A Retrospective Clinical Study on the Correlation between the Theory of Five Movements and Six Climates， and Kidney Deficiency with Governor Vessel Cold Syndrome and Kidney Deficiency Damp-Heat Syndrome in Ankylosing Spondylitis / 中医杂志

ObjectiveTo explore the relationship between the kidney deficiency and governor vessel cold syndrome and the kidney deficiency damp-heat syndrome in ankylosing spondylitis （AS） patients and the five evolutive phases and six climatic factors of their birth and onset year based on the theory of five movements and six climates （FMSC）. MethodsTotally 1791 patients with AS who were admitted to China-Japan Friendship Hospital from September 2010 to September 2020 and met the diagnostic and inclusion criteria were selected in this study. The clinical data were classified into two types of syndromes， kidney deficiency and governor vessel cold syndrome and the kidney deficiency damp-heat syndrome based on the diagnostic criteria of traditional Chinese medicine syndromes. The date of birth and the year of disease onset were converted into FMSC symbols according to the perpetual almanac （《万年历》）， and the two could be converted into the terrestrial branch， year evolutive phase， host evolutive phase， guest evolutive phase， host climatic qi， guest climatic qi， celestial manager qi， guest climatic qi adding to fixed host qi， combined analysis of five evolutive phases and six climatic factors， solar terms， and season of the date of birth， as well as the terrestrial branch， year evolutive phase， and celestial manager qi of the year of disease onset. Univariate analyses were performed using the two independent samples t-test or the Mann Whitney U-test， the Pearson （Pearson） χ2 test， or one-way logistic regression analyses， and variables for which statistical significance existed in the one-way analyses were included in the multivariate logistic regression analyses. General conditions， clinical manifestations， physical signs， laboratory indicators ［including C reactive protein （CRP）， erythrocyte sedimentation rate （ESR）， and humans leukocyte antigen B27 （HLA-B27）］， measurement （including occipital wall distance， jaw peduncle distance， finger-to-ground distance， thoracic range of motion， and Schober experiment）， and distribution of FMSC of birth and disease onset between AS patients with kidney deficiency and governor vessel cold syndrome and with the kidney deficiency damp-heat syndrome were compared， and the association between FMSC and AS patients with kidney deficiency and governor vessel cold syndrome and the kidney deficiency damp-heat syndrome was studied. ResultsThe differences in ESR， CRP， chest mobility， occurrence of achilles tendon enthesitis， and peripheral arthritis between the two groups of patients were statistically significant （P＜0.05）. Single factor analysis found that taking kidney deficiency and governor vessel cold syndrome as control the following FMSC factors increases the risk of developing kidney deficiency damp-heat syndrome： excess of water in year evolutive phase at birth， excess of wood in host evolutive phase at birth， excess of wood in guest evolutive phase at birth， excess of wood in year evolutive phase of onset， deficiency of metal in year evolutive phase at birth （OR = 2.000， P = 0.004）， excess of metal in host evolutive phase at birth （OR = 1.745， P = 0.024） or excess of wood （OR = 1.781， P = 0.023）， deficiency of fire in guest evolutive phase at birth （OR = 1.689， P = 0.049） or deficiency of wood （OR = 1.901， P = 0.018） or excess of metal （OR = 2.163， P = 0.004）， excess of water in year evolutive phase at the disease onset （OR = 1.880 ， P = 0.013） or deficiency of wood （OR = 1.707， P = 0.022）. Multivariate logistic regression analysis found that the risk of developing kidney deficiency damp-heat syndrome in AS was increased by deficiency of metal in year evolutive phase at birth， excess of metal in host evolutive phase at birth， higher level of ESR， greater the chest mobility， incidence of concomitant Achilles tendon enthesitis and peripheral arthritis. ConclusionThe year evolutive phase and host evolutive phase at birth play a significant role in the development of kidney deficiency and governor vessel cold syndrome AS. Risk of developing kidney deficiency damp-heat syndrome can be increased by excess of water or deficiency of metal in year evolutive phase at birth， and excess of wood or excess of metal in host evolutive phase at birth and the kidney deficiency damp-heat syndrome in ankylosing spondylitis.

Preliminary study on screening and diagnosis of fetal cleft palate by two-dimensional combined with three-dimensional ultrasound in early pregnancy / 中华超声影像学杂志

Objective:To explore the feasibility of ultrasound screening and diagnosis of fetal cleft palate in early pregnancy, analyze and summarize the imaging technology and image characteristics of two-dimensional and three-dimensional ultrasound in normal fetus and cleft palate fetus.Methods:A total of 10 519 pregnant women participated in the early pregnancy were included from January 2016 to June 2020 in Shenzhen Hospital, University of Chinese Academy of Sciences. The palatal line on the standard section of fetal nuchal translucency (NT) measurement was used as a screening marker for routine observation. For fetuses with abnormal palatine line, posterior nasal triangle of coronal plane and axial plane of maxillary alveolar arch of two-dimensional ultrasound were added as the diagnostic sections, and three-dimensional volume data of fetal face were collected, and three dimensional multimodal imaging technology was used to analyze the volume data off-line to determine or exclude fetal severe cleft palate. All fetuses were followed up during the second trimester for deformity scanning and post natal (or induced labor) assessment.Results:Of the 10 519 fetuses, the standard NT plane was obtained and the palatal line was observed in 10 204 cases(97.01%), with normal palatal line in 10 169 cases.In 35 suspected cases, 13 cases were confirmed cleft lip and palate by two and three dimensions ultrasound, and were confirmed by induced labor. There were 7 cases in unilateral side, 3 cases in bilateral, 2 cases in median cleft lip and palate, 1 cases in irregular cleft lip and palate, and no false positive results were reported. Twenty-two suspicious cases were excluded by increasing the two-dimensional sectional and three-dimensional volumetric off-line analysis, and screening after the second trimester and after birth. There was 1 case of missed diagnosis of simple cleft palate.Conclusions:Palatal line is a good screening marker for fetal cleft palate in early pregnancy. For fetuses with abnormal palatine line, the adding of posterior nasal triangle and the axial plane of maxillary alveolar arch, and combining three-dimensional volume data for off-line analysis can determine or exclude severe cleft palate. This study is of great significance for early screening and diagnosis of severe fetal cleft palate, prenatal genetic counseling and prevention birth defect.

Application of problem-based learning method in the internal medical teaching of TCM / 国际中医中药杂志

Objective To explore the effect of problem-based learning method in traditional Chinese internal medicine teaching. Methods 58 students enrolled in the major of integrated traditional Chinese and western medicine in class C at the Beijing University of Chinese medicine were arranged to receive PBL(test group)or traditional teaching methods(control group)in 2 courses and complete 116 questionnaires. The teaching outcomes were evaluated by questionnaire and individual interviews. Results Compared with controls,students receiving PBL performed significantly better in terms of active classroom atmosphere, broadening their knowledge, and improving teamwork ability(χ2 were 7.16, 4.07, 4.09, P<0.05). Conclusion The PBL strategy has the advantage than the traditional teaching methods in traditional Chinese internal medicine teaching.

Construct and explore the question database of after-department examination for traditional Chinese medicine resident standard train / 国际中医中药杂志

Resident standard training for traditional Chinese medicine(TCM) is an important part of medical training, after-department examination plays the role of its quality control. Through the construction of question database for after-department examination, combining TCM residency standard training requirements and actual situation of the department, it contribute to the formation of standardized examination,improve the system of resident standardization training for TCM, help to training appropriate and qualified TCM residency.

The prenatal ultrasonic diagnosis of isolate fetal cleft palate / 中华医学超声杂志（电子版）

Objective To summarize the characteristics and associated malformation of fetal isolate cleft palate in prenatal ultrasonography, and analyze the reason of ultrasound misdiagnosis and missed diagnosis in isolate fetal cleft palate prenatally. Methods Systemic screening was performed with two-and three-dimensional ultrasonography in 3 576 cases. The fetal lip and plane were observed especially in nasolabial coronary plane, axial plane through maxilla, median sagittal plane, oblique coronal plane through oral cleft. Meanwhile the accompanied deformity were also screened. And prenatal ultrasound results were compared with postpartum ifndings. Results Eleven in 3 598 cases (0.31%, 11/3 598) were diagnosed as fetal isolate cleft palate by prenatal ultrasonography. The ultrasonic characteristics of isolate cleft palate were:(1) One case ofⅠ° cleft palate, the ultrasonic manifestations:in median sagittal plane, the hyperecho line of median palatine suture was disappeared, and the mucous membranes above and below it were complete;in oblique coronal plane of soft palate through oral cleft, the soft palate was complete and continuous;uvula couldn′t be displayed. (2) Three cases ofⅡ° cleft palate, the ultrasonic manifestations:in median sagittal plane though jaw, the hyperecho line of median palatine suture was shorter;the latter half and the midline of soft palate was disappeared;in both paramedian sagittal plane, the arc-shaped hyperecho line of median palatine suture were displayed;and longer than the hyperecho of midline of palate;in oblique coronal plane of hard palate through oral cleft, the ifrst half hyperecho line of hard palate was continuous, the middle of the latter half hyperecho line was interrupted;in oblique coronal plane of soft palate through oral cleft, the midline of soft palate was interrupted. 3D volume data analysis showed that the ifrst half hard palate was complete, the midline of the latter half hard palate and soft palate was interrupted. (3) Seven cases ofⅢ° cleft palate, the ultrasonic manifestations:in median sagittal plane, the hyperecho line of median palatine suture was disappeared;in oblique coronal plane of hard palate through oral cleft, the middle part echoes of the hard palate was interrupted;in oblique coronal plane of soft palate through oral cleft, the midline of soft palate was interrupted;oral and nasal cavity were communicated;the hyperecho of the vomer at the lower edge of the nasal septum could be displayed though oral cavity. 3D volume data analysis showed that hard palate and soft palate were interrupted. The hyperecho of the vomer at the lower edge of the nasal septum could be displayed clearly though oral cavity. Prenatal ultrasonic diagnosis was conifrmed by postpartum ifndings. And 2 cases were misdiagnosed (0.06%, 2/3 598), 1 case was missed diagnosed (8.33%, 1/12). The incidence of isolate fetal cleft palate was 0.33%(12/3 598). In 12 cases of isolate fetal cleft palate, 11 cases were accompanied with other fetal deformities, including central nervous system malformations (6/12), small jaw (6/12), urinary tract malformation (5/12), hydramnios (2/12), and absence of amniotic lfuid (1/12). Conclusions Fetal secondary palate should be routinely included in the prenatal screening. When secondary palate planes weresuccessfully demonstrated, the isolate cleft palate could be detected. Prenatal diagnosis of the isolate cleft palate is contributive to prenatal counseling and risk assessment.

Clinc observation on 106 cased of ankylosing spondylitis treated by combination therapy / 中华中医药杂志

Objective: To investigate the clinical effect of combination therapy on ankylosing spondylitis. Methods: 160 Cases were divided into treatment group and control group randomly. The patients of treatment group were given Bushenqingdu Decoction and Hanbiwaiyongfang by external use. The patients of control group were given Wangbi Granule. The symptoms and signs were observed before and after treatment in both groups. Results: There was significant difference between treatment group and control group in total effective rate as well as morning stiffness and signs (P

Effect of Bushen Qiangdu Formula on Serum Osteoprotegerin,Bone Mineral Density and Bone Metabolism of 50 Patients of Osteoporosis with Ankylosing Spondylitis / 中医杂志

Objective To study the effect of and its mechanism Bushen Qiangdu Formula (Formula for reinforcing kidney and strengthening spine) on patients with osteoporosis induced by ankylosing spondylitis (AS).Methods All 50 AS patients with osteoporosis were treated with Bushen Qiangdu Formula for six months.Before and after treatment,the observation term includes serum osteoprotegerin (OPG),bone mineral density (BMD),serum boneglaprotein (BGP),calcitonin (H-CT),parathyroid hormone (PTH),bone-specific alkaline phosphatase (BAP),collagen I carboxyl-terminal-prolonging peptides (CICP),urine deoxidation pydidinoline (DPD),C-telopeptide of type I collagen (CTX-I),erythrocyte sedimentation rate (ESR),C reactive protein (CRP),Bath AS Function Index (BASFI),Bath AS dynamic Index (BASDI),and symptoms and signs.Results After treatment,the serum OPG significantly increased (P