To study the potential basis of Chinese herbal formula is very important for elucidating their compatible mechanism and promoting the modernization of Chinese materia medica. The pathway and method in studies on the potential basis of Chinese herbal formula, such as altering prescriptions, serum pharmacology, serum pharmacochemistry, fingerprints, pharmacokinetics, and metabonomics, etc. are summed up in this paper. The above-mentioned pathway and method will provide the significant basis in studying the effective components and fractions in Chinese herbal formula.

Objective To compare the efficiency and safety of dezocine and morphine combined with flurbiprofen for gynecologic postoperative analgesia.Methods Ninty patients for elective hysterectomy,ASA (American Society of Anesthesiologists) Ⅰ - Ⅱ,were randomly divided into three groups,given postoperative intravenous analgesic pump:dezocine 50 mg + flurbiprofen 100 mg( Group D) ;morphine 50 mg + flurbiprofen 100 mg ( Group M) ;dezocine 25 mg + morphine 25 mg + flurbiprofen 100 mg ( Group DM ).Anesthesia were induced by midazolam,etomidate,fentanyl and cisatracurium,maintained with propofol and remifentanil.At 15 -30 min before the end of surgery,flurbiprofen 50 mg was given,if pain was not relieved statsifically,morphine 5mg/per time was given additionally.VAS Pain relief scores,Ramsay sedation Score,usage of morphine and side effects such as nausea,vomiting and itch of skin were recorded at 4,8,24,48 h after surgery.Results At 4,8,24 and 48 h after surgery,VAS score at sedation was ( 2.27 ± 0.64 ),( 2.17 ± 0.65 ),( 1.97 ± 0.67 ),and ( 1.60 ± 0.56) in Group D,and ( 2.50 ± 0.63 ),( 2.40 ± 0.62),( 2.20 ± 0.61 ) and ( 1.87 ± 0.57 ) in Group DM at sedation,which were all significantly low than those of ( 3.10 ± 0.76),( 3.00 ± 0.74 ),( 2.80 ± 0.71 )and (2.40 ±0.72)in Group M.At 4,8,24 and 48 h after surgery,VAS score at active was (3.10 ±0.76),(2.97 ±0.76),(2.70 ±0.84) and (2.17 ±0.70)in Group D,(3.43 ±0.63),(3.30 ±0.65),(3.03 ±0.76)and (2.43 ± 0.68 )in Group DM,which were all significantly lower than those of (4.13 ± 0.94),(3.93 ±1.05),(3.60 ± 1.05 ) and ( 3.03 ± 0.96 ) in Group M ( Ps ＜ 0.05).And the VAS scores of Group DM was significantly higher than those of Group D.Sedation score at 48 h after surgery in group D was better than that in Group M ( x2 =4.812,P ＜ 0.05 ),The side effects at 48 h after surgery was 26.7％ in Group D,46.7％ in Group DM and 80％ in Group M,and there significant difference among these 3 groups (P ＜ 0.05 ).Conclusion Compared to Morphine and or Morphine combined with Dezocine,Dezocine 50 mg + flumazenil 100 mg group is better to release the postoperative pain,and withless adverse effects.

Objective To establish a separation method of loganin and morroniside reference substance from Fructus Corni. Methods After extracted with hot water and precipitated with alcohol, the extract of Fructus Corni was isolated and purified by macroporous resin, silica gel column chromatography, and preparative HPLC. Loganin and morroniside were identified by UV, 1H-NMR, 13C-NMR, and MS. Results The contents of loganin and morroniside was higher than 98% by normalization method of HPLC. Conclusion The developed method is simple with lower cost, by which loganin and morroniside can be used as reference substances for the qualitative and quantitative analysis of Chinese herbal medicine.

Objective To investigate the role of renin angiotensin system (RAS) in pathogenesis of nonalcoholic fatty liver disease (NAFLD).Methods Twenty-four Wistar rats were evenly divided into control group and model group.The rats of control group were fed with normal diet,and model group were with high-fat diet.Rats were killed at the eighth week and serum liver function,blood lipid,glucose and insulin were tested.The liver tissues were stained with HE and Picro acid-Sirius red for pathological observation.The liver tissue concentration of angiotensin Ⅱ was determined by ELISA method and the expression of TGF-β1 in liver tissue was examined by immunohistochemistry.Results After eight weeks high fat feeding,weight,liver index,liver function,blood lipids and serum insulin of model group were significantly higher than those of control group (weight:(463.50±22.72) g vs.(404.29±10.32) g; liver index:(3.75±0.21) g vs.(2.66±0.15) g; ALT:(79.8±8.6) U/L vs.(58.8±11.6) U/L; AST:(200.01±51.72) U/L vs.(150.30±37.27) U/L; total cholesterol:(3.67±0.48) mmol/L vs.(1.50±0.23) mmol/L; triglycerides:(2.06±0.40) mmol/L vs.(0.71±0.34) mmol/L; insulin:(17.37±2.89) pmol/L vs.(11.08±2.12) pmol/L),and all the differences were statistically significant (P＜0.01).The histopathological results of model group indicated liver steatosis,inflammatory reaction in part of lobule and portal area and significant fibrosis in part of liver tissue.The liver tissue angiotonin Ⅱ concentration of model group [(32.80 ± 2.81)pg/ml] was higher than that of control group [(22.83 ± 1.75) pg/ml,t =9.559,P＜0.01].The immunohistochemistry results showed that the expression of TGF-β1 of model group was obviously higher than that of control group (Z=-2.540,P =0.011 ).Spearman correlation analysis revealed that the increasing degree of angiotensin Ⅱ concentration was positively correlated with liver steatosis scores (r=0.644,P=0.002) and the expression of TGF-β1 (r=0.470,P=0.037).Conclusion The concentration of angiotensin Ⅱ and TGF-β1 increased in the livers of model rats,which indicated that RAS may participate in the pathogenesis and progress of NAFLD.

Objective To determine the expression of indole-2,3 dioxygenase (IDO) in human acute leukemia,and to investigate its correlations with clinicopathological parameters and prognosis in acute leukemia.Methods The expression of IDO in protein and RNA levels was detected by immunohistochemistry and real-time quantitative RT-PCR,respectively,and the correlations of IDO with clinicopathologic features and prognosis of acute myeloid leukemia (AML)-M5 were analyzed.Results The positive rate of IDO protein was 63.3 ％ (38/60) in human acute leukemia,while it in AML (34/49,69.4 ％),especially in AML-M5 patients (29/35,82.9 ％),was significantly higher than that of acute lymphoblastic leukemia (4/11,36.4 ％).The expression of IDO protein in healthy human peripheral blood mononuclear cells was negative.The RNA expression level of IDO in AML-M5 or non AML-M5 patients were significantly higher than that of healthy people (P ＜ 0.001),and AML-M5 patients had significantly higher IDO RNA level than that in non AML-M5 patients (P ＜ 0.05).The IDO gene expression was not correlated with sex,age and drug sensitivity,while it was closely related with these factors in the patients without complication of pulmonary infection.IDO could not act as an independent prognostic marker.Conclusion The expression of IDO in AML-M5 patients is significantly higher than that in non AML-M5 patients and healthy people.The positive expression of IDO is associated with poor prognosis of AML-M5 patients,but it is not an independent poor prognostic indicator.

Objective To explore the correlation of the myeloid antigen expression and clinical characteristics of acute lymphoblastic leukemia (ALL) in children.Methods The clinical data of 77 newly diagnosed ALL patients in Department of Hematology,the People's Hospital of Zhengzhou University from Jan.2010 to Dec.2013 were analyzed.The patients included 53 boys and 24 girls with a median age of 7.73 (2.00-15.00) years old.Based on flow cytometry (FCM) analysis of bone marrow,these patients were divided into 2 groups:one group included 26 patients with positive myeloid antigen expression (MyAg + ALL) and the other group included 51 patients with negative myeloid antigen expressions (MyAg-ALL).The correlation among myeloid antigen expression,clinical features,prednisone experiment,myelogram on the 15th day was analyzed through induction chemotherapy and minimal residual disease (MRD) on the 33rd day,and the rate of disease-free survival (DFS) was compared between the 2 groups.Results There were 26 cases with myeloid antigen expression among 77 patients (33.77％),CD13 + accounting for 19.48％ (15/77 cases),CD33 + 10.39％ (8/77 cases),and CD117 + 5.19％ (4/77 cases).Among these patients,there were 2 patients expressing both CD13 + and CD33 +,and 1 patient expressing both CD33 + and CD117 +.There was no difference between the MyAg + ALL group and MyAg-ALL group in gender (x2 =0.217,P =0.641),age (≥ 10 years old,x2 =0.011,P =0.918),white blood count(≥50 × 109/L,x2 =1.198,P =0.274),lactate dehydrogenase (LDH) (≥500 U/L,x2 =0.317,P =0.573),genetic abnormality (x2 =0.377,P =0.539),immunophenotype (B-ALL/T-ALL,x2 =0.397,P =0.529),and risk stratification (low-risk group,middle-risk group and high-risk group,x2 =0.260,P =0.878).Univariate Logistic regression showed that the reaction rate of prednisone experiment (P =0.023,OR =3.422) and positive rate of MRD (P =0.001,OR =0.133) of MyAg + ALL group were obviously higher than those in MyAg-ALL group.Multivariate Logistic regression showed that positive rate of MRD in CD13 + ALL group was obviously higher than that of CD13-ALL group (P =0.034,OR =120.765).The DFS rate of CD13 + ALL group and CD13-ALL group were (50.4 ± 13.8)％ and (77.4 ±6.7)％ respectively,and there was a significant difference between the 2 groups (x2 =3.928,P =0.047).Conclusions There is no significant correlation between myeloid antigen expression and clinical characteristics of children patients with ALL.For the patients with myeloid antigens,the early reaction of induction chemotherapy is bad,and for patients with CD13,the prognosis is not good.

Objective To investigate the role of different parenting styles plays in conduct problems of 3-years-old preschool children.Methods Participants were from 148 preschools in Longhua Shenzhen,China.A structured questionnaire covering family demographic characteristics,Conners' Parent Symptom Questionnaire and Egna Minnen Betraffande Uppfostran-Parents (EMBU-P) were conducted among primary caregivers of each child.There were 9289 valid participants in the analysis and logistic regression was used to assess the relationship between three dimensions of parenting (rejection,emotional warmth and control/overprotection) and conduct problems.Results After allowing for certain confounders,parental rejection (OR =1.17,P＜0.01) and control/overprotection (OR =1.03,P＜0.01) was positively associated with conduct problems and emotional warmth was negatively related to conduct problems (OR=0.98,P＜0.01).Stratified analysis showed a significant relationship between conduct problems and both parents' rejection (OR father=1.16,P＜0.01;OR motber=1.17,P＜0.01),father's emotional warmth (OR=0.96,P＜0.01) and mother's control/overprotection (OR=1.04,P＜0.01).This relationship did not vary between boys and girls and between single and not single children.Conclusion Influence of parenting should be taken into consideration in the prevention and intervention of conduct problems.

Objective Colorectal polyp is a precancerous lesion of colorectal cancer .Aim of the study was to explore the risk fac-tors of colorectal polyp malignant transformation .Methods The related information of 75 084 colonoscopies performed from 2003 to 2012 in Southwest Hospital in Chongqing were collected and the relationship between polyp malignant transformation and the pa-tient age ,sex ,polyp location ,size or histological types was analyzed .Results From 2003 to 2012 ,polyps were diagnosed in 14 806 cases of the total 75 084 patients with a 19 .72% detection rate .There were significant difference of the left-side and right-side pol-yp detection rate in different age groups ,and the frequency of polyps distributed in the whole colorectum increased with the increase of age .The rates of epithelial neoplasia and malignant transformation increased with age .At the same time ,malignant transforma-tion rate was significant higher in polyps located in left-side than that in right-side (P<0 .0167) ,in adenoma than that in inflamma-tory hyperplastic polyp (P<0 .01) .The larger diameter and the more villus ,the higher rate of malignant transformation .Conclusion Patient age ,polyp size ,location and histological type could be considered as the significant predictors of colorectal polyp malignant transformation .It may be useful to treat the polyp with endoscopy in patient with age more than 45 and adenoma whose diameter was not less than 1 cm ,located in left-side for prevention of colorectal cancer .

Objective To investigate the levels of literacy and numeracy in type 2 diabetes patients with poor glycemic status in communities of Shanghai,China,and to evaluate their associations with blood glucose level.Methods A total of 800 type 2 diabetes patients with recent HbA1c≥7.5％ or fasting plasma glucose level ≥10 mmol/L were recruited from 8 communities in Minhang district and Changning district of Shanghai,China,and were interviewed using a structured questionnaire during February 2015 and March 2016.Literacy and numeracy levels of all patients were evaluated using the validated Health Literacy Management Scale (HeLMS) and the 5-item version Diabetes Numeracy Test (DNT-5),respectively.Results The patients included in this study were observed to have higher levels of health literacy,with a median score of HeLMS being 116 [interquartile range (IQR),108-120] and a median correct rate of DNT-5 of 80％ (IQR,60％-100％).Age,educational level and occupation were significantly related with health literacy levels and numeracy.Sex and income were closely related with health literacy levels.HeLMS score was not significantly associated with HbA1c level (P =0.383),while the lower correct rate of DNT-5 was linked with a higher level of HbA1c.The median HbA1c level was 8.3％ (IQR 7.7％-9.4％) in the patients with the lowest tertile of DNT-5 correct rate,significantly higher than 8.2％ (IQR:7.5％-9.2％) in the medium and 8.0％ (IQR:7.5 ％-8.8 ％) in the highest tertile group (P =0.009).Conclusions Diabetes patients with poor glycemic status in communities of Shanghai have high levels of health literacy,which was significantly related with age,sex,educational level,occupation and income.Ability in numeracy may be a more important influence factor than health literacy for glycemic status of diabetes patients.

Objective:To analysis the policy tools and targets of the policies of free training for order-oriented medical students in rural areas of China, for reference for further improving the free medical student training policy.Methods:The research team searched the official websites of the State Council, National Health Commission, Ministry of Education, and other ministries, as well as the Peking University Treasure Database, for national level policy documents related to free training of order-oriented medical students released from June 2010 to May 2023. Policy tool-policy target analysis framework was used to quantitative analysis the policy documents.Results:A total of 16 policy documents were included and 213 policy provisions were extracted. From the perspective of policy tools, the proportion of policy provisions using imperative policy tools was the highest, accounting for 63.38% (135 articles), followed by advisory policy tools(18.78%, 40 articles)and reward based policy tools(13.61%, 29 articles), while functional expansion tools(2.82%, 6 articles) and authoritative restructuring tools(1.41%, 3 articles) accounted for a relatively low proportion. The institutional education stage is the main policy target, with provisions accounting for 76.06% (162 articles), followed by the continuing education stage and the post graduation education stage, accounting for 17.84% (38 articles) and 7.51% (16 articles), respectively. It was uneven distribution of various policy tools and their sub tools within the same policy target.Conclusions:The distribution of policy tools for the free training policy of rural order oriented medical students in China needed to be further balanced. The policy targets were mainly concentrated in the education stage of universities.