The Menghe Medical School is a highly influential academic school of Chinese medicine in China.Its academic features are mainly learning from others'strengths,openness and tolerance;integrity as the foundation,communication as the strength;harmo-ny as the way,and agility as the technique.The Menghe Medical School originated in Menghe,developed in Shanghai,spread all over the country,and spread around the world.The reasons for the prosperity and development of the Menghe Medical School are analyzed.Among them,imperial doctors being rewarded and supported,the stars having their roots in Menghe,inheritance from teach-ers by blood,help from in-laws,and the establishment of education and leadership in development are the main factors.On the basis of inheriting the scholarship of Menghe Medical School,Professor Tong Xiaolin innovatively proposed academic ideas such as the train-ing path of Xiang thinking,state-target differentiation and treatment,and dosage and effectiveness of prescriptions and medicines,pushing the academic thought of Menghe Medical School to a new theoretical peak in the new era.Based on the majestic development path of the Menghe Medical School,the implications for the inheritance,innovation and development of modern Chinese medicine are analyzed.

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Objective To investigate the effect of a Chinese medicine formula GAPT, a combination containing Chinese herbs ginseng,Acorus tatarinowii, Polygala and tuber curcuma, on the behavior and cholinergic system in mice with scopolamine-induced memory impairment, and to explore the neuroprotective mechanism of GAPT. Methods ICR mice were randomly divided into normal control group(solution of 0.5% carboxy methyl cellulose, CMC), model group (0.5% CMC),positive control group(donepezil, 0.92 mg/(kg·d)), GAPT high, medium and low dose groups(20 mg/(kg·d),10 mg/(kg·d),5 mg/(kg·d)),18 mice in each group, were given intragastric gavage once a day for 30 days. After the last administration,the control group and model group received intraperitoneal injection of normal saline,and the other groups intraperitoneal injection of scopolamine(3 mg/(kg·d)), dissolved in 0.9% normal saline. Morris water maze test was performed to assess the learning and memmory ability. Then the mice were killed and the Ach content and AchE and ChAT activity in the cortex and hippocampus were detected. Results GAPT increased the swimming dis-tance,swimming time and the residence time in target quadrant of the model mice,increased the content of Ach and the ac-tivity of ChAT,and decreased the activity of AchE in the brain of the model group. Conclusions GAPT can improve the learning and memory ability of mice induced by scopolamine,and its mechanism may be related to cholinergic system.

Objective To observe the characteristics of magnetic resonance angiography of(MRA) ophthalmic artery in patients with diabetic retinopathy (DR).Methods A total of 36 eyes of DR patients (DR group) diagnosed by clinical examination were included in the study.Among them,there were 42 eyes in 21 males and 15 eyes in 15 females.The average age was 55.2 years old.The average duration of diabetes was 7.56 years.All eyes were examined by MRA and fluorescein fundus angiography (FFA) in the ophthalmic artery.At the same time,24 eyes of 12 patients were examined by computed tomography angiography (CTA).Twenty-two healthy volunteers with age and gender matching were selected as the control group.Among them,there were 13 males and 9 females.All patients underwent MRA examination of the ophthalmic artery;at the same time,5 eyes of 5 eyes were examined by CTA.MRA and CTA were classified into three grades according to the development condition and shape change of the ophthalmic artery.0 grade:no abnormality;grade Ⅰ:mild lesion;grade Ⅱ:obvious lesion.According to the results of FFA examination,it was divided into no obvious disease stage,background stage,proliferative stage,proliferative stage.The morphological features of the MRA of the ophthalmic artery in the DR group and the control group were compared.The relationship between the MRA grading of the ophthalmic artery and the FFA staging was observed in the DR group.The consistency analysis between the MRA and CTA grades of the ophthalmic artery in the DR group was performed by Kappa test;the relationship between the MRA grade and the FFA staging of the ophthalmic artery was analyzed by Spearson correlation analysis of the same data with two-way ordered attributes.Results In 44 eyes of the control group,the MRA in grade 0 and Ⅰ of the ophthalmic artery were 41 and 3 eyes,respectively;all eyes of the CTA examination of the ophthalmic artery were grade 0.In 72 eyes of the DR group,the MRA in grade 0,Ⅰ,and Ⅱ of the ophthalmic artery were 28,28,and 16 eyes,respectively.Among the 24 eyes examined by CTA,there were 13,6,and 5 eyes in grade 0,Ⅰ,and Ⅱ,respectively.In the DR group,the classification of MRA and CTA of the ophthalmic artery was highly consistent (Kappa value =0.86).There were significant differences in the number of eyes with different grades of MRA in the DR group and the control group (Z=-5.74,P=0.000).In 72 eyes of the DR group,there were 8,12,22,and 30 eyes in no obvious disease stage,background stage,proliferative stage,and proliferative stage,respectively.Correlation analysis showed that there was a significant correlation between MRA grading and FFA staging in the DR group (r=0.405,P=0.000).Conclusions MRA can show the changes of ophthalmic artery morphology and reflect DR staging to a certain extent.It has a high consistency with FFA vascular changes.

Objective To compare effectiveness,performance,and complications between ultrasound-guided selective cervical nerve root block and interscalene brachial plexus block for patients undergoing arthroscopic surgery in perioperative period.Methods Seventy patients scheduled for arthroscopic surgery,25 males and 45 females,aged 18-75 years,were randomly divided into two groups.They were given either selective cervical nerve root block (group S,n =35) or interscalene brachial plexus block (group ISB,n=35).In group S,C5 and C6 nerve roots were given 0.5％ ropivacaine 5 ml respectively;In group ISB,patients were given 0.5％ ropivacaine 10 ml under ultrasound guidance.The primary outcome:VAS score and forearm modified Bromage scale (MBS) score were recorded at 4,12 and 24 hours after surgery;Secondary outcomes:cumulative tramadol consumption,the patients' satisfaction rate and adverse effects were recorded.Results The VAS scores in group S was significantly lower than that in group ISB at 12 hours after surgery (1.7±0.8 vs 3.6±0.7,P＜0.05).The forearm MBS scores in group S was significantly higher than that in group ISB 4 hours after surgery (P＜0.01).Compared with group ISB,the amount of tramadol consumption was lower at 24 hours after surgery [(37.5±35.9) mg vs (112.5±43.5) mg,P＜0.05)].The satisfaction rate of group S was higher than group ISB (88％ vs 56％,P＜0.05).There was no significant difference in side effects between the two groups.Conclusion In arthroscopic surgery,the selective cervical nerve root block is superior to the brachial plexus block.

Objective:To analyze the clinical efficacy of compound honeysuckle decoction hot and humid joint fusidic acid cream in the treatment of targeted drugs-induced rash.Methods:80 cases of patients with targeted drugs-induced rash admitted in our hospitalfrom August 2014 to August 2016 were selected and divided into two groups with 40 cases in each group according to the drawing method.The control group was treated by fusidic acid cream,while the observation group was treated by compound honeysuckle decoction hot and humid joint fusidic acid cream,the changes of symptom score,quality of life after treatment,clinical efficacy and incidence of adverse reactions were compared between two groups.Results:After treatment,the symptoms score of observation group ((6.87± 1.25) points) was lower than that of the control group ((10.29± 2.74) points)(P＜0.05),the quality of life score ((3.15± 0.57)points) of observation group was lower than that of the control group ((6.42± 1.20) points)(P＜0.05).The effective rate of observation group(95.00％) was higher than that of the control group(77.50％)(P＜0.05),no statistical difference was found in the incidence of adverse reactions was observed between two groups (P＞0.05).Conclusion:Compound honeysuckle decoction hot and humid joint fusidic acid cream was effective in the treatment of targeted drugs-induced rash,it could effectively relieve the clinical symptoms,improve the quality of life.

Objective: To detect the vascular paths in the lateral wall of maxillary sinus using cone beam computer tomography (CBCT), and to retrospect the surgical managements of avoiding bleeding complication during the lateral approach maxillary sinus elevation.Methods: The documents of 71 consecutive patients with 81 sides maxillary sinus elevation surgery were collected.The vascular paths in the lateral wall of maxillary sinus were detected by the preoperative CBCT, and the messages about the vascular in surgical records were analyzed.Results: The paths of the vascular could be detected in 77 (95.1%) sides maxillary sinus in the reconstruction panoramic images of CBCT.At the position of the first molar, the paths of the vascular of the lateral maxillary sinus walls could be detected in 54 sides (66.7%) in the reconstruction coronal images of CBCT, and the other 27 sides (33.3%) could not be detected.Two approximately parallel paths of the vascular were found in 3 sides (3.7%) of the lateral maxillary sinus walls.The different diagnoses occurred in 6 sinuses between two observers.The kappa of diagnostic consistency of the two observers was 0.842 (P<0.001).The mean distance between the lower border of the vascular path to the plane of the alveolar crest of 54 sides maxillary sinuses was about (13.0±4.7) mm.The mean distance between lower border of vascular path to the plane of the floor of the sinus was (9.3±4.8) mm.The vascular path was located in the floor wall in 1 sinus.During the lateral approach maxillary sinus elevation operation, intraosseous vessels were dissected in 4 sides sinus lateral wall, the vascular path was avoided consciously in 3 sides, and the sinus elevation surgery had to be given up in 1 side for the vessel was torn and bleeding.There were no vascular related messages in 73 sides of the lateral approach maxillary sinus elevation operation records.Conclusion: The vascular paths of maxillary sinus wall could be detected by CBCT in most cases.Preoperative CBCT examination was proved to be reliable.The vascular paths of maxillary sinus wall should be examined carefully.It was helpful to make the surgical design perfectible and reduce the risk of tearing the vessel in operation.

Heterotopic ossification is a common complication after acetabular fractures and fractures of the elbow.Heterotopic ossification often leads to severe joint movement disorder,which brings great pain to the patient.This paper reviewed the clinical research,including pathogenesis,clinical diagnosis,prevention,treatment and future directions of heterotopic ossification to investigate the effective method in prevention and treatment of heterotopic ossification.

Objective To predict the risk of 28-day mortality in septic patients in intensive care unit (ICU) with the combination of Weighted index of comorbidities (WIC) and sepsis-related organ failure assessment (SOFA) score.Methods The clinical data of adult severe sepsis/septic shock patients in Department of Emergency Medicine of Changzheng Hospital and Department of Critical Care Medicine of Jinan Military General Hospital from October 2011 to February 2013 were analyzed retrospectively.The etiological factor,past history,having severe sepsis or not were recorded.Age score,WIC score,acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score and SOFA score were calculated at or 24 hours after admission.The logistic regression was used and the receiver operating characteristic curve (ROC curve) was drawn to calculate the patients' outcome.Results In 310 enrolled patients,223 (71.9％) patients survived and 87 (28.1％) died.Univariate analysis showed that the P values of the age score,WIC score,APACHE Ⅱ score and SOFA score,chronic cardiac insufficiency,type 2 diabetes,cerebrovascular disease,tumor,multiple injury,pulmonary infection and having severe sepsis or not were all less than 0.2.The above 11 variables were put into the multivariate logistic regression equation 1,of which predicted probability was reserved.It revealed that 5 variables were independently associated with 28-day prognosis,of which influence power in descending order were SOFA score [odds ratio (OR) =1.308,95％ confidence interval (95％ CI):1.158-1.478,P=0.000],having severe sepsis or not (OR =0.206,95％ CI:0.100-0.424,P=0.000),APACHE Ⅱ score (OR =1.090,95％CI:1.021-1.164,P=0.010),WICscore (OR=1.441,95％CI:1.067-1.947,P=0.017),agescore (OR=1.228,95％CI:1.027-1.468,P=0).024),the Walswere 18.554,18.369,6.725,5.662,5.067,respectively.The 3 variables,age score,WIC score and SOFA score,were brought into the multivariate logistic regression equation 2,of which predicted probability was reserved too.It revealed that age score (OR=1.330,95％CI:1.145-1.546,P=0.000),WIC score (OR =1.496,95％ CI:1.145-1.546,P=0.000) and SOFA score (OR =1.429,95％ CI:1.303-1.567,P=0.000),were independently associated with the septic patients' 28-day prognosis.There was no significant difference in the area under receiver operating characteristic curve (AUC) between the SOFA score and APACHE Ⅱ score (0.784 vs.0.780,Z=0.014,P=0.989).However,compared with APACHE Ⅱ score,the AUC of equation 1 (0.888) and 2 (0.851) were much more (Z=4.333,P=0.000; Z=2.669,P=0.008).Conclusion The sensitivity of 28-day prognosis by WIC score was improved greatly with the combination of SOFA score and age score.