Objective To study the fouling mechanism during the filtration of traditional Chinese medicine decoction by inorganic ceramic membrane so as to make a valuable exploration both on membrane fouling prevention and the industrialization of membrane separation technology in the field of Chinese materia medica. Methods Micro-filtrating Qingluo Tongbi Decoction using alumina ceramic membrane, researching the applicability of the membrane with different pore sizes, observing the fouling on membrane surface by scanning electron microscopy, studying the resistance distribution of membrane in filtration process, analyzing the fouling existence shape, position, and forming rule. Results In this system, alumina membrane with the pore size of 0.2 ?m was most suitable, which had the biggest permeating flux and reservation rate of effective component with less fouling. Among the alumina membranes with three different pore sizes, auto resistance and pore block resistance made up inferior percentage in total resistance, fouling resistance distribution mainly consisted of the reversible resistance, such as concentration polarization and gel layer resistance. Conclusion Optimizing parameters of the techniques in membrane process, using suitable pretreatment method and cleaning method can reduce membrance fouling and make the memberane property recover.

Objective To compare the efficacy of different antibiotics strategy,introperitoneal (IP) cefazolin plus third-generation cephalosporin versus IP Vancomycin plus thirdgeneration cephalosporin on peritoneal dialysis (PD)-related peritonitis.Methods All episodes of PD -associated peritonitis happened in prevalent PD patients between January 2008 and December 2012 were recruited from the PD Center of Peking University First Hospital.According to their empiric antibiotics scheme,episodes were divided into group A (where IP cefazolin plus third-generation cephalosporins were administrated) and group B (where IP Vancomycin plus third-generation cephalosporins were administrated).Multivariable logistic regression model was used to explore the influence of different emnpiric antibiotics scheme on peritonitis outcome.Results Patients in Group B had significantly lower level of serum albumin (33.5±6.0 vs 35.3±5.2 g/L) and cholesterol (4.6±1.3 vs 4.9± 1.1 mmol/L) than those in group A.In group A,the percentage of gram-positive bacteria was similar to group B (43.2％ vs 43.3％,P =0.96),but gram-negative bacteria was numerically lower (16.9％ vs 24.7％,P =0.08).Different empiric antibiotics strategy was not independent predictor of peritonitis outcome [OR =1.07,95％ CI(0.45,2.56),P=0.87].Conclusion Both cefazolin and vancomycin can be selected as first-line empiric antibiotic covering gram-positive organisms in the treatment of PD related peritonitis.

A total of 526 team members from 28 community health service (CHS) centers in 5 pilot cities were surveyed by a questionnaire.All CHS centers developed team service.And 275 service teams were established and the coverage rate of area resident committee was 100％.The teaming modes were mainly divided into four kinds:medical-nursing-prevention classic combination,big team professional expansion,small team medical combination and non-health technology extensive participation.The team services showed multiple advantages of professionism,energy and time complementing.We should strengthen team construction,improve perfect team service mode and policy support and create a good environment for CHS development.

Objective: To understand their appearance and microscopic characteristics, as well as their differences by studying the pharmacognosy of Yi medicine Elsholtzia rugulosa and Elsholtzia bodinieri, in order to provide a basis for identification and improvement of quality standards.
Methods: Stereo microscopy and optical microscopy and the macroscopic and microscopic identification methods were adopted to compare identification and digital representation for Elsholtzia rugulosa and Elsholtzia bodinieri from overall character, local characteristics, the microscopic identification characteristics, the transverse section and the powder.
Results:There were significant differences in the the macroscopic and the microscopic identification characteristics of Elsholtzia rugulosa and Elsholtzia bodinieri.
Conclusion: This study summarized the exclusive and practical features in pharmacognosic identification of Elsholtzia rugulosa and Elsholtzia bodinieri, it provides a useful reference for supervision the clinical medication,inspection,and standard drafting.

Given the vital role of vasculature in solid tumors, the potential of vascular disrupting therapy in the treatment of triple-negative breast cancer (TNBC) is promising. In this study, we prepared the acid-sensitive liposome PPD/CA4P/Lip-Rap loaded with the vascular disrupting agent CA4P and the anti-angiogenic drug rapamycin (Rap) to explore the potential of the vascular disrupting strategy in TNBC. PPD/CA4P/Lip-Rap was characterized by ¹H NMR, dynamic light scattering, and transmission electron microscopy. Its drug loading and acid sensitivity were determined. The particle size of PPD/CA4P/Lip-Rap is 161.53 ± 1.89 nm, the zeta potential is -20.03 ± 0.9 mV and it demonstrated good drug release on acidic sensitivity responses. CCK-8 experiments proved that Rap can enhance the ability of CA4P to destroy tumor vascular endothelial cells. Rap can kill marginal residual tumor cells, suppress tumor recurrence. Nanocarriers can further enhance the therapeutic effect. Western blot (WB) showed that Rap decreased the expression of hypoxia-inducible factor-1α (HIF-1α) via the mTOR/p70S6K and mTOR/4E-BP1 pathways. Thus, tumor hypoxia activation and angiogenesis were inhibited. PPD/CA4P/Lip-Rap can effectively destroy tumor vessels, inhibit tumor angiogenesis and recurrence, and provide a new strategy for the treatment of TNBC by targeting disruption of tumor vessels.

Objective To evaluate the clinical results of operative treatments for the complex posterior tibial plateau fractures via posterior approach. Methods Eleven cases with complex posterior tibial plateau fracture from June 2008 through June 2010 were reviewed retrospectively. There were 7 males and 4females, with age from 33 years to 60 years (average, 47.8 years). According to AO classification, there were 41-B2.2.4 type in 2 cases, 41-B3.1.2 type in 3, 41-B3.3.2 type in 3, 41-B3.1.2 type combined 41-B3.3.2 type in 2, 41-C3.3 type in 1. Carlson posterior lateral approach were used in 5 cases, posterior medial approach were used in 3 cases, and posterior medial and/or lateral approach combined with anterior approach were used in 3 cases. All fractures were fixed with plates. Autogenous ilium grafts were used if necessary.Results All cases were followed up. The average follow-up time was 1.6 years (range, 3-24 months). At the final follow-up visit, bone union was obtained in all cases. The mean Rasmussen score was 16.7 (range, 15-18), and the mean HSS was 86.2 (range, 75-96). The postoperative knee range of motion were 0°-135°, 0°-130° and -10°-125° in 5 cases with posterior lateral plateau fractures, 3 cases with posterior medial plateau fractures and 3 cases with anterior and posterior plateau and intercondylar fractures respectively. There was no vascular and nerve injuries. Loosing or breaking of hardware's was not found. Conclusion The Carlson posterior lateral and/or medial approach is preferred for the complex posterior plateau fractures, with the advantages of direct reduction and stabilization.

Abstract?AIM: To evaluate the visual acuity, visual function, q uality of lfi e, and cost/effectiveness of cataract surgery in patients with low soc ioeconomics tatus ( LSES ) who received government subsidies for free cataract surgery.?METHODS: Retrospectively, 334 eyes of 334 patient s were reviewed. Visual function and quality of l ife questionnaires we re available in 83 patie nts. The cost/effectiveness of cataract surgery was analyzed in 225 patients with LSES and 12 0 patients who rec eived standard cataract surgery. Mutl iple linear regression anal ysis and logistic regression analysis were used to assess the factors affecting the postoperative visual acuity.?RESULTS: At 1wk postoperatively, uncorrected visual acuity ( UCVA ) was improved significantly compared to these preoperait vely (P<0.50 ), 235 eyes (70.4%) had UCVA of 20/40 or better, and 16 eyes (4.8%) had UC VA wor se than 20/400. Multiple linear regresis on ana lysis revealed that other ocular diseases and cataract classification wer e factors contributing to po stop erative UC VA. Logistic regression analysis showed that low preoperative visual ac uti y and other ocular diseases were risk factors of postopera tive low vision, and the odds ratio (95%confidence int erval) values were 6.5 (2.8-14.8) and 1.3 (1.0-1.6), respe ctively.Visual fun ction and quality of life were significantly improved after the surgery. Th e cost/effetc iveness of c ataract su rgery in patients with LSES was lower than that in standard cataract patients.?CONCLUSION: Visual acuity and visual function were significantly better after the surgery in catara ct patients wti h LSES, and the operation cost was low.Quality of life in these patients was significantly improved.

AIM: To observe the change of nitric oxide (NO) generation system in the vascular adventitia, media and intima in septic shock rats. METHODS: The septic shock model was made in rats by caecal ligation and puncture. The intima, media and adventitia of the rat aorta were separated. NO production (NO - 2) , nitric oxide synthase(NOS) activity and L-arginine (L-Arg) transport were measured, separately. Inducible NOS (iNOS) distribution was detected by immunohistochemistry. RESULTS: Both in early and late stage of septic shock, NO - 2 from the intima was decreased by 66.1% and 78.9%( P

Objective To observe the effects of combined generalepidural anesthesia on perioperative myocardial enzymogram and troponin T of the myocardium(cTnT)in old patients undergoing thoracic surgery.Methods Thirty-eight ASAⅠ-Ⅱ patients aged 60～80 years old were randomly divided into two groups.General anesthesia group(group G): anesthesia was induced with fentanly,propofol and vecuronium and maintained with isoflurane,propofol and vecuronium.Combined anesthesia group(group C):general anesthesia was performed as in group G and continuous epidural block with(1.6%) lidocaine was added during operation.Peripheral blood CK,CK-MB,AST,LDH and cTnT were measured before anesthesia,at the end of operation and at 6,24,48 hours after operation.Results Two groups could provide same postoperative analgesia.There was no change for HR,RR and MAP in two groups.Serum CK,AST,LDH and cTnT concentration in group G after operation were significantly higher than those before anesthesia(P

Objective To explore the relationship between obesity phenotypes and adipocytokines in children.Methods Based on the Beijing child and adolescent metabolic syndrome (BCAMS) study,3 508 children (1 788 boys and 1 720 girls) aged 6-18 were recruited.In this study,participants were categorized into four groups:226 cases in general obese group,192 cases in abdominal obese group,1 004 cases in combined obese group and 2 086 cases in non-obese group,according to the sex,age,specific body mass index(BMI),and waist circumference (WC) equal to or greater than the 90th percentile for age and gender of school children in Beijing in 2004.The levels of plasma insulin,serum leptin,resistin and adiponectin were measured by sensitive,specific double-antibody sandwich enzyme-linked immunosorbent assays (ELISA).Analysis of covariance,multivariate linear regression and binary logistic regression analysis were performed.Results There were highest plasma insulin and serum leptin,and lowest adiponectin levels in combined obese group than those in other obese groups and non-obese group and resistin level in abdominal obese group was highest than those in other obese groups or non-obese group.Among subjects with general obesity and conbined obesity,WC was more important factor than BMI for plasma insulin[?(WC)=0.158 P0.05].With covariates adjusted,the odds ratios(OR)and 95% confidence intervals of general obesity,abdominal obesity and combined obesity were 3.46(2.44-4.91),5.41(3.87-7.57) and 10.10(8.26-12.35) for predicting hyperinsulinemia,respectively,5.83(4.02-8.45),7.07(4.97-10.05)and 20.82(16.49-26.28) for hyperleptinaemia,respectively,1.47(1.05-2.07),2.0(1.42-2.80) and 2.66(2.23-3.18) for hypoadiponectinaemia,respectively.Serum resistin was highest in abdominal obesity.Conclusion The levels of adipocytokines in children were correlated with the phenotypes of obesity,especially for abdominal obesity.