Objective: To establish a method for the determination of paracetamol, caffeine and chlorphenamine maleate in Compound Ganmaoling Tablets. Methods: The RP-HPLC was conducted on a Phenomenex C 18 column(5?m,250mm?4.0mm) with methanol: water: acetic acid(35∶65∶1.5) as a mobile phase, detect wavelength at 270nm. Results: Paracetamol, caffeine and chlorphenamine maleate respectively showed good linear relationship in the following concentrations of ranges:50.4～117.6?g?mL -1,3.6～8.4?g?mL -1,0.84～1.96?g?mL -1; The average recoveries were obtained as 99.9%,99.8%,100.0%(n=6); respectively. Conclusion: The method was simple, sensitive, accurate and suitable for the determination of three constituents in Compound Gamaoling Tablets.

Objective:To study the expression and clinical significance of GPRC5A and SOCS3 in colorectal carcinoma.Methods:SP immunochemical method was performed to detect the expression of GPRCSA and SOCS3 in 45 cases of colorectal carcinoma,25 cases of colorectal adenomas and 22 cases of normal colorectal tissues.Results:1)Expression of GPRC5A in colorectal cancinoma tissue (22.2％) was significantly lower than that in adenomas tissue (52.0％,P＞0.05).The Latter was significantly lower than that in normal colorectal tissue (81.8％,P＜0.05).GPRC5Awas closely related to lymph node metastasis,Duke's stages and the deepness of invasion (P＜0.05).2) Expression of SOCS3 in colorectal cancinoma tissue (24.4％) was significantly lower than that in adenomas tissue (56.0％,P＜0.01).The Latter was significantly lower than that in normal colorectal tissue (86.4％,P＜0.05).SOCS3 was closely related to pathological differentiation,the deepness of invasion,Duke's stages and lymph node metastasis (P＜0.05).3)The expression of GPRC5A was positive correlated with SOCS3 (P＜0.05).Conclusions:The reduced expressions of GPRC5A and SOCS3 may participate in the occurence and development of colorectal carcinorma,suggesting that GPRC5A and SOCS3 may act as biological markers for evaluating the malign degree,prognosis and therapeutic targets of colorectal carcinorma.

Mixed-ownership hospitals constitute an experiment of such ownership in the health care sector,attracting high attention as of its birth.This paper introduced the background of such ownership,and analyzed the development of such hospitals in terms of policy,present situation and external effects.The authors,arguing against major challenges,stated their views on such hospitals along with in-depth analysis of key issues in their development.

Based on a field survey of typical hospitals in Zhejiang,this paper drew a conclusion on three models of the mixed-ownership hospitals development in Zhejiang.It summed up the experiences learnt in the practice about how to maintain the public welfare of the public hospitals,how to ensure the essential health services supply as well as the incentive mechanism for social capital.Suggestions were proposed to develop the mixed-ownership hospitals based on the analysis.

Objective To compare the efficacy of laparoscopic and conventional open total mesorectal excision (TME) in the treatment of rectal cancer, and to explore the considerations of laparoscopic TME. Methods 75 cases of laparoscopic group and 61 cases of open surgery group were analyzed retrospectively, and cohort study was used to compare the perioperative indicators and clinicopathological results in the two groups. Results Between the laparoscopic group and the open surgery group, the operative incision [8.7 cm (8.0-10.0 cm) vs. 13.6 cm (10.0-16.0 cm)], the use of postoperative analgesics (8 cases vs. 23 cases), postoperative time to remove the drainage tube [5 d (5-6 d) vs. 6 d (6-8 d)], postoperative time to get out of bed [3 d (3-7 d) vs. 5 d (4-8 d)] and postoperative hospital stay time [6 d (5-18 d) vs. 8 d (6-25 d)] had statistical difference (all P<0.05). The cost of laparoscopic group was higher than that of open surgery group (each patient in laparoscopic group spent more about 7 000 yuan than ones in open surgery group ). There was a significant difference in the overall complication rate between the laparoscopic group and the open surgery group [6.7 % (5/75) vs. 13.1 % (8/61), P<0.05]. Conclusions The postoperative analgesics, removal of drainage tube time, hospital stay and other indicators in the laparoscopic TME are superior compared with those in the open surgery, but due to the use of high-value consumables, the cost of laparoscopic surgery is higher. Besides, laparoscopic resection of rectal cancer should be careful.

Objective:To study the effects of dexamethasone,cyclophosphamide,cyclosporin A and mycophenolate mofetil on the expression of Dectin-1 and TLR2 receptor in RAW264.7 cell line.Methods:In vitro culturing RAW264.7 macrophages ,the cells were given different doses of dexamethasone and cyclophosphamide ,cyclosporin A and mycophenolate mofetilfor 24 h.The influence of different immunosuppresants on cell proliferation was detected by CCK-8 assay.Dectin-1,TLR2 mRNA and protein levels of change were detected with RT-PCR technique and flow cytometry .Results:CCK-8 cell proliferation toxicity experiment results showed that with the increase of the dose of dexamethasone ,cyclophosphamide ,Cyclosporin A and mycophenolate mofetil ,the different degree of inhibi-tion of RAW264.7 cell proliferation in mice can be saw after the intervention of 24 h (P<0.05).After 24 h of dexamethasone stimula-tion,Dectin-1 mRNA and protein level decreased,TLR2 mRNA and protein levels elevated (P<0.05).However cyclophosphamide had no obvious influence on Dectin-1 and TLR2 ( P>0.05 ) .Mycophenolate mofetil and cyclosporin A could both inhibit the expression of Dectin-1 and TLR2 (P<0.05).Conclusion:There are significant differences among the regulatory functions of various immunosupres -sants on the expression of pattern recognition receptors .Different immunosuppressive agents exert their inhibitory effects on immune rec-ognition process of fungal pathogens not only by selectively regulating their target PRRs expression ,but also by inhibiting the growth and proliferation of macrophages .

Objective To determine the perioperative risks of partial hepatectomy by determining the preoperative liver functional reserve in patients with hepatocellular carcinoma (HCC),and to compare the model for end-stage liver disease (MELD) score with the Child-Pugh classification in predicting prognosis.Methods We reviewed the clinical data of 202 patients with HCC who underwent partial hepatectomy.The MELD score and the Child-Pugh classification were determined preoperatively.Results The incidence of postoperative liver dysfunction happened in 44.0％ of Child A patients,50％ in Child B patients,41.6％in patients with a MELD score below 14,and 91.7％ in patients with a MELD score of ＞ 14.The difference between the rates of postoperative liver dysfunction in patients with a preoperative MELD score above 14 and below 14 was significant (P ＜ 0.05),while that between patients with Child-Pugh A and B was insignificant (P ＞ 0.05).The incidences of postoperative liver dysfunction in patient with a MELD ＜ 8,8 ≤ MELD ≤ 14,MELD ＞ 14 were 38.2％,57.6％ and 91.7％,respectively,indicating that there was a positive co-relationship between the MELD score and the incidences of liver dysfunction.The Spearman rank correlation test showed the MELD score was significant correlated with the Child-Pugh score (r =0.404 ; P ＜ 0.05).The areas under the ROC curves of the MELD score and the Child-Pugh score were 0.703 and 0.587 (P ＜ 0.05).Conclusions The MELD score predicted postoperative liver dysfunction more accurately than the Child-Pugh classification.HCC patients undergoing partial hepatectomy with a preoperative MELD score ＞ 14 had a high perioperative risk.To ensure the safety of partial hepatectomy,HCC patients with a preoperative MELD score ＞ 14 requires active preoperative preparation,bringing the score near to or less than 14.

Bring up high quality medical talents with innovative consciousness and practical ability is the aim of high medical ed- ucation.Improving the innovative ability of teachers and quality of teaching with the perfect combination of science and humanities, so as to improve our understanding of the importance and necessity of innovation education,and carry out an overall quality edu- cation which chiefly works for the training of students' innovative consciousness and practical ability during practicing period.

0.05). But there were significant differences between them and the stronger positive rate cases. There were significant differences between the positive and stronger positive rate of MTS 1 protein comparing normal gastric mucosa to small intestinal type(84.6%,61.5%), colonic type(85.7%, 50.0%) of IM and gastric carcinoma (83.0%,60.4%)( P

Objective To study the feature of bone metabolism in different phase of elder type 2 diabetic nephropathy (DN) patients.Methods One hundred and fifty elder type 2 DN patients (non-microalbuminuria group,microalbuminuria group,clinic proteinuria group,DN renal inadequacy group and DN uremia group,each group was 30 cases),60 elder non-DN patients in chronic renal failure (CRF) (non-DN renal inadequacy group and non-DN uremia group,each group was 30 cases) ,and 30 elder healthy people (control group) were selected to observe the changes of osteocalcin (OT),β -crosslaps,parathyroid hormone ( iPTH),alkaline phosphatase (AKP),serum calcium (Ca),serum phosphorus (P) and Ca × P.Results In non-microalbuminuria group,microalbuminuria group and clinic proteinuria group,OT and β -crosslaps levels were lower than those in control group,and the lowest in microalbuminunia group (P＜0.01).In DN renal inadequacy group and DN uremia group,OT and β -crosslaps levels were higher than those in control group(P＜0.01).In the phase of CRF,OT,β -crosslaps and iPTH had no statistic difference between DN patients and non-DN patients,but had linear correlation.Serum P level was higher in DN renal inadequacy group and DN uremia group than that in control group(P＜0.01).Either DN or non-DN,serum P had more influence to Ca × P than serum Ca.Conclusions In the different phase of elder type 2 DNpatients,the effect of bone metabolism is different because of the different injury of renal function.Bone metabolism in the different phase has respective feature and mechanism,with low turnover in the first and high turnover in the end.