This paper is based on the theory of"internal diseases will be presented externally"in Traditional Chinese Medicine, combined with the idea of syndrome differentiation and grasping the main symptoms, and proposes the concept of"virtual special disease". It is extracted from ancient books and expert experience, and it is believed that it is widespread and can be tested by clinical practice. The application of virtual syndrome to diagnosis can achieve the purpose of simplifying the complexity TCM syndrome differentiation. On the one hand, it provides a new exploration for enriching the TCM syndrome differentiation system; on the other hand, it provides new ideas for supplementing the biological research of syndromes and developing the diagnosis of integrated traditional Chinese and Western medicine.

Liver depression and spleen deficiency syndrome is common in clinical practice. It has both the symptoms of uncomfortable liver depression and poor digestion of spleen deficiency. The brain-gut peptide not only regulates the gastrointestinal tract, but also participates in the regulation of mood, which is consistent with the mechanism of liver depression and spleen deficiency syndrome. At present, there are more than 10 brain-gut peptides discovered. This paper reviews several of these brain-gut peptides that are most closely related to liver depression and spleen deficiency syndrome to explore the relationship between brain-gut peptides and liver depression and spleen deficiency.

Wuling powder, which is from Treatise on Cold Damage and Miscellaneous Diseases of Zhang Zhongjing, is a famous formula from thousand years now on. As people have a deeper understanding of Wuling powder, its application range is more extensive. In Treatise on Cold Damage and Miscellaneous Diseases and Essentials from the Golden Cabinet, there are a total of 11 articles concerning Wuling powder. Wuling powder syndrome can be classified as pulse floatation, fever, thirst, irritability, vomiting and urination, which can also occur in dehydration by sorting out and analyzing these articles. This paper talks about the relationship between Wuling powder syndrome and dehydration from the etiology, the symptom and the clinical application as well as to the thought of Wuling powder syndrome several aspects.

Objective To observe the effect of 3D-Slicer combined with sina software assisted minimally invasive neuroendoscopic surgery for hypertensive intracerebral hemorrhage,and investigate the application value of 3D-Slicer combined with sina software in the preoperative localization of minimally invasive neuroendoscopic surgery.Methods From July 2015 to October 2017,38 consecutive patients with supratentorial hypertensive intracerebral hemorrhage admitted to Shunde Hospital,Guangzhou University of Chinese Medicine were enrolled retrospectively.According to the different treatment methods,they were divided into an endoscopic group and a puncture group (n =19 in each group).The endoscopic group was treated with 3D-Slicer combined with sina software for neuroendoscopic hematoma removal,and the puncture group was treated with the hematoma minimally invasive soft-channel puncture and drainage under the CT localization.The effect of 3D-Slicer combined with sina software in the preoperative localization of hypertensive intracerebral hemorrhage by the minimally invasive surgery was evaluated by comparing the hematoma clearance of the first and third day of the two groups of patients after procedure,puncture to the preset position success,postoperative rebleeding,postoperative complications,and good prognosis at 3 months after procedure.Results The clearance rate of hematoma at the first day after operation in the endoscopic group was significantly higher than that in the puncture group ([90 ± 10]％ vs.[46 ± 16]％;t =2.348,P ＜ 0.05).The success of the puncture to the preset position was better than that in the puncture group (19/19 vs.14/19;x2 =5.758,P =0.016),and postoperative rebleeding rate was lower than that in the puncture group (0 vs.4/19;x2 =4.471,P =0.034).There were significant differences.There was no significant difference in postoperative infection complications between the two groups (all P ＞ 0.05).The prognosis of the endoscopic group was good in 17 patients within 3 months after procedure,and the prognosis was good in 11 patients in the puncture group.The good prognosis in the endoscopic group was better than that in the puncture group (x2 =4.866,P =0.027).Conclusion The effect of 3D-Slicer combined with sina software assisted minimally invasive neuroendoscopic surgery for hypertensive intracerebral hemorrhage was better than the hematoma minimally invasive soft-channel puncture and drainage under the CT localization,and the 3D-slicer combined with sina software can provide rapid and accurate preoperative localization for minimally invasive neuroendoscopic surgery of hypertensive intracerebral hemorrhage.

Objective To observe the heart protective effect of exercise preconditioning (EP) in the acute exhaustion exercise (EE) rats, and explore its action mechanism further. Methods Eighty healthy male Sprague-Dawley (SD) rats were divided into control group (C group), EP group, EE group, and EP+EE group randomly, with 20 rats in each group. The rats in EP and EP+EE groups were trained for 3 weeks according to the daily swimming for 60 minutes (swimming 15 minutes, resting 5 minutes, repeating 3 times) with 6 days each week. The rats in EE and EP+EE groups on the last 1 day after 3 weeks, 3% weight heavy weight was carried once for swimming EE. Two hours after the last EE, abdominal aortic blood and heart was harvested, the levels of serum MB isoenzyme of creatine kinase (CK-MB) and calcitonin gene related peptide (CGRP) were determined by enzyme linked immunosorbent assay (ELISA); the ultrastructure of myocardium was observed by optical microscopy; the levels of myocardial malondialdehyde (MDA) and superoxide dismutase (SOD) were determined by ELISA, the mRNA expression of myocardial CGRP was assayed by reverse transcription-polymerase chain reaction (RT-PCR), and the protein expression of myocardial CGRP was assayed by Western Blot. Results Compared with C group, the levels of serum CK-MB and myocardial MDA were significantly increased, serum CGRP content, myocardial SOD activity, and mRNA and protein expressions of myocardial CGRP were significantly decreased in EE group and EP+EE group. Compared with EE group, the levels of serum CK-MB and myocardial MDA in EP+EE group were decreased [CK-MB (U/L): 13.11±0.77 vs. 15.55±0.90, MDA (μmol/L): 389.57±49.60 vs. 709.08±160.49], the level of serum CGRP, and mRNA and protein expressions of myocardium CGRP were increased [serum CGRP (ng/L): 120.41±9.07 vs. 97.97±9.05, CGRP mRNA (2 -ΔΔCT): 0.45±0.09 vs. 0.14±0.02, CGRP protein (gray value): 0.78±0.08 vs. 0.41±0.04, all P < 0.05], the degree of myocardial injury was obviously alleviated. There was no significant difference in the indexes between the EP group and C group. Conclusion EP has the heart protective effect for the acute EE rats, and the mechanism is closely related to the endogenous protective substance CGRP.

Objective To assess the effectiveness of Bankart repair under arthroscope in treatment of recurrent anterior shoulder joint instability. Methods From February 2010 to February 2015, 63 patients with recurrent anterior shoulder dislocation under arthroscipic Bankart repair, and 53 patients (28 male, 25 female) were available for follow-up. The mean age at the time of surgery was 27.9 years (range, 16 ~ 51). All of the 63 patients underwent surgical treatments, and the effectiveness was evaluated with University of California at Los Angeles (UCLA), American Shoulder and Elbow Surgeon scores (ASES), Constant-Murley scores, forward elevation, abduction and external rotation and X-ray. Results The ASES scores, UCLA scores were (97.0 ± 6.8), (29.6 ± 2.5) respectively, improved significantly higher after the surgery (P < 0.05). No significant change was found regarding Constant-Murley scores (99.1 ± 2.4), forward elevation (168.7 ± 2.7)°, abduction and external rotation (72.6 ± 8.7)° compared with the pre-operation. Conclusions Significant difference between pre-operation and post-operation suggests that Arthroscopic Bankart repair is a good option for the treatment of recurrent anterior shoulder dislocation without large glenoid bone loss and poor quality Ligament and joint capsule. Risk factors of recurrence should be evaluated before the surgery to reduce the recurrence rate of dislocation.

Objective To evaluate the efficiency of thyroid ultrasound grading formulated by American Thyroid Association (ATA) and fine-needle aspiration (FNA) biopsy in diagnosing benign and malignant thyroid nodules.Methods A retrospective analysis of 357 thyroid nodules in 342 patients underwent surgical excision or FNA biopsy after thyroid ultrasound was performed.All ultrasonograms were graded according to ATA diagnosis guideline for thyroid nodule versi on 2015.The diagnostic efficiency of ATA grading and FNA biopsy were evaluated comparing with postoperative pathological results.Results There were 248 of 357 thyroid nodules confirmed with postoperative pathology,including 233 malignant and 15 benign nodules.The diagnostic accuracy,sensitivity,specificity,positive and negative predictive value of ATA guideline in diagnosis of malignant thyroid nodules was 88.31％ (219/248),90.99％ (213/233),46.67％ (7/15),96.36％ (212/220)and 25.00％ (7/28),respectively,while of FNA biopsy was 98.81％ (83/84),100％ (75/75),88.89 ％ (8/9),98.68％ (75/76) and 100％ (8/8),respectively.The area under the curve (AUC) of ROC was 0.653 and 0.944 for ATA grading and FNA biopsy,respectively (Z=2.397,P=0.017).Conclusion ATA guideline has high diagnostic value in differential diagnosis of thyroid nodules,while FNA may be more effective in diagnosis of thyroid nodules.

Objective To discuss the mechanism about exercise preconditioning (EP) protected myocardium by means of regulate NLRP3 inflammasome signal pathways on exhausted exercise rats. Methods The male Sprague-Dawley (SD) rats were randomly divided into four groups: normal control group (C group), no EP on exhausted exercise group (EE group), 3dEP + EE group, and 3wEP + EE group, with 12 rats in each group. In C group and EE group, the rats had not done exercise, while EE group took an exhausted swimming exercise with 3% heavy weight on tail at the end of 3 weeks; 3dEP + EE group and 3wEP + EE group exercised according to the standard of swimming for 60 minutes every day (swam 15 minutes, took a rest for 5 minutes, repeated 3 times), 6 days in a week, and were trained for 3 days and 3 weeks respectively, and took an exhausted swimming exercise on the last day. A light microscope and electron microscope were used to observe the myocardial histopathology and ultrastructure change, and enzyme linked immunosorbent assay (ELISA) was used to detect the levels of serum interleukin (IL-1β, IL-18, IL-6), hypersensitive C-reactive protein (hs-CRP), MB isoenzyme of creatine kinase (CK-MB), and brain natriuretic peptide (BNP). The protein expressions of NLRP3 and caspase-1 were detected by Western Blot. The correlations among all the parameters were analyzed by Pearson correlation analysis. Results Under the light microscope and electron microscope, the myocardial fiber morphological structure was normal, neatly, and no interstitial edema, muscle membrane damage or myocardial cell swellen was found in C group. In EE group, heart tissues were stained obviously uneven, a large number of myocardial fibers were fractured and messed, interstitial fibers were hyperplasiaed and edema moderately, much of myocardial cells were edema and necrosis, inflammatory cells were infiltrated, the number of average infiltration inflammatory cells was highest, mitochondria were edema seriously, part of the crest and a small number of membrane were blended together, fuzzy and crest were fractured, sarcomere were disordered; 3dEP + EE group and 3wEP + EE group heart tissues injuries were obviously alleviated, among the three groups, and the best results were in 3wEP + EE group. Compared with C group, the serum contents of IL-1β, IL-18, IL-6, hs-CRP, CK-MB, BNP and heart tissues protein expressions of NLRP3 and caspase-1 in EE group were significantly increased [IL-1β (μg/L): 18.77±1.28 vs. 12.00±1.55, IL-18 (μg/L): 236.79±15.73 vs. 150.74±7.09, IL-6 (μg/L): 59.31±9.17 vs. 34.65±2.89, hs-CRP (mg/L): 469.37±137.73 vs. 107.15±14.22, CK-MB (U/L): 15.57±0.91 vs. 7.40±0.40, BNP (ng/L): 532.08±63.44 vs. 386.96±34.77, NLRP3 protein (gray value): 0.66±0.07 vs. 0.16±0.06, caspase-1 protein (gray value): 0.96±0.08 vs. 0.48±0.06, all P < 0.01]. Compared with EE group, the above indicators in 3dEP + EE group and 3wEP + EE group were remarkably decreased, each index in 3wEP + EE group was lower than that in 3dEP + EE group except BNP [IL-1β (μg/L): 14.26±1.42 vs. 16.57±1.81, IL-18 (μg/L): 168.49±7.05 vs. 191.92±14.16, IL-6 (μg/L): 32.62±3.81 vs. 45.61±6.20, hs-CRP (mg/L): 207.06±41.68 vs. 339.56±89.65, CK-MB (U/L): 9.97±1.08 vs. 13.10±0.78, NLRP3 protein (gray value): 0.33±0.07 vs. 0.48±0.06, caspase-1 protein (gray value): 0.65±0.06 vs. 0.79±0.02, all P < 0.01; BNP (ng/L): 432.53±32.03 vs. 478.46±44.79, P > 0.05]. A positive correlation was shown among IL-1β, IL-18, IL-6, hs-CRP, BNP, CK-MB, NLRP3, and caspase-1 (all P < 0.01). Conclusions EP can reduce inflammatory reaction by regulating the NLRP3 inflammatory signal pathways, and protect the myocardial injury. The protection of the heart by long-term EP is more obvious than that of short-term EP.

BACKGROUND:Zinc-modified calcium silicate (CaSiO3) bioceramics coating on the titanium surface prepared in preliminary experiments has good chemical stability and antibacterial property. OBJECTIVE:To observe the effects of zinc-modified CaSiO3 bioceramics coating on osteointegration. METHODS:MC3T3-E1 cels were respectively cultured on the titanium with zinc-modified CaSiO3 bioceramics coating (experiment group), titanium with CaSiO3 bioceramics coating (control group) and pure titanium (blank control group). Then, cel adhesion, proliferation, calcification rate and the expression of type I colagen and osteocalcin were detected. The implant materials mentioned above were respectively inserted into the femurs of New Zealand white rabbits, and after 1.5 months, the osteoproliferation and osteointegration between the implants and the host were tested. RESULTS AND CONCLUSION:In vitro experiment: The number of adhesive cels at 12 hours after co-culture was significantly increased in the experimental group compared with the control group and blank control group (P < 0.05). At 14 days after co-culture, cel proliferation ability and ability of calcium nodule formation in the experiment group were significantly better than those in the other groups (P < 0.05). At 21 days after co-culture, there was no significant difference in the expression of type I colagen, but the expression of osteocalcin in the experiment group was higher than that in the control group and blank control group (P < 0.05).In vivo experiment: In the experiment group, a large amount of bone substances were detected, the coating materials directly contacted with the bone interface, new bone tissues and little fibrous tissues were observed at the interface. In contrast, there was a small amount of bone hyperplasia in the control group and almost no bone hyperplase in the blank control group. Moreover, a small part of the implant directly contacted with the bone interface and the most part was separated from bone trabeculae by fibrous tissues. These findings indicate that zinc-modified CaSiO3 bioceramics coating can enhance the ability of osteointegration between titanium implants and the host.

Objective To propose SHA.LIN nephrolithometry scoring system for assessing and predicting the stone-free rate of percutaneous nephrolithotomy ( PCNL) and to investigate the clinical value of SHA.LIN scoring system for nephrolithiasis in patients undergoing PCNL .Methods A literature review from 1976 to 2014 was performed to identify clinically relevant and reproducible variables that could affect the outcomes of PCNL. Six reproducible variables available from preoperative noncontrast-enhanced computed tomography were measured , including stone size ( S) , hydronephrosis ( H) , anatomic distribution (A), length of tract(L), indicator of CT(I), number of involved calices(N) and was named as SHA.LIN nephrolithometry scoring system .A retrospective analysis was conducted of clinical data of 116 patients with nephrolithiasis undergoing PCNL from June 2011 to March 2015. The general conditions , preoperative information , stone characteristics and perioperative variables were collected . The correlation of nephrolithometry scores based on SHA.LIN scoring system with stone-free status, operation time, blood loss, length of hospital stay and postoperative complications were analyzed . Receiver operating characteristic ( ROC) curves was drawn to detect sensitivity and specificity of SHA .LIN score in predicting the stone-free rates of PCNL.Results The SHA.LIN score was 9.13 ±2.24 in this cohort.The stone free rate was 75.9%(88/116).Postoperative complications occurred in 32 (27.6%) cases.In those patients with stone
free, the SHA.LIN score was 8.27 ±1.62, significantly lower than that in those patients with residual stones 11.86 ±1.72 ( t =-10.069, P=0.000) .The SHA.LIN score showed significant correlation with the postoperative stone free status, operation time, estimated blood loss (P<0.01).But, it did not correlate with postoperative complications and length of hospital stay (P>0.05).The area under curve of ROC curves for the SHA.LIN scoring system was 0.923 ( 95%CI 0.870 -0.975 ) . Conclusions The SHA.LIN nephrolithometry scoring system can predict postoperative stone-free status of PCNL and can be used for disease related assessment.Further research is required to evaluate its performance in predicting peri-operative variables and postoperative complications .