AIM: To observe the curative effect of Angong Niuhuang Bolus on diffuse axonal injury(DAI) prognosis. METHODS: 30 cases of DAI treated with Angong Niuhuang Bolus in addition to conventional modern therapy as treatment group,another 30 cases with modern therapy only as control group,the curative effect of Angong Niuhuang Bolus on DAI was observed and analyzed through the comparisons of GCS,clinical effectiveness and death rate. RESULTS: GCS of treatment group was higher than that of the control group(P

Objective: To explore the effect of Qishen-Xiaodian Decoction combined with laser acupoint irradiation on oxidative stress and renal function on children with recurrent henoch schonlein purpura (HSP). Methods: A total of 120 children with recurrent HSP in the dermatology department clinic of Hospital of Xinle City from January 2015 to November 2017 were divided into two groups according to the random number table method, with 60 cases in each group. The control group took loratadine, Troxerutin and vitamin C orally, while the treatment group took Chinese medicine combined with laser acupoint irradiation based onthe control group. Drugs were taken orally for 4 weeks, laser acupoint irradiation treatment for 2 weeks. The level of glutathione peroxidase (GSH-Px) in plasma was detected by ELISA, the levels of MDA and SOD in plasma were detected by thiobarbituric acid colorimetry and hydroxylamine method, the level of IgG, micro albumin (Alb), β2-microglobulin (β2-MG) in urine were detected by radioimmunoassay, and the clinical effect was evaluated. The recurrence was recorded. Results: After treatment, the plasma GSH-Px (90.45 ± 15.36 μmol/L vs. 81.62 ± 13.68 μmol/L, t=3.318), SOD (99.64 ± 18.66 IU/ml vs. 84.21 ± 16.73 IU/ml, t=4.769) in the treatment group were significantly higher than the control group (P<0.01); the MDA (5.58 ± 1.31 μmol/L vs. 4.37 ± 1.36 μmol/L, t=4.964) was significantly lower than the control group (P<0.01); the ratio of urine IgG (3.48 ± 0.95 mg/L vs. 6.56 ± 1.47 mg/L, t=13.630), Alb (7.80 ± 2.94 mg/L vs. 12.73 ± 4.26 mg/L, t=7.378), β2-MG (4.02 ± 1.61 mg/L vs. 6.95 ± 2.10 mg/L, t=8.577) were significantly lower than those of the control group (P<0.01). The total effective rate was 95.0% (57/60) in the treatment group and 80.0% (48/60) in the control group. There was statistically significant difference between two groups (χ²=6.171, P=0.013). Follow-up of 6 and 12 months, the recurrence rate of the treatment group were significantly lower than that of the control group (χ² value were 4.931, 4.574, P<0.05). Conclusions Qishen-Xiaodian Decoction combined with laser acupoint irradiation can improve the oxidative stress of children with recurrent HSP, protect the renal function, improve the clinical efficacy and reduce the recurrence rate.

The article reviewed the current status, reform measures and progress of the tiered medical services in Zhejiang province, and analyzed main roadblocks in such a system.Proposals made in the paper include such reform measures as further expanding quality medical resources of better talents and equipments to enhance primary medical institutions;forming the gatekeeper practice featuring firstvisit at community health centers with enhanced primary capabilities;insisting on joint reform of medical treatment, medical insurance and drugs, promoting the development of tiered medical services and utilization efficiency of medical resources in the province.

Covered in the paper are the policies and progress of the county-level public hospital reform in the province,and a summarized analysis of the self-appraisal reports and hospital reform statements submitted by the health authorities and up to 300 hospitals in 79 counties of the province.As found in the papers,the ongoing reform in Zhejiang is focused on reforming the business models in place,seeking breakthroughs from the zero mark-up policy on drug sales,in addition to such policies as reducing drug costs,adjusting medical service pricing,financial subsidies,and medical insurance payment reforms.Despite the initial success,further policy studies are needed in terms of internal management,upper and lower linkage,and personnel incentives.

With the current accumulation of metagenome data, it is possible to build an integrated platform for processing of rigorously selected metagenomic samples (also referred as "metagenomic communities" here) of interests. Any metagenomic samples could then be searched against this database to find the most similar sample(s). However, on one hand, current databases with a large number of metagenomic samples mostly serve as data repositories but not well annotated database, and only offer few functions for analysis. On the other hand, the few available methods to measure the similarity of metagenomic data could only compare a few pre-defined set of metagenome. It has long been intriguing scientists to effectively calculate similarities between microbial communities in a large repository, to examine how similar these samples are and to find the correlation of the meta-information of these samples. In this work we propose a novel system, Meta-Mesh, which includes a metagenomic database and its companion analysis platform that could systematically and efficiently analyze, compare and search similar metagenomic samples. In the database part, we have collected more than 7 000 high quality and well annotated metagenomic samples from the public domain and in-house facilities. The analysis platform supplies a list of online tools which could accept metagenomic samples, build taxonomical annotations, compare sample in multiple angle, and then search for similar samples against its database by a fast indexing strategy and scoring function. We also used case studies of "database search for identification" and "samples clustering based on similarity matrix" using human-associated habitat samples to demonstrate the performance of Meta-Mesh in metagenomic analysis. Therefore, Meta-Mesh would serve as a database and data analysis system to quickly parse and identify similar
Cluster Analysis ; Computational Biology ; methods ; Databases, Genetic ; Humans ; Metagenome ; Metagenomics ; methods

The paper covered the initial success of Zhejiang province in furthering its development of a basic healthcare system in alignment of social and economic growth. Such progress has been achieved by adhering to the principles of coordinated arrangement,highlighting key points and step-by-step progress. Also presented are the methods and experiences of the province in its reform and perspectives for furthering the ongoing reform.

PURPOSE: Estrogen receptor (ER) and progesterone receptor (PR) have been used as indicators of endocrine system status since the mid-1970s in the clinical management of breast cancer. The predictive role of ER in endocrine therapy is undisputed, but the prognostic value of PR is still debated. The aim of this study was to investigate the clinical characteristics and prognosis of ER positive breast cancer with different PR expression levels. METHODS: A population cohort of 3,030 primary invasive ER positive breast cancer patients from a single cancer center underwent surgery and received adjuvant endocrine therapy from 2004 to 2010. The clinical and biological features of these patients with high PR-expressing tumors were compared with those of patients with low PR-expressing tumors. The follow-up data for disease-free survival (DFS), overall survival (OS), and breast cancer specific survival (BCSS) was obtained from 2,778 patients. Cox regression analysis was used to correlate biomarkers and tumor characteristics with DFS, OS, and BCSS. RESULTS: Tumors with low PR expression had more invasive pathological features and biological indexes than those with high PR expression. Low PR expression was an independent poor prognostic factor for DFS (p=0.014; hazard ratio [HR], 0.781; 95% confidence interval [CI], 0.641–0.950), OS (p=0.002; HR, 0.699; 95% CI, 0.560–0.873), and BCSS (p=0.005; HR, 0.714; 95% CI, 0.566–0.902). Furthermore, in low PR expressing tumors, patients who received chemotherapy had better DFS (p=0.002; HR, 0.449; 95% CI, 0.268–0.751), OS (p<0.001; HR, 0.341; 95% CI, 0.192–0.606), and BCSS (p<0.001; HR, 0.292; 95% CI, 0.156–0.549) than patients who did not received chemotherapy. CONCLUSION: Patients with ER positive invasive breast cancer with low PR expressing tumors have a worse prognosis than those with high PR expressing tumors, and these patients can benefit from chemotherapy.
Asian Continental Ancestry Group* ; Biomarkers ; Breast Neoplasms* ; Breast* ; Cohort Studies ; Disease-Free Survival ; Drug Therapy ; Endocrine System ; Estrogens* ; Follow-Up Studies ; Humans ; Progesterone* ; Prognosis ; Receptors, Progesterone* ; Tamoxifen

Objective To discuss the value of early prediction and evaluation using ultrasound-guided diffuse optical tomography (US-guided DOT) of neoadjuvant chemotherapy (NCT) for breast cancer.Methods Sixty-two primary breast cancer patients were included.Before every neoadjuvant chemotherapy and surgery,the total hemoglobin concentration(Hb) was measured by US-guided DOT.According to the RECIST 1.1 standard,62 patients were divided into partial response (PR) group,complete response (CR) group,progressive disease(PD) group and stable disease(SD) group.According to the Miller and Payne (MP) grading system,the patients were divided into poor efficacy group(MP grade 1-3) and the effect of excellent group (MP grade 4-5).According to the postoperative pathological results,patients were divided into pathologic complete response(pCR) group and non pCR group.Hb with imaging and postoperative pathological results were analyzed.Results All of the 62 patients finished the NCT.After first cycle of chemotherapy and all chemotherapy,the value of Hb in the above groups had different degrees of decline,and the difference among the groups was statistically significant(P ＜0.001).When the descending value of Hb was 44.5 as the threshold for early prediction of NCT efficiency,the area under the curve of ROC (Az) was 0.745,and the sensitivity was 75.0％,specificity was 73.1％,positive predictive value was 79.4％,negative predictive value was 67.9％,and accuracy was 74.2％,respectively.Conclusions In the process of neoadjuvant chemotherapy of breast cancer,the decrease of Hb value is positively related to the therapeutic effect of chemotherapy.The change of Hb value can predict and evaluate the efficacy of neoadjuvant chemotherapy in the early time.

Objective In order to understand the chondrogenesis differentiation of mesenchymal stem cells in either hydrogel or pellet culture,we applied the two methods and reveal the possible mechanism and for further investigation.Methods In C3H10T1/2 chondrogenic differentiation,we apply extracellular matrix hydrogel mixed the cell suspensions of freshly prepared (including scaling chondroitin sulfate,sodium hyaluronate synthesis and cross-linking agent) co-culture system and high cell density pellet formed by centrifugation.Chondrogenic differentiation of C3H10T1/2 was induced by treatment with TGF-β3 (10 ng/ml),dexamethasone (100 nmol/L),ascorbic acid (50 ug/ml),1 ∶ 100 dilution ITS+Premix and high glucose-DMEM medium with 0.2 volume fraction fetal bovine serum.And high glucose-DMEM medium with 0.2 volume fraction fetal bovine serum is for control group.Histochemistry staining was utilized to identify extracellular proteoglycan and real-time PCR was performed to assess gene expression of SOX9,collagen Ⅱa1/Ⅹa1 and aggrecan for the 1st,2nd and 3rd week respectively.Results In the hydrogel model for 3 weeks chondrogenic differentiation,the expression of master transcription factor SOX9 was upregulated in both culture models.While the marker genes of collagen Ⅱa1 and collagen Ⅹa1 were all promoted in hydrogel culture,the aggrecan gene expression was peaked in pellet culture.In addition,immunocytochemistry analysis of the hydrogel and pellet for 3 week illustrated the expression of extracellular matrix and more obviously in the hydrogel model.Conclusion In compared with pellet culture,the MSCs in the hydrogel were more likely promoted chondrogenesis leading to the eventual expression of marker genes.And the hydrogel would be applied in regeneration of cartilage injury.

Portal vein thrombosis (PVT) is one of the most common complications of liver cirrhosis. Due to coagulation disorder and the risk of bleeding in liver cirrhosis, there are many controversies over the treatment of liver cirrhosis with PVT in clinical practice. Common therapies for PVT include anticoagulant therapy, intervention, and thrombolysis. This article elaborates on the current status of the treatment of liver cirrhosis with PVT, in order to provide help for the development of standard and reasonable clinical treatment strategies.