The current official quality control approaches meet the challenges from the complexity of herbal medicines.In fact,any herbal medicines containing numerous unknown components,its curative effect usually depends on the whole of herbal medicines,so it is impossible and unnecessary to qualitatively and quantitatively study every component.By investigating the limitations of current quality control approaches for herbal medicines and the difference and similarity in the chemical substantial style as well as quality control pattern of herbal medicines,a new quality control approach for Chinese herbal medicines should be explored and designed.The combination approach of chemical analysis with bioassay is promising to be developed and employed in order to ensure the safety and efficacy of Chinese herbal medicines.

To explore the new pattern of Chinese medicine solid preparations (CMSP) in vitro dissolution, a method testing the bio-thermal activity in combination with UPLC was used. Microcalorimetry was used to obtain the characteristic metabolic growth power-time curves and a series of biothermodynamic parameters of the inhibition of Staphylococcus aureus by Yinhuang tablet dissolving solutions at the pH 6.8 (phosphate buffer) dissolution medium at different times. From these results, the cumulative dissolution of Yinhuang tablet based on bio-thermal activity was obtained. The dissolution rates of two components of chlorogenic acid and baicalin were determined by UPLC method. Then f2 similar factor method was used to evaluate the relevance of these two methods. The result showed that f2 values all were more than 50, indicating that there is a good correlation between the two methods of measuring the dissolution rate. It is feasible to determine CMSP in vitro dissolution by using bio-thermal activity, and to provide new evaluation methods for controlling the quality of CMSP.

To compare the microcalorimetric fingerprint profiles of Lonicerae japonicae Flos (Lj.F) and Lonicerae Flos (L.F), microcalormietry was applied to find the heat change regularity of Bacillus shigae (B. shigae) metabolism affected by Lj.F and L.F (we choose Lonicera macranthoides Hand.-Mazz in this paper) with different concentrations. The thermogenic curves and thermodynamics parameters were investigated as evaluation index, and then the date of experiment was studied by similarity analysis. All the results indicated that the Lj.F and Lonicera macranthoides Hand.-Mazz (L.m.H-M) significantly impacted the microbial growth and had good similarity in its inhibitory activities. The combination approach of chemical analysis with bioassay was developed and employed to ensure the safety and efficacy of Chinese herbal medicines.

Objective To investigate the clinical characteristics and treatments of endometrioid carcinoma patients with preoperative diagnosis of endometrial hyperplasia.Methods From 2005 to 2010, 404 patients were diagnosed with endometrioid carcinoma after hysterectomy.Among these patients,44 of them were diagnosed atypical endometrial hyperplasia(AEH) preoperatively.Retrospectively analysis the characteristics of these patients with SPSS13.0.Results Among the 44 cases, all of them were grade G1 disease, and 39 of them received comprehensive staging surgery.14(32%)young cases preserved bilateral ovaries.9 cases(20%) were given adjuvant radiology.No recurrence was detected during the median follow up of 52 months.Compared to the premenstrual group, although no statistical difference was detected, more patients with risk factors of deep myometrium invasion(4/22 vs 1/22) and lymph-vascular space invasion(LVSI, 3/22 vs 0/22) in the postmenstrual group.Compared to the patients who diagnosed with endometrioid cancer(EC) preoperatively, there are more patients with grade G1(P=0.000), fewer patients received adjuvant chemotherapy(P=0.003) and fewer recurrence(P=0.019) in AEH group.Conclusions The endomtrioid cancer patients who diagnosed with atypical hyperplasia preoperatively have better prognosis.Hysterectomy with bilateral ovaries preserved is acceptable in young patients.Post menopause patients have more risk factors of deep myometrium invasion and LVSI.

Aim To investigate the molecular mecha-nism of Gab2 in the invasion and metastasis of breast cancer and provide a theoretical basis for clinical pre-vention of breast cancer invasion and metastasis. Methods The Gab2 , MMP-2 and MMP-9 expressions in 80 cases of breast cancer were detected by immuno-histochemistry . Western blot was used to detect the ex-pression of Gab2 protein in MDA-MB-231 cells and MCF-7 cells. The siRNA plasmid was used to transfect MDA-MB-231 cells. Western blot was used to detect the proteins expression of Gab2 , MMP-2 and MMP-9 . Transwell in vitro experiment was used to detect the in-vasion ability of each group transfected MDA-MB-231 cells, Western blot was used to analyze phosphorylation of Akt and ARK5 induced by epithelial growth factor ( EGF ) in transfected cells ( SiGab2/MDA-MB-231 and Scr/MDA-MB-231 ) . Results The expression of Gab2 protein in invasive ductal carcinoma was signifi-cantly higher than in normal breast tissue ( P<0. 01 ) . The expression of Gab2 was dramatically correlated with lymph node metastasis, ER expression, tumor his-tological grade, MMP-2 and MMP-9 (P<0. 05). The expression of Gab2 protein in MDA-MB-231 cells was higher than in MCF-7 cells. The expression of Gab2, MMP-2 and MMP-9 decreased in SiGab2/MDA-MB-231 cells and the invasion ability of SiGab2/MDA-MB-231 cells was significantly decreased ( P<0. 05 ) , and after 5 minutes’ stimulating by EGF, the phosphoryla-tion of Akt and ARK5 was significantly reduced. Con-clusion Gab2 can promote the invasion and metasta-sis of breast cancer by effecting the expression of MMP-2 and MMP-9 through PI3 K/ Akt /ARK5 signal path-way.

Objective To analyze the assets and liabilities of secondary public hospitals of Wuhan city in Hubei province ,in order to provide references to control the debt scale of such hospitals .Methods Twenty‐one public secondary public hospitals of Wuhan city were analyzed using official statistics on their asset and liabilities from 2012-2014 .Results Such a timeframe witnessed a year‐on‐year growth of both total assets and liabilities of these hospitals ,yet the growth rate of total assets(35.15% ) falls behind that of total liabilities (53.62% )significantly ;significantly slower growth rate of non‐current assets since 2013 ;higher current liabilities than long‐term liabilities on yearly basis ;year‐on‐year grow th of liquidity rate and quick ratio in general ;significant rise of debt‐to‐assets ratio .Conclusions The overall debt scale of such hospitals keeps growing ,a trend deserving actions and correction .

As an important part of the hierarchical medical system in China ,urban secondary hospitals play as a pivot between tertiary hospitals and community healthcare centers.By describing the overall development status of such hospitals in China ,the paper discussed the problems existing in the development of urban secondary hospitals and put forward strategies in the hope of providing reference for the transformation of these hospitals .

Objective To evaluate the clinical feature and potential reasons of delayed papillary bleeding after endoscopic retrograde cholangiopancreatography (ERCP),and search for effective hemostasis and strategies.Methods A total of 76 patients with post-ERCP bleeding underwent endoscopic treatment in the Eastern Hepatobiliary Hospital from August 2000 to August 2016.Clinical data,haemostatic methods,and treatment outcomes of patients were retrospectively analyzed.Results Delayed papillary hemorrhage mostly occmred within 48 hours after ERCP (67.2％,45/67),with main manifestations of hematemesis,bloody stool,and bile.The lowest incidence of delayed bleeding was detected after endoscopic papillary balloon dilation (EPBD,0.1％),which was followed by papillary precut (0.6％) and endoscopic sphincterotomy (EST,0.9％).And EST+EPBD had the highest incidence of delayed post-ERCP papillary hemorrhage (2.4％).The most bleeding site was the left side of the incision (67.1％,51/76).Emergent endoscopic interventions were applied in all patients with success of hemostasis in 71 out of 76 (93.4％),and injection with diluted epinephrine,electric coagulation,hemoclipping,and metal stenting were used sequentially for hemostasis.Among the 71 successful cases of hemostasis,66 patients were performed endoscopic hemostasis for once,4 patients took twice,and 1 case took thrice.Endoscopic hemoclipping was the most commonly used method with successful rate of 76.9％ (50/65) for hemostasis.Conclusion Precut papillotomy is safe and effective,and its complication occurrence rate is similar to that of EST.Hemorrhage should be prevented and timely dealt with in small/median EST and/or EPBD.Once hemorrhage is suspected clinically,endoscopic inventions should be applied timely,and hemoclipping is a safe and effective method.

Objective To evaluate the feasibility and the safety of endoscopic closure for acute colon perforations with novel successive endoclips in animal model. Methods Approximately 1. 5 to 2 cm colonic full-thickness resections were created with an electrotome in 3 Ba-Ma pigs that were under general anesthesia and were closed with the conventional endoclips and novel successive endoclips respectively. The procedure time and the efficacy of each endoclip were recorded. After the procedure,the general condition and physiological indicators were carefully monitored. After a follow-up of 1 week,the pigs were euthanized for an endoscopic observation of the healing condition and the residual endoclips. A postmortem examination was performed to observe the abdominal infection and incision condition. Transverse sections of the colon across the site of perforation were taken for histopathologic examination to assess the healing process. Results All the colonic perforation models in three pigs were established successfully. Endoscopic closure for acute colon perforation with two kinds of endoclips was technically successful in all 3 pigs. The mean time of the procedure with successive endoclip was less than that with the conventional endoclip(54. 0 seconds VS 91. 9 seconds,P<0. 001),but the successful release rate of the successive endoclip was lower than that of the conventional endoclip without significant difference[62. 5%(15/ 24)VS 14/ 16,P= 0. 17].All the ani-mals survived without infection and hemorrhage. Five perforations demonstrated signs of healing,whereas one closed with the novel successive endoclips failed to heal completely. Conclusion Endoscopic closure for a-cute colon perforations with novel successive endoclips is effective and safe. The novel successive endoclip has the advantage of saving time,but it needs to be further improved and perfected to satisfy the clinical need.

Objective To determine the prognostic significance of positive peritoneal cytology (PPC) among patients with endometrial cancer and to find out potential risk factors for PPC in endometrial cancer.Methods Data were extracted from Peking Union Medical College Hospital between Jan 1 2005 and Dec 31 2010.Only those patients who had undergone a staging procedure were included.A total of 486 patients were identified.Statistical analyses were performed using Fisher`s exact test, Kaplan-Meier log rank, and Cox proportional hazards models.ResultsRate of PPC was 4.8% in endometrial cancer.Non-endometrioid endometrial cancer(P=0.000), stage Ⅲ/Ⅳ(P=0.000), deep myometrial invasion(P=0.001), and cervical stromal involvement(P=0.018) appeared to be risk factors for PPC in endometrial cancer.Univariate analysis revealed statistically difference in 5-year PFS (70.9% vs 90.0%) and 5-year OS (72.2% vs 96.0%).Progression-free survival and overall survival showedstatistically difference(P=0.005,P=0.000)between PPC and NPC endometrial cancer.On multivariate analysis, PPC remained no statistically difference in progression-free survival or overall survival(RR=3.812,95% CI 0.897-16.200,P=0.070;RR=3.426,95% CI 0.800-14.673,P=0.097).Conclusions PPC is not an independent risk factor in patients with endometrial cancer.Aggressive histology, FIGO stage, deep myometrial invasion and cervical stromal involvement are presumed to be associated with PPC in endometrial cancer.