Objective To observe the effect of Dachengqi decoction combined with β-aescine on pulmonary function in patients with acute lung injury (ALI) after chest trauma.Methods Ninety-five patients with ALI after chest trauma admitted to the Department of Thoracic Cardiothoracic Surgery of Dingxi People's Hospital of Gansu from April 2013 to May 2016 were enrolled, and they were divided into a Dachengqi decoction group (47 patients) and a control group (48 patients) by random number table. The control group patients were treated with conventional therapy and β-aescine 0.4 mg/kg+ 10% Glucose (250 mL) intravenous drip, while the Dachengqi decoction group patients were additionally treated with Dachengqi decoction on the treatment of the control group (rhubarb 12 g, magnolia officinalis 24 g, fructus aurantii immaturus 12 g, mirabilite 9 g), one dose daily, taken twice in a day, once in the morning and once in the evening orally, both groups were treated for one week. Before and after treatment, the changes of esophageal pressure, respiratory dynamics, the indexes of pulmonary function and blood gas analysis were observed. Results Compared with those before treatment, the levels of plateau pressure (Pplat), mean airway pressure (mPaw), airway resistance (Raw) and arterial partial pressure of carbon dioxide (PaCO2) of the two groups after treatment were significantly reduced, but the levels of lower esophageal sphincter pressure (LESP), peak airway pressure (PIP), the first second forced expiratory volume (FEV1), forced vital capacity (FVC), peak expiratory flow rate (PEF), the mean maximum expiratory flow (MMEF), pulse oxygen saturation (SpO2), arterial partial pressure of oxygen (PaO2), oxygenation index (PaO2/FiO2) were all increased significantly; the changes of the above indexes in the Dachengqi decoction group were more significant than those in the control group [LESP (mmHg, 1 mmHg = 0.133 kPa):18.64±2.79 vs. 15.46±3.09, Pplat (cmH2O, 1 cmH2O = 0.098 kPa): 14.27±1.68 vs. 16.00±1.87, PIP (cmH2O): 40.23±5.03 vs. 32.19±4.45, mPaw (cmH2O): 8.57±0.67 vs. 9.41±1.23, Raw (cmH2O·L-1·s-1): 6.76±1.01 vs. 9.31±1.43, FEV1 (L): 1.73±0.27 vs. 1.46±0.25, FVC: (3.95±0.51)% vs. (3.30±0.46)%, PEF (L/s): 3.81±0.47 vs. 3.11±0.38, MMEF (L/s): 0.93±0.16 vs. 0.77±0.12, SpO2: 0.96±0.06 vs. 0.91±0.05, PaO2 (mmHg): 97.82±10.13 vs. 74.73±8.02, PaCO2 (mmHg): 36.49±4.28 vs. 47.13±5.46, PaO2/FiO2 (mmHg): 362.47±20.82 vs. 259.79±17.61, allP < 0.05]. Conclusion Dachengqi decoction combined with β-aescine can reduce the respiratory intensity of patients with ALI after chest trauma and improve the lung function and blood oxygen level.

Objective To observe the therapeutic effects and side effects of FLAG regimen(fludarabine, Ara-C, and granulocyte-colony stimulating factor( C-CSF) for refractory or relapsed acute myeloid leukemia( AML). Methods Twenty-six AML were treated with fludarabine plus intermediate-dose Ara-C and G-CSF,of whom 15 cases belonged to refractory and 11 cases belonged to relapsed. Results After two courses of treatment, 14 cases were completely relieved (53. 8% ) and 5 cases were partially relieved (19.2% ). The overall effective rates was 73.1%. The main side effects were severe myelosuppression and non-hematological toxicity was mild. Conclusion FLAG regimen was very effective for refractory or relapsed acute myeloid leukemia and was well tolerated. The treatment-related mortality rate was low,so it provided a treatment choice for these patients.

Leptin,the product of the obese gene,is a protein produced and secreted primarily by adipose tissue.Leptin initiates several biological effects by binding to its receptors.Many studies have shown that leptin can reduce fat accumulation,but its mechanism is still unclear.This article reviewed the effects of leptin on lipogenesis,and especially on proliferation and differentiation of preadipocytes.

ObjectiveTo evaluate the characteristics,treatment and prognosis of metachronous bilateral primary breast cancer(mBPBC). MethodsClinical materials of 48 patients were performed with retrospective study. ResultsIn 48 patients,43 cases taken both sides modified radical mastectomy and 5 cases taken lumpectomy and axillary dissection in the second side.All patients were treated with chemical treatment and treated with radiotherapy in accordance with lymph node metastasis.Besides a part of patients were treated with endocrine therapy in accordance with the expression of estrogen receptor(ER)and progesterone receptor(PR).The follow-up time was 6 ～ 48 months and the average time was 21.9 months.No died and 5 cases found distant metastasis. ConclusionmBPBC should be diagnosed earlier,taken appropriate treatment and followed up actively,so it would have a better therapeutic effect.

This paper introduces the current status of Chinese medical device testing and inspection institutes. There are 53 such institutions, including 10 national institutions. Medical device testing and inspection institutions service in government regulation and supervision of medical devices, playing a technique support role for medical devices from registration before appear on market to monitor and supervision after listing. Meanwhile, they are important practitioners of medical devices standardization work. Finally, put forward the current problems and countermeasures of the inspection institutes in order to facilitate the sustainable development of our national medical equipment.
China ; Equipment and Supplies ; standards ; Health Systems Agencies ; Reference Standards

OBJECTIVE:To compare the efficacy and safety of desloratadine citrate disodium and acrivastine decremental thera-py in the treatment of chronic urticaria. METHODS:132 patients with chronic urticaria were randomly divided into group A(62 cases)and group B(70 cases). Group A was orally given 8.8 mg Desloratadine citrate disodium tablet in 12 2 weeks,once a day;8.8 mg in 3-4 weeks,once every 2 days;8.8 mg in 5-6 weeks,once every 3 days;8.8 mg in 7-8 weeks,once every 4 days;and 8.8 mg in 9-10 weeks,once every 5 days. Group B was orally given 8 mg Acrivastine capsule in 12 2 weeks,3 times a day;8 mg in 3-4 weeks,twice a day;8 mg in 5-6 weeks,once a day;8 mg in 7-8 weeks,once every 2 days;and 8 mg in 9-10 weeks, once every 3 days. The treatment course for both groups was 10 weeks. Clinical efficacy,and plasma histamine levels and total scores of signs and symptoms before and after treatment in 2 groups were observed,and recurrence and incidence of adverse reac-tions after 4 weeks of stopping drugs in 2 groups were followed-up. RESULTS:There were no significant difference in the total ef-fective rate and incidence of adverse reactions between 2 groups(P>0.05). After treatment,the total scores of signs and symptoms in 2 groups were significantly lower than before,the difference was statistically significant(P<0.01),and there was no significant difference between 2 groups(P>0.05). The recurrence rate in group A was significantly lower than group B,the difference was sta-tistically significant(P<0.05). CONCLUSIONS:Both efficacy and safety of desloratadine citrate disodium and acrivastine decre-mental therapy in the treatment of chronic urticaria are good,however,desloratadine citrate disodium is better than acrivastine in re-ducing recurrence rate.

OBJECTIVE:To study the immunosuppressive chemical constituents from the n-butanol extract of the debark root of Tripterygium wilfordii hook.f.METHODS:Several compounds were isolated from the n-butanol extract by columns of silica gels and Sephadex LH-20,their structures were identified by NMR,MS spectral analysis and comparing with standard substances on TLC,and the immunosuppressive activity was determined.RESULTS:One of the compounds was identified as emodin,an anthraquinone,it had marked immunosuppressive effect on animal.CONCLUSION:Emodin is obtained from the plants of Tripterygium wilfordii hook.f.for the first time.

Objective To observe the effects of leptin on the proliferation and differentiation of human preadipocyte in vitro, and to explore the possible mechanism of the generation of obesity regulated by leptin. Methods The human preadipocytes were isolated from human subcutaneous adipose tissue of abdomen and cultured in vitro. The effects of leptin (0-1 000 ng/ml) on the proliferation, lipid accumulation and the mRNA expression of PPAR-γ2 and C/EBP-α, which are the differentiation and transcription factor of human preadipocyte, were analyzed by the methods of MTT, cell counting, extracting stained intracytoplasmic lipid with oil red O and RT-PCR. Results Leptin (1 000 ng/ml) could stimulate the proliferation, lipid accumulation and the mRNA expression of PPAR-γ2 and C/EBP-α (P<0. 05). There were not obvious effects on the proliferation and lipid accumulation in the groups of lower (10 ng/ml) and common (100 ng/ml) concentration (P>0. 05). Conclusion Leptin in higher concentration can stimulate the proliferation and differentiation of preadipocye in vitro, which indicates that leptin may regulate the generation of obesity through acting on the proliferation and differentiation of preadipocyte at the pathologic state of leptin resistance and high leptin concentration in serum.

Objective To study the combination treatment of lfexible/lfexible sheath and rigid ureteroscopic lithotripsy (F-ul) for upper and middle ureteral stones. Methods The clinical data of patients diagnosed of upper and middle ureteral stones were collected. The treated group (110 cases):ifrstly treated with rigid ureteroscopic lithotripsy to broke and removed stones through lfexible sheath, then the lfexible ureteroscopic lithotripsy was used to broke and removed stones through lfexible sheath;The control group (110 cases):traditional operation for ureter calculi. The clinical data was compared between the two groups. Results The effective ratio of treatment group is 90.0%, which was better than that of control group (87.3%) (P>0.05). The operation time, stone processing time of treatment group were signiifcantly shorter than those of control group (P<0.05), and F-ul using time was signiifcantly much more (P<0.05). The hospitalization time and complication rate were no signiifcantly difference between the two groups (P> 0.05). Conclusion The method of combining flexible/flexible sheath and rigid ureteroscopic lithotripsy for upper and middle ureteral stones was better than that of traditional operation, which worth to be popularize in clincal treatment.

Objective To analyze clinicopathologic features and treatment strategy of postsurgical incidental papillary thyroid microcarcinoma(PTMC).Methods A total of 305 patients undergoing surgery for thyroid diseases from Apr.2012 to Mar.2013 were retrospectively analyzed.Results Among the 305 patients,19 patients(18 females and 1 male)showed PTMC incidentally after surgery.The mean age was (43.2 ± 12.8)years (ranging from 23 to 67 years old).All patients underwent subtotal thyroidectomy,including 17 endoscopic surgery and 2 open surgery.All frozen sections were benign during operation while pathologic results were PTMC after surgery.The average size of tumors was(2.2 ± 1.5) mm which all was unicentric with no lymph node enlargement intraoperatively.Immunohistochemistry showed that the positive rate of cytokeratin 19,galectin-3,mesothelial cell,and CD56 was 87.5％,43.8％,81.3％ and 18.8％,respectively.There were 4 cases of B-raf V600E mutation found in 6 patients.All patients discharged 1 to 3 days after surgical treatment with no complication and received levothyroxine therapy with a suppressive dose of thyrotropin(TSH).131I therapy was not given.Conclusions PTMC is found more common in female and younger age under 45 years.Tumor is usually unicentric and less than 5 mm.Lymph node metastasis is rare.Immunohistochemistry and B-raf V600E mutant test can help the diagnosis.Initial endoscopic subtotal thyroidectomy is effective.There is no need of further surgery and 131I therapy.