OBJECTIVE:To analyze the clinical application and trend of antitumor drugs in 42 hospitals from Beijing,Shang-hai and Chengdu,and to provide reference for rational drug use in clinic. METHODS:The utilization of antitumor drugs in 42 hos-pitals from Beijing,Shanghai and Chengdu during 2012-2016 was analyzed statistically in respects of consumption sum,DDDs. RESULTS:The consumption sum of antitumor drugs in 3 cities,Beijing ranked the first;annual growth rate of Shanghai was the highest. In the list of consumption sum of antitumor drugs of 3 cities in 5 years,immunosuppressive agents as tacrolimus,mycophe-nolate mofetil were among top 10 antitumor drugs in the list of consumption sum. Top 1 antitumor drug in the list of consumption sum in Beijing,Shanghai and Chengdu were thymopentin,tacrolimus and thymalfasin,respectively. Among subtype of antitumor drugs,other antitumor drugs and adjuvant drugs in Beijing and Chengdu during 2012-2014 took up the first place in the list of con-sumption sum;the consumption sum of antimetabolite during 2015-2016 occupied the first place,and that of Beijing was higher than that of Chengdu. The cost of antimetabolite in Shanghai during 2012-2016 was the highest. The consumption sum of other antitumor drugs and adjuvant drugs were the highest in 3 cities during 2012-2014;that of antimetabolite was the highest during 2015-2016. Among related drugs,immune enhancer,immunosuppressive agents and analgesics ranked the top in the list of consumption sum. Among top 10 antitumor drugs in the list of DDDs,most were antineoplastic medicine,and only cyclophosphamide among alkylat-ing agents entered the ranking. CONCLUSIONS:The growing trend of antitumor concumption sum is stable. Antimetabolite,hor-mones and plant-derived antitumor are becoming larger. Molecular targeted therapies have a good prospect for application.

In order to obtain the present effective prestress and its longitudinal distribution of prestressed tendon during the process of inspection and evaluation, a unified analogue method was put forward. Based on the theory for calculating instantaneous prestress loss of the tendons with complicated geometry, a universal numerical model was established. Therefore, the distribution of effective prestress could be simulated after recognizing the nominal coefficients of prestress loss with the obtained stress data of objective steel tendon. The numerical simulation results of a full-length tendon of a three-span continuous beam bridge show that the relative errors between the calculated value and the value in the code are within 5%, which meets the requirement for engineering application.

Objective To investigate the tissue distribution character of cinobufagin in in vivo in rats,in order to provide some references for rational drug use in the clinic.Methods Two kinds of solutions of cinobufagin were given to rats(0.5 and 1 mg/kg) by sublingual iv injection.The cinobufagin concentration in rat tissues corresponding to different time-point was determinated by HPLC.The biological samples of the different tissuses were performed by liquid-liquid extraction method.Results Cinobufagin distributed rapidly to tissue after sublingual iv injection.At 30 min cinobufagin in eight tissues except fat was detected.At 60 min the concentration in a majority of tissue achieved the peak value and liver′s was tiptop.When the concentration of cinobufagin increased by gemination,the time of reaching peak value had no change.Only the concentration of cinobufagin increased slightly corresponding to the time-point.Conclusion The distribution of cinobufagin in tissues of rats is extensive.Both the absorption and elimination of cinbufagin are quick and up to the top concentration in brain tissue.

AIM:To directly differentiate the induced pluripotent stem cells (IPS cells) into hepatocytes in chemically-defined,monolayer conditions in vitro. METHODS:Based on the knowledge of mammalian hepatic development,we differentiated the IPS cells into hepatic lineage efficiently. The present study involves stepwise transition of IPS cells through a series of media designs to first specify cells towards anterior definitive endoderm,and secondly,to induce hepatic maturation. RESULTS:The IPS cells recapitulated the development of liver in vivo at RNA and protein level. Realtime PCR analysis was performed on cell preparations at various times during the culture process to determine the time course and degree to which the IPS cells differentiated toward a hepatocyte phenotype. Analysis included markers for endoderm-specific gene expression (Sox17; FoxA2,CXCR4),hepatocytespecific gene expression (albumin and AFP),and markers for undifferentiated IPS cells (OCT4 and Nanog). The endodermspecific gene expression increased early while the expression of OCT4 and Nanog decreased and hepatocytespecific gene expression progressively increased over the course of the differentiation program. The resultant hepatocytelike cells(HLCs) showed phenotypic similarities with adult hepatocytes (expressing AFP and albumin) and additionally showed functionality expected to welldifferentiated hepatocytes such as indocyanine green(ICG) uptake and release. The P450 activity of cytochromsome was also positive. CONCLUSION:We successfully construct the IPS cells which efficiently differentiate into hepatocytes and recapitulate the hepatocytic development in vivo. The reproducible and efficient generation of HLCs from IPS cells represents a critical step towards the ultimate goal of producing functional HLCs for clinical use including cell transplantation or bioartificial liver support. Moreover,our system provide a valid way to study the liver development since it is monolayer,serumfree and mimic the in vivo liver development.

Objective To evaluate the follow-up diagnostic value of 3 T magnetic resonance angiography (MRA) after intracranial aneurysm coil embolization.Methods The databases such as PubMed,EMbase,Cochrane Library,CBM,CNKI and VIP were retrieved.According to the inclusion criteria of diagnostic tests,the diagnostic tests of the follow-up diagnostic value about MRA were screened after intracranial aneurysm coil embolization.The methodological quality included in the studies was evaluated using QUADAS items and the meta-analysis was conducted using Meta-Disc 1.4 software.The receiver operating characteristic curve was drawn and the area under the curve was calculated.The residual sensitivity and specificity diagnosed by MRA after intracranial aneurysm embolization were evaluated.Results A total of 6 studies were included,including 253 patients.The pooled sensitivity and specificity in 3 T MRA diagnosing residual intracranial aneurysms were 0.915 (95％ confidence interval [ CI]0.850 - 0.959) and 0.847 (95％ CI 0.787 - 0.896) respectively.The area under the receiver operating characteristic curve was 0.951,Q =0.892.Conclusions 3 T TOF MRA can be used as an effective and feasible imaging follow-up method after embolization of intracranial aneurysms,however,because of the methodological limitations,the high-quality research is needed to further validate the application value of the MRA during follow-up after intracranial aneurysm embolization.

OBJECTIVETo analyze the effect of Chinese herbs used by Prof. LI Tao on peripheral blood T subsets in treating multiple sclerosis (MS) by using association rules and statistical methods, thereby providing evidence for optimizing prescriptions.

METHODSData of MS inpatients and outpatients recorded by data collecting system, Xiyuan Hospital, China Academy of Chinese Medical Sciences were resorted. The relationship between Chinese herbs and T cell subsets were analyzed using SPSS17.0 and Aprior module in SPSS Clementine 12.0.

RESULTSRadix bupleuri, Radix Paeoniae alba, Fructus Aurantii, Atractylodes, and Radix Glycyrrhizae were most commonly used herbal combinations.Radix Aconiti lateralis preparata and Rhizoma Smilacis glabrae were often added. Radix Aconiti lateralis preparata was associated with decreased Th1 cells (confidence level 83.78%, supportive level 36.26%). Decreased Th1 cell was associated with Radix Aconiti lateralis preparata (confidence level 71.26%, supportive level 36.26%).Radix Aconiti lateralis preparata was obviously associated with decreased Th1 cells. Radix Bupleuri, Radix Paeoniae alba, bitter orange, Atractylodes , Radix glycyrrhizae, and Radix Aconiti lateralis preparata could reduce peripheral blood Th1 subsets of MS patients and elevate Th2 subsets (all P < 0.01).

CONCLUSIONSThe herbal combination of Radix Bupleuri, Radix Paeoniae alba, Fructus Aurantii, Atractylodes, Radix Glycyrrhizae, Rhizoma Smilacis glabrae, and Radix Aconiti lateralis preparata could lower peripheral blood Th1 cells and elevate Th2 cells, and prevent the relapse of MS possibly by reducing Th1 cells and elevating Th2 cells. Especially Radix Aconiti lateralis preparata played important roles in aforesaid changes of Th1 and Th2.

Aconitum ; chemistry ; Atractylodes ; chemistry ; Bupleurum ; chemistry ; China ; Drugs, Chinese Herbal ; therapeutic use ; Fruit ; chemistry ; Glycyrrhiza ; chemistry ; Humans ; Multiple Sclerosis ; therapy ; Paeonia ; chemistry ; Plant Roots ; chemistry ; Rhizome ; chemistry ; Smilacaceae ; chemistry ; T-Lymphocyte Subsets ; drug effects

Objective To study the value of helical multi-phase contrast scanning in the preoperative evaluation of cholangiocarcinoma hilar.Methods Pre-and post-contrast CT scanning of upper abdomen were performed in 26 cases with hepatic portal cholangiocarcinoma.Arterial phase scan of the whole liver began at 30 s after initial injection of contrast medium and the portal venous phase scan started at 70 s.15 of 26 cases underwent additional delayed phase scans began at 3~4 min.Thin thickness(3~5 mm)scanning of hepatic portal was used in each post-contrast phase scanning.The location,size,enhancement patterns of the lesions and the extent of the tumor involvement were observed and surgical resecetability was evaluated.Results All of 26 lesions were detected in helical multi-phase contrast scanning. 16 lesions enhanced on the arterial phase. On the portal venous phase, all lesions were enhanced and marked enhancement was seen in 19 lesions. Prolonged enhancement was seen in 15 lesions on the delayed phase scanning. The accuracy of evaluating surgical respectability was 84.62%. Conclusion Multi-phase contrast scanning combined with thin thickness scanning can demonstrate obviously the location and enhanced patterns of hepatic portal cholangiocarcinoma, the accuracy in evaluating surgical respectability is improved, and it is helpful in choosing the preoperative treatment program and assessing the prognosis.

This article analyzed the types and causes of clinical research misconduct including the definition and background.We then set up the research management system to control and prevent such misconduct behavior.Our strategy includes using various technical tools to actively carry out clinical research integrity related education and training program,establishing integrated control model,and clinical research misconduct handling mechanism to jointly cope with the problems,to promote a good atmosphere for clinical research and to establish the integrity of the research.Our goal is to promote the medical technology development and to improve the patient care.

The high incidence of postoperative recurrence of hepatocellular carcinoma ( HCC) is a most difficult obstacle for improving the prognosis of patients.Several adjuvant modalities have been developed to prevent recurrence in patients after surgery; nevertheless , there is no consensus regarding the standardized adjuvant therapy in terms of indications , clinical efficacy and interactions.In this article we review the currently available evidence in the medical literature on adjuvant therapy in HCC after radical resection.