[Research on the characteristics of the formation and inheritance of Lei's medicine in Quzhou from the perspective of regional medicine].

Lei's medicine is the main school of traditional Chinese medicine in Quzhou, Zhejiang Province. It originated from Xin'an medical school. It has been passed on for more than 200 years, but it is still lack of in-depth study. From the perspective of regional medicine, combined with the regional characteristics of Quzhou, absorbing the research results of local social history and environmental history, starting with the historical materials such as Lei's medical works, local chronicles literature and so on, the school characteristics are summarized as: the formation of "treatment in accordance with three types of disease causes" , the academic inheritance of "inheriting the past and integrating the present" , the inheritance mode of "multiple integration" , the cultural connotation of "combining medicine with Confucianism" , and the school characteristics of "integration and innovation" . The purpose of this paper is to provide reference for the research of academic schools and the inheritance of traditional Chinese medicine.

[The changes of processing method and theoretical pharmacodynamic analysis of largehead atractylodes rhizome].

Largehead atractylodes rhizome, known as "the first essential medicine for invigorating qi and strengthening spleen" , is one of the most commonly used Chinese materia medica. According to the different clinical treatment requirements, largehead atractylodes rhizome can be processed into a variety types of products, such as raw, fried with earth, stir-frying with bran, and deep-fried largehead atractylodes rhizome. The processing quality is of great significance to ensure the efficacy, drug safety and improve the preparation process. Through the detailed research on the processing methods of largehead atractylodes rhizome in ancient books, modern documents and norms, this study clarifies the history and evolution of the processing technology of largehead atractylodes rhizome in ancient and modern times, and summarizes the internal laws and external factors of the processing technology changes by combining the processing technology differences, materials addition and theoretical analysis of pharmacodynamics. It not only saves the tedious and repeated steps, but also improves and optimizes the efficacy and quality of the preparation, and gets standardization and unification in the follow-up practice, which provides a reference for the research and development of the processing technology of largehead atractylodes rhizome and other Chinese materia medica.

[Acellular xenogenic dermal matrix as a spacer graft for treatment of eyelid retraction related to thyroid associated ophthalmopathy].

Objective: To evaluate the efficacy and safety of an acellular xenogenic dermal matrix (AXDM) as a spacer graft in the surgery to treat upper and/or lower eyelid retraction (UER/LER) in patients with thyroid associated ophthalmopathy (TAO). Methods: This was a retrospective case series study. From January 2016 to December 2017, all the TAO patients who underwent the eyelid retraction surgery with an AXDM as a spacer graft in Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine were included in the study. The follow-up duration was at least 6 months. Eyelid height, ocular discomfort symptoms, and complications were recorded and used to evaluate the efficacy and safety. The treatment outcomes were divided into good, acceptable and unacceptable outcomes. Nonparametric test was used to compare the efficacy of upper and lower eyelid surgery. Results: Eighty patients (102 eyes) were included, consisting of 43 patients (56 eyes) with UER and 37 patients (46 eyes) with LER. The UER patients included 34 females (median age, 37 years) and 9 males (median age, 47 years). The LER patients included 20 females (median age, 39 years) and 17 males (median age, 40 years). At 6 months after surgery, ocular discomfort was relieved in 79.0% (64/81) eyes; photophobia was relieved in 69.5% (41/59) eyes; tearing was relieved in 94.9% (37/39) eyes; lagophthalmos was relieved in 80.7% (67/83) eyes. In patients with UER, the margin reflex distance was lowered from 8.0 (7.5, 8.0) mm to 3.5 (3.4, 4.0) mm (Z=-6.587, P<0.01). The upper scleral show was lowered from 3.0 (3.0, 3.5) mm to 0 mm (Z=-6.616, P<0.01). In patients with LER, the margin reflex distance was lowered from 8.5 (7.5, 9.0) mm to 5.5 (5.5, 6.0) mm (Z=-5.979, P<0.01). The lower scleral show was lowered from 3.0 (2.5, 3.5) mm to 0.0 (0.0, 0.5) mm (Z=-5.965, P<0.01). In total, 71.3% (57 cases) of the patients acquired good outcomes, 22.5% (18 cases) acquired acceptable outcomes, and 6.3% (5 cases) had recurrence, and no significant difference was found between the patients with UER and LER (33, 8, 2 cases vs. 24, 10, 3 cases, Z=-1.176, P>0.05). No other complications, such as infection, rejection, and dislocation, were observed. Conclusion: AXDM as a spacer graft can be a reasonable and safe alternative for eyelid retraction in TAO patients, achieving both the functional and aesthetic improvements. (Chin J Ophthalmol, 2019, 55: 821-827).

Comparison of rim-sparing versus rim-removal techniques in deep lateral wall orbital decompression for Graves' orbitopathy.

The aim of this study was to compare the surgical outcomes of deep lateral orbital decompression using the rim-sparing technique versus the rim-removal technique in Graves' orbitopathy (GO). A retrospective cohort study of 75 orbits in 50 patients with GO was performed. Proptosis, best corrected visual acuity (BCVA), intraocular pressure (IOP), upper and lower lid margin to reflex distances (MRD-1 and MRD-2, respectively), diplopia, ocular restriction, and GO quality of life (GO-QOL) questionnaire results were analyzed pre- and postoperatively. The average proptosis reduction ranged from 3.5mm to 6.7mm with the rim-sparing technique and from 3.6mm to 6.7mm with the rim-removal technique (P>0.05). All orbits with dysthyroid optic neuropathy in the rim-sparing group and 87.5% of such orbits in the rim-removal group showed improved BCVA (P=0.321). Reductions in IOP, MRD-1, and MRD-2 were observed with both techniques. Patients in the rim-sparing group had greater improvements in GO-QOL appearance score (P=0.043). In conclusion, rim-sparing orbital decompression provides efficacious outcomes with greater improvements in patient quality of life than the rim-removal technique. The rim-sparing technique should be considered as a preferable option because it preserves the integrity of the lateral vertical maxillary buttress and bony protection for the orbital contents.

A study of microemboli monitoring of atherosclerotic thrombotic cerebral infarction and artery stenosis.

This study aimed to assess the relationship between the recurrence and prognosis of patients with acute middle cerebral artery infarction, atherosclerotic brain infarction, and the existence of microemboli. We continuously enrolled patients with acute atherosclerotic thrombotic cerebral infarction artery stenosis. We performed transcranial Doppler color ultrasound micro emboli monitoring, color Doppler ultrasound carotid artery tests, intracranial and carotid artery magnetic resonance angiography, impairment evaluation of nerve function, and registration of stroke recurrence and stroke mortality. Of the 49 patients enrolled in the study, 123 main arteries presented atherosclerotic stenosis or formed plaques, and 33 patients had symptomatic stenosis. Patients with symptomatic stenosis have a higher incidence of microemboli than patients with asymptomatic stenosis (P = 0.009). The microembolus-positive rate increased in patients with unstable plaques (P = 0.001). Patients who were microembolus-negative were more likely to show a neural function deficient NIHSS (National Institutes of Stroke Scale) score improvement than patients who were microembolus-positive at one week (P = 0.026). However, we found no significant difference between mRS (modified rankin scale) score (P = 0.319), relapse, and death (P = 0.179). The rate of microembolus-positivity increased in patients with atherosclerotic thrombotic cerebral infarction and unstable plaques. Patients who were microembolus-negative were more likely to show an improvement of neural function deficiency than patients with microembolus-positivity at one week (P = 0.026).