As a characteristic tumor therapy in China, Chinese medicine (CM) plays an important position in comprehensive treatment of tumor. It's a critical issue of objective realization, analysis and evaluation of CM safety for scientific decision-making in tumor safe medication and it also is a pivotal issue which affects the international communication. The safety evaluation of CM includes three phases: pre-clinical safety evaluation, clinical trials (micro-dose studies and traditional clinical trials) and post-marketing CM safety assessment. The key point of evaluation should be distinguished among different stages and various types of CM (such as classic formulas, Chinese herbal extracts, etc). Emphasis should be given to chronic toxicity when evaluating oral Chinese herbal , microdose studies and quality control must be underlined while injection is evaluated and more attention should be pay to the dose-effect relationship and time-effect relationship when turned to toxic Chinese medicine , and so as for the toxicity grading study. Moreover, we should constantly improve CM safety assessment method in various stages of tumor treatment, such as introducing the concept of syndrome classification theory, bringing in metabonomics and real-world research method which are similar to the CM therapeutic concept. Most importantly, we must keep its own feature of CM theory when we learn the concept of safety evaluation from abroad. Actively exploring the anti-tumor medicine safety evaluation methods and strategies is of great significance for clinical and experimental research, and it can provide supportability platform to CM's international communication.
Animals ; Combined Modality Therapy ; Humans ; Medicine, Chinese Traditional ; adverse effects ; methods ; Neoplasms ; therapy ; Safety

The article discusses a number of important marketing ideas which should be clarified and fully understood in strengthening the follow-up management of patients,including understanding of the meaning of customers,the formation of the concept of market and the evolution of marketing.The adoption of patient follow-up management could delivered value to customers and promote their satisfaction.In the end,the article proposes that a long-term marketing mechanism of patient follow-up services should be established in order to achieve the a better development of hospitals.

Objective To examine serum lipid levels and to investigate the risk factors of dyslipidemia in children and to study the indices of screening test for dyslipidemia of children in Beijing.Methods Serum total cholesterol(TC),triglyceride(TG),high density lipoprotein-cholesterol(HDL-c) and low density lipoprotein-cholesterol(LDL-c) were detected by HITACHI 7060 automatic biochemical analyzer in Beijing students.Body height, weight,upper body height,waist circumference,upper arm circumference and blood pressure were measured.Body mass index(BMI) was calculated according to the measurement of body height and weight.Waist-to-height ratio(WHR) was also calculated.Then a Logistic regression analysis and ROC study were conducted to examine the relationship between the above indices and dyslipidemia.Results Of 962 students,107 were found dyslipidemia.The prevalence rate was 11.12%.The upper body height,upper arm circumference,BMI,WHR,systolic pressure and diastolic pressure in children with dyslipidemia were higher than those of normal subjects(P

Objective To investigate the brain protective effect of isoflurane preconditioning on the rat liver against ischemia-reperfusion through determining the content of S-100β protein in peripheral blood in combination with mitochondrial ultrastructure in rat brain.Methods A total of 45 SD rats were randomly divided into three groups,sham group (group S):the only separation of the hepatoduodenal ligament,but did not block the hepatic portal blood supply; ischemia-reperfusion group (group I/R):liver ischemia 60min,reperfusion 120 min; isoflurane preconditioning group (group ISO):60 min before liver I/R,ISO pretreatment for 30 min,elution in the air after 30 min; 24 h after recirculation the forebrain tissues were rapidly removed.The changes of mitochondrial ultrastructure were observed by electron microscopy.The content of S-100β protein in serum was measured before ischemia and reperfusion 120 min through the application of Elisa kit.Results Marked swelling of mitochondria with disrupted cristae and damaged matrix were observed in group I/R,while relative intact mitochondria were seen in sham and ISO groups.The content of S-100β protein in serum was significantly higher in I/R group [(1.52 ±0.26) μg/ml] than in sham [(0.31 ±0.05)μg/ml] and ISO [(0.79 ± 0.21) μg/ml] groups (P ＜0.05).Conclusions The liver ischemia-reperfusion may injure the brain of the rat and isoflurane preconditioning can protect the rat brain from injury.

Objective:To investigate the possibility for human papillomavirus (HPV)infection to be a predictable signal for the carcinogenesis of oral mucosa by comparing the prevalences of HPV in each stage of oral mucosal carcinogenesis and to compare the sensitivity differences of the two methods in de-tecting HPV infection in oral cavity.Methods:The hybrid capture (HC-Ⅱ)was used to detect infection of HPV in 255 samples taken from 1 2 cases of healthy oral mucosa,21 1 cases of patients with pathologi-cal diagnosis and 32 cases of patients with clinical diagnosis.The diagnosed cases included 8 cases of be-nign lesions of the oral mucosa,precancerous lesions [74 cases of oral leukoplakia (OLK)with hyper-plasia and 42 cases of OLK with oral epithelial dysplasia (OED)],91 cases of precancerous condition
[oral lichen planus (OLP)]and 28 cases of oral squamous cell carcinoma (OSCC).And in situ hybri-dization (ISH)was used to detect infection of HPV in 33 cases of OSCC and 76 cases of OLK,including 30 cases of hyperplasia,1 5 cases of mild OED,1 5 cases of moderate OED and 1 6 cases of severe OED. Results:The prevalence of HPV in OLP samples was higher (1 2.1 2%,8/66 )than that of OLK (2.59%,3/1 1 6)(χ2 =4.666,P=0.031 )and OSCC(7.1 4%,2/28,χ2 =0.51 3,P=0.474).The prevalence of HPV in OSCC (7.1 4%,2/28)was higher than that of OLK (2.59%,3/1 1 6),and no significant difference was found.There was only one case of smoke spot and statistical analysis was not carried out.ISH was used to detect type 1 6/1 8 and type 31 /33 HPV DNA in 1 09 cases of oral mucosal lesions in paraffin sections and only one case of OSCC was HPV positive.Thirty-seven cases were detec-ted by HC-Ⅱ and ISH methods at the same time.The same negative results by the two methods were found in 94.6% samples (35/37).In the other two samples,one was OSCC with early infiltration and the other was OLK with hyperplasia,The HC-Ⅱ results were positive while the ISH results were nega-tive.The patients with OLP and HPV testing results were followed up and the average follow-up period was (36.2 ±1 0.5)months.It was found that three of them had a malignant transformation,and the ma-lignant transformation rate of HPV positive patients was 1 2.50% (1 /8),which was higher than that of HPV negative patients (3.45%,2/58),and the difference was not statistically significant,P=0.249. Conclusion:HC-Ⅱ assay was more sensitive in detecting HPV infection of oral mucosal lesions than ISH.The results of this study showed that there was insufficient evidence for taking HPV infection as a predictor of OLK carcinogenesis.Patients suffering from OLP were in a precancerous condition.The pre-valence of HPV in OLP patients of this study was higher than that in OLK and OSCC patients,suggesting that for some reason,OLP patients were susceptible to HPV.HPV testing can be considered as routine in patients with OLP,and HC-Ⅱassay was recommended.And patients with OLP and HPV positive should be followed up regularly.

Objective:To observe the effects of lactoferrin(LF)on the proliferation,migration and osteogenic differentiation of human periodontal ligament cells(HPDLCs)in vitro.Methods:HPDLCs were cultured and identified.The proliferation and migration of HP-DLCs cultured with 0,10 and 20 μg/ml lactoferrin respectively were tested by MTT assay,Transwell assay and scratch test.The os-teogenic differentiation of the cells was evaluated using alizarin red staining and real-time PCR.Results:Lactoferrin at 10 and 20μg/ml increased the proliferation(P <0.05),increased the quantities of mineralized nodules and the expression of alkaline phospha-tase(ALP),osteocalcin(OCN)and osteopontin(OPN)(P <0.05).Conclusion:Lactoferrin promotes the proliferation,migration and osteogenic differentiation of HPDLCs.

Objective To compare the perioperative outcomes and short-term efficacy of three-port extraperitoneal laparoscopic radical prostatectomy (ELRP) and four-port ELRP.Methods Two hundred patients who had undergone ELRP for prostate cancer by a single surgeon from November 2010 to October 2014 were retrospectively analyzed.Among them,95 cases underwent three-port ELRP and 105 cases underwent four-port ELRP.On the basis of traditional four-port ELRP,three-port ELRP was characterized by the omission of the trocar on the inner side of right anterior superior iliac spine.The mean age was 66.8 ± 15.5 years,and mean total prostate specific antigen (tPSA) was 15.3 ± 12.4 μg/L.There were no significant differences including age,body mass index,tPSA,clinical stages,acceptance of neoadjuvant hormone therapy,history of transurethral resection of the prostate,history of diabetes mellitus between the 2 groups (P ＞ 0.05).Patients in three-port ELRP group had significantly smaller prostate volume than fourport group (35.6 ± 16.7 ml versus 42.2 ± 24.7 ml,P ＜ 0.05).The clinical factors as operative time,estimated blood loss,hospital stay,drainage tube keeping days,pathological Gleason scores,pathological stages,positive surgical margin rates,biochemical recurrence rates and urinary incontinence rates were compared between the 2 groups.Results The three-port group had significantly shorter operative time than the four-port group (81.0 ± 18.6 min versus 103.6 ±34.6 min),less estimated blood loss (102.6 ±75.8 ml versus 217.5 ± 182.9 ml),less positive surgical margin rates (13.7％ versus 27.6％).There were 9 patients having Gleason scores more than 7 in the three-port ELRP group and 29 patients in four-port ELRP group (P ＜ 0.05).There were no significant differences of hospital stay,drainage tube keeping days,pathological stages between the 2 groups (P ＞ 0.05).Eighty-three cases in the three-port ELRP group (87.4％) were followed up for 5-19 months with the median time of 11 months.Ninety-two cases in fourport ELRP group (87.6％) were followed up for 17-52 months and the median time was 27 months.There were no significant differences of biochemical recurrence rates and urinary incontinence rates between the 2 groups(P ＞ 0.05).Conclusions Compared to four-port ELRP,three-port ELRP can provide shorter operative time,less blood loss,better negative surgical margin rates,similar oncological control and recovery of postoperative continence.In experienced hands,three-port ELRP could be a feasible and effective option for localized prostate cancer.

Objective To evaluate the learning curve of three-port extraperitoneal laparoscopic radical prostatectomy(ELRP) and to minimize operative time and blood loss about this procedure.Methods From August 2013 to October 2014,the data from 95 consecutive patients,who had undergone three-port ELRP for prostate cancer,were retrospectively analyzed.The mean age was 65.9 ± 7.7 years,mean total PSA level was 15.4 ± 12.7 μg/L,and mean body mass index(BMI) was 24.8 ± 3.2 kg/m2.According to the number of procedures performed by the surgeon,all patients were classified into three chronologic groups,including group A (No.1-32),group B (No.33-64) and group C (No.65-95).There were no significant differences including age,BMI,tPSA,estimated prostate volume,clinical stages,history of neoadjuvant endocrine therapy,history of transurethral resection of the prostate (TURP) among group A,B and C (P ＞ 0.05).The operative outcomes analyzed were operative time,estimated blood loss,hospital stay,drainage tube indwelling days,pathological Gleason scores,pathological stages,positive surgical margin rates,biochemical recurrence rates and urinary incontinence rates.Among these 95 patients,the results of the first 32 cases were compared with those of the remaining 63 cases,the first 64 with the remaining 31.Results The average operative time in 95 patients was 81.0 ± 18.6 min.The sloping learning curve for this surgeon showed that the operative time for all 95 cases was strongly correlated with additional experience (| rs | =0.612,P＜0.01).Operative time,however,was not strongly correlated with the surgeon's experience in each group of A,B and C(P ＞0.05).Group A had longer operative time than that of Group B plus C(96.4 ± 11.3 min vs 73.2 ± 16.7 min,P ＜0.01).Group A plus B had longer operative time than that of group C (87.6 ± 17.2 min vs 67.5 ± 13.8 min,P ＜ 0.01).For all cases,the estimated blood loss was strongly correlated with additional experience (| rs | =0.677,P ＜ 0.01).Estimated blood loss was strongly correlated with the accumulation of experience for the initial 32 cases(| rs | =0.619,P ＜ 0.01).However,no strong correlation was observed over the next 63 cases.Group A had more blood loss than that of Group B plus C (158.7 ± 81.3 ml vs 74.1 ± 54.4 ml,P ＜ 0.01).Group A plus B had more blood loss than that of group C (125.5 ± 71.6 ml vs 55.3 ± 61.6 ml,P ＜ 0.01).But hospital stay,drainage tube keeping days were not strongly correlated with additional experience in each group(P ＞ 0.05).There were no significant correlation between the accumulation of experience and positive surgical margin rates,biochemical recurrence rates and urinary incontinence rates.Conclusion Our experience of three-port ELRP cases appears to be favorable with decreasing tendency in operative time,estimated blood loss with experience accumulation.Exposure to 32 surgeries,operative time and estimated blood loss reduced significantly,and after 64 cases operative time and estimated blood loss further reduced.

Objective To evaluate the effect of transnasal optic nerve decompression for traumatic optic neuropathy in different surgery time. Methods The databases of the Cochrane library, Embase, PubMed, Wanfang Database, China Journal Full-text Database (CNKI), Weipu Database(VIP) were searched for retrospective studies and clinical controlled trials. The search words included traumatic optic neuropathy, TON, eye traumas, transnasal endoscopicoptic decompression, TEOND, decompression of optic canal and endoscopy. According to the inclusion and exclusion criteria, the data were extracted. The RevMan 5.3 was used to analyze the data. Results All of 1 087 studies were detected. Sixteen eligible studies were enrolled, including 803 eyes. Meta analysis showed that the recovery degree of visual acuity, curative effect in operation group within 7 d of trauma was obviously superior to the operation group 7 d after trauma (OR=2.78;95%CI:2.02-3.82;P<0.01). Conclusions Transnasal endoscopic optic nerve decompression in treatment of traumatic optic neuropathy should be operated as soon as possible, and it is better to operate within 7 d.