Objective: To study the ecological suitability of Angelica sinensis growing in Gansu Province and guide the rational cultivation. Methods: Through visiting and field investigation, 1 545 batches of Chinese angelica samples were collected from the county areas in Gansu Province. The information about the longitude, latitude, altitude of each sampling point was collected by using the GPS, combining with national environmental factor data, and using Maxent model and spatial analysis function of ArcGIS software. Results: The areas with high suitability of A. sinensis distribution are in the southeast of Gansu Province. The main ecological factors affecting the suitability distribution of A. sinensis were altitude, rainfall in March, May and December, wettest month precipitation, soil pH and other ecological factors. Conclusion: The research findings are basically consistent with the living habits of A. sinensis that cultivated in high-cold mountain areas and plateau flat pasture areas with a cool climate, moderate soil, moisture, slightly acidic to neutral fertile and loose brown sandy loam soil. This result can provide scientific basis for the reasonable distribution of A. sinensis cultivation area in Gansu Province.

Objective To study the expressions of α1-AT and VEGF-C in human bronchoalveolarcarcinorrm, and the relation of the expression to the patholo~cM differentiation and clinical stage. Methods All 49 Darffin embedding samples of patients with bronchoalveolar carcinoma were studied. α1-AT and VEGF-C were detected by immunohistochemical SP method.Automated image analyzer was used to quantify α1-AT and VEGF-C expressions.Results The immunohistochemical positive stainings of α1-AT and VEGF-C in brown or dark brown were located in cytopla8m.The expression levels of α1-AT and VEGF-C were not related with the gender,age,tumor position and size,and histology subtypos(P＞0.05).It Was found that the expression of α1-AT in patients with local lymph node metastasis was significantly lower than those without node metastasis(P＜0.001).It was found that the expression of VEGF-C in patients with local node metastasis significantly higher than th08e without node metastasis(P＜0.001).There Was a negative correlation between the expression level of α1-AT and the expression level of VEGF-C in bronchoalveolar carcinoma(r=-0.324,P＜0.05).Conclusion α1-AT and VEGF-C could be secreted by bronehoalveolar carcinoma.Bronehoalveolar carcinoma with lower α1-AT expression and higher VEGF-C expression is more likely to have lymph node metastasis.Lower α1-AT expression and higher VEGF-C expression can participate in the mechanism of lymph node metastasis in carcinoma together.

Objective: To investigate the factors affecting macular degeneration (MD) in middle-aged and elderly populations, so as to provide the reference for prevention and treatment of MD. Methods: People at ages of 50 years and older who were admitted to ophthalmology department of Hangzhou First People's Hospital and received MD screening were selected as the study subjects. General information including age, gender, eye-using habits and family history of MD were collected by questionnaire surveys. MD was diagnosed by ophthalmological examination, and the prevalence of MD in middle-aged and elderly people was analyzed. A multivariable logistic regression model was used to identify the influencing factors of MD. Results: A total of 2 832 people were investigated, including 1 527 males (53.92%) and 1 305 females (46.08%), and 1 878 people (66.31%) aged 70 years and older. There were 498 people (17.58%) with good eye-using habits, 1 180 (41.67%) with general eye-using habits and 1 154 (40.75%) with poor eye-using habits. There were 1 817 people with family history of MD (64.16%). Multivariable logistic regression analysis showed that people at ages of 70 years and older (OR=2.815, 95%CI: 1.350-5.871), with poor eye-using habits (OR=2.354, 95%CI: 1.373-4.035), with family history of MD (OR=2.782, 95%CI: 1.138-6.799), with cataract (OR=2.593, 95%CI: 1.157-5.815) and with visual central defect (OR=2.601, 95%CI: 1.252-5.404) had a higher risk of MD. Conclusion Age, eye-using habits, family history of MD, cataract and visual central defect are influencing factors for MD in middle-aged and elderly populations.

Objective To explore the early-term efficacy of porous titanium trabecular metal acetabular (TTM) compo-nents produced by E-beam technology in total hip arthroplasty(THA). Methods From May 2012 to JUN 2013, nineteen primary THA patients (20 hips) were devided into observation group of porous TTM acetabular prosthesis produced by E-beam technology and control group of Pinnacle acetabular prosthesis. TTM group had nine patients (10 hips), including 7 males and 2 females, with the mean age of 61.0 years. Pinnacle group had ten patients (10 hips), including 6 males and 4 females, with the mean age of 58.6 years. The patients were followed up at the 6,12,24 weeks after operation. X-rays were taken at the follow-ups. Acetabular compo-nent stability and osseointegration were assessed through radiograph. Harris scores system,SF-36 Heath Survey Questionnaire and WOMAC Osteoarthritis index were recorded before and after operation to evaluate clinical effects of surgery. Results In TTM group, the Harris score improved from 48.2 ± 5.5 preoperatively to 89.5 ± 4.0 postoperatively, SF-36 scores from 329.1 ± 86.7 to 763.8 ± 15.1, and WOMAC index from 18.8 ± 11.0 to 1.3 ± 0.9. No cases suffered aseptic loosening and migration. After 24 weeks, There was no significant difference regarding Harris scores system,SF-36 Heath Survey Questionnaire and WOMAC Os-teoarthritis index between two groups. In TTM group, two hips had a radiolucent line postoperatively, which occurred in 2 and 3 zone. The lines were disappeared 24 weeks later. Conclusion In THA, the initial stability of TTM produced by E-beam tech-nology was fine, which can facilitate bone ingrowth in early stage. However, the long-term follow-up effect still needs to be con-firmed.

Background and purpose:This study investigated the value of cervical ultrasound and TSH-sup-pressed thyroglobulin in the diagnosis of recurrence or metastasis of differentiated thyroid carcinoma (DTC).Methods:This study analyzed the data on 196 thyroid carcinoma patients who underwent neck dissection after clinically sus-pecious recurrence of DTC in Peking Union Medical College Hospital from Aug. 2010 to Dec. 2014. Among the 196 patients, 62 patients sonographically suspecious recurrence after total thyroidectomy and/or radioactive iodine ablation therapy were enrolled in this study. The ultrasonic features of lymph node involvement were retrospectively analyzed. The value of the ultrasonic features in the diagnosis of lymph node involvement and a TSH-suppressed serum Tg level in the diagnosis of recurrence or metastasis of DTC was also evaluated.Results:Of the 62 patients, 59 were pathologi-cally conifrmed with lymph node involvement, 1 case with local recurrence and 2 cases without recurrence or metasta-sis. There were 121 ultrasonographically suspected lymph nodes, conifrmed by pathology, 92 were metastatic ltsions, 25 were non-metastatic, 3 were ifbrous tissue and 1 was striated muscle. The positive predictive rate of cyst, calciifcation or hyper-echogenicity in cortex was 100% in the diagnosis of lymph node involvement. There was a signiifcant difference in disordered vascularity and cyst in cortex between metastatic and non-metastatic lymph nodes. Forty-nine patients were positive for Tg, whereas 13 were negative. The accuracy, sensitivity and speciifcity of TSH-suppressed serum Tg in the diagnosis of recurrence or metastasis of DTC were 82.3%, 81.7% and 100%.Conclusion:The disordered vascularity and cyst in cortex of the lymph node are highly speciifc indexes in diagnosing lymph node involvement. TSH-suppressed serum Tg level has high diagnostic value for detection of recurrence or metastasis of DTC. Cervical ultrasound can identify recurrent or metastatic lesions in both Tg-positive and Tg-negative patients.

Objective To quantitatively assess the cardiopulmonary exercise function of spinal cord injury (SCI) patients and observe the effect of aerobic exercise on cardiopulmonary function, motor function and activities of daily living. Methods From December, 2014 to June, 2016, 34 incomplete SCI patients (ASIA C and D) and 23 healthy controls received cardiopulmonary exercise test (CPET). SCI pa-tients were randomly divided into conventional rehabilitation group (n=17) and aerobic exercise group (n=17). The aerobic exercise group received aerobic exercise for four weeks. They were assessed with CPET, motor and sensory function, walking index for spinal cord injury II (WISCI II) and spinal cord independence measure (SCIM) before and four weeks after training. Results Oxygen uptake (VO2)peak, anaerobic threshold (AT), metabolic equivalent of energy (METpeak), VO2/heart rate (HR)peak, respiratory exchange rate (RER)peak, minute ventilation (VE)peak, work rate (WR)peak and systolic blood pressure (SBP)peak were lower in the patients than in the controls (t>2.714, P<0.05). VO2peak、AT、METpeak、VO2/HRpeak、WRpeak increased in the aerobic exercise group after training (t>2.431, P<0.05). METpeak and WRpeak improved in the conventional rehabilitation group after training (t>3.282, P<0.01). The scores of motor in ASIA and SCIM improved in both groups after training (t>2.985, P<0.05). Conclusion The cardiopulmonary function decreased in incomplete SCI patients, which could be improved by moderate intensity aerobic exercise.

Objective To analyze the clinical value of continuous veno-venous hemofiltration (CVVH) treatment in children with severe hand-foot-and-mouth disease(HFMD) complicated with cardiopulmonary failure,via the prognostic comparison of the general comprehensive treatment and CVVH add-on treatment.Methods Fifty-one cases of severe HFMD with cardiopulmonary failure were divided into a CVVH group (n =19) and a control group(n =32) based on whether CVVH add-on or not.Their physiological and biochemical indicators were recorded and pediatric critical illness score (PCIS) and pediatric risk of mortality score (PRISM Ⅲ) were calculated within 24 hours,when they were diagnosed with neurogenic pulmonary edema (NPE)/pulmonary hemorrhage.Both groups were treated with endotracheal intubation,mechanical ventilation with high PEEP,corticosteroids,ulinastatin,actively lowering the intracranial pressure,fluid resuscitation,milrinone,dopamine and other vasoactive drugs,high-dose intravenous gamma globulin,the CVVH group were added with CVVH treatment(duration ＞ 12 h).Prognosis difference of CVVH add-on treatment after diagnosed with NPE/pulmonary hemorrhage by tracking indicators of the third day.Survival analysis between two groups were compared by 3-day survival rates,7-day survival rates,28-day survival rates and the finally survival rates.Results (1) The overall conditions of two groups were comparable when diagnosed with NPE/pulmonary hemorrhage.PCIS,PRISM Ⅲ,WBC counting,lactic acid,micro-blood sugar,myocardial enzymes and liver enzymes showed no significant difference between two groups.Three days after treatment,WBC and lactic acid decreased,but there was no significant difference (P ＞ 0.05),the remaining indicators had significantly improved in the CVVH group than those in the control group (P ＜ 0.05).(2) The 3-day survival rate,7-day survival rate,28-day survival rate and the finally survival rates in control group and CVVH group were 40.63 ％ vs.84.21％,37.50％ vs.73.68％,25.00％ vs.63.16％,18.75％vs.52.63％,the survival rate in CVVH group were significantly higher(P ＜0.05).(3)The survival curve indicated that the survival time of CVVH group was significantly longer than that of the control group,the median survival time were 17 d and 2 d,respectively,and the difference was statistically significant (P ＜ 0.05).(4)In the CVVH group,15 cases received CVVH after diagnosed with NPE/pulmonary hemorrhage within 12 hours,of which 10 cases(66.67％) ultimately survived,while the other 4 cases received CVVH after 12 h were all end to death,the difference was statistically significant(P ＜ 0.05).Further analysis of the impact of the timing of blood purification on the prognosis of children showed that the mortality rates of children received CVVH within 6 hours,6 to 12 hours,after 12 hours of diagnosis of NPE/pulmonary hemorrhage,were 2/8,3/7,4/4,respectively.Conclusion Continuous hemofiltration can significantly improve the prognosis of children with severe HFMD,and may be preferable to perform in early stage.

Objective To investigate the effects of bamboo leaf extract on the malignant growth of human breast cancer MCF-7 cells under hypoxic microenvironment and the molecular mechanism .Methods Cultured human breast cancer MCF-7 cells were randomized into six groups :control group , hypoxia group ,0 .2 μg/mL bamboo leaf extract group ,0 .4μg/mL bamboo leaf extract group ,0 .8μg/mL bamboo leaf extract group and 0 .8μg/mL bamboo leaf extract group treated with IGF-1 .The cell proliferation activity in each group was determined using cell counting Kit-8 (CCK-8) assay .The expressions of proliferation markers PCNA ,Ki-67 and CCK-8 MCM2 in MCF-7 cells were detected by RT-PCR and Western blot .Flow cytometer was used to analyze the cell cycle arrest and cell apoptosis .The protein expressions of Bax ,Bcl-2 ,caspase-3 and survivin were measured by Western blot . Furthermore ,the effect of Akt/HIF-1αpathway underlying bamboo leaf extract-mediated inhibition on cancer cell growth was also explored .Results After treatment with bamboo leaf extract ,cell proliferation activity and the expressions of PCNA ,Ki-67 and MCM2 under hypoxia were obviously inhibited in a dose-dependent manner ( P<0 .01) . The proportion of MCF-7 cells upon hypoxia in the G2/M phase of the cell cycle was increased after treatment with bamboo leaf extract (P<0 .01) .The apoptosis rate of MCF-7 cells was enhanced after bamboo leaf extract stimulation ,accompanied with an increased protein levels of Bax and caspase-3 ,and decreased expressions of Bcl-2 and survivin (both P< 0 .01) .Moreover ,bamboo leaf extract down-regulated the expressions of p-Akt and HIF-1αin MCF-7 cells under hypoxia .IGF-1 ,an Akt/HIF-1α pathway agonist ,reversed the inhibiting effect of bamboo leaf extract on the malignant growth of MCF-7 cells under hypoxia .Conclusion Bamboo leaf extract inhibits the malignant growth of human breast cancer MCF-7 cells by suppressing the Akt/HIF-1αsignaling pathway under hypoxic microenvironment .

Objective:To investigate the effects of oxymatrine(OM)on the apoptosis of human hepatoma HepG2 cells and its possible mechanisms.Methods:HepG2 cells were treated with different concentrations of OM.The proliferation inhibition was measured by MTT assay and the apoptosis of HepG2 cells were examined by Hochest staining method.Flow cytometry was used to analyze the cell cycle distribution and apoptosis rate.The expression of caspase-3,Bcl-2,Bcl-x_L and Bax proteins was assayed by Western blotting assay.Results:OM inhibited HepG2 cells growth in a time-and dose-dependent manner.After treatment with OM for 24 hours,some cells appeared typical apoptotic characteristics and the apoptosis rate was increased. Treatment with OM also increased caspase-3 activity and Bax expression in HepG2 cells,and decreased the expression levels of Bcl-2 and Bcl-x_L.Conclusion:OM can induce HepG2 cell apoptosis,which may be related to the down-regulation of PI3K/Akt signal pathway,suppression of Bcl-2 and Bcl-x_L activity,and activation of caspase-3.

Objective To find out and describe the feeling of the family members who wag taking care of the patients undergoing renal transplantation in order to provide proper psychological support by medical professionals.Methods 11 family members were interviewed by opened questionnaires,and the data were collected and analyzed.Results The data of characteristic feeling and pressure were obtained from family numbers.Conclusions There is a need for extensive and persistent support to the family members,and the nurses should take characteristic nursing measures to help and guide the patients and their family members in order to improve the life quality.