AIM:To stuudy the relationship of the constituents of Erxiang Zhitong Capsule(Rhizoma alpiniae officinarum,Rhizoma cyperi and Radix aucklandiae) and its pharmacodynamics.METHODS:The use of supercritical CO_2 fluid extraction as extraction for three herbs acted as experimental materials.The preparation composed of Rhizoma Alpiniae officinarum extract,Rhizoma Cyperi extract;Radix Aucklandiae extract(3∶3∶2) had obviously antiulcerative,antispasmodic and anti-inflammatory analgesic effects.CONCLUSION: From view of pharmacodynamics view,we gain ratio of components of Erxiang Zhitong Capsule better than that of classical prescription.

Hepatocellular carcinoma(HCC) is one of the most common devastating neoplasms worldwide with very poor prognosis.Recent studies have identified a CpG is land methylator phenotype(CIMP),which was characterized by simultaneous methylation of multiple TSGs.CIMP has been observed in multiple human malignant tumors including HCC.CIMP also plays a critical role in HCC carcinogenesis,progression,metastasis and recurrence. Therefore,detection of the methylation status of tumor-related genes can provide key information for early diagnosis,molecular classification and predicting prognosis of HCC.

Objective By analyzing the epidemiological characteristics of brucellosis in Shanxi Province,to provide a scientific basis in formulation of strategies for effective prevention and control of the disease.Method Surveillance data of human brucellosis from China Information System for Disease Control and Prevention between 2004 and 2013 were statistically analyzed by descriptive epidemiological method.The regional,time,age and sex,occupational distribution of brucellosis were analyzed.The prevalence trend of brucellosis in Shanxi Province was summarized.Results From 2004 to 2013,the total incidence presented a rising tendency and the highest reported incidence was 19.10/10 million in 2013.A total of 43 061 cases of brucellosis occurred in Shanxi Province.The average incidence of brucellosis was 12.52/10 million.Regional distribution range was relatively focused on the north areas of Shanxi Province,the number of reported cases of Datong City was the largest (12 157 cases),being 28.23％.The incidence of Shuozhou City was the highest (42.97/10 million).The epidemic was spreading through all county areas.The disease was found each month throughout the year,the obvious incidence peak seasons were between March and June.The disease was most commonly found in 15-64 age groups(87.19％,37 545/43 061).Occupation distribution of patients was mainly farmers (83.34％,35 887/43 061).Conclusions The situation of brucellosis epidemic in Shanxi Province is relatively serious;the reported incidence of brucellosis in Shanxi Province is in a rapid upward trend year by year,even highly active in some particular areas.Different regions should establish regional mechanisms for joint prevention and control and implement different prevention and control measures to comprehensively and sequentially control brucellosis.

Objective Build the hospital scientific research management platform.Methods According to expenditure process and the management standard requirements,the establishment of a fund management system platform to achieve budget、accounted for,spending and audit feedback function.Results Scientific research funds management platform is mainly composed of project application,project establishment and review,the report query and remittance receipt of financial department.Full consideration of the personnel,project,financial and other related system interface.In the construction of data using the standards of the state and the university scientific research information.Conclusions Through building the hospital scientific research management platform,improving the working efficiency,reducing the labor intensity of the management and financial personnel,realizing the accuracy and effectiveness of management.

Objective To assess the Chinese System for Cardiac Operative Risk Evaluation (SinoSCORE) model in patients undergoing heart valve surgery at our center.Methods From January 2009 to December 2011,2098 consecutive adult patients who underwent heart valve surgery at our center were collected and scored according to the SinoSCORE model.All patients were divided into three risk subgroups.The entire cohort and each risk subgroup were analysed.Calibration of the SinoSCORE model was assessed by the Hosmer-Lemeshow(H-L) test.Discrimination was tested by calculating the area under the receiver operating characteristic (ROC) curve.Results Observed mortality of all 2098 patients was 3.00％.Despite there were significant differences between the SinoSCORE population and our own population sample,the SinoSCORE model showed good calibration(Hosmer-Lemeshow:P =0.783) and discriminative power (area under the ROC curve of 0.752)in predicting in-hospital mortality at the entire cohort.Conclusion The SinoSCORE model give an accurate prediction for individual operative risk in heart valve surgery patients at our center.

Objective Investigate the prognosis of patients undergoing liver transplantation (LT) for end-stage autoirnmune liver disease (ALD).Method The clinical data of 45 patients with endstage ALD undergoing LT from April 2001 to March 2015 in the first affiliated hospital of Zhejiang University were analyzed retrospectively.The postoperative cumulative survival rate of the recipients was calculated,and the causes of death were analyzed.The postoperative rejections,new onset viral hepatitis and ALD recurrence were also analyzed.Result In 45 ALD recipients,33 cases survived and the postoperative 5-year cumulative survival rate was 78.8％.Causes for 12 dead cases were mnultiple organ failure,liver graft failure,respiratory complications,hemorrhage and hepatic artery embolization.In 45 ALD recipients,6 cases suffered rejection after operation with the incidence bing 13.3％.One case suffered new onset hepatitis B infection 8 years after opcration.One recipient suffered primary disease (primary biliary cirrhosis) recurrence 2 years after operation,and 1 recipient with primary disease (primary sclerosing cholangitis) developed into overlap syndrome.They all survived for a long term after active treatments.Conclusion Most LT recipients with endstage ALD can obtain a long term survival.Attentions should be paid to the immunosuppressive regimens in early period after LT,prevention of infection,rejection and postoperative new onset viral hepatitis,and timely diagnosis of primary disease recurrence.

Objective To define the incidence and perioperative risk factors of new-onset atrial fibrillation for patients with preoperative sinus rhythm after successful mitral valve replacement.Methods Retrospective analysis was performed on 586 patients with preoperative sinus rhythm who underwent successful mitral valve replacement in our hospital from 1998 to 2008.The cases were classified into postoperative atrial fibrillation (AF group) or postoperative sinus rhythm (SR group).Twenty-nine risk factors including clinical and echocardiography data were selected into univariate analysis by using student' s t test or chi-squared test according to the data type.The factors with a value of P ＜ 0.1 in univariate analysis were assessed by multivariate logistic regression.A value of P ＜ 0.05 (two-sided) was considered to be statistically significant in multivariate logistic regression. ResultsOne hundred and eighteen patients had atrial fibrillation postoperatively. The incidence was 20.1％.Univariate analysis revealed that the factors including age,chronic lung disease,left ventricular mass,left atrial volume,right atrial volume,tricuspid valve regurgitation,heart failure,valvular pathology,postoperative prosthetic mitral effective orifice area index,postoperative mechanical ventilation time,serum levels of potassium and magnesium significantly increased the risk of postoperative atrial fibrillation.However,in multivariate logistic regression,age,left atrial volume and postoperative prosthetic mitral valve effective orifice area index and serum of potassium had significant statistically significances between AF group and SR group.Conclusion Age,left atrial volume,postoperative prosthetic valve effective orifice area index and serum of potassium were significant predictors of postoperative new-onset atrial fibrillation for patients with preoperative sinus rhythm after mitral valve replacement.

Objective The aim of the study was to analyze the predictive value of the European system for cardiac operative risk evaluation score (EuroSCORE) and the Society of Thoracic Surgeons predicted risk of mortality (STS-PROM) in -dult patients undergoing aortic valve replacement (AVR).Methods We carried out a retrospective statistical analysis on 521 adult patients undergoing AVR between 1999 and 2008 in Changhai hospital.Patients with concomitant coronary artery bypass grafting were also included.Excluded from this study were patients having surgery for congenital heart defects,aneurysm of thoracic aorta and atrial fibrillation.Operative mortality was defined as death before discharge from the hospital.The mortality risk calculation of EuroSCORE and STS-PROM for aortic valve procedures was performed by the online available EuroSCORE or STS score calculator.Based on the additive EuroSCORE risk calculation,patients were divided into low-risk,medium-risk and high-risk groups.The valuation of three different algorithms depended on the assessment of two features:calibration and discrimination.A comparison of observed and predicted mortality rates was also performed.Results A total of 521 patients were identified as having undergone aortic valve replacement.In-hospital mortality was 4％ (21 cases) overall.The expected mortality for the additive,logistic EuroSCORE and the STS-PROM was 3.36％,2.82％ and 1.25％,respectively.The observed to expected ratio was 1.2 for additive EuroSCORE,1.43 for logistic EuroSCORE and 3.23 for STS-PROM.The STS-PROM underpredicted observed mortality significantly ( P ＜ 0.01 ) and showed poor calibration in predicting in-hospital mortality in the entire cohort,medium- and high-risk subgroups.The logistic EuroSCORE underpredicted observed mortality in the mediumrisk subgroup ( P ＜ 0.05 ).EuroSCORE underpredicted in-hospital mortality in the high-risk subgroup with the observed-expected mortality rate of 1.84 for additive EuroSCORE and 1.46 for logistic EuroSCORE.The EuroSCORE in three subgroups showed poor discrimination in predicting mortality as well as the STS-PROM did in the medium- and high-risk subgroups ( ROC ＜ 0.7).Conclusion Both the EuroSCORE and the STS-PROM give an imprecise prediction for individual operative risk in patients undergoing aortic valve replacement in our study.These algorithms seem unsuitable to identify a high-risk patient population undergoing isolated AVR.It is necessary to construct a risk stratification model for valve surgery according to the profiles of Chinese patients.

Objective To validate the value of Cleveland Clinical Score in predicting acute renal injury requiring renal replacement therapy(RRT-AKI) after cardiac valve surgery in Chinese adult patients.Methods An analysis was conducted for all the adult patients who underwent cardiac valve surgery from January 2010 to December 2014 in Changhai Hospital,Shanghai.A total of 3 230 adult patients were included.Based on Cleveland Clinical Score,the patients were divided into 3 risk stages:0 to 2 point,3 to 5 point,and 6 to 8 point.The incidence of RRT-AKI were compared between different stages.And the predictive value of the Cleveland Clinical Score model was assessed by area under the receiver operating characteristic curve(AUC-ROC) and the model calibration was assessed using the Hosmer-Lemeshow test.The patients were also divided into two groups:Non-RRT group and RRT-AKI group.The mortality were compared between these two groups.Results The incidence of RRT-AKI was 1.67％ vs the predicted ratio of RRT-AKI 1.70％ (x2 =0.018,P =0.892).Among the stage 1,2,and 3,the actual incidence of RRT-AKI,was 1.23％,2.66％,and 16.7％ vs the predicted incidence 0.40％,1.80％,and 9.50％,respectively.The AUC-ROC for Cleveland Clinical Score predicting RRT-AKI was 0.64 [95 ％ CI(0.57,0.71),P ＜0.01].Compared with Non-RRT group,the RRT-AKI group got a higher mortality(87.00％ vs 1.50％,x2 =1 330,P ＜0.01).Conclusion The Cleveland Clinical score had no real predictive value for RRT-AKI in Chinese adult patients after cardiac valve surgery.The incidence of RRT-AKI of the whole population and the stage 3 patients could be predicted by the model.And the patients with a high Cleveland score got a higher mortality than that of patients with a low Cleveland score.

Objective To establish a surgical risk prediction model for in-hospital mortality of adult rheumatic heart disease.Methods The study sample comprised of 3 889 patients with adult (is, or older than 18 years) rheumatic heart valve surgery only.All patients were divided into three subgroups according to the surgery site of left atrioventricular valve: mitral valve surgery group;aortic valve surgery group;and mitral and aortic valve surgery group.The data was splited into development(60％) and validation(40％) data sets, and then the risk model was developed by using a logistic regression model according to the data in development data set.Model calibration was analyzed by Hosmer-Lemeshow goodness-of-fit statistic, and model discrimination was tested by calculating the area under the receiver operating characteristic(ROC) curve.Risk score was finally set up according to the coefficient β and rank of variables in logistic regression model.Results The general in-hospital mortality of the whole group is 4.2％ (165/3 889).We established a risk prediction model and found seven risk factors: heart function in NYHA functional class ≥ Ⅱ grade (OR =3.36, 95％ CI: 2.42-4.67) , preoperative creatinine ＞ 110 mmoL/L (OR =2.69, 95％ CI: 1.51-4.79) , history of previous chest pain(OR =2.33, 95％ CI: 1.07-5.11) , surgical status(OR =2.32, 95 ％ CI: 0.94-5.73) , previous history of hypertension (OR =2.24, 95 ％ CI: 1.19-4.23), preoperative critical state (OR =2.14, 95％ CI: 1.27-3.60) and age ＞ 50 years (OR =1.57, 95 ％ CI: 1.18-2.09).Our risk model showed good calibration and discriminative power for the development data set, validation data set, and three subgroup in which Hosmer-Leme-show test' s P value were greater than 0.05 and the area under the ROC curve were greater than 0.70.Scoring methods: age 51-60years: 1 point, age 61-70 yeas: 2 points, age ＞70 years: 3 points;history of hypertension: 1 point;creatinine ＞ 110 umol/L: 4 points;NYHA class stage Ⅱ : 2 points, NYHA class stage Ⅲ: 4 points;NYHA class stage Ⅳ: 6 points;history of previous chest pain: 1point;preoperative critical condition: 2 points;urgent surgery: 2 points: emergency surgery: 4 points.Conclusion We have created a new risk prediction model and risk score, which can accurately predicts outcomes in patients undergoing heart valve surgery for our center.Furthermore, our risk model can also enable benchmarking and comparisons between multicenter in a meaningful way in the future.