The effective components are the material basis for efficacy of Traditional Chinese Medicine (TCM), also the core of its quality control. This paper focused on two key scientific issues that how do the effective components form?, How can we improve the effective components?, combining with examples of our group's research, to dis-cuss the research thoughts, technical methods for TCM quality-design. This paper provided a methodological refer-ence for the study of TCM quality-control.

PurposeTo discuss the imaging characteristics and prognostic value of 18F-FDG PET/CT in primary osteosarcoma.Materials and MethodsThirty patients with osteosarcoma confirmed by pathology were enrolled in the study. The imaging characteristics of preoperative whole body18F-FDG PET/CT were analyzed retrospectively. The max standard uptake values (SUVmax) and CT values of lesions were obtained, and tumor volume was calculated; disease-free survival duration was calculated according to the reoccurrence and metastasis of tumor and death; the SUVmax of different components was compared, and the SUVmax in each position was analyzed in terms of the correlation with the corresponding CT value and factors influencing the prognosis.ResultsCT images showed that 28 patients with primary osteosarcoma had bone destruction, 20 had ground-glass or cotton-like neoplastic bone, 24 with soft tissue mass and 16 with periosteal reaction had increased18F-FDG uptake, and 17 with high-density neopalstic bone had low 18F-FDG uptake. The SUVmax of high-density neoplastic bone was significantly lower than that of bone destruction, low-density neoplastic bone and soft tissue mass (F=5.196, P<0.01). There was a weak negative correlation between the SUVmax of various parts such as bone destruction, low-density neoplastic bone, high-density neoplastic bone and soft tissue mass and the corresponding CT value (r=-0.315,P<0.01). The disease free survival time was (36.9±14.9) months. The Kaplan-Meier curve analysis showed that the disease free survival time was longer in patients with SUVmax≥9 than in those with SUVmax<9 (χ2=0.696,P<0.05). The Cox regression analysis presented that SUVmax had independent prognostic value (Wald=4.213,P<0.05).Conclusion18F-FDG PET/CT has advantages in presenting the anatomical structure changes and metabolic changes in primary osteosarcoma. Combined with semi-quantitative analysis of SUVmax, PET/CT can be helpful in finding out the highest biological activity part from the complex tumor structures. Neoplastic bone with low density/high metabolism suggests high malignancy. The higher the SUVmax, the worse the prognosis is in patients with primary osteosarcoma.

Objective To analyze the diagnostic accuracy and safety of adenosine stress 99mTc-MIBI myocardial perfusion single photon emission computed tomography(SPECT)for assessing coronary artery disease(CAD)in the elderly. Methods 63 elderly patients(≥65 years old)without myocardial infarction were enrolled in the research.They were admitted into hospital because of suspected CAD or suffering from acute coronary syndrome.Adenosine was infused intravenously at a rate of 140μg·kg-1·min-1 for 6 minutes.During the period.all patients were given electrocardiogram monitor and blood pressure detection,the uncomfortable symptoms were recorded.At the end of 3 minutes of adenosine infusion,925MBq of 99mTc-MIBI was injected intravenously.Then adenosine stress SPECT myocardial imaging acquisition was obtained.If the results were abnormal.the rest SPECT myocardial imaging would be performed next day.All patients underwentcoronary angiography(CAG)within 1 week before or after SPECT. Results In the 53 CAD patients diagnosed by CAG,there were 51 cases with positive adenosine 99mTC-MIBI myocardial perfusion SPECT.In 10 cases with normal CAG there were 7 cases with negative adenosine myocardial imaging.The results showed the sensitivity,specificity and accuracy of adenosine stress SPECT in detection of CAD in comparison with CAG were 96.2%,70.0%,92.1%respectively.The results of CAG also showed that 74 coronary arteries had been affected(defined as≥50%coronary vessel lumen reduction).There were 44 cases with affection in left anterior descending(LAD),18 eases in left circumflex(LCX)and 25 cases in right coronary artery(RCA).Correspondingly,there were 42 patients with lowering myocardial perfusion in anterior wall territory,10 patients in lateral wall territory and 21 patients in inferior wall territory.The sensitivity of adenosine 99mTc-MIBI myocardial perfusion SPECT for diagnosing LAD lesion was 95.5%,which was higher than for the other 2 coronary arteries,but the specificity for detecting LCX lesion was 100%.The adverse effects during the adenosine stress test were found in 50%patients,no serious events occurred.Conclusions Adenosine stress 99mTc-MIBI myocardial perfusion SPECT is a good noninvasive method with high diagnostic accuracy and safety in detection of CAD in the elderly,especially.highly accurate for detection and localization of significant CA D.

Objective:To bring the teaching quality assessment to a full play and enhance the monitoring of teaching procedure by comparing and analyzing the teaching quality assessment by college students and teaching supervisors.Method:To select the teaching quality scores of 80 person-times by students and teaching supervisors in Second Military Medical Universities from March to April in 2007 as samples and to apply Kappa statistics to evaluate the identity of the assessment by students and supervisors.Results:The Kappa value is lower than 0.4,showing that the teaching quality assessments by students and supervisors are not very identical.Conclusion:Taking effective measures to improve the reliability,validity and correctness of teaching assessment is especially necessary.

Objective To observe the effects of the chronic adventitia injury on the vasoconstriction of the rat carotid artery. Methods A non-occlusive silicone collar was positioned around the right carotid artery of rats. Blood flow and vascular reactivity to 5-HT were examined, and both carotids were harvested for morphometry at day 3,7 and 14 after operation. Results In the early stage of advenfitia injury induced by positioning a silicone collar around file rat carotid artery, there appeared the characteristic histological changes of chronic vasospasm in collared artery, such as the reduction of the luminal area for （12.15±2.29）% at day 3 after operation （P =0.003 ） and （45.17±3.84）% at day 7 （P 〈 0.001 ）] ,corrugation of the internal elastic lamina,medial thickening up to [ （23.04±5.96）% at day 3 （P =0.009）, （61.65±10.32）% for day 7 （P 〈 0.001 ）] ,the reduction of the blood flow and the increase of vascular reactivity to 5-HT when compared to con- tralateral arteries. Two weeks after collar placement, the vascular wall remodeling was observed in injured artery, such as the medial thickening for [（31.52±4.56） %,P =0.012] and a diffuse intimal hyperplasia,the reduction of the lunfinal area [（37.17±4.57）% （P 〈 0.001）] and the carotid artery blood flow. The average neointima area was （0.19±0.05） rom2 in collared arteries. The vascular reactivity to 5-HT came back to the normal level. Conclusions Collar-induced advenfitia injury caused the enhancement of vascular contractility and the neointima formation. The change of vascular contractility appeared before the formation of neointima.

Objective: To deepen students' comprehension on theory knowledge of pharmacognosy and reinforce the understanding of cultivar identification,quality evaluation and resources exploration on crude drug.Methods: Designing experiment of pharmacognosy on cultivar identification and quality evaluation which are divided into three stages: formulating experimental scheme,implementing experiment and making summary and analysis.Results: Students have complete and systematic recognition about cultivar identification and quality evaluation of pharmacognosy,their self-study ability has been enhanced and their innovation and ability cultivated.Conclusions: The designing experiment combined with practical work of pharmacognosy,and teaching theory has trained the students practical and innovational ability,and good teaching result has been obtained.

Objective To evaluate the influences of susceptibility interpretation of Escherichia coli,Klebsiella pneumonia and Proteus mirabilis in China mainland according to the old and new ceftazidime,cefotaxime and ceftriaxone breakpoints in CLSI M100-S20 and CLSI M100-S19. Methods First, We analyzed the antibacterial susceptibility results of the three bacteria by agar dilution method in the SEANIR surveillance item, which were collected from 15 national hospitals between the year of 2005 and 2007 and excluded the AmpC enzyme positive isolates according to the PGR-DNA sequencing method and/or the antibacterial susceptibility phenotype. ESBL phenotype was confirmed by the CLSI phenotypic confirmatory test. Antibacterial susceptibility of the total 2733 Escherichia coli, Klebsiella pneumonia, Proteus mirabilis isolates was retrospectively analyzed by WHONET 5. 4 software according to the breakpoints of the CLSI M100-S19 (S19) and CLSI M100-S20 (S20). Second, 207 isolates of Peking Union Medical College Hospital with the results of both agar dilution method and disk diffusion method were performed by recurrent analysis. Then we observed the inter-method agreement through the scatter diagram according to the breakpoints of S19 and S20. Results First, as to the ESBL positive Escherichia coli, Klebsiella pneumonia and Proteus mirabili.s, the resistant rate of cefotaxime increased from 65.2% , 55.5%, 14. 6% under S19 (64 μg/ml) to 99. 7%, 96. 2% , 93. 8% under S20 (4 μg/ml). The susceptibility rates decreased from 6. 0%, 11.5%, 33.3% under S19 (8 μg/ml) to 0%, 0. 2%, 0% under S20 ( 1 μg/ml). Ceftriaxone had the same trend as cefotaxime. Though ceftazidime was more active than cefotaxime and ceftriaxone, as to the ESBL positive Escherichia coli and Klebsiella pneumonia, the resistant rates slightly increased from 30. 3%,43. 2% under S19 (32 μg/ml) to42.0%, 56. 0% under S20 (16 μg/ml). The susceptibility rates slightly decreased from 58. 1%, 44. 1% under S19 (8 μg/ml) to 44. 7%, 28.0% under S20 (4 μg/ml). Second,as to the ESBL negative Escherichia coli, Klebsiella pneumonia and Proteus mirabilis, all the susceptibility rates of ceftazidime, cefotaxime and ceftriaxone were between 99. 2%-100. 0%, the resistant rate were between 0%-0. 4%. Third, the S20 MIC breakpoints had a good correspondence with the ESBL phenotype.Fourth, according to the recurrent analysis of MIC testing and disk dilution method, r value was 0. 67,0. 79, 0. 77 for ceftazidime, cefotaxime and ceftriaxone, respectively, and all P value were under 0. 01. The intermethod rates of S19 and S20 were both acceptable. Conclusions If the cefotaxime and ceftriaxone S20 new breakpoints were used, the concordance of antibacterial susceptibility results and ESBL phenotype would increase greatly. The clinician could select proper antibiotics according to the antibacterial susceptibility results and clinical symptoms. It is no longer necessary to edit results for cephalosporins, aztreonam, or penicillins from susceptible to resistant. However, until laboratories implement the new interpretive criteria,ESBL testing should be performed as described in Supplemental Table 2A-S1. The relationship between the new breakpoints of ceftazidime and clinical outcomes need to be further evaluated.

Objective To evaluate the performance of modified Hodge test on the detection of carbapenemases among Enterobacteriaceae with decreased susceptibility to carbapenems. Methods Fortynine Enterobacteriaceae isolates with decreased susceptibility to carbapenems ( MIC of imipenem, meropenem or ertapenem was ≥ 2 μg/ml ) were collected from 16 teaching hospitals from 2004 to 2008. MICs of imipenem, meropenem and etapenem were determined by agar dilution method. Carbapenemases were detected by modified Hodge test. Carbepenemase-causing positive results and AmpCs-causing positive results were differentiated by phenyl boronic acid and oxacillin. Beta-lactamases encoding genes including blaNDM-1were detected by PCR and sequencing. Results Thirty-six of 49 isolates were non-susceptible to imipenem (MIC >4 μg/ml), 31 were non-susceptible to meropenem (MIC > 4 μg/ml) and 47 were non-susceptible to ertapenem (MIC > 2 μg/ml). Twenty-three isolates showed positive modified Hodge test result, including 9 weak-positive results and 14 strong-positive results. Through PCR detection and sequencing, 2 out of 9 isolates showing weak-positive results carried blaKPC-2 and other 7 did not carry any carbapenemase genes but AmpCs/ESBLs genes. Among the 14 isolates showing strong-positive results, 4 carried blaKPC-2, 8 carried blaIMP-4 and 2 caried blaIMP-8. All 26 isolates with negative modified Hodge test result didn't carry any carbapenemase genes. No isolate carried blaNDM-1. Carbapenemases genes PCR detection was regarded as a gold standard, and the sensitivity, specificity, positive predictive value and negative predictive value of modified hodge test was 100%, 79%, 70% and 100% on the detection of carbapenemases among Enterobacteriaceae with decreased susceptibility to carbapenems. Conclusions Modified Hodge test revealed great sensitivity but showed a few false positive results. True and false positive results can be effectively differentiated by phynel boronic acid and oxacillin.

This study attempts to develop a reference substance for the live bacteria count of Streptococcicosis live vaccines in order to evaluate the validity of live bacterial count in inspection and testing. We prepared a batch of live Streptococcus suis reference substance for live bacterial count, tested their physical property, purity, vacuum degree, remaining moisture, and determined their homogeneity, thermal stability and transportation stability. Moreover, we organized collaborative calibration to assign count values to the reference substance and determine the shelf life of the reference substance in 12 months. The results showed that the physical property, the purity, the remaining moisture and the vacuum degree of the reference substance were all in compliance with the requirements of the Chinese Veterinary Pharmacopoeia. The homogeneity test showed that the coefficient of variation of the count of the reference substance was less than 10%, indicating a good homogeneity. Transportation stability test showed that the reference substance remained active after 72 h transportation in summer and winter with the package of styrofoam boxes and ice packs. Thermal stability test showed that the reference substance could be stored for up to 3 months at -20 °C, or up to 21 days at 4 °C. According to the collaborative calibration, the reference vaccine was assigned a count value range of (8.5-12.1)×107 CFU/ampoule. The shelf life test showed that the reference substance was stable for 12 months when stored at -70 °C. The reference substance could provide a reference for the live bacterial count of Streptococcicosis live vaccines. Moreover, it could also be used as a reference to evaluate the quality of corresponding agar media.
Bacterial Load ; Reference Standards ; Vaccines, Attenuated