2 cisplatin every 3 weeks. The primary endpoint was progression-free survival (PFS). The secondary endpoints included overall survival (OS) and adverse events, while exploratory endpoint was the association of biomarkers with efficacy. Results: After the median follow-up of 25.0 months, the median PFS and OS of 34 enrolled patients were 7.1 months (95% confidence interval [CI], 5.4 to 13.7) and 16.4 months (95% CI, 10.9 to 23.6), respectively. The most common treatment-related adverse events at ≥ 3 grade were neutropenia (26.5%) and leukopenia (26.5%). Survival analyses demonstrated that carcinoembryonic antigen (CEA) levels could monitor patients’ survival outcomes. A significant increase in the number of infiltrating CD4+ cells (p=0.008) and a decrease in programmed death-1–positive (PD-1+) cells (p=0.032) were observed in the response patients. Conclusion In advanced BTC patients, nab-paclitaxel plus gemcitabine and cisplatin regimen showed therapeutic potential. Potential prognostic factors of CEA levels, number of CD4+ cells and PD-1+ cells may help us maximize the efficacy benefit.

Objective To evaluate the therapeutic outcome of horizontal bone augmentation by using the modified split crest technique of piezosurgery in mandible molar area. Methods The present study reviewed the record of 15 patients from 2016 January to 2017 March in the department of oral implantology center of Stomato-logical Hospital of Southern Medical University,who underwent the modified split crest technique of piezosurgery in mandible molar area. Preoperative CBCT was performed to determine the bone thickness of the toothless alveo-lar crest of the mandibular posterior region,and the bone thickness was less than 3 mm. The modified split crest technique of piezosurgery was performed for the horizontal bone augmentation at mandibular posterior region. Meanwhile,GBR and the postoperative CBCT were performed to determine the bone width increments,followed with 1-week anti-inflammatory therapy postoperation. Three months after the operations,the bone width incre-ment was examined by CBCT. SPSS13.0 software was used to analyze the collected data. Results The modified split crest technique of piezosurgery in mandible molar area was successfully established,resulting in the mini-mal operative wounds and the slight postoperative reaction,without obvious infection. The postoperative crest width increase achieved 6.05 ± 0.65 mm. At 3 months after operation,the crest width increase reduced to(5.81 ± 0.61)mm. There were significant differences of the alveolar ridge thickness between the preoperative and post-operative patients(P<0.05). There were significant differences between the preoperative crest width and the 3 months after treatment(P<0.05). Conclusion Horizontal bone augmentation of the modified split crest tech-nique of piezosurgery was efficient,which could be performed in very narrow alveolar ridge,and which was rela-tively safe and accurate,with less trauma. No damage was observed to the soft tissue,and the cutting direction can be well controlled.

Objective To investigate the impacts of LASP-1 on the behavior and cell proliferation ability of tumor derived osteoblast-like cells and non tumor derived osteoblasts. Methods QRT-PCR and Western blot were performed to detect LASP-1 expressions in mouse bone marrow mesenchymal stem cells(BMMSC),human osteoblasts (hOB) and human osteosarcoma cell (MG-63). With the construction of recombinant vector and the transfection of shLASP-1,the expression changes in both LASP-1 and osteocalcin(OCN),and the cell number of cell-cycle phase distribution were analyzed. Results With up-or down-regulation of LASP-1,osteocalcin(OCN) expression,cell proliferation ability and the cell number of G2/M phase in non tumor cells(BMMSC,hOB)had no obvious changes. However,as for the tumor cells(MG-63),with an increased expression of LASP-1,the expression of OCN,cell proliferation number and the cell number at G2/M phase changed. There was no significant effect on the moving ability of each cell. Conclusions LASP-1 has no significant effect on the osteogenic proper-ties,cell proliferation ability and cell cycle distribution of non tumor derived cells,but has a regulatory effect on tumor derived cells(MG-63).

Objective: To investigate the effect of pure titanium surface of large diameter TiO2 nanotubes modified by RGD peptide on the adhesion and proliferation of MG63 osteoblasts. to provide theoretical proof for developing titanium implants. Methods: Commercially pure titanium discs were divided into four groups and treated with SLA to obtain a microrough surface (SLA group). Then, nanotubes were imposed on this microrough surface by anodization (SLA+80 group). The surface was then modified by dopamine (DOPA) (DOPA Group), after which bioactive RGD peptide layers were generated on the TiO2 nanotube surfaces via electrochemical and molecular self-assembly techniques (RGD group). The titanium surface morphology and elemental composition of each group were characterized by field emission scanning electron microscopy (FE-SEM) and X-ray photoelectron spectroscopy (XPS). MG63 cells were cultured in vitro to evaluate biological activities of titanium before and after treatment, including the evaluation of early-stage cell adhesion capacity by fluorescence microscopy, proliferation capacity by MTS assay, and mRNA expression of the cell osteoblast-related genes alkaline phosphatase (ALP) and osteocalcin (OCN) by qRT-PCR. Results: FE-SEM and XPS showed that hierarchical micro/nanosurfaces decorated with TiO2 nanotubes were produced on titanium using sandblasting and large grit etching combined with anodization, dopamine was then self-polymerized to form a polydopamine film on the TiO2 nanotube surfaces, and RGD peptides were then conjugated to the polydopamine film, finally forming RGD peptide-modified bioactive layers. In vitro experiments showed that compared with the other three materials, the RGD-modified material was more conducive to cell adhesion and proliferation (P < 0.05). The expression levels of ALP and OCN mRNA in the RGD group were significantly higher than those in the SLA group and DOPA group (P < 0.05). Conclusion Hierarchical micro/nanosurfaces decorated with TiO2 nanotubes functionally modified with RGD peptides have good biocompatibility and could be used for developing titanium implants and further improving early osseointegration.

Objective To explore the relationship between histological chorioamnionitis(HC),fetal vasculitis(FV)and the morbidity of neonatal respiratory distress syndrome(RDS).Methods Three hundred and forty-seven cases of infants at the gestational ages of 28 +0 to 31 +6 weeks who were admitted to the Neo-natology Department of our hospital from October 2009 to June 2013 were analyzed retrospectively.They were divided into four groups according to the occurrence of HC and FV,namely,HC positive group and HC negative group,FV positive group and FV negative group.The patients in the HC positive group were further divided into FV positive group and FV negative group according to the occurrence of FV.The morbidity of RDS among above-mentioned groups was compared.Results The clinical characteristics including propor-tion of male,gestational age,birth weight,cesarean delivery,antenatal corticosteroid use,gestational hyperten-sion,gestational diabetes and cholestasis of pregnancy showed no statistically significant difference among all the groups(P 〉0.05).The incidence of RDS in the HC positive group(145 cases)was 49.6%(72 cases), which was significantly lower than that in the HC negative group(67.3%,126 /202,P 〈0.05).The incidence of RDS in FV positive group(64 cases)was 42.2%(27 cases),which was significantly lower than that in FV negative group(63.3%,179 /283,P 〈0.05)In the HC positive group(145 cases),the incidence of RDS in FV positive group (64 cases)was 42.2% (27 cases),and 55.6% (45 cases)in FV negative group (81 cases),which showed no significant difference(P ﹦0.01 ).Conclusion (1 )HC or FV can reduce the incidence rate of RDS in premature infants.(2)HC combined FV cannot furtherly reduce the incidence of RDS.

Objective To explore the correlation between histological chorioamnionitis (HC) and brain injury in preterm infants. Methods Three hundred and forty-seven cases of infants at the gestational age of 28-31 weeks who were admitted to the neonatology department of our hospital were analyzed retrospectively. They were divided into the HC group and the control group according to the pathological examination. Moreover, HC group was divided into FV group and non-FV group according to the pathological findings of fetal vasculitis (FV). Based on the findings of periodical ultrasonography, the incidences of periventricular leukomalacia (PVL), periventricular-intraventricular hemorrhage (PVH-IVH), and the PVL+PVH-IVH were compared among groups. Results The incidences of PVL in the HC group and the control group were 17.9% and 10.3%respectively. The incidences of PVL+PVH-IVH in the two groups were 5.5%and 1.48%respectively, and the difference between two groups was signiifcant (P<0.05). The incidences of PVH-IVH in the two groups were 28.9%and 26.2%respectively, and the difference between two groups was not signiifcant (P>0.05). In the HC group, the incidences of PVL in FV group and non-FV group were 28.1%and 9.87%respectively, and the difference between two groups was signiifcant (P<0.05). The incidences of PVH-IVH in FV group and non-FV group were 34.3%and 24.7%respectively, and the difference between two groups was not signiifcant (P>0.05). The incidences of PVL+PVH-IVH in FV group and non-FV group were 7.81%and 3.70%respectively, and the difference between the two groups was not have signiifcant (P>0.05). Conclusions HC may increase the ncidences of PVL and PVL+PVH-IVH in the preterm infants, while its effect is minimal on PVH-IVH. FV could increase the incidence of brain injury in preterm infants.

Objective To evaluate the role of protein kinase C (PKC ) in reduction of mitochondrial injury during myocardial ischemia-reperfusion (I/R) by ischemic preconditioning in rats .Methods Forty male Sprague-Dawley rats ,aged 12-13 weeks ,weighing 280-320 g ,were randomly divided into 4 groups ( n=10 each) using a random number table:sham operation group (S group) ,I/R group ,ischemic preconditioning group (IP group) and PKC inhibitor chelerythrine group (C group) .Myocardial I/R was produced by 35 min occlusion of left anterior descending branch of coronary artery followed by 120 min reperfusion .Ischemic preconditioning was induced by 3 episodes of 5 min occlusion of left anterior descending branch at 5 min intervals before myocardial ischemia . Chelerythrine 1 mg/kg was injected intravenously via the caudal vein before ischemic preconditioning in group C . At 120 min of reperfusion ,the animals were sacrificed and the hearts were immediately removed .Mitochondrial suspension was prepared for determination of activities of succinate dehydrogenase (SDH ) , xanthine oxidase (XOD ) , glutathione peroxidase (GSH-Px ) and Ca2+-ATPase , content of Ca2+ , myocardial mitochonerial permeability transition pore (mPTP) opening and membrane potential (Δψm ) .Results Compared with S group , the activities of XOD and Ca2+-ATPase ,content of Ca2+ and mPTP opening were significantly increased ,and the activities of SDH and GSH-Px and Δψm were decreased in I/R group ( P<0.05) .Compared with I/R group ,the activities of XOD and Ca2+-ATPase , content of Ca2+ and mPTP opening were significantly decreased , and the activities of SDH and GSH-Px and Δψm were increased in IP group ( P<0.05) .Compared with IP group ,the activities of XOD and Ca2+-ATPase , content of Ca2+ and mPTP opening were significantly increased , and the activities of SDH and GSH-Px and Δψm were decreased in C group ( P<0.05) .Conclusion PKC is involved in reduction of mitochondrial injury during myocardial I/R by ischemic preconditioning in rats .