Based on insoluble phenomenon in trace metal powder in TCM granules produced by small and medium-sized pharmaceutical companies, this article discussed the causes and countermeasure from the aspects of formulation composition, preparation technology, and TCM pretreatment, with a purpose to provide the basis for strengthening the quality standard of TCM granules.

Objective:To analyze the characteristic peaks of gypsum fibrosum from authentic product area Hubei Yingcheng via X-ray diffraction. Methods:The fingerprint and common peaks of gypsum fibrosum from different areas were analyzed via X-ray diffrac-tion, and the characteristic peaks of gypsum fibrosum from authentic product area Hubei Yingcheng were identified Results:The finger-prints of X-ray diffraction of gypsum fibrosum from different areas were obtalned. Sixteen common peaks were determined, and two characteristic peaks of gypsum fibrosum from authentic product area Yingcheng were determined via X-ray diffraction with interplanar spacing of 1. 68 and 1. 51, respectively. Conclusion:The determination of two characteristic peaks of gypsum fibrosum from authentic product area Hubei Yingcheng can distinguish gypsum fibrosum from the other areas and provide basis for the quality evaluation of gyp-sum fibrosum.

School of public health of Qiqihar Medical University has integrated the concept of talent cultivation “University excellence, big medicine sincere” and the talents training goal of “three orientation” with CDIO engineering education mode. From the philosophy and mode of engineering education, the school has carried on the comprehensive reform on training target, training model, training plan, course setting, innovative practice system, the teaching reform and assessment methods.“Target management stage” training model has also been formulated and implemented to explore the education model of training students' comprehensive quality and ability which can not only meet the social needs but also improve the various aspects throughout their college.

Objective To evaluate the quality of the examination paper of the theory of Clinical Diagnostics,to explore and reflect on the teaching methods,so as to improve the quality of teaching.Methods Finals results of Clinical Diagnostics including 40 clinical undergraduates of Capital Medical University were analyzed.SPSS 20.0 was used to make analysis of the frequency,means statistics and normality of the examination paper.Kuder Richardson/Cmnbacha formula,percentage unification methods and so on were used to calculate confidence,validity,difficulty and degrees of distinction.Acquisition of relevant knowledge was assessed according to score distribution,while test paper quality was evaluated based on indicators including confidence,validity,difficulty and degrees of distinction.Results Test scores of 40 students were between 61 to 96 (83.64 ± 8.07).The degree of confidence (γ) for choice questions and subjective questions was 0.65 and 0.59 respectively;The validity (V) was 0.27;The overall difficulty (P) of the examination was 0.84;The degrees of distinction (D) were between 0.16 to 0.30.And the total points losing rate was 16.36％.Conclusion The examination is of medium difficulty and good degree of distinction,but the teaching strategies still need further adjustment in order to improve the students' ability of flexible application of the basic knowledge.

BACKGROUND:The treatment method of tibial avulsion fractures of anterior cruciate ligament is varied;each has its advantages. OBJECTIVE:To investigate the methods and clinical effects of the treatment of avulsion fractures of tibial insertion of anterior cruciate ligament by the means of making two decussate lines and four strands of non-absorbable Arthrex sutures passing through two bone tunnels combined with pushlock free knotting anchor under arthroscopy. METHODS:From December 2014 to November 2015, 23 cases of avulsion fractures of tibial insertion of anterior cruciate ligament were treated in the Second Hospital of Inner Mongolia Medical University. Under the arthroscopy, avulsed fracture was fixed in tibial intercondylar eminence by the means of making two decussate lines of Arthrex sutures passing through. At the same time, pushlock free knotting anchor beside tibial tubercle provided a tightening of tension for Arthrex sutures, which could strengthen the fixation of avulsion fracture blocks. Knee joint Lysholm and Tegner scores were fol owed up. Knee stability was evaluated by anterior drawer test and Lachman test. Postoperative reset and healing were evaluated with X-ray films. RESULTS AND CONCLUSION:(1) Al 23 patients were fol owed up for 6 months to 1 year. (2) Lysholm scale of the knee function was (47.31±6.16) preoperatively and (94.69±1.28) postoperatively (P<0.05). Tegner score was (3.14±1.58) preoperatively and (7.74±1.69) postoperatively (P<0.05). (3) Lachman test of al cases was negative. X-ray films demonstrated that fracture healing was good. There was no repeated swel ing or cross locking of the joint. The knee was not limited by flexion or extension. No infection or deep venous thrombosis of lower extremity occurred. (4) The method of Arthrex sutures passing through two bone tunnels combined with pushlock free knotting anchor under arthroscopy has the advantages of minimal y invasive, simple operation, reliable fixation, no metal implants and satisfactory result to treat the tibial intercondylar eminence fracture of anterior cruciate ligament.

BACKGROUND:Alogeneic tendon has been frequently used to reconstruct the anterior cruciate ligament. However, there is a lack of middle- and long-term clinical evaluation. OBJECTIVE:To evaluate the middle- and long-term curative effect of alogeneic tendon reconstruction of the anterior cruciate ligament under arthroscopy. METHODS:Twenty-five patients with anterior cruciate ligament injury under alogeneic tendon transplantation were reviewed retrospectively. They were al folowed up for 3 years or more. The clinical outcomes were evaluated and compared using Lyshlom score scale, IKDC2000 and Tegner score scale. RESULTS AND CONCLUSION:Al the patients were folowed up. Lysholm scale scores on the knee function, Tegner scores and IKDC scores were significantly increased after transplantation (P < 0.05). No complications of infection and compartment syndrome occurred. Symptoms were relieved and the function of knee joint was improved. There was one case weakly positive for anterior drawer test. Both Lachman test and pivot shift test showed negative signs. Overal, the reconstruction of anterior cruciate ligament with alogeneic tendon has less trauma and complications, with good middle-term efficacy.

Objective　To investigate the effect of intratumor injection of 131I-3H11 for gastric cancer (GC). Methods　16 patients with GC subjected to endoscopic intratumor injection of 131I-3H11 as a treatment group; 6 GC patients with FAM chemotherapy as a control group. Histological examination of the postoperative specimens of the two group were comparated. Results　In treatment group, 75.0%(12/16) of cases were found to have morphological changes with karyopyknosis, karyorrhexis, coagulation of cytoplasm, and invasion of lymphocyte in mesochyma. Most of these changes were medial; but in control group no obvious morphological change was found. Conclusions　The results suggest that GC subjected to endoscopic intratumor injection of 131I-3H11 preoperatively has promising application in the clinic.

Objective To investigate the effect of intratumor injection of 131 I 3H11 for gastric cancer (GC). Methods 16 patients with GC subjected to endoscopic intratumor injection of 131 I 3H11 as a treatment group; 6 GC patients with FAM chemotherapy as a control group. Histological examination of the postoperative specimens of the two group were comparated. Results In treatment group, 75.0%(12/16) of cases were found to have morphological changes with karyopyknosis, karyorrhexis, coagulation of cytoplasm, and invasion of lymphocyte in mesochyma. Most of these changes were medial; but in control group no obvious morphological change was found. Conclusions The results suggest that GC subjected to endoscopic intratumor injection of 131 I 3H11 preoperatively has promising application in the clinic.

The expression of survivin, a member of inhibitor of apoptosis (IAP) family, was examined in bladder transitional cell cancer (BTCC) tissue and adjacent normal tissues to examine its clinical implication in the development of BTCC. Thirty specimens of bladder cancer were detected for the expression of survivin by using immunohistochemistry and real-time quantitative reverse transcription polymerase chain reaction (RT-QPCR) in BTCC tissue and adjacent normal tissues. Our results showed that the positive rate of survivin immunostaining specimen were 0 and 60% (18/30) in the adjacent normal tissues, bladder cancer, respectively. The-DeltaDeltaCT value of survivin in bladder cancer tissue was 10.2829 (9.0034-11.5624) times that in the adjacent normal tissues. The expressions of survivin were correlated with the pathological grades of tumor and clinical stages. It is concluded that there was only weak expression of survivin mRNA in the adjacent normal tissues, but the expression of survivin mRNA in bladder cancer tissue was much higher than that in the adjacent normal tissues and the expression of survivin was correlated with pathological grades and clinical stages of tumor.
*Carcinoma, Transitional Cell/metabolism ; *Carcinoma, Transitional Cell/pathology ; Microtubule-Associated Proteins/genetics ; Microtubule-Associated Proteins/*metabolism ; Prognosis ; RNA, Messenger/genetics ; RNA, Messenger/metabolism ; Tumor Markers, Biological/genetics ; Tumor Markers, Biological/*metabolism ; Urinary Bladder Neoplasms/*metabolism ; Urinary Bladder Neoplasms/*pathology

Objective To study the species and amount of bacteria in sputum of patients with ventilator associated pneumonia (VAP) by using 16S rDNA sequencing analysis,and to explore the new method for etiologic diagnosis of VAP.Methods Bronchoalveolar lavage sputum samples were collected from 31 patients with VAP.Bacterial DNA of the samples were extracted and identified by polymerase chain reaction (PCR).At the same time,sputum specimens were processed for routine bacterial culture.The high flux sequencing experiment was conducted on PCR positive samples with 16S rDNA macro genome sequencing technology,and sequencing results were analyzed using bioinformatics,then the results between the sequencing and bacteria culture were compared.Results ① 550 bp of specific DNA sequences were amplified in sputum specimens from 27 cases of the 31 patients with VAP,and they were used for sequencing analysis.103 856 sequences were obtained from those sputum specimens using 16S rDNA sequencing,yielding approximately 39 Mb of raw data.Tag sequencing was able to inform genus level in all 27 samples.② Alpha-diversity analysis showed that sputum samples of patients with VAP had significantly higher variability and richness in bacterial species (Shannon index values 1.20,Simpson index values 0.48).Rarefaction curve analysis showed that there were more species that were not detected by sequencing from some VAP sputum samples.③ Analysis of 27 sputum samples with VAP by using 16S rDNA sequences yielded four phyla:namely Acitinobacteria,Bacteroidetes,Firmicutes,Proteobacteda.With genus as a classification,it was found that the dominant species included Streptococcus 88.9％ (24/27),Limnohabitans 77.8％ (21/27),Acinetobacter 70.4％ (19/27),Sphingomonas 63.0％ (17/27),Prevotella 63.0％ (17/27),Klebsiella 55.6％ (15/27),Pseudomonas 55.6％ (15/27),Aquabacterium 55.6％ (15/27),and Corynebacterium 55.6％ (15/27).④ Pyrophosphate sequencing discovered that Prevotella,Limnohabitans,Aquabacterium,Sphingomonas might not be detected by routine bacteria culture.Among seven species which were identified by both methods,pyrophosphate sequencing yielded higher positive rate than that of ordinary bacteria culture [Streptococcus:88.9％ (24/27) vs.18.5％ (5/27),KlebsieHa:55.6％ (15/27) vs.18.5％ (5/2 7),Acinetobacter:70.4％ (19/27) vs.37.0％ (10/27),Corynebacterium:55.6％ (15/27) vs.7.4％ (2/27),P＜0.05 or P＜0.01].Sequencing positive rate was found to increase positive rate for culture of Pseudomonas [55.6％ (15/27) vs.25.9％ (7/27),P=0.050].No significant differences were observed between sequencing and ordinary bacteria culture for detection Staphylococcus [7.4％ (2/27) vs.11.1％ (3/27)] and Neisseria bacteria genera [18.5％ (5/27) vs.3.7％(1/27),both P＞0.05].Conclusions 16S rDNA sequencing analysis confirmed that pathogenic bacteria in sputum of VAP were complicated with multiple drug resistant strains.Compared with routine bacterial culture,pyrophosphate sequencing had higher positive rate in detecting pathogens.16S rDNA gene sequencing technology may become a new method for etiological diagnosis of VAP.