Aiming at the confused situation of Stephania tetrandra and its adulterants in the production,supply and sale market,the author had overviewed information on Stephania tetrandra and its adulterants in source,character identification,microscopic identification,physical and chemical identification at home and abroad in recent years,so thus for scientific identify of species,distinguishing between the families and genera and correcting medication for clinical use.

Objective To investigate risk factors of Alzheimer's patients with aspiration pneumonia and inter-vention,to provide a reference for clinical treatment.Methods From January 2013 to June 2014,322 patients with Alzheimer's disease were selected,the incidence of aspiration pneumonia was analyzed,and the age,gender,depression Tian water test grading,underlying diseases,aspiration and other potential factors were analyzed to get risk factors of aspiration pneumonia,and summarized countermeasures.Results Multivariate analysis showed that underlying disea-ses (95%CI =1.694 -5.319,P =0.011),invasive procedures(95%CI =1.884 -6.362,P =0.001),depression Tian water test grade(95%CI =2.184 -9.636,P =0.000),malnutrition(95%CI =2.501 -11.114,P =0.000), Glasgow Coma Scale(95%CI =1.271 -3.569,P =0.011),were risk factors for Alzheimer patients with aspiration pneumonia(P <0.05).Conclusion Alzheimer's patients with inhalation pneumonia have multiple risk factors,more expectoration should be done for caring,e.g.oral care,in order to reduce the probability of pneumonia.

Reflex tests are ordered when a particular test result indicates that additional testing should be performed according to the guidelines or the feedback process formulated by clinical consultation. The application scope of the reflex tests involves various subspecialties of laboratory medicine. The clinical application needs the support of qualified laboratory doctors, comprehensive information and financial system, clinical guidelines, and so on. Active application of reflex tests can promote the standardization of evidence-based medicine in clinical practice, save medical resources, and shorten the diagnosis and treatment time of patients.

Objective To compare the clinical application value of the real-time fluorescence PCR method and flow cytometry method for detecting human leukocyte antigen B27(HLA-B27).Methods Blood HLA-B27 level in 225 patients with suspected ankylosing spondylitis was detected by using real-time fluorescence PCR method and flow cytometry method.The detection results were compared and analyzed between the two methods.Results The results of 95.1% sample were identical detected by two methods without statistically significant difference(P>0.05).Taken the results of flow cytometry as reference, the sensitivity of real-time fluorescence PCR for detecting HLA-B27 was 94%, the specificity was 96%.Gene sequencing was performed if results of a sample detected by two methods were different, which was identical with the result detected by real-time fluorescence PCR.Conclusion Both methods for detecting HLA-B27 all have high sensitivity and specificity.Real-time fluorescence PCR method is more superior to the flow cytometry method in the results accuracy.

In order to compensate for the deficiencies of current medical education, improve the comprehensive quality of medical students, the First Clinical College, Tongji Medical College of Huazhong University of Science and Technology took the lead in carrying out the health management practice of rela-tives and friends, and made a beneficial exploration of humanistic education for medical students. Relatives and friends were regarded as the specific practice objects, and by telephone and network at school, face-to-face communication during the vacation, medical students established, managed and track the health records of relatives and friends. The students could practice while learning, which made medical students, in im-proving the knowledge structure, enhance their emotional communication with friends and relatives, improve their doctor-patient communication ability, establish the concept of humanistic care, and cultivate their occupation moral respect for life and their dedication to medicine and the sense of responsibility and mission to the society. It provides a new strategy for medical humanities education.

Objective To establish the MALDI-TOF-MS technique platform for detecting Cytochrome P450 gene polymor-phismfrom of patients.Methods Collected 53 EDTA anticoagulation peripheral blood samples from October 2013 to June 2014 in Peking Union Medical College Hospital.The whole genomic DNA was extracted from patients’peripheral blood. Used MALDI-TOF-MS to identify the SNP polymorphism of CYP2C9*2(rs1799853),CYP2C9*3(rs1057910),CYP2C19*2(rs4244285),CYP2C19*3(rs4986893),CYP2C19*4(rs28399504),CYP2C19*5(rs56337013)and CYP2C19*17 (rs12248560).To verify the above SNP polymorphism by Sanger sequencing method.Results The MALDI-TOF-MS could perform 53 samples on two cytochrome gene and 7 SNP locus simultaneously.In all the 53 patients,25 AG,6 AA and 22 GG genotypes were identified in CYP2C19*2(rs4244285),the allele frequency of A genotype was 34.9%.4 AG and 49 GG genotypes were identified in CYP2C19*3 (rs4986893),the allele frequency of A genotype was 3.8%.5 CA and 48 AA gen-otypes were identified in CYP2C9*3 (rs1057910),the allele frequency of C genotype was 4.7%.No mutation loci were i-dentified in CYP2C9*2 (rs1799853),CYP2C19*4 (rs28399504),CYP2C19*5 (rs56337013)and CYP2C19*17 (rs12248560).All the identification data were confirmed by Sanger sequencing.The coincidence rate was 100%.Conclusion The MALDI-TOF-MS technique platform for the cytochrome enzyme SNP was established.This platform has high throughput and accurate characteristics.It has important clinical application value for the treatment of personalized medicate.

Objective To analysis the related factors and the morbidity of patients with Chlamydia trachomatis(CT),Neisse-ria gonorrhea(NG),Ureaplasma urealyticum (UU)in Beijing Union Medical College Hospital.Methods Simultaneous Am-plification and Testing (SAT)was used to detect CT-RNA,NG-RNA,UU-RNA of patients from January of 2013 to Decem-ber of 2014.Results There were 6 262 cases in all and 2 412 cases in 2013,and 3 850 cases in 2014.The positive rate of CT-RNA,NG-RNA and UU-RNA were 7.29%,3.44% and 38.21% in 2013.The positive rate of CT-RNA,NG-RNA and UU-RNA were 8.17%,4.15% and 45.71% in 2014 respectively,which were higher than those of in 2013.There was a signifi-cant difference in UU-RNA positive rate between the two years (χ2 =12.66,P <0.01).The positive rate of CT-RNA,NG-RNA and UU-RNA were 8.15%,3.89% and 42.77% respectively in two years.The positive rate of UU-RNA in women’s (61.05%)was significantly higher than the men’s (24.50%)(χ2 =316.13,P <0.01).Most of the people with CT-RNA, NG-RNA and UU-RNA-positive were between 21 to 30 years old.The highest detection positive rate was in cervical swabs samples of UU-RNA.Conclusion There was a significantly increasing trend of the infection with UU.Male were more sus-ceptible to CT and NG.However,female were more susceptible to UU.There was the highest infection rate in youth (21~30 years)with CT,NG and UU.

Objectives The cellular repressor of E1A-activated genes (CREG), a novel gene, was recently found to play a role in inhibiting cell growth and promoting cell differentiation. The purpose of this study was to obtain antibody against CREG protein and to study the expression of CREG protein in human internal thoracic artery cells (HITASY) which express different patterns of differentiation markers after serum withdrawal. Methods The open reading frame of CREG gene sequence was amplified by PCR and cloned into the pGEX-4T-1 vector. Glutathione-S-transferase (GST)-CREG fusion protein was expressed in E. Coli BL21 and purified from inclusion bodies by Sephacryl S-200 chromatography. Rabbits were immunized with the purified GST-CREG protein. Western blot examined with immunohistochemistry staining and the protein expression level was analyzed by Western blot in HITASY cells after serum removal. Results It was confirmed by using endonuclease digesting and DNA sequencing that the PCR product of CREG was correctly inserted into the vector. The GST-CREG protein was purified with gel filtration chromatography. Polyclonal antibody against GST-CREG was obtained from rabbits. CREG protein immunohistochemistry staining displayed a perinuclear distribution in the cytoplasm of HITASY cells. Results from Western blot suggested that comparing with the untreated cells upregulation of CREG polyclonal antibody against CREG was comfirmed. Using this antibody, the changes of CREG protein expression was observed in the process of phenotypic modulation of HITASY cells. These results provide basic understanding on the relationship of CREG gene with the cell phenotypic conversion.

Objective To investigate the role of transcranial magnetic stimulation(TMS)in the modulation of abnormal functional status and damage characteristics of key brain regions in adult patients with anisometropic amblyopia via the resting-state functional magnetic resonance imaging(rs-fMRI)technique.Methods Single(left)eyes of 20 adult refractive amblyopia patients were included in this study and randomly divided into a surgical group[Implantable Collamer Lens(ICL)surgery]and a TMS combined group(TMS treatment on top of the surgical group),with 10 patients in each group.In both groups,the visual a-cuity of patients was examined before and after treatment via international standard visual acuity charts to evaluate the therapeu-tic effect.Moreover,patients in both groups underwent an fMRI examination once before and after treatment,and local coher-ence(ReHo),amplitude at low frequency(ALFF),and ratio amplitude at low frequency(fALFF)algorithms were used to char-acterize the functional state and response characteristics of the brain regions in the acquired f MRI images.Results Compared with that before treatment,the visual acuity of patients in both groups significantly improved after treatment and was signifi-cantly greater than the pretreatment corrected visual acuity(P＜0.05).Compared with that in the two groups after treatment,the improvement in visual acuity in the TMS combined group was greater than that in the surgical group(P＜0.05).There was no difference in the ReHo or fALFF values before and after treatment between the TMS combined group and surgical group.Compared with those before treatment,the ipsilateral frontal ALFF values were increased in the surgical group after treatment,and the ipsilateral cerebellar ALFF values were decreased in the TMS combined group.Compared with those in the surgical group,the ipsilateral frontal lobe and superior frontal gyrus ReHo values decreased,the contralateral temporal lobe and superior temporal gyrus ALFF values decreased,and the contralateral occipital lobe and cuneiform lobe fALFF values increased after treatment in the TMS combined group(all P＜0.05).Conclusion The improvement in spontaneous brain activity in pa-tients with anisometropic amblyopia in the surgical group and in the TMS combined group was significant.ICL implantation may act by activating the ipsilateral frontal lobe,ICL implantation in combination with TMS may act by improving cerebellar func-tion,increasing the excitability of the contralateral occipital and cuneate lobes,modulating neuronal activity in the adjacent cor-tex of the occipital lobe and in the other visually related cortices(ipsilateral frontal and contralateral temporal lobes),and correc-ting the difference in excitability between the two eyes of the patients.and correcting the excitability differences between the pa-tient's two eyes.

Objective:To investigate the clinical characteristics and change trend of patients with perianal lesions before or after Crohn′s disease (CD) diagnosed.Methods:From January 2008 to September 2018, at The Tenth People′s Hospital Affiliated to Tongji University, the clinical data of 747 hospitalized CD patients were retrospectively collected, 293 patients were PCD patients. The clinical characteristics of PCD patients before or after CD diagnosed were analyzed and the change trend was followed. T test, Mann-Whitney U test, and Chi-square test were performed for statistical analysis. Multivariate logistic regression analysis was used to analyze factors associated with perianal lesions onset time. Spearman correlation analysis was used to analyze the change trend of clinical characteristics. Results:Before CD diagnosis, 86.3% (253/293) PCD patients had perianal lesions. The median follow-up time (range) was 72 months (36 to 108 months). Compared with the patients presented with perianal lesions after CD diagnosis, the onset age of patients with perianal lesions before CD diagnosis was younger ((36.0±12.6) years vs. (24.2±10.2) years), and the rates of male (62.5%, 25/40 vs. 77.9%, 197/253), non-structuring and non-penetrating type (32.5%, 13/40 vs. 56.9%, 144/253) and perianal surgery (55.0%, 22/40 vs.76.7%, 194/253) were high, but low rate of abdominal surgery (37.5%, 15/40 vs. 13.0%, 33/253), and the differences were statistically significant ( t=2.630, χ2=4.442, 8.379, 8.379 and 15.081; all P<0.05). The results of logistic multivariate analysis showed that before CD diagnosis, non-structuring and non-penetrating type was more common than structuring type (odds ratio ( OR)=0.447, 95% confidence interval ( CI) 0.207 to 0.962, P=0.039) and penetrating type ( OR=0.264, 95% CI 0.089 to 0.780, P=0.016). The short disease duration of CD ( OR=0.981, 95% CI 0.968 to 0.995, P=0.008), structuring type ( OR=2.239, 95% CI 1.040 to 4.822, P=0.039) and penetrating type ( OR=3.788, 95% CI 1.281 to 11.198, P=0.016) were the risk factors of perianal lesions after CD diagnosed. The number of PCD patients ( r=0.964, P<0.01) and the proportion of biological agents ( r=0.879, P<0.01) increased with years, while PCD duration ( r=-0.828, P<0.01) and the rate of abdominal surgery significantly decreased with years ( r=-0.882, P<0.01). The proportion of biological agents was negatively correlated with the rate of abdominal surgery ( r=-0.770, P=0.006). Conclusions:The perianal lesions should be closely monitored in adult CD patients with short disease duration, structuring type and penetrating type for early diagnosis and treatment. Biological agents can improve the clinical outcomes of PCD.