This article explored the treatment of laryngopharyngeal reflux disease （LPRD） from the perspective of ascending and descending of qi. It is believed that the disorder of qi movement of the middle jiao （焦） is the key to the pathogenesis of LPRD. The ascending and descending disorder of liver and lung is an important factor in its prolongation and progression. The treatment of LPRD should follow the nature of the spleen and stomach， with the focus on fortifying and transporting the spleen and the stomach， supplemented by soothing the liver and diffusing the lung. The herbs such as Cangzhu （Rhizoma Atractylodis）， Fuling （Poria）， Yiyiren （Semen Coicis）， Gegen （Radix Puerariae Lobatae） and Shanyao （Rhizoma Dioscoreae） could be used for fortifying and circuiting the center earth， and Chaihu （Radix Bupleuri）， Muxiang （Radix Aucklandiae）， Zhiqiao （Fructus Aurantii） and Baishao （Radix Paeoniae Alba） for soothing the liver and nourishing the blood to harmonize the ascending and descending. Jiegeng （Radix Platycodonis） and Xuanfuhua （Japanese Inula Flower） are supplemented to diffuse and direct lung qi downward thereby mediating the center jiao. In this way， the qi movement of the spleen and stomach is restored， and the ascending and descending between the liver and lung are harmonized， and therefore the disease is cureda.

Objective To reveal the potential mechanism of electroacupuncture regulating the neuroinflammatory signaling pathway mediated by triggering receptor expressed on myeloid cells 2(TREM2)in trigeminal ganglion(TG)and caudate nucleus of spinal trigeminal nucleus(SpVc)of rats with type 2 diabetes and dry eyes and alleviating ocular surface sensory abnormalities.Methods Healthy male Sprague-Dawley(SD)rats were induced by intraperitoneal injection of 10 g·L-1 streptozotocin to establish a type 2 diabetes dry eye rat model after 4 weeks of high-glucose and high-fat diets.In the 12th week of the experiment,successfully modeled rats were randomly divided into the model group,electroacupunc-ture group,sham-acupuncture group and fluorometholone group,and healthy male SD rats fed with normal diets were se-lected as the blank group.Rats in all groups were intervened for 2 weeks.The corneal fluorescein sodium staining(FL),tear secretion[detected by phenol red thread(PRT)test],tear film break-up time(BUT),and corneal touch threshold(CTT)in each group were measured before,after modeling,and after the intervention.The changes in tissue morphology of TG and SpVc and TREM2 positive expression sites in each group were observed.The messenger ribonucleic acid(mR-NA)expression of TREM2,interleukin-18(IL-18)and interleukin-1β(IL-1β)of TG and Sp Vc in each group were detec-ted.Results After modeling,compared with the blank group,the FL scores of rats significantly increased and PRT,BUT and CTT significantly decreased in other groups(all P＜0.01).After the intervention,compared with the model group,the electroacupuncture group and fluorometholone group showed significant reductions in FL scores and significant increases in PRT,BUT and CTT(all P＜0.01);there was no statistically significant difference in these indicators in the sham-acupuncture group(all P＞0.05).Compared with the electroacupuncture group,the PRT and CTT of rats in the flu-orometholone group and sham-acupuncture group were significantly reduced,the FL score significantly increased and BUT significantly decreased in the sham-acupuncture group(all P＜0.01),and there was no statistically significant difference in FL score and BUT of rats in the fluorometholone group(both P＞0.05).Compared with the sham-acupuncture group,the fluorometholone group showed a decrease in FL score and an increase in PRT,BUT and CTT in rats,with statistically dif-ferent significances(all P＜0.05).The immunofluorescence double-labeling assay showed a positive expression of TREM2 in activated microglia of TG and SpVc in the model group.The reverse transcription-polymerase chain reaction of TG and SpVc showed that compared with the blank group,the TREM2 mRNA expression in the TG and SpVc of the model group,electroacupuncture group,fluorometholone group and sham-acupuncture group decreased,the IL-18 and IL-1β mRNA in TG and SpVc of the model group,IL-18 and IL-1β mRNA in TG and IL-1β mRNA in SpVc of the sham-acupuncture group increased(all P＜0.05);compared with the model group,the TREM2 mRNA expression increased and IL-18 and IL-1β mR-NA expression decreased in the TG and SpVc of the electroacupuncture group and fluorometholone group(all P＜0.05).Compared with the electroacupuncture group,the TREM2 mRNA expression decreased and IL-18,IL-1β mRNA expression increased in TG and SpVc of the sham-acupuncture group(all P＜0.05),and no significant difference was found in TREM2,IL-18 and IL-1β mRNA expression in TG and SpVc of the fluorometholone group(all P＞0.05).Compared with the sham-acupuncture group,the TREM2 mRNA expression in TG and SpVc increased in the fluorometholone group,while the IL-18 mRNA expression in SpVc decreased(all P＜0.05);the IL-1β mRNA in TG and SpVc and the IL-18 mRNA in TG of the fluorometholone group showed no statistically significant difference(all P＞0.05).Conclusion Electroacupunc-ture can effectively alleviate the ocular surface sensory abnormalities of rats with type 2 diabetes and dry eyes by regulating the inflammatory signaling pathway mediated by TREM2 in TG and SpVc.

Morinda genus of Rubiaceae has been widely used in medicine at home and abroad. Many parts of Morinda tree are utilized in research, mainly including roots, stems, leaves, branches and seeds. Through the research of online databases, the chemical components and biological activities of the iridoids in Morinda genus were summarized in this paper. Up to now, more than 50 kinds of iridoids have been identified. In addition, more and more studies proved that Morinda iridoids might benefit human via such anti-inflammatory, antinociceptive, anti-oxidation, anti-tumor and bone protection. The theoretical basis was provided for the further development and utilization of the iridoids in Morinda genus.

Objective To explore the effects of Yiqi Jianpi decoction on inflammatory reaction, immune function and nutritional status in patients after surgery of laparoscopic rectal cancer. Methods Eighty-two patients with post-operative laparoscopic rectal cancer resection admitted to Pingxiang People's Hospital from June 2017 to March 2019 were enrolled, and according to whether traditional Chinese medicine (TCM) was used or not, they were divided into a western medicine treatment control group (control group) and a combined traditional Chinese and western medicine treatment group (combined group), 41 cases in each group. The control group was treated with symptomatic conventional western therapy, while the combined group was additionally treated with Yiqi Jianpi decoction based on the conventional western treatment as in the control group; the composition of the decoction: hedyotis herba, herba agrimoniae, radix astragali each 30 g; radix codonopsis, ganoderma lucidum each 20 g; rizoma atractylodes, poria cocos and prunella chinensis 15 g each; pinellia ternata 9 g, licorice root 6 g; all the above ingredients were together boiled with water and the fluid (decoction) was filtered, 150 mL once orally taken, twice a day, 21 days constituting one therapeutic course, and the clinical efficacy was evaluated after 1 course of therapy. The changes of TCM syndrome score, simple health situation scale (SF-36) score, inflammatory indexes, immune function and nutritional status of the two groups were observed before and after treatment. Results After treatment, the levels of TCM syndrome score, C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and CD8+ in the two groups were significantly lower than those before treatment, while the levels of SF-36 score, CD4+, CD4+/CD8+, transferrin (TRF) and albumin (Alb) were significantly higher than those before treatment (all P < 0.05), and the degree of changes in the combined group were more significant than those in control group [TCM syndrome score: 3.79±2.22 vs. 6.86±2.02, SF-36 score:75.18±4.13 vs. 64.17±4.01, CRP (mg/L): 4.54±1.31 vs. 5.71±2.21, IL-6 (μg/L): 20.21±2.21 vs. 26.12±2.13, TNF-α (μg/L): 33.04±4.56 vs. 36.41±3.23, CD4+: 0.37±0.03 vs. 0.35±0.03, CD8+: 0.25±0.03 vs. 0.28±0.03, CD4+/CD8+: 1.51±0.39 vs. 1.19±0.37, TRF (g/L): 3.05±0.41 vs. 2.28±0.42, Alb (g/L): 43.88±2.28 vs. 39.86±2.03, all P < 0.05]. Conclusion Yiqi Jianpi decoction in the treatment of patients after surgery of laparoscopic rectal cancer can effectively promote the recovery of gastrointestinal function, reduce the inflammatory reaction, elevate the immune function and improve clinical prognosis.

Objective To investigate the causes of misdiagnosis related to rheumatism diseasecases.Methods A search was performed in database WanFang to identify the misdiagnosed clinical cases reports which were published in Chinese Journal and a retrospective analysis was conducted.All data were analyzed by chi-square test and Fisher's exact test.Results We screened 705 citations and identified 215 articles on the rheumatic diseases,finally,187 reports and 195 cases in total with definite diagnosis were included,accounting for 25.5％ of the total number of misdiagnosed cases.Primary vasculitis (72 cases),rheumatoid arthritis (25 cases),spondyloarthropathy (17 cases),polymyositis (14 cases),systemic lupus erythematosus (13 cases) and Sj(o)gren's syndrome (SS) (12 cases) were amongst the top misdiagnosed rheumatic diseases.There was no difference between 1998-2006 and 2007-2015 in the overall misdiagnosis cases.Single disease comparison,polymyositis,spondyloarthropathy and IgG4 related disease were increased (P=0.002;P=0.034;P=0.060;respectively),while polymyositis was delayed (P=0.002).Rheumatism misdiagnosed cases reported mainly came from tertiary hospitals and the department of rheumatology.Conclusion Misdiagnosed rheumatism are common in clinic.Strengthen the physicians' continuous education,the validity of clinical thinking mode and rational use of diagnostic criteria are important to make correct diagnosis.

Allergic rhinitis (AR) is a global health problem that causes major illnesses and disabilities worldwide. Epidemiologic studies have demonstrated that the prevalence of AR has increased progressively over the last few decades in more developed countries and currently affects up to 40% of the population worldwide. Likewise, a rising trend of AR has also been observed over the last 2–3 decades in developing countries including China, with the prevalence of AR varying widely in these countries. A survey of self-reported AR over a 6-year period in the general Chinese adult population reported that the standardized prevalence of adult AR increased from 11.1% in 2005 to 17.6% in 2011. An increasing number of original articles and imporclinical trials on the epidemiology, pathophysiologic mechanisms, diagnosis, management and comorbidities of AR in Chinese subjects have been published in international peer-reviewed journals over the past 2 decades, and substantially added to our understanding of this disease as a global problem. Although guidelines for the diagnosis and treatment of AR in Chinese subjects have also been published, they have not been translated into English and therefore not generally accessible for reference to non-Chinese speaking international medical communities. Moreover, methods for the diagnosis and treatment of AR in China have not been standardized entirely and some patients are still treated according to regional preferences. Thus, the present guidelines have been developed by the Chinese Society of Allergy to be accessible to both national and international medical communities involved in the management of AR patients. These guidelines have been prepared in line with existing international guidelines to provide evidence-based recommendations for the diagnosis and management of AR in China.
Adult ; Asian Continental Ancestry Group* ; China ; Comorbidity ; Developed Countries ; Developing Countries ; Diagnosis* ; Epidemiologic Studies ; Epidemiology ; Global Health ; Humans ; Hypersensitivity* ; Prevalence ; Rhinitis, Allergic*

Objective To investigate the effect of Shenmai injection on purine content in rat cerebral cortex in order to provide a theoretical basis concerning its brain protective mechanism. Methods Sixteen Sprague-Dawley (SD) rats were randomly divided into two groups:normal saline control group and Shenmai injection group, with 8 rats in each group. Shenmai injection 15 mL/kg was injected intraperitoneally into the rats in Shenmai injection group, while in the normal saline group, an equal volume of normal saline was intraperitoneally injected. After the injection for 24 hours, the rats were sacrificed, and the cerebral cortex was removed on ice, homogenized and its supernatant was extracted;then high performance liquid chromatography (HPLC) was used to detect adenosine triphosphate (ATP), adenosine diphosphate (ADP), adenosine monophosphate (AMP), adenosine and inosine contents in the supernatant of cerebral cortex. Results Compared with normal saline control group, ATP, ADP, AMP, adenosine and creatinine content in the cerebral cortex of Shenmai injection group were significantly higher, the differences being statistically significant [ATP (ng/L): 31.62±5.12 vs. 20.25±4.53, ADP (ng/L): 37.04±6.72 vs. 25.12±7.35, AMP (ng/L): 87.82±20.37 vs. 33.23±10.34, adenosine (ng/L): 2.82±0.15 vs. 1.12±0.61, creatinine (ng/L): 11.72±1.05 vs. 6.05±2.55, P < 0.05 or P<0.01]. Conclusion Shenmai injection can elevate ATP, ADP, AMP, adenosine and creatinine contents in the cerebral cortex of rats, possibly that is the theoretical basis for brain protective mechanism of Shenmai injection.

Objective To explore the feature and rehabilitation of ataxia post 5 times recurrence of hemangioblastoma. Methods A case was reviewed combined with literatures. Results The patient presented cerebellar ataxia after 5 times recurrence of hemangioblastoma. The score of Fugl-Meyer Assessment of balance increased from 4 to 13, while the modified Barthel Index from 50 to 90 after 3 months of rehabilitation. Conclusion Rehabilitation may improve the activeties of daily living and balance for patient with ataxia after multiple recurrences of hemangioblastoma.

Objective　To analyze the clinical indications,efficacy and safety of Chinese minimally invasive percutaneous nephrolithotomy (MPCNL) in treating upper urinary calculi based on our experience.Methods　From June 1992 to September 2010,a total of 10,452 patients (6060 males and 4392 females)with a mean age of (47.6 ± 13.7) years (7 months-93 years) received MPCNL in our center.The mean stone burden was (777.4 ± 740.3) mm2 (20 - 4 080 mm2 ).The data of stone burden,operative techniques,operating time,stone-free rate,major complication,hospital stay and stone composition were investigated.　Results　Of the 10 452 cases,11 801 procedures were performed on 10 876 (5493 left and 5383right) renal units,including 10 102 first stage procedures,1604 secondary procedures,86 third procedures and 9 fourth procedures.There were 11 830 tracts established,including 373 (3.15％ ) tracts of 14 F,7867 (66.50％) tracts of 16 F and 3590 (30.35％) tracts of 18 F.There were 1207 (10.20％),9174(77.55％) and 1449 (12.25％) punctures located in upper,middle and lower pole,respectively.956(8.79％) renal units were managed with multiple tracts,which including 2 tracts in 846 (7.78％) units,3tracts in 85 (0.78％) units,4 tracts in 18 (0.17％) units and 5 tracts in 7 (0.06％) units.Pneumatic lithotripsy was used in 8563 (72.56％) procedures,Holmium:YAG laser lithotripsy was used in 2981(25.26％)　procedures and Pneumatic lithotripsy + Holmium: YAG laser lithotripsy was used in 257(2.18％) procedures.762 (7.29％) cases needed ESWL to clean the stone after MPCNL.The average operating time was ( 101.3 ± 44.2) min ( 10 -240 min).The stone-free rate of MPCNL was 89.9％,which increased to 93％ by adjunctive ESWL.And the mean hospital stay was ( 13.2 ± 6.4) days (2 - 72 days).The major complications happened on 321 (3.07％) cases,including 294 (2.81％ ) cases of blood transfusion,12 (0.11％ ) cases of sepsis,2 (0.02％) cases of renal abscess,9 (0.09％) cases of pleura injury,2 (0.02％) cases of colon injury and 2 (0.02％) cases of death.53 (0.51％) cases needed selective renal arterial embolization to achieve hemostasis.The main stone compositions were analyzed in 4345 cases.Calcium oxalate,calcium phosphate,magnesium ammonium phosphate,uric acid,ammonium urate,carbapatite and cystin were 91.74％,90.33％,14.91％,17.77％,4.83％,8.47％ and 0.51％,respectively. Conclusions　MPCNL is an effective and safe treatment option for all kinds of upper urinary calculi in patients at all ages with a high stone free rate and low major complication rate.

Objective To explore the effect of the rational-emotive-behavior therapy (REBT) on mood, cognition and activities of dailyliving (ADL) of patients with poststroke depression (PSD). Methods 80 PSD patients were divided into control group (n=40) and observationgroup (n=40). Both groups were given Prozac (20 mg/d) for 8 weeks, and the observation group received REBT (3 times per week, 20min every time) additionally. Hamilton Rating Scale for Depression (HAMD), Mini Mental State Examination (MMSE) and Barthel Index(BI) were evaluated before and after treatment. Results After 8-week treatment, the scores of HAMD in two groups reduced significantly(P<0.01), and the scores of MMSE and BI increased significantly (P<0.01). The scores of HAMD were lower in the observation group thanin the control group (P<0.05), and the scores of MMSE and BI were higher in the observation group than in the control group (P<0.05). TheBI score was related with sleeping disorder in control group (P<0.05). The BI score was both related with sleeping disorder and somatizationin the observation group (P<0.05). There was no significant difference in the extent of effectiveness on depression between two groups(P>0.05), but there was the trend that the efficacy of the observation group was better than the control group. Conclusion REBT combinedwith antidepressant drugs can better relieve the symptoms of depression and improve cognitive function and ADL of PSD patients. The improvementof somatization and sleep disorders by REBT has a relationship with the enhancement of ADL.