OBJECTIVE:To study the effects of salvianolate on the expression of vascular endothelial growth factor (VEGF) and matrix metalloproteinase-9(MMP-9)in lung tissue of mice with lung cancer. METHODS:C57BL/6 mice were randomly divid-ed into model group (normal saline),positive control group (cyclophosphamide 50 mg/kg) and salvianolate low-dose,medi-um-dose and high-dose groups(20,40,80 g/kg)with 10 mice in each group. They were ig 1 000 mg/kg urethane,twice a day, for consecutive 4 weeks to establish lung cancer model. After modeling,they were given relevant medicine intragastrically once a day for consecutive 14 d. Mice behaviors,symptoms,body weight,tumor inhibition rate,spleen index,thymus index,and the ex-pressions of VEGF and MMP-9 in lung tissue among groups were compared. RESULTS:The activity of mice in model group disap-peared,dull coat color,preferred crowding together;the above-mentioned phenomenon improved in positive control group and sal-vianolate different dose groups. The body weight of mice in positive control group,salvianolate low-dose group,medium-dose group and high-dose group were(21.01±2.95)g,(20.89±3.14)g,(21.03±3.02)g,(21.24±3.17)g;and the tumor inhibition rates were(41.12±15.42)%,(36.92±10.42)%,(39.41±12.39)% and(37.19±10.39)%;compared with model group,spleen index,thymus index,and the expressions of VEGF (except for positive control group) and MMP-9 in other 4 groups decreased (P<0.05). CONCLUSIONS:Salvianolate shows obvious inhibitory effects on mice with lung cancer,which may be related to in-hibiting expressions of VEGF and MMP-9 in lung tissue.

Objective T o understand the assessm ent on the criminal responsibility of drug-induced m ental disorders and judicial experts’ opinions. Methods T he judicial experts from institutes of forensic psychi-atry in Shanghai were selected. T hey were asked to finish a self-m ade questionnaire of assessm ent on the criminal responsibility of drug-induced m ental disorders by letters and visits. Results Most of experts knewthe special regulation,“not suitable for evaluation” towards the criminal responsibility of drug-in-duced m ental disorders of the guideline prom ulgated by Ministry of Justice. B efore and after the guide-line was issued, no expert m ade a no-responsibility opinion in such cases. After the guideline was issued, som e experts m ade a full-responsibility or lim ited-responsibility opinion in such cases. T here was a little disagreem ent am ong the experts in the case that the crime was unrelated with m ental sym ptom s or the criminals used drugs even though he knewit could induced insanity. B ut there were still m any obvious disagreem ents am ong experts in the case that crime was related to such sym ptom s and person was no ability to debate. Most experts agreed to settle the disagreem ents with im proved legislative perfection. Conclusion Most experts are not strictly com plying with the assessm ent guidelines during their practice, and there is still an obvious disagreem ent towards the criminal responsibility of drug-induced m ental disorders.

Epidemiological, clinical, laboratory and treatment data, as well as outcomes of 66patients diagnosed as brucellosis during 1984 to 2010 in Peking Union Medical College Hospital were retrospectively analyzed. Thirty-four (51.5%) patients had a history of close contact with sheep or cows infected with brucellosis, eight (12. 1% ) had eaten not-fully-boiled or roasted mutton, three (4. 5% ) had drunk or contacted with contaminated milk, and transmission route was unknown in 21 (31.8%). The most common manifestations were fever ( 97.0%, 64/66 ), loss of appetite and fatigue ( 93. 9%, 62/66 ),sweating (47.0%, 31/66), myalgia and arthralgia (54. 5%, 34/66 ), hepatomegaly (27.3%, 18/66),splenomegaly (37.9%, 25/66), increased erythrocyte sedimentation rate (ESR) (62. 1%, 41/66), and elevated C-reactive protein (65.4%, 34/52). Average interval from onset to diagnosis was 19. 2 weeks. All 66 patients were positive in serum agglutination test for BruceUa, and 28 (42. 4% ) positive in blood or bone marrow culture for Brucella. Sixty-five of 66 patients were treated by standard combined treatment with rifampicin, quinolone, minocycline and streptomycin, with all effective, and only four with mild liver damage in treatment who got better after discontinuing medicines and changing treatment regimen.

Chitosan(CS)surface was modified with hydrophobic octyl groups to prepare N-octyl chitosan(nitro-gen-octyl chitosan;OC).Then hydrophilic group carboxyl-polyethylene glycol-amino (PEG);tumor-targeting lig-and D-glucosamine(DG);and membrane-penetrating peptide 9-D-arginine(9R)were linked to OC successively. Then the DG and 9R modified chitosan micelle (DG/9R-PEG-OC)with tumor-targeting and transmembrane effect was prepared.By hydrogen nuclear magnetic resonance spectrometer (1 H NMR)and sodium dodecyl sul-fate polyacryl amide gel electrophoresis(SDS-PAGE);the successful formation of DG/9R-PEG-OC was certified;with particle size of 151.8 nm and Zeta potential of 16.5 mV.The morphology of chitosan micelle observed by transmission electron microscope was homogeneous spherical structure.The drug loading content (DLC)(using fluorescein as a model drug)and encapsulation efficiency (EE)were about 28.2% and 75.0% measured by UV-visible spectrophotometer.Meanwhile;the drug showed a controlled releasing profile out of the micelle.Cellu-lar uptake experiments indicated DG/9 R-PEG-OC micelle had a significant tumor-tageting and transmembrane effects;especially on HepG2 cells;which exbihited high expression of the glucose transporter.Thus DG/9R-PEG-OC micelle could be a promising drug targeted delivery system of hydrophobic antitumor drugs.

Objective To summarize the clinical experience of surgical treatment for the congenital coronary artery anomaly.Methods 15 patients with coronary artery anomaly,congenital coronary artery fis-tulas were 11 patients,including 1 patient associated with Fallot,5 patients underwent ligation of isolated fistula and 1 patient's fistula was performed tangent suture though off-pump cardiopulmonary bypass,4 pa-tients'fistulas were repaired by endocardiac way and 1 patient was mended through dissection of fistula under Oil-pump cardiopulmonary bypass.Anomalous origin of the left coronary artery from pulmonary artery were 4 patients and 1 patient associated with rheumatoid valve disease.Operative methods included ligation of left circumflex (1 case),anastomosis of left subclavian artery-left artery-left main (1 case) and transplantation of left main(2 cases).Results There was 1 death becaused severe low cardiac output syndrome,and the there was good prognosis and no clinical symptoms found in 14 patients during follow-up.Conclusion The feasible operation for the coronary artery anomaly should be performed as early as possible once diagnosed correctly.

Objective To discover the effects of the Prescription Administrative Policy in force on the quality of the prescriptions in a tertiary hospital in 2007. Methods The prescriptions of 400 cases were sampled systematically for evaluation, and 60 patients were interviewed. Results The average eligibility rate of the prescriptions was but 37. 2% in this hospital, which was mainly plagued by incompleteness, nonstandard and irrationality found in prescriptions. Implementation of the Policy contributed to a significant improvement of some indicators. For example, the eligibility rate increased by 12. 2% (P=0. 004) ,the percentage of the use of antimicrobial agents dropped significantly (P=0. 001),and the percentage of generic names used rose significantly (P = 0. 000). Conclusions The implementation of the Policy is highly positive for prescription quality.

IgG4-related disease (IgG4-RD) has been proved to be associated with malignancy.The incidence and risk factors of malignancy development in IgG4-RD were not clear.Nine IgG4-RD patients with malignancies and 27 IgG4-RD control cases were analyzed for risk factors and clinical features.The incidence of malignancy in IgG4-RD was 3.3％,higher than age-controlled general population.Smoking history was significantly more common in patients with malignancies than in the control group (9/9 vs 16/27,P ＜ 0.05).A total of 6/9 malignancies occurred within the first year after the diagnosis of IgG4-RD.Colorectal,biliary and thyroid cancers were the leading types.Smoking history is a risk factor for IgG4-RD associated malignancy.Careful vigilance to monitor malignancy needs to be paid during follow-up.

Objective T o explore the difference of eye m ovem ent characteristics betw een uncooperative and cooperative subjects w ith m ental disorder after cerebral traum a. Methods T hirty-nine subjects w hich needed psychiatric im pairm ent assessm ent w ere selected. A ccording to the binom ial forced-choice digit m em ory test (BFD M T),allsubjects w ere divided into cooperative and uncooperative groups. The subjects w ere asked to take the im age com pletion test from W echsler adult intelligence scale. M eanw hile, the data of eye m ovem ent track, fixation, saccade, pupil and blink w ere recorded by the track system of eye m ovem ent. Results T here w ere significantly differences (P<0.05) in the data of saccade betw een coopera-tive (10 cases) and uncooperative groups (29 cases). T he frequency, tim e, am plitude, acceleration of saccadic in uncooperative group w ere significantly higher than cooperation group. T he saccade latencies of cooperation group increased m ore than uncooperative group. T here w as a significant difference (P<0.05) in total discrete distance, average distance and total tim e of fixation betw een tw o groups, w hile the aver-age duration tim e, num ber and frequency of fixation had no significantly difference (P>0.05) betw een tw o groups. A nd the blink frequency of cooperation group w as higher than uncooperative group. Conclusion E ye m ovem ent can be an objective index for the prim ary judgm ent of cooperation level.

Using objective structuned clinical exammation ,OSCE to access a new resident standardized training , analyze the result and perform stratifying management and teaching based on the result , which may improve the effi-ciency and effectiveness of resident standardized training .

Objective To investigate status of the intravenous use of antibiotics in outpatients and emergency patients of a tertiary first-class hospital, and provide a reference for developing management measures in next step. Methods By a retrospective method,all the prescriptions using antibiotics by intravenous administration in outpatients and emergency department patients from a tertiary first-class hospital in 2013 were extracted from the hospital information system. The categories of antimicrobial agents,proportion of intravenous use of antimicrobial drugs,ranking of the antibiotic consumption sum and defined daily dose,and the top 10 clinical departments or wards intravenously using antimicrobial drugs were chosen to analyze. The data in 2014 were extracted as a comparison. Results Outpatients and emergency department patients respectively used 8 categories 31 kinds and 8 categories 30 kinds of intravenous antimicrobial drugs, with high consumption of cephalosporins and restricted antimicrobials such as sodium cefoxitin.Intravenous use of antimicrobial drug prescription proportion in emergency department is higher than that in outpatient department. Conclusion After intervention in 2014, antibiotic consumption is effectively controlled as compared that in 2013. But management should be strengthened and appropriate interventions should be taken to ensure the use of intravenous antibiotics in a safe,effective and economical manner.