Existing traditional Chinese medicine (TCM)-related databases are still insufficient in data standardization, integrity and precision, and need to be updated urgently. Herein, an Encyclopedia of Traditional Chinese Medicine version 2.0 (ETCM v2.0, http://www.tcmip.cn/ETCM2/front/#/) was constructed as the latest curated database hosting 48,442 TCM formulas recorded by ancient Chinese medical books, 9872 Chinese patent drugs, 2079 Chinese medicinal materials and 38,298 ingredients. To facilitate the mechanistic research and new drug discovery, we improved the target identification method based on a two-dimensional ligand similarity search module, which provides the confirmed and/or potential targets of each ingredient, as well as their binding activities. Importantly, five TCM formulas/Chinese patent drugs/herbs/ingredients with the highest Jaccard similarity scores to the submitted drugs are offered in ETCM v2.0, which may be of significance to identify prescriptions/herbs/ingredients with similar clinical efficacy, to summarize the rules of prescription use, and to find alternative drugs for endangered Chinese medicinal materials. Moreover, ETCM v2.0 provides an enhanced JavaScript-based network visualization tool for creating, modifying and exploring multi-scale biological networks. ETCM v2.0 may be a major data warehouse for the quality marker identification of TCMs, the TCM-derived drug discovery and repurposing, and the pharmacological mechanism investigation of TCMs against various human diseases.

OBJECTIVETo observe the efficacy of acupuncture combined with acupoint catgut embedding sequential therapy and medication for mild and moderate ulcerative colitis.

METHODSOne hundred and twenty patients were randomized into an acupuncture and acupoint catgut embedding sequential therapy group (a combination group) and a mesalazine group, 60 cases in each one. Fifty-seven cases in the combination group and 55 cases in the mesalazine group were included into analysis. In the combination group, acupuncture was applied at Tianshu (ST 25), Shangjuxu (ST 37), Quchi (LI 11) during the activity period, and acupoint catgut embedding was applied at Pishu (BL 20), Zusanli (ST 36), Guanyuan (CV 4) during the alleviate period. The patients in the mesalazine group were treated with mesalazine orally. The treatment was given for 12 weeks. The scores of TCM symptoms, colonoscopy, mucosa healing rate were compared before and after treatment in the two groups. The effects, adverse reactions and the recurrent rates during 1-year follow-up were observed.

RESULTSAfter treatment, the scores of TCM symptoms decreased in the two groups (both <0.05), and the result in the combination group was better than that in the mesalazine group (<0.05). The total effective rate in the combination group was 87.7% (50/57), which was better than 70.9% (39/55) in the mesalazine group (<0.05). The colonoscopy scores decreased after treatment in the two groups (both <0.05). There was no significant difference between the two groups on colonoscopy score and mucosal healing rate [50.9% (29/57) vs 34.5% (19/55), both >0.05]. The recurrent rate in the combination group was 8.5% (4/47)，which was lower than 32.4% (11/34) in the mesalazine group (<0.05). No severe adverse reaction was found during the treatment in the two groups.

CONCLUSIONAcupuncture combined with acupoint catgut embedding sequential therapy can improve mild and moderate ulcerative colitis and reduce the recurrent rate.

OBJECTIVEOn the basis of western medication, to investigate the effect of electroacupuncture (EA) combined with auricular point sticking therapy for anal pain of mixed hemorrhoid after external excision and internal ligation，so as to explore the method of improving its effect.

METHODSNinety patients of mixed hemorrhoids who received external excision and internal ligation were randomly assigned into an EA group, an auricular point sticking group and a combined group, 30 cases in each one. All the treatment was applied 30 min before surgery. Electroacupuncture was used at Xialiao (BL 34) and Changqiang (GV 1) in the EA group, once a day. The auricular points were bilateral shenmen (TF), pizhixia (AT), jiaogan (AH) and gangmen (HX) in the auricular point sticking group, pressing 3-6 times every day, once 3-5 min. EA and auricular point sticking therapy were applied in the combined group. When the visual analogue scale (VAS) score was above 6, aminophenol dihydrocodeine was applied in the three groups. The scores of anal pain VAS and limb activity at the 4th, 12th, 24th, 48th, 72th hours after operation were compared among the three groups, as well as the maximum scores of VAS in 24 hours (T24max VAS) of 1-3 days after operation, the total dose of aminophenol dihydrocodeine 72 h after operation.

RESULTSThe VAS and limb activity scores at all the time points after operation, the T24max VAS on the 1st, 2nd and 3rd days after operation and the dose of aminophenol dihydrocodeine in the combined group were better than those in the EA and auricular point sticking groups (all <0.05). The VAS and limb activity scores at 4, 12, 24 h after operation and T24max VAS on the 1st day after operation in the EA group were lower than those in the auricularpoint sticking group (all <0.05). The VAS and limb activity scores at 48, 72 h after operation, and the T24max VAS on the 2nd and 3rd days in the auricular point sticking group were lower than those in the EA group (all <0.05).

CONCLUSIONEA combined with auricular point sticking therapy are better than simple EA and auricular point sticking therapy for anal pain of mixed hemorrhoid after external excision and internal ligation. The analgesic effect of EA is rapider, and the effect of auricular point sticking therapy is longer. The combination of the two methods own coordination effect.

OBJECTIVETo compare the difference in the clinical efficacy on anal pendant expansion after PPH (procedure for prolapse and hemorrhoids) of mixed hemorrhoid between acupuncture at Xialiao (BL 34) and Chang-qiang (GV 1) and oral administration of diosmin.

METHODSSixty cases of mixed hemorrhoids after PPH were randomized into an observation group and a control group, 30 cases in each one. In the observation group, since the 1st day, acupuncture had been applied to Xialiao (BL 34) and Changqiang (GV 1). The needles were retained for 30 min afterarrival, and the treatment was given once a day, totally for 7 days. In the control group, diosmin tablets had been prescribed for oral administration since the 1st day, 0.9 g each time, twice a day, totally for 7 days. The degree, persistent time and the pain score of anal pendant expansion were compared on the 1st, 2nd, 3rd and 7th days after PPH between the two groups and the efficacy was evaluated.

RESULTSOn the 1st day after PPH, the diffe-rences in the scores of the degree and persistent time of anal pendant expansion were not significant statistically between the two groups (all>0.05), but the pain score in the observation group was lower than that in the control group (<0.05) and lower than that before treatment (<0.05). On the 2nd, 3rd and 7th days after PPH, the degree and persistent time of anal pendant expansion and pain score in the two groups were all lower than those before treatment (all<0.05). The results in the observation group were better than those in the control group (all<0.05). At the end of treatment (on the 7th day after PPH), the total effective rate in the observation group was higher than that in the control group[90.0% (27/30) vs 83.3% (25/30),<0.05].

CONCLUSIONSAcupuncture at Xialiao (BL 34) and Changqiang (GV 1) achieves the superior efficacy on anal pendant expansion after PPH of mixed hemorrhoids as compared with diosmin tablets.

Objective To summarize the experiences in the diagnosis and treatment of delayed rupture of spleen.Methods The clinical data of 26 patients with traumatic delayed rupture of spleen who were admitted to the Dachang Hospital from January 2005 to December 2013 were analyzed retrospectively.The medical history,clinical presentation,results of laboratory examinations were analyzed,and the splenic trauma was graded.Surgical procedures were selected according to the condition,severity of the splenic trauma and time of injury.Patients were followed up via outpatient examination or telephone interview till June 2014.Results Twenty-six patients had the history of injury of the left hypochodriac region,and were accompanied by slight abdominal pain and a short period of pain alleviation,and then pain in all regions of the abdomen at postoperative hour 48.All thepatients had pale face,tenderness,rebound tenderness or tonus.The pulse above 100 per minute was observed in 20 patients,and 15 patients had blood pressure under 90/60 mmHg (1 mmHg =0.133 kPa).The level of hemoglobin under 5 g/L was observed in 3 patients,and 5-10 g/L in 21 patients.All the 26 patients received abdominal paracantesis,non-coagulating blood was extracted in 25 patients.Twenty-six patients received B ultrasonography,and 24 had splenic rupture.Nineteen patients received computed tomography (CT),and 19 had splenic rupture.Ten patients had type Ⅰ splenic rupture,12 had type Ⅱ splenic rupture,3 had type Ⅲ splenic rupture and 1 had type Ⅳ splenic rupture.All the 26 patients received operation,including 2 received suture of the ruptured spleen,2 received resection of the lower part of the spleen,9 received total splenic resection,and 13 received total splenic resection + autogeneous transplantation of greater omentum.Two patients died of hemorrhagic shock intraoperatively,and the other 24 patients were cured.The operation time and volume of hemoperitoneum were (90 ± 15)minutes and (1 500 ± 700) mL,respectively.Twenty-four patients received blood transfusion,with the volume of transfused blood of 1 200 mL.The mean duration of hospital stay was 16.7 days.Two patients had complications after the operation,which were left pleural effusion and splenic fossa effusion,and they were cured by symptomatic treatment.No infection or other complications were observed.All the 24 patients were followed up for 6-108 months (median,46 months).One patient died of myocardial infarction at postoperative year 5,and the other 23 patients survived.Conclusions B sonography and computed tomography are important methods for the treatment of delayed rupture of spleen.Traumatic delayed rupture of spleen should be considered when the patient had symptoms including history of injury of the left hypochondriac region,the course of abdominal pain,abdominal pain alleviation,abdominal pain recurrence,time for abdominal pain alleviation longer than 48 hours,interperitoneal hemorrhage and the signs of splenic rupture indicated by B ultrasonography and computed tomography.The indication of spleen-preservation surgery or splenectomy for patients with delayed rupture of spleen should be strictly controlled and optimal surgical procedure should be designed according to the condition of the patient.

Objective To explore the therapeutic effect on the prevention of eccyesis by optimizing fallopian tube to be pregnant.Methods Three hundred and seventy-nine patients with infertility were divided into two groups:control group with 187 patients received the combined optimized treatment,and study group with 192 patients received the combined optimized treatment and optimizing fallopian tube to be pregnant.All patients received the hysterosalpingography uterosalpingography(HSU)whik the patients of the study group received the ultraphonic monitor for the.dominant follicle besides for 6 ovulatory cycle.Results There were intrauterine gestation 59 patients(31.55%,59/187),eccyesis 20 patients(10.70%,20/187)and infertility 108 patients(57.75%,108/187)in control group while there were intrauterine gestation 83 patients(43.23%,83/192),eccyesis 10 patients(5.21%,10/192)and infertility 99 patients (51.56%,99/192)in study group.The intrauterine gestation rate in study group was higher than that in control group(P<0.05),and the eccyesis rate was lower than that in control group(P<0.05).But there was no significant difference in the infertility rate between two groups(P＞0.05).The eccyesis rate in fallopian tube unsmooth was higher than that in salpingemphraxis and fallopian tube canalization respectively[12.59%(18/143),2.63%(2/76),2.70%(2/74),P<0.05].Conclusion Selecting the optimizing fallopian tube by HSU and monitoring the dominant follicle by ultraphonic to guide pregnancy can let the dominant follicle grow and conceive in the optimizing fallopian tIlbe,and this treatment can raise the intrauterine gestation rate and decrease the cause of eccyesis.

Objective To investigate the prevalence and molecular epidemiology of clinical isolates of plasmid-mediated 16S rRNA methylases-producing Klebsiella pneumoniae. Methods From January 2006 and September 2007, 337 non-replicate clinical isolates of Klebsiella pneumoniae were consecutively collected from inpatients in a teaching hospital in Wenzhou, China. All of the isolates were identified by the automated microbiology systems. MICs of amikacin, gentamicin and tobramycin were determined by agar dilution method. The isolates were investigated for the presence of ESBLs by the CLSI-recommended confirmatory tests. PCR was used to detect 16S rRNA methylase genes, ESBL genes and class Ⅰ integrase gene. The homology of these isolates was analyzed by pulse-field gel electrophoresis (PFGE). Results Sixty-four ( 19. 0% ), 28 ( 8. 3% ) and 55 ( 16. 3% ) of 337 isolates were resistant to gentamicin, amikacin and tobramycin, respectively. Twenty-one (6. 2% ) isolates carried 16S rRNA methylase genes (3 for armA, 13 for rmtB, 5 for both armA and rmtB) and high-level resistant to gentamicin, amikacin and tobramycin ( MICs ≥256 mg/L). Nineteen of 21 isolates with 16S rRNA methylase genes were ESBL producers, blaCTX-M-14-like, blaCTX-M-like and blaSHV-12-like were predominant genotypes of ESBLs. The plasmids of 13 isolates were transferred into the recipients E. co/iJ53. PCR and sequence analysis revealed that blaCTX-M-14-like,blaCTX-M-15-like and blaSHV-12-like were co-transferred with the armA or the rmtB to the recipients. All transconjugants harbored intll and blaTEN-1. Of the 21 isolates, 14 patterns were obtained by PFGE. Conclusion Both horizontal gene transfer and clonal spread were responsible for the dissemination of the rmtB or the armA gene in Klebsiella pneumoniae.

Objective To investigate the prevalence of aac(6')-Ib-cr in clinical isolates of Klebsiella pneumoniae.Methods A total of 337 isolates of Klebsiella pneumoniae were isolated from clinical specimens in our hospital from Jan,2006 to Sep,2007.Gentamycin,amikacin or tobramicin was used to screen the isolated with aac(6')-Ib-cr.aac(6')-Ib and class 1 interase gene(intl1)was determined by PcR All PCR products of aac(6')-Ib were sequenced for determination of aac(6')-Ib-cr. MICs of antibiotics were determined by agar dilution method.The ESBLs-producing isolates were determined by the CLSI-recommended confirmatory tests.Conjugation test was used to detect the transfer of plasmid.Results Of the 337 clinical isolates of Klebsiella pneumoniae,64(19.0%),28(8.3%)and 55(16.3%)isolates were resistant to gentamycin,amikacin and tobramycin,respectively.Among 64 gentamycin-resistant isolates,24(37.5%)were positive for aac(6')-Ib-cr,including 13 ciprofloxacin-resistant isolates and 11 ciprofloxacinsusceptible isolates.The prevalence of aac(6')-Ib-cr in ciprofloxacin-resistant and-susceptible isolates were 54.2%(13/24)and 27.5%(11/40).The positive rates of ESBLs and intl1 in the 24 isolates carrying aac(6')-Ib-cr were 79.2%(19/24)and 91.7%(22/24).Plasmids carrying aac(6')-Ib-cr of 13 isolates were successfully transferred to E.coli J53.Plasmids of all transconjugants were positive for aac(6')-Ib-cr and intl1.All transconjugants were ESBL producing strains.Conclusions aac(6')-Ib-cr exists widely in clinical isolates of Klebsiella pneumoniae.aac(6')-Ib-cr and ESBL gene usually coexist in a selftransmissible conjugative plasmid by class 1 integron.

Background Traditional Chinese medicine (TCM), especially herbal medicine, has been widely used in China and now is also being increasingly used in other countries for the treatment of cardiovascular diseases. Although many studies have demonstrated that certain Chinese herbal products are effective and safe for the treatment of cardiovascular diseases, most of these lack sufficient quality. Therefore, large randomized clinical trials and further scientific research to determine its safety, effectiveness are necessary.QiShen YiQi Dripping Pills (QSYQDP) is a herbal preparation clinically used in the treatment and prevention of coronary artery disease. Preliminary observations have shown its safety and effectiveness. Methods/Design This randomized, controlled trial will recruit 3600 patients with a history of myocardial infarction. Patients will be randomized into two groups by a Centr-Randomized System. One group receives QSYQDP, the other group receive aspirin. This trial protocol will describe eligibility criteria, detailed information on the treatment definition, blinding, endpoints, statistical methods, sample size determination, data management, legal aspects, and the current status of the trial. Discussion This trial is one of the first randomized, controlled clinical trial to evaluate the efficacy and safety of traditional Chinese herbal medicine in the treatment and secondary prevention of coronary artery disease. The results of this study should help to define the role of TCM in modern medical care, as well as to provide the management strategy for CAD patients in China and other countries.

[Objective]To study the stability function of Luschka Joint(LJ) of lower cervical spine.[Method]C_(3、4) and C_(5、6) as a funtional spinal unit(FSU) were taken from 16 fresh adult cadavers and randomly divided into experimental group,its LJ was cut out and in control group,LJ was maintained.The FSU of C_(3、4) and C_(5、6)was loaded and tested on the AG-10 AT automatic electronic versatile machine in normal,flexion ≤10? and extension ≤7.5? positions.Data of sigattal horizontal displacement(SHD),rotational angulation(RA) and coronary laterral displacement(CLD) were collected,counted and 3-dimesionally analyzed by computer.[Result]The SHD,RA and CLD of FSU experimental group were significantly different with that of control group(P