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Objectives: To strengthen the causal link between TCM syndrome differentiation and curative effect of stableangina through standardized evidence-based design, measurement and evaluation methods, so as to improve the clinicalevidence of TCM. Methods: Under the framework of the top-level parental design, this study aims at the research purposeof early intervention of TCM in patients with stable angina, and adopts a multicenter practical randomized controlled trial.This study adopts superior design and refines the design points of clinical trials in terms of subject selection, interventionsetting, index system construction, sample size estimation, safety observation, and quality control. Results: The nationalkey research and development plan project, "Study on Evidence-based Optimization of TCM Syndrome and TreatmentProtocol of Stable Angina Pectoris and Cross-Boundary Syndrome"indicated that the clinical research design ofevidence-based medicine and TCM differentiation and treatment was improved. Conclusions: The practical RCT designcan fully reflect the characteristics of TCM differentiation and treatment. The evidence-based design of TCM can providemethodological support for improving the quality of evidence.
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This paper showed a brief introduction of high-quality teaching mode. The five-star teaching model was reformed for the Chinese medical science. According to the five-star teaching mode, its principle, focus and creating situation, review guide, activation, showing examples and demonstration, trying to practice and the application of new knowledge, this paper took insomnia as an example into the classroom as a try and to evaluate the teaching effect of five teaching mode.
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Background Clinical work found that triamcinolone acetonide (TA)bleeding during vitrectomy in proliferative diabetic retinopathy (PDR),but its mechanism is not clear.Objective This study was to explore the anastalsis of TA in vitrectomy for PDR.Methods A prospective study was performed.Twelve eyes of 12 patients who received vitrectomy combined with the intraocular use of TA for PDR were in cluded in Tianjin Medical University General Hospital from 2011 to 2014 and served as TA group.Thirty-two eyes of 32 patients who underwent vitrectomy for epimacular membrane or macular hole were enrolled as control group.The vitreous specimens of 0.6 ～0.8 ml was collected during the surgery.The concentrations of urokinase plasminogen activator (u-PA),tissue plasminogen activator (t-PA) and plasminogen activator inhibitors 1 (PAI-1) in vatreous were measured by ELISA.Results The mean contents u-PA,t-PA and PAI-1 in the vatreous were 25.45,127.44 and 0.42 ng/ml respectively in the TA group,and those the mean contents in the control group were 22.94,142.37 and 0.27 ng/ml respectively,shouwing a significant difference between the TA group and the control group (Z=-2.268,P＜0.05).NO significant difference was found in vitreous t-PA and PAI-1 between TA and control groups (Z =-0.092,-1.847,both at P＞0.05).Conclusions Vitreous u-PA content is increased in PDR eyes,which is more likely to lead bleeding.Anastalsis of TA during vitrectomy for PDR may be relatived to decreasing vitreous t-PA and u-PA contents as well as increasing PAI-1 contents.
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Incidence of Uveal melanoma (UM),is only secondary to cutaneous melanoma and is common primary intraocular malignant tumor of in adults.Recent studies suggest that its occurrence is related with gene mutation,chromosome aberrations and molecular pathway abnormalities.The mutations include GNAQ gene, GNA11 gene,microRNA (miRNA) (miR-34a, miR-182, miR-137).Mutations of GNAQ gene and GNA11 gene activate relevant pathways,such as MEK/ATK pathway,to promote UM metastasis, which makes the poor prognosis.Different miRNAs target the correspending genes and affect the prognosis.And the mutations of telomerase reverse transcriptase,all of them adjust the specific molecular pathways to affect tumor occurrence, development, metastasis and prognosis.Molecular genetic studies confirm that most patients with UM have chromosome 1,3,6,8,9 alterations,making the chromosome gain or less, leading to more susceptible invasion and metastasis and influencing prognosis.This paper reviewed the gene mutation and chromosome aberrations in order to provide new targets for the treatment of UM.
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The sub-health status is closely related to the functions and activities of heart in traditional Chinese medicine (TCM). The sub-health is commonly presented with a series of heart system symptoms such as palpitation, chest distress, shortness of breath, fatigue, fidgets and insomnia. It may also be accompanied with arrhythmia or blood pressure value between normal and high level. This heart system sub-health status can be transformed into re-lated heart system diseases with high possibility. This article made a review from aspects of theoretical literature, an-imal experiment, curative effect observation and clinical evaluation on the research progress of heart system sub-health status.
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Objective To explore the influence from I Ching perception of febrile disease theory to the syndrome differentiation and treatment of Viral myocarditis.Methods Documentary study.Results The febrile disease theory gained certain reference from simple ontology and motion concept in ancient Chinese philosophy.VMC was caused by disorder of five evolutive phases and six climatic factors,transition from Kan diagram to Li diagram,together with the mixture of pathogenic qi.Treatment should mainly focus on eliminating pathogen and nourishing yin to coordinate water and fire,conforming to universe rules,and smoothing Qi to reduce blockage.Conclusion The cognitive perception,pathogenesis and treatment of febrile disease theory are all deeply influenced by I Ching.Therefore,the combination of I Ching and febrile disease theory in diagnosis and treatment of VCM will improve clinical effects,as well as featuring the cultural nature of Traditional Chinese Medicine.
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Objective To study the effects of the recipe for activating blood circulation and nourishing qi on expression of mitochondrial ribosomal protein L51 (MRPL51) in CVB3 infection model in rat cardiac myocytes, to reveal the pathogenesis of CVB3 myocarditis in the genetic level, to explore the therapeutic mechanism of the recipe for activating blood circulation and nourishing qi on CVB3 myocarditis, and to confirm the validity of the recipe for activating blood circulation and nourishing qi on CVB3 myocarditis. Methods After establishing CVB3 infection model and treatment model with recipe for activating blood circulation and nourishing qi by culturing neonatal rat myocardial cells, a modified suppression subtractive hybridization (SSH) was used to isolate differentially expressed genes between two model groups. These results were further verified by fluorescence RT-PCR. Results The results of SSH showed that gene expression of the treatment group was lower than that of the CVB3 infection group. The results of fluorescent RT-PCR which agreed with that of SSH displayed the threshold cycle number (Ct) in the treatment group was higher than the virus group. Conclusion Up-regulation of MRPL51 might be one of the pathogenesis of CVB3 myocarditis. The recipe for activating blood circulation and nourishing qi could treat viral myocarditis by regulating the expression of MRPL51.
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By finishing a statistical analysis to large-sample expert questionnaire database with the method of be concluded as retention of phlegm due to stagnation of Qi, inactive of heart-yang, cold coagulation of heart meridian, and recovery stage, the syndrome can be concluded as deficiency of heart-Qi, Yang deficiency and Qi stagnation, and deficiency of both Qi and Yin.
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@#Objective To explore nursing for defecation of the patients with hip or knee replacement before and after arthroplasty.Methods 30 patients with selective bilateral hip or knee replacement were observed at different phases, including interval time, duration, score of oneself subject feeling, and rate of negative symptoms.Results ① Interval time and duration of defecation was longer after arthroplasty than before arthroplasty (P<0.05)；The index mentioned above of the second defecation was shorter than the first one(P<0.05). ②The score of oneself subject feeling and rate of negative symptoms were higher after arthroplasty than before arthroplasty(P<0.05); The index mentioned above of the second defecation was lower than the first one(P<0.05).Conclusion Difficult defecation happens to the patients with arthroplasty and the nurse should screen susceptible patients before operation, then highlight the key links and give nursing intervention in order to assist defecation.
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[Objective]To evaluate the feasibility of early off-bed exercises after arthroscopically assisted radiofrequency release of gluteal muscle contracture.[Method]Patients of gluteal muscle contracture underwent arthroscopically assisted radiofrequency release of gluteal muscle contracture.Post-operative off-bed time,side effects,duration of urinary catheter drainage,wound healing,early recovery of function,and in-hospital time were studied.[Result]Off-bed time averaged 7 hours(6~8 hours).Two cases complained of being faint and nausea.After allopathic treatment,no serious complications appeared.Averaged duration of urinary catheter drainage was 7.5 hours.Primary healing of wounds were found in 67 patients,while 1 case got delayed wound healing.None of them had any infections.Functional scores averaged 9 at the time of discharging and 10 after 1 month.Post-operative in-hospital time averaged 2.58 days(2~6 days).[Conclusion]Arthroscopically assisted radiofrequency release of gluteal muscle contracture results in early post-operative off-bed time and reduction of suffering,which is propitious to functional recovery,rate of healing,and shorter in-hospital time.
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Objective To study the reliability and validity of clinical experts questionnaire of syndrome factors, characteristics and evolution of coronary heart disease. Methods The clinical expert questionnaire was sent to 305 clinical doctors of cardiovascular disease. The questionnaire of coronary heart disease was described through four phases data, and reliability and validity of each module and the total scale were tested. Results Cronbach's ? coefficient of the modules varies between 0.959 3～0.972 5 and higher than 0.8, the value of the scale was 0.990 3. Split-half reliability of the modules varies between 0.891 8～0.922 5, Cronbach's ? of split-half reliability of the total scale was 0.920 7. Factor analysis showed that each module was abstracted four factors and the total contribution rate was more than 50%, the result after varimax rotation was consistent with the theory. Conclusion The questionnaire can fully reflect symptoms and signs of patients with coronary heart disease, and can be used for syndrome studies of coronary heart disease.
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OBJECTIVE To evaluate the feasibility and sterile effect of low-temperature plasma sterilizer produced by Chinese Academy of Sciences for the sterilization of arthroscope surgical instruments.METHODS To explore the cleaning,package,arrangement and sterile effect monitoring of instruments in the process of arthroscope sterilization using low-temperature plasma sterilizer.RESULTS In the sterilization process of arthroscope surgical instruments using low-temperature plasma sterilizer,the chemical indicators and indicating patch were discolored,the monitoring of bio-box and the sterilization monitoring of surgical instruments were all negative.CONCLUSIONS Using the low-temperature plasma sterilizer machine for the sterilization of endoscope surgical instruments can ensure the security of sterilization,make less injury of precise instruments,shorten the sterilization time,accelerate the surgical turnover,enhance the frequency of surgical instruments application,and increase the efficiency.
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The scale and questionnaires were used to analyze the constituent ratio of symptoms at different stages. The relationship between the main syndrome and pathogenesis of coronary heart disease at different stages was analyzed by statistical methods and the medical principles analysis Thus the successive order of main symptoms and the transforming relations were ascertained. So basic pathogenesis and evolution rule of symptoms that penetrated the whole process of the disease were expounded: the dificiency of syndrome and emotinal factors were the key to the whole process of onset of coronary heart disease.
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Objective: To research the effect of Wenyang Huoxue Compound Preparation on platelet receptor and signal transduction in coronary heart disease rats with yang deficiency and blood stasis of heart.Methods: The coronary heart disease rat models were established by administering high fat diet,subcutaneous injection with pituitrin and being stimulated by cold methods.Then,to observe the effect of Wenyang Huoxue Compound Preparation on platelet receptor and signal transduction.Results: Compared with model group,the concentration of plasma von Willebrand factor(vWF),the content of thromboxane B2(TXB2),the platelet aggregation rate,the molecular number of GPⅡb/Ⅲa and the content of platelet?granularmembrane protein(GMP 140) in Wenyang Huoxue Compound Preparation group decreased apparently(P
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OBJECTIVE To study the feasibility of no-hair-shaving before knee arthroscopy surgery.METHODS Totally 160 patients preparing for knee arthroscopy surgery were divided into both test and control groups randomly.The test group was no-hair-shaving before operation,and the control group was hair-shaving the day before their operation.Patients of the test group washed their skin with soap water or bathed at the operation day and patients in control group did this the day before operation.Bacterial culture was done in the operative site both before and after sterilization,and observed whether infection occurred in the incision after operation.RESULTS Bacterial culture in skin before sterilization was statistical significance between the two groups and no statistical significance after sterilization.All the incision healed well and no infection was found.CONCLUSIONS No-hair-shaving preoperatively can decrease patients′ discomfort and reduce colonies on skin surface effectively.The method is easy and safety manipulated.
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Objective To observe the influence of Wenxin Capsules on mean platelet volume (MPV) and platelet distribution width (PDW) in rats with coronary heart disease classified as heart-yang deficiency.Methods Rat model with coronary heart disease classified as heart-yang deficiency were established by gavage of high fat diet,subcutaneous injection of pitutrin and cold stimulation. Effects of Wenxin Capsules on the morphology of MPV and PDW were observed. Results MPV and PDW were decreased in Wenxin Capsules group (P