Professor TANG Han-jun is a famous expert of traditional Chinese medicine,he has 50 years’experience in TCM. With the unique theories,rich clinical experience and excellent clinical effect,he has made great contributions to the surgery developmemnt of TCM. The article tries to summarize the essence of TANG Han-jun's clinical experience,as to show the regulation and characteristics and give introduction to the reader. Professor Tang indicates that essence-finding,selection of treamment based on the differential diagnosis and combination differentiation of symptoms and signs with differential diagnosis of disease are pivotial in mastopathy. The main way to administer medicines is enriching qi and nourishing spleen. Two typical cases of Herbal pastes(hyperplasia of mammary glands and mammary carcinoma) are presented.

Objective To understand antimicrobial resistance of Enterobacteriaceae strains and distribution charac-teristics of carbapenemase-resistant Enterobacteriaceae(CRE)in Xijing Hospital in 2015,so as to provide basis for rational use of antimicrobial agents in clinic. Methods Specimens from infected inpatients and outpatients in Xijing Hospital in January-December 2015 were performed pathogenic culture,isolation and identification. Antimicrobial susceptibility testing was performed with Kirby-Bauer method,carbapenemase confirmatory test was conducted with modified Hodge test,antimicrobial resistance of Enterobacteriaceae was statistically analyzed. Results A total of 4166 pathogenic strains were isolated in 2015,1554 (37.30% )of which were Enterobacteriaceae strains,the top 5 isolated pathogens were Escherichiacoli(E. coli),Klebsiella pneumoniae(K. pneumoniae),Enterobactercloacae (E. cloacae),Proteusmirabilis,and Enterobacteraerogenes. Of 787 E. coli strains,581(73.82% )were extend-ed-spectrumβ-lactamases(ESBLs)-producing strains;of 367 K. pneumoniae strains,182 (49.59% )were ESBLs-producing strains. E. coli and K. pneumoniae had the highest resistance rates to cefazolin,which were 93.14% and 78.48% respectively. A total of 81 (5.21% )CRE were detected,K. pneumoniae,E. cloacae,and E. coli were 41 ,27,and 13 strains respectively;strains were mainly isolated from patients in departments of neurosurgery(n=42),gastroenterology(n= 9),and neurology(n= 8). 1.02% (8/787)of E. coli and 3.27% (12/367)of K. pneu-moniae were multidrug-resistant. Conclusion Enterobacteriaceae accounted for a higher proportion of pathogenic bacteria causing HAI,the detection rate of ESBLs-producing strains remains high,the isolation rate of carbapenem-resistant Enterobacteriaceae is higher than that of last year,especially K. pneumoniae.

Objetive To elucidate the mechanism of antibiotic resistance of Pseudomonas aeruginosa(P.a.) in an effort to provide a basis in clinical combined use of antibiotics against P.a.infection in clinical settings.Methods All P.a.strains were isolated by routine procedures and identified with VITEK-2 automatic bacterial identification console.The minimum inhibitory concentration(MIC) was detected using dilution method on agar plate following the instruction of CLSI.Results Ninety-two strains of P.a.were isolated from clinical infection specimens,most of them were obtained from respiratory tract(88.04%).Of the 92 strains,45(48.91%) were metallo-?-lactmases positive,and 25(27.17%) were AmpC positive.When treated with a combination of meropenem and imipenem,MIC≥1 was found in 17 strains(18.48%).The bacteriostatic rate of polymixin B and meropenem was 95.65% and 80.43%,respectively,that of amikaein,piperacillin/tazohaetam(PIT) and imipenem was 48.91%-71.74%,and that of cefoperazone/sulbactam(SUP) was 36.96%.The synergistic action of PIT,and SUP with amikacin was 60.87% and 58.70%,respectively,and that of PIT,SUP with minocycline were 44.57% and 43.48%,and of PIT,SUP with PLB were 28.26% and 7.61%,respectively.Conclusions P.a.strains in this study are mainly isolated from respiratory tract infection specimens.Multiple drug-resistant mechanisms are involved in the drug resistance of P.a.Enzyme inhibitors,such as PIT or SUP,with amikacin or polymixin B should be first selected for clinical treatment of P.a.caused infection.Meanwhile,antibiotics should be rationally administered in accordance with the seriousness of disease,and with the drug-resistant phenotype of the isolated strains.

Objective To check the maneuverability of the nursing safety management indicators for skilled nursing facilities.Methods A hospital based skilled nursing facility in Chongqing was chosen as the main study target while a Red Cross nursing hospital in Shanghai which operated earlier was also included as a comparison object.Combination of files reference,on-the-scene observation,manager interviews,sampling survey and institution's self-assessment,scores of indicators were calculated,and the total scores for both institutions were calculated as well.Results The institution from Chongqing marked 81 points while the other one got 86 points.Conclusions The indicator system had good maneuverability and the weight of indexes was consistent with the practical requirement of safety management.This indicator system could provide reference for standardize skilled nursing facilities' management,but still needed further revision and consummation.

Objective To study cervical HPV infection in female patients with vulvar condyloma acuminatum(CA)from Shanghai area.MethodsExfoliated cells were obtained from cervices and vulva lesions of CA of 194 patients.respectively.HPV genotyping was carried out in cell samples using capture-hybridization method and gene chip techniques.Results HPV was detected in vulva lesions of all the 194 patients.Among them,74.2%(144/194)were positive for low risk(LR)-HPV,and 25.8%(50/194)for high risk(HR)-HPV.A single HPV genotype(6 or 11)was detected in 136(94.4%)patients with LR-HPV.and mixed genotypes of LR-HPV and HR-HPV in 46(86%)patients with HR.HPV.Of the 194 patients.85.6%(166/194)were complicated by cervical HPV infection.including 119(61.4%)cases of LR-HPV and 46(23.7%)cases of HR-HPV,In the case of HPV genotype.the consistence between CA lesions and cervix was 95.8%(159/166).The prevalence of LR-HPV declined sequentially from subtype 11 to 6 and 53,and that of HR-HPV from subtype 16 to 18 followed by 52,31,45 and 58.Conclusions There is a high rate of infection with HR-HPV in female patients with CA.and nearly one quarter of these patients are complicated by cervical HR-HPV infection.

OBJECTIVE:To investigate the effects of Astragalus polysaccharides on heart function and myocardial fibrosis in spontaneously hypertensive rats (SHR) and corresponding mechanism. METHODS:50 SHR were randomly divided into a model group,a captopril tablets group (positive drug,30 mg/kg) and the groups of high,medium and low-dose (100,50,25 mg/kg) Astragalus polysaccharides,with 10 SHR in each group. Another 10 Wistar Kyoto rats were included into the normal group. The rats in the drug administration groups were given corresponding drugs ip,while those in the normal group and the model group were given isometric distilled water ip,once a day,for 12 consecutive weeks. The left ventricular systolic pressure (LVSP),left ventricular end diastolic pressure (LVEDP),left ventricular pressure rise rate (+dp/dtmax) and left ventricular pressure decline rate (-dp/dtmax) of the rats were recorded. The heart mass index (HMI) and left ventricular mass index (LVMI) thereof were deter-mined. The level of hydroxyproline and the mRNA and protein expression of transforming growth factor-β1(TGF-β1)and peroxi-some proliferator-activated receptor-γ(PPAR-γ)in the cardiac muscle tissue thereof were detected. RESULTS:Compared to the nor-mal group,the rats in the model group had lower LVSP,+dp/dtmax and-dp/dtmax,higher LVEDP,HMI and LVMI,as well as high-er levels of hydroxyproline and the mRNA and protein expression of TGF-β1 and lower level of the mRNA and protein expression of PPAR-γ in the cardiac muscle tissue (P<0.01). Compared to the model group,all the above-mentioned indexes of the rats in the group of high-dose Astragalus polysaccharides and the captopril tablets group were significantly improved (P<0.05 or P<0.01);except for LVEDP and the mRNA expression of PPAR-γ,all the above-mentioned indexes of the rats in the group of medi-um-dose Astragalus polysaccharides were significantly improved(P<0.05 or P<0.01);no statistically significant difference(P>0.05) in all the above-mentioned indexes was shown between the model group and the group of low-dose Astragalus polysaccha-rides,except that the-dp/dtmax of the latter was significantly higher and the level of the mRNA expression of TGF-β1 was obvious-ly lower (P<0.05). CONCLUSIONS:Astragalus polysaccharide can improve heart function and myocardial fibrosis in SHR by a mechanism which may be related to downregulating the expression of TGF-β1 and upregulating the expression of PPAR-γin the car-diac muscle tissue.

Objective To observe the effects of recombinant human interleukin 11(rhIL-11) on proliferation, migration and invasion of A549 cells, and the mechanism thereof. Methods Final concentrations of 0, 10, 20, 50 and 100μg/L rhIL-11 were added into pulmonary adenocarcinoma A549 cells. The cell proliferation was detected by MTT. The wound-healing, transwell migration assay were used to validate the capability of the migration and invasion of A549 cells. Matrix metallopro-teinases (MMP)-2 and MMP-9 protein expressions were revealed by Western blot assay. Results The proliferation of A549 cells was not significantly changed by rhIL-11. The cell capability to migrate and invade was significantly increased 24 h af-ter treatment with rhIL-11 (P<0.05). The expression levels of MMP-2 and MMP-9 were significantly un-regulated, and which were increased with the increased concentrations of rhIL-11 (P<0.05). Conclusion rhIL-11 can promote the migra-tion and invasion of A549 cells, and the up-regulation of MMP-2 and MMP-9 expression might be one of the mechanisms.

To observe the effects of Fuhuang Shengji Yuchuang (FHSJYC) Ointment, a compound traditional Chinese herbal medicine, on the expressions of types I and III collagens in granulation tissue of wound in rats with diabetes.

OBJECTIVE: To study the effects of Shengji Huayu Recipe (a traditional Chinese medicine compound recipe for resolving stagnation and promoting granulation) and its decomposed formulas (Huayu Recipe for resolving stagnation and Shengji Recipe for promoting granulation) on the synthesis of collagen types I and III in granulation tissue of rats in early wound healing. METHODS: Twenty-four male Sprague-Dawley (SD) rats with full-thickness skin lesion were randomized into 4 groups: Shengji Huayu Recipe-treated group, Shengji Recipe-treated group, Huayu Recipe-treated group and untreated group. Collagen types I and III in granulation tissue of the rats were tested with immunohistochemical methods and image analysis. RESULTS: On the third day of wound healing, collagen I of the rats in both Shengji Huayu Recipe-treated group and Shengji Recipe-treated group was higher than that in the untreated group, and collagen I of the rats in Huayu Recipe-treated group was lower than that in the untreated group (P<0.05). Collagen III of the rats in the three treated groups were lower than that in the untreated group (P<0.05). On the seventh day of wound healing, Collagen I of the rats in both Shengji Huayu Recipe-treated group and Shengji Recipe-treated group was higher than that in the untreated group (P<0.05), and collagen III of the rats in both Shengji Recipe-treated group and Huayu Recipe-treated group was higher than that in the untreated group (P<0.05). CONCLUSION: Resolving stagnation and promoting granulation therapy can promote the wound healing in rats.

Objective To investigate the expression of integrin β3 and osteopontin(OPN) in eutopic and ectopic endometrium of adenomyosis. Methods From January 2007 to July 2008, the endometrium specimens were collected from 43 patients with adenomyosis undergoing hysterectomy in Peking University First Hospital. Eutopic endometrium were 11 in proliferative phase and 32 in secretory phase (18 cases in mid-secretory phase) were collected. Ectopic endometriums were also collected. In the mean time, it was chosen 41 cases with pure subserous uterine myoma or cervical intraepithelial neoplasia (CIN) Ⅱ-Ⅲ treated by hysterectomy as controls including 12 endometrium in proliferative phase and 29 endometrium in secretory phase (19 cases in mid-secretory phase). The expression of Integrin β3 subunit and OPN in the endometrium were assessed by immunohistochemical staining and quantitative real-time polymerase chain reaction. Results (1)Immunohistochemical staining showed that positive staining of integrin β3 and OPN were present predominantly in eutopic and ectopic endometrial glandular epithelium. There was significant different protein expression of integrin β3 and OPN, which were 1.6±0.8 and 1.7±0.7 in eutopic endometrium,1.7±0.7 and 1.8±0.9 in ectopic endometrium,2.1±0.9 and 2.0±0.9 in control endometrium (P<0.05). The protein expression of integrin β3 and OPN in eutopic endometrium of adenomyosis in the proliferative phase(0.8±0.4 and 0.7±0.3) were remarkably lower than those of the secretory phase(1.8±0.8 and 1.9±0.8,P<0.01). The protein expression of integrin β3 and OPN in the endometrium of controls in the proliferative phase(1.0±0.4 and 1.0±0.4) were significantly lower than those of the secretory phase(2.5±0.7 and 2.5±0.7)(P=0.000). In the mid-secretory phase, the protein expression of integrin β3(2.0±0.9) and OPN (2.1±0.8)in eutopic endometrium of adenomyosis were significantly lower than that of control endometrium(2.7±0.5 and 2.7±0.7)(P<0.01). (2)The mRNA expression level of integrin β and OPN in eutopic and ectopic endometrium were assessed by quantitative real-time PCR(result was shown by median index). It was observed that integrin β3 mRNA and OPN mRNA were significantly lower in the eutopic endometrium of adenomyosis (4.69 and 4.23), when compared with ectopic endometrium(7.96 and 14.84)and controls (13.47 and 17.40) (P<0.05). Eutopic endometrium had higher mRNA expression of integrin β and OPN mRNA in the secretory phase (5.54 and 11.40) than that in the proliferative phase(2.69 and 3.30) (P<0.01).The mRNA expression level of integrin β and OPN of control endometrium in the proliferative phase (3.12 and 4.75)were significantly lower than that in the secretory phase(19.94 and 21.00, P=0.000). The mRNA expression of integrin β and OPN were 10.10 and 14.34 in the mid-secretory phase, which were significantly lower than 21.50 and 24.18 in control endometrium(P<0.05). Conclusions High expression of integrin β3 and OPN in ectopic endometrium of adenomyosis may cause endometriotic lesions; abnormal expression of integrin β3 and OPN in the endometrium of adenomyosis during the implantation window may contribute to infertility in some patients.