〔Abstract〕 The paper analyzes problems existing in the traditional outpatient diagnosing distribution process of hospitals , redesigns and optimizes the triage process .It designs a unified diagnosing distribution system , introduces the advantages , system composition , queuing rules and treatment priority strategies of the optimized process , and illustrates the application effects of the diagnosing distribution system with the outpatient of obstetrics and gynecology department of a large grade -III level-a hospital as an example .

OBJECTIVE:To detect and analyze the safety signals of pemetrexed in post-marketing,and provide references for rational drug use in the clinic. METHODS:A form of data mining techniques was used to detect the safety signals of pemetrexed in American adverse events reporting system and the analysis of signal effect factors i.e.,gender,age,dosage and indication was per-formed by SPSS 19.0. RESULTS:173 signals related to pemetrexed were excavated in 5 397 235 reports,and the number of report-ed adverse event in blood-lymphatic system was the most(491)and the number of signals in gastrointestinal system was the most (17). There was no statistical significance in the distribution of blood-lymphatic system and gastrointestinal system in gender(P=0.075) and age (P=0.726) compared to other system adverse event,but there was statistical significance in dosage (P=0.007) and indication(P=0.001). CONCLUSIONS:Adverse events induced by pemetrexed in blood-lymphatic system and gastrointestinal system should be monitored at the same time,especially combined with non-steroidal anti-inflammatory drugs.

Purpose To investigate the clinicopathological features, histogenesis, morphological characteristics, immunophenotypes and differential diagnosis of primary extragonadal yolk sac tumor ( eYST) . Methods Clinicopathological data, morphological charac-teristics and immunophenotypes results of 40 cases of eYST were retrospectively studied and the relevant literatures were reviewed. Re-sults All 40 patients, which included 24 male and 16 female, aged from 6 months to 42 years with a 12 years average age and 17 (42.5%) cases were over 12 years old. Mediastinum, sacrococcygeal, retroperitoneal, pineal gland and vagina were involved in 16 (40.0%), 12(30.0%), 5(12.5%), 4(10.0%) and 3(7.5%), respectively. All 40 cases included 32(80.0%) cases pure YSTs, while other 8(20.0%) cases contained other one or two types of germ cell tumor (GCT) components. Conclusions Primary eYST is rare, mediastinum and sacrococcygeal are the most common anatomic sites for eYST, and these mediastinal tumor patients are overwhelmingly confined to adult males, whose average age are significantly older than that in sacrococcygeal, retroperitoneal, pineal gland and vaginal tumor patients (P<0.05), while other sites eYST are restricted to prepubertal children. Adult eYST contain other types of GCT components in some cases, and children's counterparts are always pure YST. Extragonadal eYST manifestate pleomorphic histological features, which combine with immunohistochemical markers is definite value for diagnosis, differential diagnosis.

ObjectiveTo investigate the efficacy of superficial surround needling plus quadriceps femoris training in treating knee osteoarthritis and observe electromyographic amplitude variations by knee osteoarthritis.MethodNinety patients diagnosed with knee osteoarthritis were randomly allocated to treatment and control groups, 45 cases each. The treatment group received superficial surround needling plus quadriceps femoris training and the control group, acupuncture alone. Both groups were treated for two weeks. Pre-treatment and post-treatment knee joint functions were scored and compared using the Visual Analogue Scale (VAS), the Lysholm Knee Score Scale and the electromyographic integral value. Meanwhile, electromyography was performed and electromyographic amplitude variations by knee osteoarthritis were compared between the two groups of patients.ResultThe total efficacy rate was 88.9% in the treatment group and 60.0% in the control group. It was higher in the treatment group than in the control group (P<0.05). After treatment, the VAS score, the Lysholm score and the electromyographic integral value were significantly better in the treatment group than in the control group (P<0.05).ConclusionSuperficial surround needling plus quadriceps femoris training has a marked therapeutic effect on knee osteoarthritis.

BACKGROUND:Retinoic acid is the most promising inducer for neuroblastoma minimal residual lesion, and it can induce cel differentiationin vivo, accompanied by reducing tumor cel proliferation.
OBJECTIVE:To study the effect of nanoparticle labeling on biological characteristics of neuroblastoma stem cels, and the role of 13-cis retinoic acid to induce differentiation of neuroblastoma stem cels.
METHODS:Neuroblastoma stem cels were isolated and culturedin vitro using serum-free suspension culture method, labeled with polylysine-modified γ-Fe2O3 nanoparticles and induced in culture medium containing 13-cis retinoic acid. RT-PCR was used to detect the expression of Oct-4 before and after labeling as wel as before and after induction. Immunofluorescence method was used to detect the expression of nestin before and after labeling as wel as before and after induction.
RESULTS AND CONCLUSION:Neuroblastoma stem cels were successfuly cultured in the bone marrow samples from 5 of 20 cases. Polylysine-modified γ-Fe2O3 nanoparticle labeling did no influence the viability and proliferation ability of neuroblastoma stem cels, and also had no effect on Oct-4 mRNA and nestin expression. After cultured in the culture medium containing 13-cis retinoic acid, the cel shape changed and the growth rate slowed down. Moreover, the expression of Oct-4 mRNA and nestin was gradualy reduced. These findings indicate that polylysine-modified gamma-Fe2O3 nanoparticles can be used to label neuroblastoma stem cels, and 13-cis retinoic acid can induce the differentiation of neuroblastoma stem cels.

Objective To observe the effects of Suoquan Wan(SQW) on the endocrine and immune function of the polyuria rats with kidney-yang deficiency. Methods The model rats were induced by gastric infusion of adenine(250 mg/kg) for 4 weeks, then treated respectively with SQW (at low, middle and high dose respectively), Shenqi Wan and desmopressin for another 4 weeks. The bodyweight and organ index were recorded, and serum cortisone concentration were detected. T cell subsets in peripheral blood were determined by flow cytometry. Results The bodyweight of rats in model group was lower than that in the normal control group. And the bodyweight of rats in desmopressin group, middle-and high-dose SQW groups differed from that in the model group (P < 0. 05 or P < 0. 01). The decreased organ indexes of pituitary, adrenal and thymic glands were found in the model group (P < 0. 05 or P < 0. 01 compared with the normal group). The thymus index was elevated in all the medication groups except the low-dose SQW group (P < 0. 05). The elevated organ indexes of pituitary and adrenal glands were only found in Shenqi Wan group and high-dose SQW group (P < 0. 05). In the model group serum cortisone concentration was decreased (P < 0. 01). In Shengqi Wan group and middle-and high-dose SQW groups, the cortisone concentration was significantly increased (P < 0. 05 or P < 0. 01, compared with the model group). In the model group, the percentages of CD3+ and CD3+/CD4+ T cell subsets in pe-ripheral blood were decreased, and the percentage of CD3+/CD8+ T cell subset was increased (P < 0. 05 or P < 0. 01 compared with the normal group). Compared to the model group, the percentages of CD3+ and CD3+/CD4+ T cell sub-sets were increased and the percentage of CD3+/CD8+ T cell subset was decreased in SQW group and Shenqi Wan group. But the differences of T lymphocyte subsets were insignificant between desmopressin group and the model group. Conclu-sion SQW can regulate the endocrine and immune function of the polyuria ratwith kidney-yang deficiency.

OBJECTIVE:To study the effects of rAd-p53 injection on the proliferation,apoptosis and autophagy of nephroblas-toma cells. METHODS:Nephroblastoma cells were respectively cultured 20 h with high,medium,low concentration(1×109,1× 108,1×107 VP/mL)of Recombinant human rAd-p53 injection,cells with no injection were the blank control. Cell proliferation,cy-cle,apoptosis and related gene p21,Bax protein expressions were detected,and autophagy gene LC-3,Atg7,Atg12 expressions and number of autophagosomes were also detected. RESULTS:The proliferation inhibition rates of high,medium,low concentra-tion of Recombinant human rAd-p53 injection to nephroblastoma cells were(42.86±3.18)%,(33.64±7.25)%,(16.26±9.07)%;apoptotic rates were (53.85 ± 9.36)%,(37.35 ± 9.64)%,(23.64 ± 10.65)%,respectively. Compared with blank control,cells at period G0/G1 were increased under high,medium,low concentration Recombinant human rAd-p53 injection,effects were relatively obvious under high,medium concentration (P<0.05 or P<0.01);p21,Bax protein and LC-3,Atg7,Atg12 gene expressions were enhanced under high concentration,the number of autophagosomes was increased(P<0.01);Bax protein expression was en-hanced under medium concentration(P<0.05),the other indicators had no obvious changed(P>0.05). CONCLUSIONS:Recom-binant human rAd-p53 injection can inhibit the cell proliferation of nephroblastoma,and induce its apoptosis and autophagy.

Objective To explore the treatment effect of Zuogui pill (ZGP) on immune premature ovarian failure rats.Methods Female mice model of POF was established by multiple sites subcutaneous injection of zona pellucida 3,and treated with different dosage ZGP (low, middle and high),with prednisone and diaethylstilbestrol as positive control. We detecteed apoptosis rate of granulosa and oocyte of murine ovaries by tunel method and observd the change of sexual cycle and weight. Results Compared with the control group,the weight of model group rat in the third to eighth weeks was significant difference (P

Prof. LIN Ying-qiang,a famous bone-setting and massage doctor,is good at treating soft tissue injury. He emphasizes not only on 'treatment aiming at its pathogenesis' but also on application of anatomy and biomechanics in clinic. His bone-setting manipulations based on 'explosive force'manipulation and herbal get remarkable clinical effects on the treatment of neck-shoulder and lumbocrural pain.

Objective To study the protective effects of aqueous extract and alcohol-soluble extract of Isodon lophanthoides var.gerardianus (Benth.)Hara (ILVG) on immunity hepatic injury induced by concanavalin A (Con A) in mice.Methods One hundred and eight NIH mice were allocated into normal control group,model group,ILVG groups of aqueous extract and alcohol-soluble extract (low-,middle-and high-dosage),and bifendate group randomly.In the experimental groups,mice received either ILVG aqueous extract or alcohol-soluble extract (18.20 g?kg-1,9.10 g?kg-1,4.55 g?kg-1 respectively) or Bifendate (45 mg?kg-1) by gastric perfusion daily for consecutive 5 days.In the 5th day,Con A (20 mg?kg-1) was injected into mice via the tail vein 4h after administration.And then the blood was obtained by picking out the eyeball and the serum was separated after 8-hour fasting.The serum levels of ALT and AST were analyzed,the body weight as well as the weight of liver,spleen and thymus were measured,and pathological features of hepatic tissue were observed.Results ILVG can decrease the ALT and AST,restrain the enlargement of liver and the shrinkage of thymus and reduce the necrosis of hepatic tissue.Conclusion Aqueous extract and alcohol-soluble extract of ILVG possess the effects of protecting liver from immunity injury induced by Con A in NIH mice.