Objective To establish the method for determining the content of Fructus Cnidii in Dafeng wan by HPLC. Methods Diamonsil ODS1 C18 column was used with CH3OH-0.1 mol/L (NH4)2SO4 (70︰ 30) [adjust pH to 2.5 by sulphuric acid solution (1→5)] as the mobile phase. The detection wavelength was set at 322 nm and flow rate was 1.0 mL/min. Results The calibration curve was linear at the range of 0.101～0.808 ?g for the Fructus Cnidii and linear equation was Y =9.964 406?10-3X -1.355 684?10-1, r=0.999 5. The average recovery was 98.4% and RSD was 1.40% (n=6). Conclusion This method was simple and accurate, with good specificity and repeatability, which provides scientific quantitative analysis method of Fructus Cnidii in Dafeng wan.

Migrant workers incur the challenges of linkage and compatibility of medical insurance systems for their migration across regions and change of identities. To identify a medical insurance system adaptable to their needs, the paper recommends the following: Take their medical insurance into the national account of medical insurance; build a linkage mechanism between cities and villages, and that between cities as well; make the medical insurance system more compatible and portable, in order to safeguard their right of health.

Objective To investigate the recovery of affected side kidney function after upper urinary tract obstruction was relieved Methods 78 patients who had been diagnosed with upper urinary tract obstruction were enrolled from January to December of 2015 in our hospital.All patients received the surgery to relieve the obstruction.GFR of the affected side kidney was done after one months of the surgery.The average age was(51.3 ± 12.8)years old.The reason of obstruction was upper urinary tract calculi (72 cases) and upper urinary tract stenosis (6 cases) respectively.All the patients received CT and ECT before and after operation.All the patients was divided into 3 groups by the decreased degree of affected side kidney function,including moderately decreased group [15 rnl/min ≤ GFR ＜ 30 ml/min,n =43,mean value =(23.1 ±5.0) mL/min],severely decreased group [7.5 rnL/min≤ GFR ＜ 15 ml/min,n =23,mean value =(11.2 ± 2.3) ml/min],and extreme severely decreased group [GFR ＜ 7.5 ml/min,n =12,mean value =(4.3 ± 2.9)ml/min].Linear correlation analysis was used to analysis the relationship analysis between the GFR value (pre-operation,post-operation) and the renal cortical thickness.The follow up time of extreme severely decreased group extended to 8-12 months.Results The GFR of moderate decreased group recovered to(30.6 ± 8.5) ml/min,regained averagely (7.56 ± 7.62) ml/min;the severely decreased group recovered to (13.1 ± 4.5) ml/min,regain (1.94 ± 3.38) ml/min.Extreme severely decreased group recovered to (11.1 ± 3.4) ml/min,regained averagely (6.75 ± 4.76) rnl/min,the GFR mean value after operation 8-12 months recovered to (12.7 ± 3.6) ml/min.All groups got significant recovery of kidney function of the affected side.The correlation coefficient between GFR value and the renal cortical thickness was 0.59 (before the surgery) and 0.70 (after the surgery) respectively (P ＜ 0.05).Conclusions Most of affected side kidneys got different degree of recovery.Obstruction influenced the accuracy of ECT at the time of evaluating the actual renal function before operation.The kidneys which had been supposed should be resected in presurgical evaluation could recover to the level of kidney reserve after the surgery.

Objective To investigate the pathological change in Echinococcus granulosus hydatid cysts treated with high intensity focus ultrasound (HIFU). Methods Thirty cysts with thinner wall and proper elasticity, taken from livers of infected sheep, were randomly divided into three groups. By cyclical multilayer radiation around the cyst wall,two experiment groups were treated with HIFU under 150 W and 250 W sound power respectively. The control group was treated by ordinary ultrasound for 2 min. Results The inner cyst wall of hydatid treated with HIFU became curved,thicker, stiffer, white and less transparent. The germinal layer was detached mostly from the laminated layers of hydatid in the experiment groups. Images from the transmission electron microscopy showed that in the experiment groups fabric texture of hydatid changed significantly and germinal cells were broken. Conclusion HIFU in a model of cyclical multilayer radiation causes pathological damage of the E. granulosus hydatid.

Objective Exploring theoretical teaching model of chronic diseases management of preventive medicine undergraduates,to provide feasible suggestions to improve the theoretical teaching of the chronic disease management ability of preventive medicine specialty in China so that graduates can better adapt to chronic diseases management work.Methods On the basis of reading a large number of relevant literature both at home and abroad,the research team designed questionnaires,and conducted a questionnaire survey on 190 respondents who engaged in chronic diseases management or teaching in central China.The content includes the understanding of the importance of training chronic disease management ability in undergraduate education of preventive medicine and the constitution and training mode of undergraduates' chronic disease management ability.EpiData 3.1 software was used to input survey data,SPSS 23.0 software was used for statistical description analysis,and the usage ratio and component ratio were used for statistical description analysis.Results The survey found that more than 50％ of the respondents believed that training students with chronic disease management should focus on prevention,intervention services and health promotion ability,and chronic disease modules need to be added to undergraduate courses in preventive medicine.Conclusions preventive medicine undergraduates need to be improved,and medical colleges should change teaching model to increase undergraduates' ability of chronic diseases management.

OBJECTIVE:To study the content change regularities and the dynamic characteristics of paeonol,the major active ingredients in Cortex moutan from Chongqing Dianjang county under different influencing variables.METHODS:The determination of paeonol in moutan cortex samples was conducted by HPLC,and dynamic analysis on content change regularities was conducted.RESULTS:The content of paeonol took a para-curve pattern at an altitude from 400m to 800m,with that from 600m in altitude has the highest content;The content increased year by year from growing life of 3 to 5 years;The content took a para-curve pattern when harvested from 8mo to 11mo,with that harvested in 10mo was the highest.CONCLUSION:The optimal altitude for the growing of Cortex moutan was from 400m to 800m,in particular at an altitude of 600m,and it is preferable to harvest Cortex moutan with 4 or 5 years growing life in the first 20 days of 10mo.

Objective To analyse the effect of holmium laser incision through ureteroscopy and simple ureteroscopy treatment for refrac-tory hemospermia. Methods From December 2003 to April 2013,the data of 67 cases with refractory hemospermia were retrospectively ana-lyzed. All the patients underwent semen analysis,transrectal ultrasonography,seminal vesicle ultrasonography,some patients underwent pelvic CT or MRI. Results Simple ureteroscopy were done for 24 cases,holmium laser incision through ureteroscopy were done for 43 cases. Var-ying degrees of ejaculatory duct stenosis or obstruction were observed. Postoperative follow-up was from 6 months to 8 years,in 24 cases of simple ureteroscopy,2 cases experienced recurrence 6 or 8 months later. The ejaculatory duct narrow were found when they received reopera-tion,with holmium laser incision,hemospermia disappeared. No complications such as retrograde ejaculation,urinary incontinence or rectal injury occurred postoperatively. Conclusion The effect of holmium laser incision through ureteroscopy for refractory hemospermia is better than simple ureteroscopy,which is worthy of clinical application needs further observation and summary.

Objective To summarise and analyze the clinical effecacy of endovascular treatment(internal holmium laser incision,bal-loon dilation,ureter dilator,rigid ureter dilation)for ureteral stricture.Methods The clinical data of 628 patients from January 2010 to Jan-uary 2015 in our hospital were analyzed.The relevant operation indicators,postoperative complications and recovery condition were recorded and analyzed.Results The operation time was 5.5 to 29 minutes,with average time of 16.5 minutes,no ureteral avulsion,ureteral fragmen-tation and massive haemorrhage happened.All patients were followed up for 6 to 36 months,591 cases(94.1%)were cured,29 cases (4.6%)of postoperative stricture recurrence received endovascular treatment again,8 patients(1.3%)conversion to open ureterolithotomy. Conclusion Endovascular treatment of ureteral stricture is diversified within holmium laser incision,it has the advantages of shorter opera-tion time,fewer complications,less trauma,repeatability and so on,which is an effective and safe treatment method.

[摘 要] 目的：构建靶向CD38和CD138分子抗原的双靶点嵌合抗原受体基因修饰T淋巴细胞（CD38/CD138 CAR-T细胞），探讨其对多发性骨髓瘤（MM）细胞的体外杀伤作用。方法：利用CAR-T细胞技术，基于MM细胞高表达CD38和CD138抗原，分别构建靶向CD38、CD138的CD38 CAR-T与CD138 CAR-T细胞，以及同时靶向CD38与CD138的CD38/CD138 CAR-T细胞，实验分为未处理T、CD38 CAR-T、CD138 CAR-T和CD38/CD138 CAR-T细胞组。采用流式细胞术检测CAR-T细胞的表型，利用LDH释放法检测各种CAR-T细胞对MM细胞RPMI8226和U266的体外杀伤作用。结果：成功构建CD38 CAR-T、CD138 CAR-T和CD38/CD138 CAR-T细胞。CD38/CD138 CAR-T细胞倾向于向记忆表型分化，表达较高水平的增殖分子（CD25）、激活分子（CD27）和较低水平的耗竭分子（PD-1、CTLA-4、TIM-3）（均P < 0.001），而且CD38/CD138 CAR-T细胞不易于耗竭和衰老，且表达较低水平的r-H2AX、p-p53、p21和p16蛋白（均P < 0.01）。在不同效靶比条件下，CD38/CD138 CAR-T细胞较CD38 CAR-T、CD138 CAR-T细胞对RPMI8226和U266细胞具有更强的杀伤作用（均P < 0.001）。结论：靶向CD38和CD138治疗MM的CD38/CD138 CAR-T 细胞在体外具有较优表型及较强的抗肿瘤功能。