探寻语文教学中积极德育的“良方”

小学语文课堂是德育的重要阵地之一。语文教师可以通过在课堂中扣题眼、创情景、重朗读、播图片、巧延伸等策略，积极探寻渗透积极德育的“良方”。

《奇效良方》骨之“势”浅解

《奇效良方·正骨兼金镞门》是古代伤科文献中的重要资料,其所记载的人身"三百六十五骨节"中包括对于骨内物质"势、液、髓"的论述。这一论述在现存古代文献记载中较为少见,但它也清楚的表明古人对于人体构造是有过系统研究的,且观察比较仔细。文章对《奇效良方.正骨兼金镞门》所载"势、液、髓"中"势"进行了研究,通过"势"字的含义演变结合现代人体解剖中骨骼构造的研究进行系统分析,认为"势、液、髓"中"势"所指代相当于现代骨骼构造中骨小梁及部分骨密质结构。综上,文章意在引起中医学界对于中医学人体解剖生理的重视。

公开考评医院机关干部队伍的实践与思考

本文着眼提高机关干部的能力素质、激发创新活力,介绍了军队医院评估机关干部队伍建设的做法、取得的成效与经验体会,对各大型医院改进考核工作,加强机关干部队伍建设具有一定的参考价值。

糖痛外洗方改良皮贴治疗寒凝血瘀型痛性糖尿病周围神经病变的临床观察

目的探讨糖痛外洗方改良皮贴治疗寒凝血瘀型痛性糖尿病周围神经病变(PDPN)的临床效果。方法将60例寒凝血瘀型PDPN患者按随机数字表法分为治疗组和对照组各30例。两组患者均予以糖尿病基础治疗措施,包括糖尿病知识宣教、控制饮食、运动治疗、血糖监测等措施,对照组患者在常规治疗基础上予以普瑞巴林胶囊口服治疗,治疗组在对照组基础上增用糖痛外洗方熏洗联合改良皮贴治疗。比较两组临床疗效,观察两组治疗前后的数字模拟疼痛(NRS)评分、临床症状评分、多伦多临床评分系统(TCSS)、胫神经、腓总神经感觉神经传导速度(SNCV)和运动神经传导速度(MNCV)的差异性。结果治疗组临床总有效率为93.33%,明显高于对照组的73.33%(P<0.05)。治疗组治疗后NRS评分、临床症状评分明显低于对照组(P<0.05)。治疗组治疗后神经症状、感觉试验和TCSS总分评分明显低于对照组(P<0.05)。治疗组治疗后胫神经、腓总神经SNCV和MNCV水平明显高于对照组(P<0.05)。结论对寒凝血瘀型PDPN患者采取糖痛外洗方熏洗联合改良皮贴进行治疗,有助于提高治疗效果,改善患者疼痛和临床症状,延缓病情进展速度,促进神经传导速度的恢复。

A Method Suitable for Extracting Genomic DNA from Animal and Plant——Modified CTAB Method

[Objective] The study aimed to introduce a rapid and effective method that is suitable for extracting genomic DNA from animal and plant. [ Method ] The genomic DNAs were extracted from tender leaves of 24 peanut cuhivars and from the liver, lung and kidney of white mouse through the specifically modified CTAB method. The DNAs were run on agarose gel, next detected by DNA/Protein analyzer. Finally PCR amplification was conducted to detect the quality of DNAs extracted using the modified CTAB method. [ Result] The clear and orderly bands were observed in gel detection, and the values of OD200/OD200 for DNAs extracted via modified CTAB method were between 1.77 - 1.83. The DNAs performed well in PCR amplification. [ Conclusion] The DNAs extracted by modified CTAB method could satisfy the requirement of PCR amplification.

Chao HUANG,Main Factors Affecting the Improving Efficiency of Gypsum for Solonetzic Soil

In order to more efficiently utilize gypsum to improve meadow alkali soil slightly salinized by soda and sulfate chloride, a total of 27 treatments were de- signed from the perspectives of field capacity, alkalinity, alkaline salt content, optimal irrigation, gypsum conversion, gypsum and soil treatment and improvement depth. The ions on the obtained filtrate were analyzed in terms of salts. The improving ef- ficiency of gypsum for meadow alkali soil was analyzed through comparing the con- tents of soluble salts in pre-improvement and post-improvement soil by reasoning and calculation. The results showed that, （1） the dissolved amount and conversion amount of gypsum were increased, and the soil alkalinity was decreased corre- spondingly with the increased irrigation amount. However, after reaching a certain extent, the linear relationships became unobvious gradually. Therefore, the irrigation amount should be arranged reasonably for different treatment. （2） Compared with those at low temperature, the dissolved amount of gypsum at high temperature was increased by 1.47-1.50 times, the release amount of exchangeable sodium was in- creased by 2.98-4.70 times, and the release amount of exchangeable magnesium was increased by 2.07-2.90 times. In overall, the improving efficiency of gypsum in summer was better. However, gypsum had two shortcomings in summer. First, a large amount of gypsum leaked away. Second, a large amount of exchangeable magnesium, along with exchangeable sodium, was substituted by gypsum. （3） Compared with the other two treatments, treatment B （mixing gypsum and top 20- cm soil） showed the best improving efficiency, and it was characterized by stepwise dealkalization from top to down. In addition, mixing gypsum and topsoil is more practical in the production.

PRESENT SITUATION OF STUDY AND VIEW ON FUNCTIONAL DYSPEPSIA TREATED WITH SPECIFIC ACUPOINTS IN ACUPUNCTURE

Acupuncture plays a dominant role in treating functional dyspepsia （FD）. By reviewing and e- valuating clinical ROT and fundamental research with high quality in the past 17 years, it is found that specific acupoints are the chief in the treatment of FD; additionally, there are differences between specific acupoints and non-specific acupoints in therapeutic effect, explaining that the specificity of meridian points plays an im- portant role in treatment. However, because of inadequate high-quality researches in clinics, the specificity of acupoints can＇t be proved until the researches of clinical effect and mechanism of therapeutic difference are intensified.

Hepatic encephalopathy in patients with liver cirrhosis:Is there a role of malnutrition?

Hepatic encephalopathy(HE) is a common complica-tion in patients with liver cirrhosis but its pathogenesis remains incompletely understood.Malnutrition is com-monly encountered in patients with liver cirrhosis and it has been reported to affect the quality of life of this group of patients.Experimental studies suggest that low energy intake and poor nutritional status may facil-itate the development of HE but there are scarce data on the potential role of malnutrition in HE in patients with liver cirrhosis.Two recently published studies have evaluated the potential role of malnutrition in the development of HE in cirrhotic patients with conflicting results.In this letter to the editor we briefly present the results of the two studies as well as potential rea-sons for the conflicting results reported.

An Improved Level Set Approach to the Simulation of Drop and Bubble Motion

An improved level set approach for computing the incompressibletwo-phase flow with significantly de- formed free interface ispresented. The control volume formulation with the semi-implicitmethod for pressure-linked equations consistent (SIMPLEC) algorithmincorporated is used to solve the governing equations on a staggeredgrid. Several improvements concerning the computational grid,interface update, reinitialization procedure etc. are tested Andfound to be effective in promoting the convergence and numericalstability.

Placebo responses in patients with gastrointestinal disorders

Over the last several years there has been a growing interest in placebo, not only as an inert control in clinical trials, but also in the placebo effect as a group effect as well as a reaction in individual subjects. Methodological factors such as regression to the mean and natural history of the disease play a role in the evaluation of a possible placebo effect. In this report, we discuss several factors including PavIovian conditioning, beliefs outcome, expectations, and other factors as potential mediators of the placebo response. Placebo effects are common in gastrointestinal diseases and there seems to be no clear difference between placebo effects in functional gastrointestinal diseases （functional dyspepsia and irritable bowel syndrome） and organic gastrointestinal disease （duodenal ulcer and inflammatory bowel disease）.

Propagation methods for black locust (Robinia pseudoacacia L.) improvement in Hungary

Black locust (Robinia pseudoacacia L.) is one of the most important stand-forming tree species in Hungary and its importance is increasing in many countries. Black locust plants are commonly produced by two methods, by seed and by root cuttings. Tissue culture propagation can be considered as a relatively new method. Growing trees from seed is a relatively sim-ple method for reliably producing seedlings on a large scale under a variety of circumstances. Mechanization of the method is easy and the production cost is relatively low. Propagation from root cuttings and tissue culture are valuable for reproduction of superior individuals or varieties. By applying these methods, superior traits of the selected trees can be preserved in the clones. Recent experiments demonstrated that micropropagated trees could be successfully transplanted into soil, hardened and grown in the field.

Gastric carcinoid tumor in a patient with a past history of gastrointestinal stromal tumor of the stomach

Gastrointestinal stromal tumor is the most common mesenchymal tumor in the gastrointestinal tract. It may coexist with other type of cancers,and if so,the tumors usually involve the stomach. The most common associated cancers are gastrointestinal carcinomas. We report a 65-year-old woman with a history of gastric gastrointestinal stromal tumor who had undergone subtotal segmental gastrectomy. New polypoid lesions were detected on a follow-up gastroscopy one year later. The lesions were biopsied and found to be carcinoid tumors. There was serum hypergastrinemia,and type 1 gastric carcinoid tumor was diagnosed. A total gastrectomy was performed. Pathologic examination revealed both carcinoid tumors and a recurrent gastrointestinal stromal tumor.

Modified Approach for Calculating Four-Quark Condensates

By differentiating the dressed quark propagator with respect to a variable background field, the linear response of the dressed quark propagator in the presence of the background field can be obtained. From this general method, using the vector background tield as an illustration, we extract a general formula for the four-quark condensate （0： q（0）γμq（0）q（0）γμq（0） ： ｜0）. This formula contains the corresponding fully dressed vector vertex. We use this formula to analyze the factorization problem of the four-quark condensate and show that in the bare vertex approximation factorization holds exactly.

Traditional Chinese medicine compounds for the treatment of functional dyspepsia:an updated meta-analysis of randomized,double-blind,placebo-controlled trials

Objective To evaluate the efficacy and safety of traditional Chinese medicine(TCM)compounds for the treatment of functional dyspepsia(FD).Methods The Pub Med,Embase,Cochrane Library,Web of Science,Chinese Biomedical Database(CBM),Wanfang Data,China National Knowledge Infrastructure(CNKI),and China Science and Technology Journal Database(VIP)were searched to collect randomized,double-blind,and placebo-controlled trials of FD treated with TCM compounds.The search duration was from the establishment of the database to March 2,2021.After two researchers independently screened the literature,extracted the data,and evaluated the bias risk included in the study,they used Rev Man 5.4 software for meta-analysis.Results A total of 23 clinical trials were included,including 2898 patients.Meta-analysis showed that the overall remission rate of FD treated with TCM compounds was significantly higher than that of placebo(73.8%vs.46.2%)[RR=1.50,95%CI(1.29,1.76),P<0.00001].Among the single symptoms,TCM compounds were superior to the placebo in improving epigastric pain[MD=﹣0.99,95%CI(﹣1.37,﹣0.61),P<0.00001],epigastric burning sensation[MD=﹣0.32,95%CI(﹣0.59,﹣0.05),P=0.02],postprandial fullness discomfort[MD=﹣1.59,95%CI(﹣1.96,﹣1.21),P<0.00001],and early satiety symptoms[MD=﹣0.93,95%CI(﹣1.32,﹣0.54),P<0.00001].Compared with the placebo,TCM compounds treatment can obviously improve TCM syndrome in patients with FD[MD=﹣5.58,95%CI(﹣7.55,﹣3.61),P<0.00001],gastric emptying rate[MD=12.22,95%CI(8.90,15.55),P<0.00001],and helped to improve patients’quality of life[MD=11.27,95%CI(0.10,22.43),P=0.05].No severe adverse events were reported between the two groups[RR=1.34,95%CI(0.91,1.96),P=0.14].Conclusion Our results showed that TCM compounds treatment could significantly alleviate FD symptoms,improve gastric emptying in FD patients,and help to improve their quality of life.No severe adverse reactions have been reported in clinical applications.Due to the limitation of the quantity and quality of the included studies,the above conclusions need to be verified by more high-quality studies.

Application of Modified G'/G-Expansion Method to Traveling Wave Solutions for Whitham-Broer-Kaup-Like Equations

A modified G′/G-expansion method is presented to derive traveling wave solutions for a class of nonlinear partial differential equations called Whitham -Broer- Kaup-Like equations. As a result, the hyperbolic function solutions, trigonometric function solutions, and rational solutions with parameters to the equations are obtained. When the parameters are taken as special values the solitary wave solutions can be obtained.

Effects of Different Soil Amendments on the Yield of Salt-alkali Tolerant Rice

Aiken base silicon,advanced silicon,activated carbon,desulphurization gypsum,ferric phosphate,humic acid,aluminum dihydrogen phosphate etc.were used as raw meterials to conduct the compound development of salt-alkali soil amendents,and the salt-tolerant rice"Chaoyouqianhao"was used as the test variety to verify the effect of increasing yield under simulated salt stress environment.The results showed that at the tillering stage,the growth indexes of rice plant in the treatment with soil amendements were better than that in the treatment without soil amendments(CK2).Of which,T5 and T6 had the best effect,and the dry weight of rice plant increased by 40.99%and 70.06%,respectively,compared to the CK2.At the maturity stage,T5,T6 and T7 had a better effect on the increase of rice yield.Of which,T5 had the highest yield,up to 6533.32 kg/hm^(2),which increased by 29.97%compared to the CK2.Focused on the soil amendments formulation in the T5 and T6,the two formulations all contained ferric phosphate,humic acid,calcium magnesium phosphate fertilizer,indicating that these substances played an important role in saline-alkali soil improvement.

Reassessment of functional dyspepsia:From the editor

Dyspepsia refers to group of upper gastrointestinal symptoms that occur commonly in adults. Dyspepsia is known to result from organic causes, but the majority of patients suffer from non-ulcer or functional dyspepsia. Epidemiological data from population-based studies of various geographical locations have been reviewed, as they provide more realistic information. Population-based studies on true functional dyspepsia （FD） are few, due to the logistic difficulties of excluding structural disease in large numbers of people. Globally, the prevalence of uninvestigated dyspepsia （UD） varies between 7%- 45%, depending on definition used and geographical location, whilst the prevalence of FD has been noted to vary between 11%-29.2%. Risk factors for FD have been shown to include females and underlying psychological disturbances, whilst environmental/lifestyle habits such as poor socio-economic status, smoking, increased caffeine intake and ingestion of non-steroidal anti-inflammatory drugs appear to be more relevant to UD. It is clear that dyspepsia and FD in particular are common conditions globally, affecting most populations, regardless of location.

The effect and side effects of Gemcitabine plus Vinorelbine in patients with triple-negative metastatic breast cancer

Objective： The aim of this study was to evaluate the anti-tumor activity and safety of Gemcitabine （GEM） combined with Vinorelbine （NVB） in patients with advanced TNABC after chemotherapy. Methods： Thirty-seven patients with immunohistochemical proved TNABC were enrolled. The patients received 21-day cycles of NVB 25mg/m^2 i.v. with GEM 1000 mg/m^2 i.v. on days 1 and 8. Results： A total of 136 cycles were given to 37 patients（median 4 cycles, ranged 2-6 cycles）. The treatment response was evaluable in all patients. Of the 37 patients, 1 received complete remission （CR）, 8 received partial remission （PR）, 20 had stable disease （SD）, 9 had progressive disease （PD）. Overall objective response （CR＋ PR） were 24.3 %. The median time to progress （TTP） was 6 months （95% CI, 4-6 months）. The median overall survival was 24 months （95% CI, 11-37 months）. The median 1-year survival rate was （66.24±8.43）%. The median 3-year survival rate was （28.77±11.96）%. The major adverse events were grade Ⅰ-Ⅱ myelosuppression, peripheral neurologic toxicities, nausea and vomiting. Some patients had rash and hepatic dysfunction. A total of 40% of patients experienced flu-like symptoms. Alopecia and diarrhea were rare. Conclusion： The combination of GEM and NVB is an effective and well tolerated regimen for the patients with TNABC.

Hemobilia due to hepatic artery aneurysm as the presenting sign of fibro-muscular dysplasia

Fibro-muscular dysplasia(FMD)is a rare but well documented disease with multiple arterial aneurysms. The patients,usually women,present with various clinical manifestations according to the specific arteries that are affected.Typical findings are aneurysmatic dilatations of medium-sized arteries.The renal and the internal carotid arteries are most frequently affected, but other anatomical sites might be affected too.The typical angiographic picture is that of a"string of beads". Common histological features are additionally described. Here we present a case of a 47-year-old woman,who was hospitalized due to intractable abdominal pain.A routine work-up revealed a liver mass near the portal vein.Before a definite diagnosis was reached,the patient developed massive upper gastrointestinal bleeding.In order to control the hemorrhage,celiac angiography was performed revealing features of FMD in several arteries, including large aneurysms of the hepatic artery.Active bleeding from one of these aneurysms into the biliary tree indicated selective embolization of the hepatic artery.The immediate results were satisfactory,and the 5 years follow-up revealed absence of any clinical symptoms.

A case report of endocrine cell carcinoma in the sigmoid colon with inferior mesenteric vein tumor embolism

We report a case of endocrine cell carcinoma in the sigmoid colon with inferior mesenteric vein （IMV） tumor embolism. A 79-year-old woman was admitted to our hospital with narrowing of the stools. We performed colonoscopy, computed tomography and positron emission tomography, which disclosed sigmoid colon cancer with IMV tumor embolism. She underwent sigmoidectomy and lymph node dissection. The tumor was diagnosed as endocrine cell carcinoma （type 4, pSS, med, INFa, v3, n1, stage Ⅲb）. Immunohistochemically, chromographin A, synaptophysin, cytokeratin 20 and mucicarmine showed partial staining, and CD56 was totally reactive. Three months after operation multiple liver metastases appeared. She was treated with chemotherapy of cisplatin （CDDP） ＋ irinotecan （CPT11）. This case highlights the aggressiveness of endocrine cell carcinoma with tumor embolism, and it is essential to establish an accurate diagnosis and effective treatment.