AIM The quality standard of Tongmai Jiangzhi Capsules (Rhizoma Curcumae Longae, Radix et Rhizoma Rhei, Fructus Ligustri Lucidi, Rhizoma Alismatis) has been established. METHODS TLC was used to identify curcumin, rhein, emodin, chrysophanol and aloe-emodin. HPLC was used to determine the content of curcumin, free-chrysophanol and free-emodin. RESULTS[WTBZ]: The linear relation was excellent for determination with ODS column and methanol-water-acetic acid(77∶ 22∶ 1)as mobile phase. The average recoveries of curcumin, free-emodin, free-chrysophanol were 101.8 % , 97.55 % and 97.64 % , respectively. The curcumin content in capsule was 2.27 mg, free-emodin 0.162 mg, free-chrysophanol 0.291 mg. CONCLUSION The methods are available with a good reproducibility and can be used to control the quality of Tongmai Jiangzhi Capsules.

Objective To investigate the predictive value of sphingosine‐1‐phosphate (S1P) and adiponectin after coronary stent implantation .Methods Fifty patients confirmed by coronary angiography with in‐stent restenosis were selected as in‐stent resteno‐sis group while 50 patients without in‐stent restenosis were chose as control group .All cases were detected with the density of their serum S1P ,HDL‐S1P ,adiponectin and IL‐18 and analyzed relevance to in‐stent restenosis .Results Compared with the control group ,serum S1P in in‐stent restenosis group were lower [ (96 .10 ± 26 .33)ng/mL vs .(113 .40 ± 32 .72)ng/mL ,P<0 .01] ,and the levels of HDL‐S1P and adiponectin were also significant lower [(32 .81 ± 10 .02)ng/mL vs .(42 .72 ± 11 .75)ng/mL ,P< 0 .01 ;(7 .38 ± 2 .11)mg/L vs .(9 .25 ± 3 .29)mg/L ,P< 0 .01] .IL‐18 levels between the two groups had no significantly difference [(258 .15 ± 82 .19)ng/L vs .(224 .98 ± 84 .15)ng/L ,P>0 .05] .Adiponectin showed a positive correlation between S1P (r=0 .712 , P<0 .05) and HDL‐S1P (r=0 .821 ,P<0 .01) .Conclusion S1P and adiponectin could be independent predictive factor of coronary stent restenosis ,and high concentrations of S1P and adiponectin may reduce risk of in‐stent restenosis in patients with stenting per‐cutaneous coronary intervention (PCI) .

Objective To evaluate the in vitro antimicrobial activity of tigecycline in combination with imipenem against multi-drug resistant and pan-drug resistant Acinetobacter baumannii isolates,so as to discuss the feasibility of drug combination and provide the basis for chnical rational use of antimicrobial agents.Methods Sixteen multi-drug resistant and pan-drug resistant Acinetobacter baumannii isolates were collected between January and April in 2015 from all kinds of infected specimens of Nanjing Drun Tower Hospital.The protocol was designed by checkerboard method,and the minimum inhibitory concentration (MIC) of antibiotics was determined by microdilution broth method,and the fractional inhibitory concentration (FIC) index was calculated according to MIC results.Results The average value of MIC (MICG),MIC50,MIC90 of tigecycline and imipenem single were 1.73,1,4 μg·mL-1and 31.00,32,64 μg·mL-1.When tigecycline was combined with imipenem,MICG,MIC50,MIC90 of tigecycline and imipenem were 0.24,0.25,0.50 μg·mL-1 and 8.16,8.00,16.00 μg·mL-1,respectively.Compared with the drug single use groups,MIC was significandy decreased in the drug combination group.In 6 strains (37.50％),synergy effect (FIC≤0.5) was observed,and in 10 strains (62.50％),additive effect (0.5 ＜ FIC ≤ 1) was found.No negative and independent effects were shown.Conclusion Both additive and synergistic action is observed when tigecyclineis combined with imipenem against multi-drug resistant and pan-drug resistant Acinetobacter baumannii isolates.No negative and independent effects are shown.This combination use against multi-drug resistant and pan-drug resistant Acinetobacter baumannii may be an effective therapy for clinical treatment.

Background and purpose:Increasing thyroid cancer (TC) incidence has caused wide public concern. It is typically interpreted as an increase in the true occurrence of TC but may also relfect changing life style or aging of population or increased diagnostic scrutiny. This study describes the temporal trend for incidence of TC and survival rate of patients by summarizing the 41 years TC incidences and follow-up data in Xuhui District, Shanghai.. Methods:Annual TC incidence data of Xuhui District from 1973 to 2013 were provided by Shanghai Cancer Registry System. The calculation of age-standardized incidence rates (ASIR) was based on the population of the year 1973. Temporal trends in TC incidence were analyzed based on the natural spline regression model. Annual percentage change (APC) was estimated by Jointpoint software from US National Cancer Institute, as well as survival rates were estimated using Kaplan-Meier method by Stata software.Results:During the period from 1973 to 2013, papillary cancer was the dominant type with proportion 69.8%. The ASIRs for female TC were 2.51-2.70 times as high as those for male TC. The average age of TC incidence for male was 50.04±14.71 while for female was 48.57±13.65. When aging factors were removed, incidence rate of TC was on the rise since 1981 with the APC of 8.46% (95%CI: 5.9%-11.1%), and on a rapid growth from 2004 to 2013 with the APC of 20.30% (95%CI: 9.8%-31.7%). The study showed that the 5-year TC survival rate was 95.21%, and the 10-year TC survival rate was 89.09%. In addition, survival rate of female was higher than that of male (χ2=15.43,P=0.000 1).Conclusion:The rising trend of TC in Xuhui District is similar to those in Shanghai and some developed countries. Although the mortality rate of TC is low, it has a rapid increase in incidence. Studies on factors associated with TC will help to clarify the epidemiological features about TC and promote more eff-cient prevention and control strategies.

Objective To explore the prevalence of depression in diabetes foot ulcer patients , and to an-alyze the correlation between depression morbidity and various factors such as age , HbA1c level, and quality of life etc.Methods 73 diabetes foot ulcer patients admitted from Sep .2012 to Sep.2014 were enrolled.Depres-sion was assessed using the 9-item patient health questionnaire (PHQ-9).Data such as the age, sex, duration of diabetes and foot ulcer , HbA1C level, smoking were recorded .The severity of foot ulcer was evaluated by Wagner's classification.The quality of life was scored by short form(SF-36)health survey questionnaire.Results The morbidity of depression in diabetes foot ulcer patients was 49.3%in total and 17.8% in the moderate to severe depression group .The prevalence in patients with HbA 1c≥7.0%was significantly higher than that in pa-tients with HbA1c<7.0%(66% vs 35%,P<0.01).Higher occurance of HbA1c≥7.0% was found in the moderate to severe depression group compared to that in the mild depression group .The prevalence of depression was 39.1%in grade 1 in wagner classification , 48.6% in grade 2 to 3 in wagner classification and 69.2% in grade 4 to 5 in wagner classification , showing the two was positively correlated .When duration of foot ulcer lasted more than 6 months, the morbidity of depression(58.1%)was significantly increased(P<0.05).The quality of life was significantly declined in patients with depression by SF-36 questionnaire ( P<0.05 ) .No association was found between the depression morbidity and the age , duration of diabetes , amount of complications or smoking (P>0.05).Conclusions This study shows a high prevalence of depression symptom in diabetes foot ulcer pa -tients.Depression is associated with HbA1c level, the extent and duration of foot ulcer .

Objective To detect the levels of IL-9,IL-17,and IFN-γ in CD4+T cells from patients with rheumatoid arthritis (RA).Methods The peripheral blood mononuclear cells (PBMCs) from patients with RA and healthy controls were obtained,then the CD4+ T lymphocytes were tested by immunomagnetic beads.The protein levels of IL-9,IFN-γ and IL-17 were measured by flow cytometry (FCM).The mRNA levels of IL-9,IL-17,RORγt and IFN-γwere also detected by qRT-PCR.Data were analyzed by comparison between groups using variance analysis,and Pearson's correlation analysis was used for linear correlation analysis.Results The isolation of untouched human CD4+ T cells from PBMC was effective and its purity was over 90％.The protein levels of IL-9,IL-17,IFN-γwere higher in patients with active RA as compared with patients with inactive RA (P＜0.01) which were (1.62±0.23)％ vs (1.15±0.24)％(P＜0.01),(1.47±0.20)％ vs (1.04±0.26)％(P＜0.01) and (8.1±0.6)％ vs (6.9±1.0)％(P＜0.01) respectively,so did the patients with RA when compared with healthy controls (P＜0.01).The mRNA levels of IL-9,IL-17,RORγt and IFN-γ were higher in patients with active RA as compared with inactive RA patients (P＜0.01),which were (3.0±0.6) vs (1.8±0.4) (p＜0.01) (4.2±0.9)vs (2.3±0.7) (P＜0.01),(4.1±0.7)vs (2.9±0.3) (P＜0.01)and (4.0±0.8)vs (2.3±0.6) (P＜0.01) respectively,so did the patients with RA when compared with healthy controls (P＜0.01).Intracelluar IL-9 levels were positively correlated with IL-17 (r=0.632,P=0.001),IFN-γ (r=0.515,P=0.008),DAS28 (r=0.519,P=0.009) and ESR (r=0.857,P=0.038) but had no correlation with CRP (r=0.38,P=0.61).Conclusion The levels of IL-17,IL-9,IFN-γare higher in the PBMCs of RA patients,and these cytokines may participate in the pathogenesis of RA.

Objective To explore the impact of the variable number of tandem repeats of monoamine oxidase A gene (MAOA-uVNTR) on the intensity of brain activation during the recognition of facial expression in patients with depression and healthy controls.Methods 28 cases of depression,as well as 33 healthy controls who were matched in gender, age and years of education were divided into different genotypes with the methods of polymerase chain reaction (PCR) amplification and 1.5% agarose gel electrophoresis separation.61 cases were scanned to compare the intensity of brain activation in the recognition of happy, sad and neutral facial expression.Results In healthy controls,cases with high-activity genotype showed increased activation in left cuneus,left inferior frontal gyrus, right medial frontal gyrus and left inferior parietal lobule in comparision with carriers of low-activity genotype.In the depressed, compared with patients with low-activity genotype, cases with high-activity genotype decreased activation in bilateral putamen, left postcentral gyrus, left fusiform gyrus, right superior temporal gyrus and right thalamus.Conclusion Healthy controls with high-activity genotype shows the trend of priority for the identification of negative emotion,this genotype may be one of the risk factors for normal people suffering from depression.Patients with high-activity genotype is associated with the inhibitory of positive emotional state, this may attribute partly to the emotional symptoms in such kind of patients more serious.

ObjectiveTo explore the genetic impact of TPH1 A218C,MAOA-uVNTR on abnormal frontal lobe of depressed patients and the interactions between the two polymorphisms using the method of genetic imaging.Methods28 patients with major depression and 34 healthy controls which were equal in sex,age,years of education and had negative family history of mental illness were recruited in our study.All paticipants underwent functional Magnetic Resonance Imaging (FMRI) in negative emotion recognition and were divided into different genotypes.Then frontal lobe was extracted as region of interest by WFU software into six subregions-bilateral superior frontal lobe,middle frontal lobe and inferior frontal lobe.ResultsPatients (0.19 ± 0.01 ) and controls (0.15± 0.05 ) with TPH1 AA genotype showed increased activation in left inferior frontal lobe than patients and controls with AC or CC genot.Patients with AA genotype showed increased activation in right inferior frontal gyrus(0.28 ±0.07) than other five groups as well.Patients with MAOA-H genotype showed increased activation in right middle frontal gyrus(0.15 ±0.06),left inferior frontal gyrus(0.18±0.02) than patients and controls with L genotype.Superimposition of TPH1 A218C and MAOA-uVNTR exsited in abnormal function of left inferior frontal gyrus(F=4.98,P =0.047 ).Patients with AA and H genotype showed increased activation in this area significantly than other patient group.ConclusionDifferent genes in serotonin system can affect brain function through a common 5-HT feature.

Objective To compare the outcomes of multifetal pregnancy reduced to twins with initial twin pregnancy.Methods This study included all patients who had high-order multiple pregnancies from August 2007 to September 2010 ( n =567 ) in outpatient or inpatient of Department of Obstetrics and Gynecology,Provincial Hospital Affiliated to Shandong University.There were 478 initial twin pregnancys (non-reduced group ) and 89 multifetal pregnancy reduced to twins (reduced group).All fetal reduction procedures were performed after 12 weeks gestation.The maternal ages,gestational ages at delivery,pregnancy complications,birth weight of twins and neonatal outcomes were observed in all groups.Results ( 1 ) Average maternal ages and mean gestational ages at delivery:the average maternal ages were ( 29.7 ± 4.5) and (29.9 ± 5.0 ) years for the non-reduced and reduced groups,respectively,no statistical significance (P =0.755).The mean gestational ages at delivery in the nonreduced and reduced twins were (35.3 ± 3.9) and ( 34.4 ± 6.3 ) weeks,respectively ( P ＜ 0.01 ).( 2 ) Pregnancy complications:the rate of pre-eclampsia was 8.2％ ( 39/478 ) in the nonreduced group and 12.4％ (11/89) in the reduced group,no statistical significance ( P =0.199 ).The rates of gestational diabetes mellitus were 1.7％ ( 8/478 ) and 3.4％ ( 3/89 ),respectively,no statistical significance ( P =0.287 ).( 3 ) Neonatal outcomes:① the frequencies of birth weight discordances ＞ 400 g were 28.9％ for the nonreduced group and 27.0％ for the reduced group,no statistical significance ( P =0.715 ).The frequencies of birth weight discordances ＞ 100 g were 75.1％ for the nonreduced group and 75.3％ for the reduced group,no statistical significance (P =0.972).②The mean birth weight of the nonreduced twin group was significantly higher than that of the reduced group [ ( 2700 ± 468 ) g vs.( 2352 ± 602 ) g,respectively,P ＜ 0.0l ],there was statistical significance.The mean birth weight of gestational ages ＞ 36 +1 weeks at delivery of the nonreduced twin group was significantly higher than that of the reduced group [ (2809 ± 424) g vs.(2707 ± 506) g,respectively,P ＜0.01 ],there is statistical significance.③The rate of infant mortality( gestational ages ＞28 weeks at delivery) was 1.3％ ( 1/78 ) for the reduced group and 2.2％ ( 10/448 ) for the nonreduced group.The major morbidity rate was 3.8％ (3/78) for the reduced group and 4.0％ (18/448) for the nonreduced group,no statistical significance ( P =0.588,0.943 ).Conclusions Multiple pregnancies after fetal reduction were still associated with a mild increased risk when compared to initial twin pregnancies and their abortion rate is high.The gestational ages of the reduced group were affected by the initial number of fetuses,and the birth weights of reduced twins were lower than that of the nonreduced twins.

Objective To explore the real feeling and experience of the nurses when they changed their role into patients (in hospital), and find out the defect and disadvantage of nursing service, then we can identify the direction of how to improve our nursing service. Methods Six nurses who were hospital-ized for operations were interviewed about the feeling of being patients, before and after operations.The in-formation was collected and analyzed, then questions were raised up. Results The various feelings of 6 nurses before and after operation were got and 6 themes were summarized. Conclusions When the nurs-es have experienced the feeling of being patients, they understand the patients better, they consider that more thinking from another way could help to form good relationship between nurse and patient,"more un-derstand, more trust, less complain, less grumble".