This paper was aimed to explore the relationship between different commercial specification and chemical constituents on Radix Rehmanni,which provided experimental evidences for drawing up the commodity commercial specification and grading criteria of Radix Rehmanni.Several classified indexes,including grade,surface color,section color,section texture were carried to explore the change rules of chemical constituents by setting the contents of iridoid glycoside,sugars,water content,total ashes,acid-insoluble ashes and water extract as the markers.The results showed that the grade,surface color and section texture had less impact on chemical constituents.However,the section color had more influence.Along with the section color gradually being deepened,the contents of iridoid glycoside and oligosaccharides of Radix Rehmanni were lower,and the contents of monosaccharide and polysaccharide were higher.It was concluded that there was correlation between commercial specification and chemical constituents of Radix Rehmanni.

Objective To analyze the psychological condition of postgraduates in clinical hos-pitals of colleges and universities before and after the implementation of psychological mentor scheme so as to evaluate the effect. Methods Quantitative questionnaire (SCL-90 scale) and qualitative fo-cus interview were used to compare psychological condition of postgraduates. Totally 182 copies of questionnaires were sent to two hospitals (A and B) respectively. Then, psychological mentor scheme was carried out in A hospital. Afterwards, 206 and 140 copies of questionnaires were sent again to the hospitals respectively to compare the results. Eight student psychological consultants, 12 postgraduates and 5 postgraduate management staff were enrolled in qualitative focus interview. Excell2003 software was adopted to establish the database and SPSS 11.0 software was used for statistical analysis. Descrip-tive analysis, frequency analysis, t test, chi-square test and variance analysis were adopted for data analysis. P<0.05 signifies for statistically significant difference. Results Mental health status of both groups was better than the national level before the implementation (total SCL score: A hospital=118 . 08 ±36.20; B hospital =100.33 ±22.90). However, SCL-90 score of A hospital was decreased (total SCL score: 102.58 ±25.23) and that of B hospital (total SCL score:134.01 ±38.92) was in-creased (part of items higher than the adult national norm) at one year after conducting psychological mentor scheme. Conclusions Psychological mentor scheme can effectively relieve stress and interper-sonal stress so as to reduce the general psychological problems and can help to improve mental health of the students.

Objective To investigate maternal risk factors for fetal congenital heart diseases (CHD). Methods A case-control study was conducted on 16 645 pregnant women who underwent cardiovascular malformation screening for fetal cardiovascular system,whose pregnancy outcomes were recorded,and whose newborns were scanned by an echocardiography in Peking University People's Hospital,Haidian,Changping,Mentougou and Daxing Maternal and Child Health Hospital from Nov.2006 to Oct.2009.One hundred and twelve pregnant women whose babies were found to be CHD (40 severe CHD and 72 simple CHD) before or after delivery were taken as study group.Women in control group (n =304) were randomly selected from those pregnant women who had infants without CHD.Logistic regression analysis and x2 test were used to analyze the maternal risk factors for fetal CHD. Results (1) The average age of women whose infants had severe CHD was 28.3 years (21-40 years),and it was 29.9 years (22-39 years) for women whose infants had simple CHD.There were no significant differences between the control group (29.5 years,20-44 years) and the above two groups (t=1.511 and -0.826,P=0.138 and 0.410 respectively).(2) Single factor analysis:during first trimester,the rate of upper respiratory infection (18/39,46.2 ％) and exposure to certain chemicals (13/40,32.5％) of severe CHD group were higher than those of control group [(14.9％ (45/303) and 2.0％ (6/304)] (x2 =22.399 and 62.678,OR=4.895 and 23.753,95％CI:2.419-9.905 and 8.358-67.506,P =0.000 respectively).Compared with control group (0.0％,0/304),the rate of pregnant women with CHD family history in simple CHD group was significantly higher (4.2％,3/72)(Fisher exact test,P=0.007).(3) Logistic regression analysis:maternal upper respiratory infections (OR =5.120,95％CI:2.340-11.206,P =0.000) and exposure to certain chemicals (f)R=23.030,95％CI:7.506-70.665,P=0.000) during first trimester were risk factors for fetal severe CHD. Conclusions Upper respiratory infection and exposure to certain chemicals during first trimester might play important roles in the occurrence of fetal severe CHD.Maternal family history of CHD might associate with fetal simple CHD.

The article summarized the teaching experience to cultivate the capability of writing the standardized diagnostic imaging reports in the internes of the medical imaging speciality.The need and content of diagnostic imaging reports was standardized.The skill to read image and the capability to write the standardized diagnostic imaging report was cultivated gradually by three phases composed of the accidence phase,and the improve phase and the practice phase.

Objective To explore the clinical implication of serum Dectin-1 level in the non-agranulocytic patients with pulmonary aspergillosis. Methods Serum specimen were collected from the non-agranulocytic patients with pulmonary aspergillosis to determine the serum level of Dectin-1 with ELISA.The relationship between serum Dectin-1 level,the results of G test and galactomannan (GM)test of Aspergillus,and white blood cell count was analyzed.Results The serum Dectin-1 level was (427.2 ± 42.6)pg/mL in the patients with Aspergillus infection,and (280.8 ± 39.4)pg/mL in the control patients (P<0.05 ).Dectin-1 level was not correlated to white blood cell count,or the result of G test,or GM test. Conclusions Serum Dectin-1 level increases significantly in the non-agranulocytic patients with pulmonary aspergillosis, suggesting that Dectin-1 is an important anti-Aspergillus immune molecule.

Aim To investigate the effect of ribonucleic acidⅡon apoptosis in human leukemia cell lines K562 and KG1 a.Methods Cell counting kit-8(CCK-8)as-say was performed to detect proliferation activity of K562 and KG1 a cells treated with ribonucleic acidⅡ. Apoptosis index was assessed by flow cytometry(FCM) and fluorescent Hoechst 33258 staining was used for observing morphologic changes of apoptosis.Expres-sion levels of p53,Bax,Bcl-2 and cleaved caspase-3 were analyzed by Western blot.Results The prolifera-tion of K562 and KG1 a cells was significantly inhibited by ribonucleic acid Ⅱ treatment for 12 h,24 h,48 h at concentrations of 100~300 mg·L-1 ,which indica-ted the inhibitory effect of ribonucleic acid Ⅱ was in dose-dependent and time-dependent manners.FCM re-sults displayed a dose-dependent increase in cell apop-totic rate.Hoechst 33258 staining showed the typical apoptotic morphology in some leukemic cells treated with ribonucleic acid Ⅱ,including increased nuclear chromatin concentration and edge accumulation.West-ern blot analysis showed the increased expression of p53,Bax,cleaved caspase-3 and decreased expression of Bcl-2 in K562 and KG1 a cells treated with ribonu-cleic acid Ⅱ.Conclusions Ribonucleic acid Ⅱ can induce apoptosis of leukemia K562 and KG1 a cells by up-regulating p53,which mediates Bcl-2/Bax balance and activates caspase-3 .

Objective To explore the feasibility and clinical efficacy of long-segmental bone defects after en bloc tumor resection of lower limb segment with composite of titanium alloy 3D printed prosthesis and vascularized fibular autograft and bioceramics.Methods 5 patients with lower extremity tumor (1 high grade chondrosarcoma,1 Ewing sarcoma,1 single metastatic tumor and 2 osteosarcoma) were treated by en bloc resection and precise reconstruction with segmental 3D-printed,custom-made prosthesis from August 2015 to November 2016,which composed of 1 male and 4 females,ranged from 16 to 56 years old,the average was 32± 19.3 years old.Three-dimensional computed tomography reconstructed images of patients' tumors were built before surgery.Custom-made prostheses were manufactured based on the patients' reconstructed images with micro-pores on the surface.After en bloc tumor resection with the help of osteotomy guide plate,the defects were reconstructed with 3D-printed,custom-made prostheses.Vascularized fibular autografts were put inside the prostheses,and the interval space among them was filled with bioceramics.Results All the 5 cases were performed surgical planning before the surgery with prosthesis and guide plate were designed at the same time.After verification of the finite element analysis SLM (2 cases) and the EBM (3 cases) were used to process prosthesis,and were designed into porous sharp with 210.98±66.16 mm in length and 26 901.76±12 903.96 mm3 in volume.Then the prosthesis would be cleaned and sterilized.All 5 operation were proceeded according to the plan of preoperative.The intra-operative guide plate were installed on the bone surface stably.The bone cutting was guided according to the plan of preoperative.By intra-operative frozen pathological examination,there were no malignant tissues in near and far marrow cavity.Unfolded fibular flap with 168.75±49.07 mm in length and porous tricalcium phosphate particle composite implants with 10±4.08 g were used in 4 cases and bone cement was used in 1 cases of metastatic tumor.The average operation time was 261±85 min and average blood loss was 540±182 ml.After a mean follow-up time of 6.4 months (1-15 months),all 5 cases survived with no local recurrence and pulmonary metastasis tumor.2 cases with vascular pedicle fibular transplant confirmed the survival of fibula via bone scan 3 months after operation.All cases were no infection,fractures,prosthesis loosening,except broken screw in 1 case.The Musculoskeletal Tumor Society (MSTS) 93 score was 17-26.Conclusion Long segment tubular titanium alloy 3D printed prosthesis with vascularized fibular autograft and bioceramics could reconstruct the segmental defects caused by tumor resection.

We report the case of a 23-year-old woman who presentedwith prolonged menstruation and multiple bruises on thelimbs and trunk. Investigations revealed severethrombocytopenia and deranged coagulation profile withmarkedly prolonged activated partial thromboplastin time(aPTT). Lupus anticoagulant, anti-cardiolipin antibody andanti-beta-2-glycoprotein 1 antibody were positive. She wasdiagnosed with Immune Thrombocytopenic Purpura (ITP)with positive antiphospholipid antibody serology and givena course of intravenous methylprednisolone and taperingdoses of oral prednisolone. She was steroid free and had nobleeding or thrombotic event over two years follow up.

Objective To understand the incidence and epidemiological characteristics of hand injuries among registered population in Jiading District of Shanghai, so as to provide evidence for scientific prevention and control. Methods Anting town, Huangdu town and Huating town were selected for investigation.Incidence of hand injuries among registered population was investigated by questionnaires. Results A total of 10 083 registered population was included in the study, with the average age being 57.1 ± 10.4 years old.Of them, 4 039 were male and 6 044 were female, 92.2% were married and 7.8% had college degree or above.The 26.8% of the subjects smoked at least one cigarette per day for more than six months, 13.1% drank at least three times per week for more than six months, and 43.7% exercised at least 10 minutes per week.The 37.9% had hypertension, 8.6% had diabetes, and 14.5% had hyperlipidemia.The incidence of hand injuries was 2.1%, of which 61.8% occurred at home and workplaces.Multivariate analysis showed that hypertension was the risk factor and smoking was the protective factor associated with hand injuries. Conclusion The incidence of hand injuries is low in Jiading District.Household hand injuries may be crucial for prevention; in addition, patients with hypertension might be a key population for prevention.

Purpose: This study aimed to evaluate the effectiveness of an interactive virtual reality (VR) play intervention including instructional play and emotional catharsis play sessions in reducing children's pain and fear during intravenous placement. Methods: A randomized controlled trial with parallel groups was conducted. The sample consisted of 134 hospitalized children aged 6–12 years (intervention group: n = 69; comparison group: n = 65). The intervention involved one immersive intravenous scene in VR before the actual intravenous placement and one emotional catharsis VR play after injection. The comparison group received an educational photo book about intravenous placement before receiving intravenous placement. The children and their caregivers rated their pain and fear by using the Wong–Baker FACES Pain Rating Scale and the Children's Fear Scale. The time required for successful intravenous insertion was also compared between the two groups. Results: Children's pain (p = .028) and fear scores (p = .004) were significantly lower in the intervention group than in the comparison group. Their caregivers' pain and fear scores (both p < .001) were significantly lower in the intervention group. The time required for successful intravenous insertion did not differ significantly between the intervention and comparison groups. Conclusions The interactive play intervention with VR effectively reduced children's levels of pain and fear during the intravenous placement procedure. The results of this study can serve as a reference for the implementation of a feasible, child-friendly care practice for clinical intravenous placement in school-aged children.