Various cancers have seriously threatened human' s health. Screening newer and more effective anticancer agents from natural sources to cure these diseases is the focus in research. As novel sources of potential medicine, a number of metabolites isolated from endophytic fungi have been proved to have anticancer bioactivity. Usually, these endophytic fungi have special biochemical pathway and they can accumulate anticancer agents in cultures such as taxane, alkaloids, cytochalasins, podophyllotoxin, brefeldin A and so forth. The research advance on anticancer agents purified from endophytic fungi is expatiated systemically. In addition, the strategy of screening anticancer agents as well as the prospect on this area is introduced briefly.

Objective To observe the clinical effect of moxibustion on body sub-health fatigue state.Methods 120 cases of body sub-health patients were randomly divided into A,B,C three groups,with 40 cases in each group.Group A was treated with moxibustion,group B was treated with acupuncture therapy,and group C (control group) did not receive any measure of treatments.Fatigue scale (FS) was adopted to the three groups respectively for measuring physical fatigue score,mental fatigue score and total fatigue score before and after the treatment.Treatment efficacy was evaluated and analyzed after three weeks of continuous treatment.Results The total score of fatigue scale was 6.10 ± 2.47、6.82± 2.36、and 10.10±2.66 respectively in group A,group B and group C.Compared with group C,the difference in group A and group B was statistically significant (P＜0.01).Compared with group B,the difference in group A was not statistically significant (P＞0.05) ; The Physical fatigue points of group A,B,C was 2.46± 2.06、3.60 ± 2.24 and 5.03 ± 2.66 respectively.Compared with C group,the difference in group A and group B was statistically significant (P＜0.01).Compared with group B,the difference in group A was statistically significant (P＜0.05).Conclusions Moxibustion and acupuncture can effectively improve patients total body sub-health state of fatigue.Moxibustion treatment showed better effects in alleviating physical fatigue,

Objective To investigate the effects of low frequency repetitive transcranial magnetic stimulation (rTMS) on motor function and excitability of motor cortex in Parkinson's disease (PD) patients and to study the mechanism of PD from the electrophysiology. Methods Twenty-eight patients with PD received 1 Hz rTMS therapy for 15 d. Thirty normal volunteers were enrolled as controls. Unified Parkinson's Disease Rating Scale (UPDRS) and motor evoked potential (MEP) were adopted as assessment indicators. The excitability of motor cortex was assessed by rest motor threshold (RMT), central motor conduction time (CMCT) and the amplitude of MEP. Results The initial RMTs and CMCTs of PD patients were significantly lower than those of the controls, but MEP amplitudes were not significantly different. After rTMS treatment, motor function of PD patients improved, RMTs increased and CMCTs prolonged. Conclusion In PD patients, motor function disorder and increased motor cortical excitability were observed. Low frequency rTMS may inhibit these changes to some extent.

Objective To investigate the ultrasonic appearance of peripheral neurilemmoma.Methods Ultrasonic appearances of 43 patients with 46 neurilemmomas confirmed by surgery and pathology were analyzed retrospectively and compared with their MRI and pathological features.Results Forty-five neurilemmomas were with regular shape and clear boundary,except one at the root of nerve C4 that was irregular in shape and unclear in boundary,like adumbbell.Sonography showed that there were 30 neurilemmomas displaying as solid tumors,15 as cystic and solid,and 1 as entirely cystic.Posterior echoenhancement,target sign,rat tail sign and vessels accompanying sign were found in 39,21,23 and 17 neurilemmomas,respectively.There were 4 neurilemmomas with ultrasound blood flow grade 0,9 with grade Ⅰ,22 with gradeⅡ,and 11 with grade Ⅲ.The target signs were found in 21 cases (21/46,45.6％) and 26 cases (26/46,56.5 ％) by ultrasound and MRI,respectively.The capability of ultrasound finding the target sign in neurilemmoma was comparable to MRI(Kappa =0.527,P ＜0.001).The diagnostic accuracy rate of neurilemmoma by ultrasonography was 73.9％(34/46).Conclusions The ultrasound has a relatively high detection of the target sign in neurilemmoma,which may provide a new basis for the ultrasonic diagnosis of neurilemmoma.

Objective To explore a scientific and reasonable fiscal input mechanism for public hospitals, in order to fully leverage the policy guidance and efficiency of such funding.Methods With literature review, expert consultation and demonstration, a basic subsidy model for public hospitals was established.According to the past operation data of 4 public hospitals in Baoshan district of Shanghai, the study figured out specific subsidy standards.Results The basic subsidy for public hospitals should be determined according to the number of approved beds, the number of outpatients and emergency visits, hospital bed days, surgeries, key services, and the quality and efficiency of work.In Baoshan district, the standard reference value of subsidy for each approved bed, each outpatient and emergency visit, each bed-day, each surgical operation is 42 096 yuan, 27.9 yuan, 104.9 yuan and 244 yuan respectively.The standard value of subsidy is 100 yuan per bed for critically ill inpatients.For patients under clinical pathway management, the subsidy is 300 yuan per case, and for hospital maternal care, it is 150 yuan per person.Conclusions The basic subsidy model for public hospitals has overcome the shortcomings of fiscal input based on hospital scale or hospital workload, and established an incentive mechanism to promote the implementation of key services.These measures can improve the operation mechanism of public hospitals and encourage them to play their role of public welfare as designed.

Objective: To explore the clinical features and prognostic factors of elderly MM patients. Methods: A retrospectively analysis of clinical characteristics in 93 newly diagnosed MM patients with more than 70 years of old between August 2011 and August 2016. Based on age, basic activities of daily living scale, instrumental activities of daily living scale, Charlson comorbidity index at diagnosis, patients were divided into three groups: Fit (score=0, n=15) , Intermediate fitness (score=1, n=31) , Frail (score≥2, n=47) according to a geriatric assessment system proposed by Antonio Palumbo et al. The treatment response rate, progression free survival time (PFS) and overall survival (OS) of the three groups were analyzed. Results: Complete remission was 60.0% in Fit, 22.6% in Intermediate fitness and 12.8% in Frail (Fisher χ²=12.398, P=0.002) . The median PFS for the three groups were 31 months, 24 months and 13 months (χ²=17.832, P<0.001) . The median OS was not reached for Fit, 58 months for Intermediate fitness and 25 months for Frail (χ²=40.678, P<0.001) . In 47 Frail cases, patients who received chemotherapy containing new drugs (proteasome inhibitor or immune-modulator) had a longer PFS (17 months vs 9 months, χ²=6.454, P=0.011) and patients who achieved CR had prolonged PFS and OS than non-CR (PFS: 24 months vs 12 months, χ²=4.117, P=0.042; OS: 37 months vs 25 months, χ²= 6.507, P=0.011) . Conclusion The health status of the elderly MM patients was associated with better response and longer PFS and OS. Given on those with poor health status, new drugs may have better PFS and prolonged OS.

Objective To investigate the related factors and preventive measures of delayed gastric emptying after operation for esophageal and cardiac carcinoma.Methods A total of 45 patients with delayed gastric emptying after operation for esophageal and cardiac carcinoma were selected as observation group,and 45 patients without delayed gastric emptying after operation for esophageal and cardiac carcinoma were selected as control group.Differences in the relevant factors were compared between the two groups.Results Single factor analysis showed that older age,high body mass index,short time education,malnutrition,poor mental state,rural residence,surgical incision,blood loss,long operation time,postoperative analgesia pump application,and the large amount of fluid volume were related risks of delayed gastric emptying (P ＜ 0.05).The Logistic regression analysis showed that older age (OR =4.15,95 ％ CI:1.89 ～ 26.30),bad psychological reaction (OR =3.96,95％ CI:1.38 ～ 25.38),long operation time (OR =3.40,95％ CI:1.11 ～ 20.28) and malnutrition (OR =3.02,95％ CI:1.09 ～ 19.35) were independent factors of delayed gastric emptying.Conclusion Delayed gastric emptying is one of the common complications after operation for esophageal and cardiac carcinoma,and the influencing factors are complex.

Objective To investigate the related factors and preventive measures of delayed gastric emptying after operation for esophageal and cardiac carcinoma.Methods A total of 45 patients with delayed gastric emptying after operation for esophageal and cardiac carcinoma were selected as observation group,and 45 patients without delayed gastric emptying after operation for esophageal and cardiac carcinoma were selected as control group.Differences in the relevant factors were compared between the two groups.Results Single factor analysis showed that older age,high body mass index,short time education,malnutrition,poor mental state,rural residence,surgical incision,blood loss,long operation time,postoperative analgesia pump application,and the large amount of fluid volume were related risks of delayed gastric emptying (P ＜ 0.05).The Logistic regression analysis showed that older age (OR =4.15,95 ％ CI:1.89 ～ 26.30),bad psychological reaction (OR =3.96,95％ CI:1.38 ～ 25.38),long operation time (OR =3.40,95％ CI:1.11 ～ 20.28) and malnutrition (OR =3.02,95％ CI:1.09 ～ 19.35) were independent factors of delayed gastric emptying.Conclusion Delayed gastric emptying is one of the common complications after operation for esophageal and cardiac carcinoma,and the influencing factors are complex.

Esophageal squamous cell carcinoma(ESCC)is a major histological subtype of esopha-geal cancer with a poor prognosis.Although several serum metabolomic investigations have been reported,ESCC tumor-associated metabolic alterations and predictive biomarkers in sera have not been defined.Here,we enrolled 34 treatment-naive patients with ESCC and collected their pre-and post-esophagectomy sera together with the sera from 34 healthy volunteers for a metabo-lomic survey.Our comprehensive analysis identified ESCC tumor-associated metabolic alterations as represented by a panel of 12 serum metabolites.Notably,postoperative abrosia and parenteral nutrition substantially perturbed the serum metabolome.Furthermore,we performed an examina-tion using sera from carcinogen-induced mice at the dysplasia and ESCC stages and identified three ESCC tumor-associated metabolites conserved between mice and humans.Notably,among these metabolites,the level of pipecolic acid was observed to be progressively increased in mouse sera from dysplasia to cancerization,and it could be used to accurately discriminate between mice at the dysplasia stage and healthy control mice.Furthermore,this metabolite is essential for ESCC cells to restrain oxidative stress-induced DNA damage and cell proliferation arrest.Together,this study revealed a panel of 12 ESCC tumor-associated serum metabolites with potential for monitor-ing therapeutic efficacy and disease relapse,presented evidence for refining parenteral nutrition composition,and highlighted serum pipecolic acid as an attractive biomarker for predicting ESCC tumorigenesis.