Objective:To compare and analyze the volatile components in different medicinal parts of silktree Albizzia julibrissin and their relative contents .Methods:Chromatography-mass spectrometry using headspace solid phase microextraction combined with gas method ( HS-SPME-GC-MS) was used to analyze the volatile components in the bark and flowers of silktree Albizzia julibrissin and the relative contents were calculated by a peak area normalization method .Results:In the bark and flowers of silktree Albizzia julibris-sin, totally 30 and 33 compounds were respectively identified , which respectively accounted for 73.20%and 88.29%of the total vola-tile.A total of 15 components, including alkanes, alkenes, aldehydes, furans, alcohols and acids were in the bark and flowers of silk-tree Albizzia julibrissin, among them, the content of cineole was the highest (bark:15.02%and flowers:21.9%).Conclusion:The HS-SPME technique can be used to analyze and compare the volatile components in the bark and flowers of silktree Albizzia julibrissin, which provides scientific basis for the reasonable development and application of the bark and flowers of silktree Albizzia julibrissin.

In the context of ongoing health reform,it is important to establish and improve the regulation system of public hospitals.By defining the concept of regulation,regulation theories for public hospitals,the regulation systems of the typical countries,the paper summarizes the international experience enlightenment to China's public hospital regulation reform.

Objective To observe the clinical effect of oral use and acupoint application of Chinese herbal medicine with the actions of strengthening spleen and regulating stomach, lowering rebellious Qi to stop vomiting in treating pregnant pernicious vomiting. Methods One hundred and twenty-two spleen-stomach deficiency pregnant pernicious vomiting cases were randomly divided into observation group ( N=63) and control group (N=59). At the end of the trial, 2 cases of the control group dropped out, and the total case number was 57 in the control group. Both groups were treated with intravenous infusion, dietary care, daily life and emotional nursing, and oral use of Chinese herbal medicine with the actions of strengthening spleen and regulating stomach, lowering rebellious Qi to stop vomiting. Additionally, the observation group was given acupoint application of herbs for strengthening spleen and regulating stomach, lowering rebellious Qi to stop vomiting. The treatment was performed once a day, 4 days constituted one treatment course, and the treatment lasted two continuous courses. The improvement of vomiting, therapeutic effect and the safety were compared between the two groups after treatment. Results ( 1) The total effective rate was 96.8%in the observation group and was 71.9%in the control group, the difference being significant (P<0.01). (2) The time for stopping vomiting in the observation group was significantly less than that in control group (P<0.01). (3) During the treatment, no obvious adverse reaction was found in the two groups. Conclusion Acupoint application of herbs for strengthening spleen and regulating stomach, lowering rebellious Qi to stop vomiting has obvious synergistic effect on the clinical efficiency of spleen-stomach deficiency pregnant pernicious vomiting treated by oral use of herbal medicine, intravenous infusion, dietary care, and daily life and emotional nursing.

Objective To evaluate laparoscopic radical cholecystectomy for T2 gallbladder cancers.Methods A retrospective analysis was made on 44 patients with pathology confirmed T2 gallbladder cancer undergoing laparoscopic vs open radical cholecystectomy.The clinicopathological and follow-up data were compared.Results Laparoscopic cholecystectomy was performed in 32 patients,the implantation metastasis rate of this approach has no statistical differences compared with the open cholecystectomy (P =1.000).26 patients underwent laparoscopic radical resection and the remaining 18 patients underwent open radical resection.There was no statistical difference in operation time (P =0.953),blood loss (P =0.193)and postoperative complications (P =1.000),but the laparoscopic radical resection group is superior to the open group on postoperative pain grading (P =0.022),ambulation time (P =0.000),nothing per mouth time (P =0.000) and length of hospital stay (P =0.048).The mean number of lymph nodes retrieved was 5 ±4 (range 1-12) in the laparoscopic radical group and 6 ± 3 (range 1-12) in the open group (P =0.983);the 1,3,5 year survival rates was 92.3％,70.3％,61.5％ and 92.3％,76.3％,69.3％,respectively(P =0.473).Conclusions Initial laparoscopic cholecystectomy does not increase the rate of seeding metastasis in the context of intact gallbladder carcinoma.Totall laparoscopic radical resection is feasible in selected T2 gallbladder cancer patients.

Objective To establish a determination method for leuprolide acetate microspheres. Methods HPLC was performed on Inertsil ODS-SP (150×4.6 mm×5μm) with mobile phase consist of 0.1 mol/L of Ammonium Dihydrogen Phosphate(adjust its pH to 7.00±0.05 with Ammonium Hydroxide) and Acetonitrile in ratio of 3:1(V/V),and the flow rate was 1.0 mL/min.The wavelength was 220 nm and column temperature was 30℃. The injection volume was 20 μL. Results The linear range of leuprolide acetate was 20.0-160.0μg/mL (r=0.9999) with an average recovery of 99.80%,RSD=0.63%(n=9). Conclusion The method of HPLC was accurate,reliable and specific, which could be used to determinate the assay of leuprolide acetate microspheres and for quality control of microspheres.

Objective To study the therapeutic effect and immunologic regulation of human amniotic mesenchymal stem cells (hAMSCs) in rats with experimental type 1 diabetes mellitus (T1DM).Methods The hAMSCs from human amnion were isolated and cultured in vitro,then phenotype was analyzed by flow cytometry.T1DM were produced by administering streptozocin to rats.The rats were divided into normal control group (n =6),T1 DM model group (n =6),medium treated group (n =6),hAMSCs transplanted group(n =6),and insulin treated group(n =6).5 × 106of hAMSCs or vehicle were administered to rats via sublingual vein.Blood glucose levels of rats were recorded weekly in the groups for six weeks by Blood Sugar Meter.At the end of 6 weeks after hAMSCs transplantation,concentrations of plasma insulin were detected by ELISA; histopathological changes of pancreas,surviwl and differentiation of transplanted hAMSCs in pancreatic tissue were studied with HE staining,and immunofluorescence staining; percentages of lymphocyte subsets in peripheral blood mononuclear cells were determined by flow cytometry ; concentrations of plasma cytokines were determined by cytometric bead array.Results After hAMSCs transplantation,blood glucose levels in rats with T1DM were decreased (P ＜ 0.01),while concentrations of plasma insulin were increased significantly (P＜0.01).At 6 weeks,cell-treated animals showed an improvement in pancreas damage ; the percentages of CD4 + IFN-γ+ (Th 1) and C D4 + interleukin (IL)-17 + (Th 17) cells were reduced (all P＜0.05),while the percentages of FoxP3-positive regulatory T cells (FoxP3 +Treg) and CD4+ IL-4+(Th2) cells were increased (all P＜0.01) ; plasma concentrations of interferon-γ,IL-2,and tumor necrosis factor-αwere decreased (all P＜0.01),but IL-4 level was increased (P＜0.05).No histological evidence of insulin producing cells from hAMSCs was seen within pancreas.Conclusions hAMSCs may reduce blood glucose and alleviate the islet damage in rats with T1 DM,which is related to their potential to up-regulate FoxP3 +Treg cells.

Objective To predict and identify liner B-cell epitopes in the hemagglutinin ( HA) of human-infected avian-origin H7N9 influenza virus and analyze the specificity of H7 subtype.Methods Three serum samples collected at different times from the same patient who was confirmed to be infected with H7N9 influenza virus were provided by Shaoxing People’s Hospital, and one serum sample from healthy person was collected as the control.The extracellular region of HA protein was predicted by TMHMM Sever v.2.0.The potential B-cell epitopes were predicted by DNAStar Lasergene’ s Protean, BcePred and ABCpred tools, and the immunogenicity of the predicted B cell antigen epitopes was assessed by indirect enzyme-linked immunosordent assay ( ELISA ) .H7 subtype specificity was analyzed by comparing HA protein amino acid sequence with H7N9 and H1-H16 subtype influenza virus from Genbank using Clustal X 2.1 software, and Cn3D 4.3.1 software was used to detect the distribution and 3D structure of predicted epitopes on the HA protein of H7N9.Results The potential B-cell epitopes may be located in 172-183, 363-380, 452-472 and 491-506 of extracellular N-terminus of HA protein.ELISA showed that four predicted eptiopes specifically reacted with positive serums from patient.Multi-sequence alignment demonstrated that peptide 172-183 and 363-380 had higher H7 subtype specificity compared with amino acid sequences of other subtypes.Moreover, the predicted linear B-cell epitopes all located on the surface of HA protein according to the 3D structure analysis.Conclusion Four potential B-cell epitopes were identified, in which peptide 172-183 and 363-380 have higher H7 subtype specificity, and may be used in the design of epitope-based vaccines and diagnostics tests.

Objective:To clarify the clinical characteristics and related fators of children with delayed antibody production of mycoplasma pneumoniae pneumonia(MPP).Methods:Two hundreds and eithty-five cases of children hospitalized at Children′s Hospital of Soochow University with MPP(positive for nucleic acid testing of respiratory secretion)were chosen from January 1st, 2019 to September 31st, 2019.Delayed antibody production group included 36 cases, who were tested for negative IgM antibody meanwhile the titer of IgG antibody changed less than 4 folds within 14 days.Positive group included 249 cases who were tested for positive IgM antibody or the titer of IgG antibody changed over 4 folds within 14 days.The characteristics of clinical manifestation, immunology and radiology were comparatively analyzed.Results:The medium age of delayed antibody production group was 0.75(0.30, 2.78)years old, which was obviously younger than that from positive group[5.50(3.73, 7.20)years old]( P<0.001). Low level of serum immunoglobulin IgG was the independent effect factor of delayed production for Mycoplasma pneumoniae antibody( P=0.037). When the serum immunoglobulin IgG level was lower than 7.155mmol/L, the sensitivity of predicting delayed production for mycoplasma pneumoniae antibody would be 0.819 and the specificity was 0.833.The underlying diseases associated with delayed antibody production were hospitalization history during neonatal period( P=0.007)and congenital heart disease( P=0.001). There were 11.11%(4/36)of children appearing spasmodic cough, 41.67%(15/36)of children showing wheezing and 33.33%(12/36)showing diarrhea in delayed antibody group, which were significantly higher than those in positive group[0.40%(1/249), 24.50%(61/249)and 9.64%(24/249), respectively, P<0.05]. The incidence of fever in delayed antibody group were 63.89%(23/36), which was lower than that in positive group[92.37%(230/249)]( P<0.001), meanwhile, the fever last time was 2.50(0, 4.75)days in delayed antibody group, which was shorter than that in positive group[ 7(5.00, 8.50)days]( P<0.001). In the delayed antibody group, there was 19.44%(7/36)of children sufferring from lobar pneumonia, and no extrapulmonary manifestations occurred, which were significantly lower than those in positive group[75.50%(188/249), 14.86%(37/249)]( P<0.05). Conclusion:Delayed antibody production in children with MPP is more common when serum immunoglobulin IgG level is lower than 7.155 mmol/L, especially in the presence of neonatal hospital history and congenital heart disease.The clinical manifestations of these children are mainly characterized by spasmodic cough and wheezing, with low probability of fever, lobular pneumonia and extrapulmonary manifestations.

Objective To observe the clinical efficacy of Jiajian Yijing Decoction on improving clinical symptoms and pregnancy rate of patients with diminished ovarian reserve(DOR)and kidney deficiency and hepat-ic depression syndrome. Methods Patients with DOR and kidney deficiency and hepatic depression syndrome were randomly divided into traditional Chinese medicine group(n = 33)and western medicine group(n = 34). Patients in TCM group were treated with Jiajian Yijing Decoction and those in western medicine group with artificial periodic therapy(Progynova 2 mg/d+Dydrogesterone 20 mg/d).All cases were treated with 3 menstrual cycles.The improvement of clinical symptoms of DOR and kidney deficiency and hepatic depression syndrome and pregnancy rate were observed. Results The improvement of clinical symptoms of DOR and kidney deficiency and hepatic depression syndrome after treatment in TCM group was more obvious than that in western medicine group(P<0.05 or P < 0.01). The pregnancy rate after treatment in TCM group was higher than that in western medicine group, but it had no statistic difference(P>0.05).Conclusions Jiajian Yijing Decoction can obviously improve the clin-ical symptoms of patients with DOR and kidney deficiency and hepatic depression syndrome and increase the preg-nancy rate in infertile patients.It is worthy of clinical popularization.

Objective:To explore the effect of mind mapping combined with continuous quality improvement in the teaching of interns in gastroenterology department.Methods:The 55 students who interned in the gastroenterology department of our hospital from September 2019 to January 2020 were set as the control group and adopted traditional teaching methods; the other 54 students who interned in the gastroenterology department of our hospital from February 2020 to June 2020 were set as the control group; 55 students who interned in the gastroenterology department of our hospital from July 2020 to November 2020 were set as a combined group, and received mind mapping combined with continuous quality improvement teaching. The gastroenterology knowledge and theory assessment results, practical skills operation assessment results and learning initiative, self-study ability, comprehensive thinking ability, teamwork ability, analysis and problem-solving ability, induction and summary ability and so on were compared between the two groups, and the teaching satisfaction rate at the time of leaving the department were also compared. SPSS 20.0 was used for t test and chi-square test. Results:Before the training, there was no statistically significant difference in the three groups of theoretical assessment scores, practical skills operation assessment scores and various ability scores. When leaving the department, the theoretical assessment scores of the combined group and the mind mapping group were (89.74±4.18) points and (86.52±3.72) points, and the performance evaluation scores of practical skills were (90.04±4.86) points and (87.46±4.52) points, respectively. The theoretical evaluation scores and practical skills evaluation scores of the two groups were higher than those of the control group, and the combined group was higher than the mind mapping group, with statistically significant differences ( P<0.05). The scores of various abilities of the combined group and the mind mapping group were higher than those of the control group, and the scores of all indicators in the combined group were higher than those of the mind mapping group, with statistical significance ( P<0.05). The total teaching satisfaction of combined group and mind mapping group was higher than that of the control group, and the total teaching satisfaction of the combined group was higher than that of the mind mapping group. Conclusion:Mind mapping combined with continuous quality improvement has a significant effect on the teaching of gastroenterology interns, which can improve students' abilities and the teaching satisfaction.