Objective:To screen the best decocting technology by multi-index comprehensive score combined with response sur-face. Methods:The content of paeoniflroin and the ratio of dry extraction were used as the indicators, and response surface Central Composite with two factors and five levels was used in the experimental design. The effects of the ratio of solvent to solid, decocting du-ration and decocting times on the preparation process of tonic semifluid extract of ten ingredients were studied. Results:Design Expert 8. 0. 6b software was used for the data analysis. A quadratic mathematical model between the factors and the comprehensive score of paeoniflroin content and the ratio of dry extraction was established. Combined with the actual production, the best decocting conditions were as following:the ratio of solvent to solid was 10. 6 ml·g-1 , the decocting duration was 96 min, and decocted 3 times. Conclu-sion:The optimal decocting technology is scientific, reasonable and stable.

Objective To determine the coverage of gonorrhea and syphilis case reporting in China,and provide information for managing STD case-reporting,investigating under-reporting and evaluating STD epidemic.Methods The gonorrhea and syphilis case-reporting data from 31 provinces in 2005 were collected with systematic sampling by months of February,May,August and November through National Information System for Disease Control and Prevention,and the coverage of the casereporting by county category in 31 provinces were analyzed.Results The average coverage of gonorrhea case-reporting were 56.66%,66.33%,68.90% and 68.27% in February,May,August and November in 2005,respectively,while the average coverage of syphilis were 42.61%,55.56%,59.46% and 60.59% in these months,respectively.The coverage of case reporting in developed or southeast ern areas,such as Shanghai,Beijing,Tianjin,Chongqi,Zhejiang,Jiangsu,Guangdong,Guangxi,Hainan,and Fujian provinces was higher by more than 80%.However,the coverage in economically less-developed or west ern areas,including.Hebei,Shanxi,Inner Mongolia,Shaanxi,Gansu,Yunnan,Guizhou,Qinghai and Tibet provinces,was lower by less than 50%.Conclusions Overall,the coverage of gonorrhea and syphilis case reporting in the country is relatively low,which directly compromises the accuracy of STD case reporting data.It is suggested that management,surveillance and evaluation of STD case reporting should be strengthened,especially in economically less-developed or western areas.

Objective To determine the serum level of pepsinogenⅠ,Ⅱ(PGⅠ,PGⅡ) and PGⅠ/Ⅱin the residents from Zhuanghe county,a high risk area of gastric cancer in North China,and to explore their distribution as well as related factors.Methods Serum PGⅠand PGⅡlevels were detec- ted with ELISA method in 6990 subjects.Gastric diseases were diagnosed by endoscopy and histopatho- logic examination.Serum H.pylori-IgG antibody was determined by ELISA method.Results The me- dian values for PGⅠ,PGⅡ,PGⅠ/Ⅱwere 86.9/?g/L,10.6/zg/L and 8.1 respectively.Serum PGⅠand PGⅡin male(95.2?g/L,12.1?g/L) were significantly higher than those in female(79.7?g/L, 9.4?g/L;P=0.000),PGⅠ/Ⅱratio(7.9) was significantly lower in male (8.3,P=0.000).There were significantly decrease in PGⅠ/Ⅱratio along with age increase.PGⅠ/Ⅱratio decreased signifi- cantly following with progression of gastric mucosa from normal (10.4) to non-atrophic lesions(8.8) and to atrophic lesions (6.6).Serum PGⅠand PGⅡin H. pylori positive subjects (88.7?g/L,11.4?g/L) were significantly higher than those in H.pylori negative subjects (81.4?g/L,8.4?g/L;P= 0.000),PGⅠ/Ⅱratio(7.7) was significantly lower in H.pylori positive subjects (9.6,P=0.000). For patients with atrophic lesions,the area under the PGⅠ/ⅡROC curve was 0.622.The best cut-off point for PGⅠ/Ⅱwas 6.9,with sensitivity of 53.2%,and specificity of 67.5%.Factors linked to PGⅠ/Ⅱwere identified using multinomial logistic regression:male (OR:1.151,95% CI:1.042—1.272, P=0.006),age=61(OR:1.358,95% CI:1.188—1.553,P=0.000),atrophic lesion(OR:2.075,95% CI:1.870—2.302,P=0.000),and H.pylori infection (OR:1.546,95% CI:1.368—1.748,P= 0.000).Conclusions The serum PG levels are significantly skewed from normal distrubition in the residents of Zhuanghe county,and affected by age and gender,as well as associated with gastric diseases and H.pylori in- fection.Compared with PGⅠand PGⅡalone,PGⅠ/Ⅱis more suitable for screening gastric cancer.

Objective To evaluate the correlation between intracranial hyperintense vessel sign (HVS) on fluid-attenuated inversion recovery(FLAIR) and the degree of the stenosis of internal carotid artery (ICA).The effect of carotid endarterectomy(CEA) on HVS was assessed.Methods A retrospective analysis of MR FLAIR sequence and cerebral-cervical computed tomography angiography(CTA) was performed in 1 total of 491 patients.Of the 491 patients,41 treated with CEA were evaluated using their pre-and post-operative image data.Patients were divided into ICA stenosis group and non-stenosis group according to the CTA imaging findings.The ICA stenosis group was subdivided into unilateral group and bilateral stenosis group.Furthermore,we measured and graded the ICA of the unilateral stenosis group into seven stenotic degrees,they were＜50％(n=40),50％-＜60％(n=15),60％-＜70％(n=17),70％-＜80％ (n=6),80％-＜90％ (n=7),90％-＜100％ (n=23),100％ (n=24),respectively.Chi square test was used to analyze the occurrence rates of HVS between ICA stenosis and non-stenosis group,and between ICA unilateral and bilateral stenosis group,respectively.Spearman rank correlation was performed to evaluate the correlation between the presence of HVS and stenotic degrees of the ICA.For the 41 patients who underwent CEA,pre-and post-operative image data were compared,focusing on the presence or disappearance of the HVS on MR FLAIR imaging.Results HVS on FLAIR images were observed in 81 of 177 patients(45.76％) with ICA stenosis,and in 59 of 314 patients(18.79％) without ICA stenosis.The occurrence rate of HVS was significantly higher in patients with ICA stenosis than those without ICA stenosis (x2=40.40,P＜0.01).There was no statistical significance in the occurrence rates of HVS between ICA unilateral stenosis group and bilateral stenosis group(x2=0.24,P＞0.05).The occurrence rates of HVS of ICA graded as the seven stenotic degrees were 22.00％(8/40),26.67％(4/15),35.29％(6/17),33.33％ (2/6),42.86％ (3/7),69.57％ (16/23),83.33％ (20/24),respectively.There was a significant positive correlation between the occurrence rates of HVS and the degrees of ICA stenosis(r=0.964,P＜0.01).HVS disappeared in 19(86.36％) out of 22 patients with HVS on pre-operative MR images after CEA in The remaining HVS in 3(13.64％) patients was attributed to the failure of completely recanalization of ICA.Conclusions A close relationship exists between HVS and ICA stenosis.The presence of HVS indicates a high probability of the existence of severe ICA stenosis.A further assessment for ICA stenosis is warranted.HVS disappearance after successful CEA indicates that HVS can be a useful marker for the the evaluation of consequence associated with CEA.

Objective To investigate the trends in and characteristics of syphilis epidemiology in China,and to provide a scientific basis for the development of control strategies.Methods An epidemiological study was performed on syphilis cases reported from 31 provinces,autonomous regions and municipalities between 2000 and 2013.Results The reported syphilis incidence increased yearly from 6.43 per 100 000 person-years in 2000 to 32.86 per 100 000 person-years in 2013,with an average annual growth rate of 13.37％.Syphilis was reported in most (99％) counties/districts in China mainland except for a few remote mountain areas,with a significant difference in the incidence of syphilis between different regions.The regions with a high incidence of syphilis included minority areas in Northwest China (Xinjiang,Qinghai and Ningxia),Minjiang River area,Yangtze River Delta (Zhejiang,Shanghai),Zhujiang River Delta (Guangxi,Guangdong),etc.There had been a rapid increase in the incidence of syphilis in some regions previously reported to have a low incidence (such as Guizhou,Shaanxi,Henan,etc).Among the reported cases,female patients predominated with an average male/female ratio of 0.92 ∶ 1.The incidence of syphilis was highest in the age group of 20-39 years,but increased yearly by more than 30％ in the population aged ＞ 60 years.Of 20 occupations,peasant workers accounted for the highest proportion (31.56％) of syphilis cases,and retired population showed the most rapid increase by about 27.35％ per year.The constituent ratio of primary and secondary syphilis in all the syphilis cases had declined yearly,while that of latent syphilis increased by more than 50％ after 2010.Conclusions Syphilis remains a major public health issue in China,and measures based on the epidemiological features are urgently needed to effectively control epidemic syphilis.

Objective To analyze the current status of neonatal resuscitation in medical institutions in China.Methods With the number of obstetric beds as the inclusion criteria,the survey was conducted in 163 medical institutions randomly selected in 11 provinces (including 51 tertiary hospitals,88 secondary hospitals and 24 primary hospitals) from October 1 to December 31 in 2011.The mail-questionnaire was sent to collect information about system establishment,personnel training,neonatal resuscitation equipment etc.Statistical data was analyzed by t-test,variance analysis and Chi-square test.Results The incidence of neonatal asphyxia among live birth babies was 2.15％ (3328/154 853) in tertiary hospitals,1.41％ (2829/200 731) in secondary hospitals and 1.50％ (701/46 695) in primary hospitals (x2=298.559,P＜0.01).The mortality rate during delivery was 0.41‰ (63/154 853),0.24‰ (48/200 731) and 0.60‰ (28/46 695) at the three different level hospitals,respectively (x2=16.993,P＜0.01).The mortality rate within 24 hours after delivery was 0.42‰ (65/154 853) in tertiary hospitals,0.24‰ (49/200 731) in secondary hospitals and 0.62‰ (29/46 695) in primary hospitals (x2 18.075,P＜0.01).About 86.5％ (141/163) of the included hospitals maintained routine neonatal resuscitation trainings,but only 73.0％ (119/163) applied resuscitation training equipments during the trainings.The outfit rate of basic neonatal resuscitation equipments (such as neonatal laryngoscope,radiant heater) was high in most hospitals,but the outfit rate of equipments recommended by the new guideline (such as umbilical venous catheter,T piece and oxygen saturation meter) was low.For example,the outfit rate of umbilical venous catheter was 23.5％ (12/51),10.2％ (9/88) and 4.2％ (1/24) in tertiary,secondary and primary hospitals respectively (x2 =6.992,P ＜ 0.05).47.9％ (78/163) of the hospitals had set up neonatal intensive care unit,with the proportion in tertiary,secondary and primary hospitals being 80.4％ (41/51),34.1％ (30/88) and 27.2％ (7/24),respectively (x2=31.677,P＜0.01).Most of the hospitals (80.4％,131/163) could ensure the pediatricians being presented in the delivery room for high risk women,and the proportion was 94.1％ (48/51),79.5％ (70/88) and 54.2％ (13/24) in tertiary,secondary and primary hospitals,respectively (x2 =16.591,P＜0.01).There were 88.3％ (144/163) of the hospitals had routine neonatal resuscitation case audit,with the proportion in the three different level hospitals being 94.1％ (48/51),92.0％ (81/88) and 62.5％ (15/24),respectively (x2 =18.388,P＜0.01).Conclusions Strengthen the training,equipment and system establishment in primary medical institutions is conducive to promote neonatal resuscitation.

Objective To explore the expression and significance of vascular endothelial growth factor (VEGF) and transforming growth factor β1 (TGF-β1) in hepatic fibrosis.Methods Fifty-six cases of patients with hepatic fibrosis were selected as observation group and 50 healthy persons as control group.Immunohistochemistry were performed to detect VEGF and TGF-β1 in two groups.Results Serum VEGF and TGF-β1 in observation group were significantly higher than those in control group(VEGF:(110.87 ±32.64) μg/L vs (15.98 ±6.75) μg/L,t =20.166,P ＜0.001;TGF-β1:(15.08 ±4.27) ng/L vs (7.17 ±2.86) ng/L,t =11.066,P ＜ 0.001) ;There were significant differences on VEGF and TGF-β1 level among S1,S2,S3 and S4 subgroups(VEGF:(84.25 ±16.86) μg/L vs (101.87 ±36.70) μg/L vs (118.04 ±40.75)μg/L vs (134.65 ± 45.73) μg/L,F =15.689,P =0.015 ; TGF-β1:(10.87 ± 2.64) ng/L vs (13.06 ± 2.74)ng/L vs (17.87 ± 3.28) ng/L vs (22.76 ± 4.75) ng/L,F =12.438,P =0.026).VEGF had positive correlation with TGF-β1 (r =0.532,P =0.013).Conclusion VEGF and TGF-β1 level have close relationship with the occurrence and development of hepatic fibrosis.Combined detection of VEGF and TGF-β1 can be serum index for diagnosis and evaluation disease condition.

Objective To survey the major host animal and media fleas of plague in Beipanjiang Basin,to gain insights into plague foci and to provide a basis for prevention and control of plague.Methods According to the epidemiological site survey methods,from 2008 to 2010 five villages in five townships (towns) in coastal watershed of Beipanjiang were selected.The methods of cage trapping and 5 meters thread clamp were used to capture rodents indoor and outdoor,respectively.After rats were anesthetized with ether anesthesia,rat body flea were combed and stored in sterile tubes.The liver and spleen of rodents were collected and stored in the test tube with preservation solution,and free body fleas on rats were collected with flea sticky paper and stored in sterile tubes.Blood specimens (5 ml) of indicating animal and normal people were collected,serum was separated and sent for laboratory test.The four-step method was utilized to isolate Yersinia pestis from rodents and fleas,the indirect hemagglutination (IHA) was used to test F1 antibodies on the blood of rodents filter,blood serum of humans and rodents.Results Totally 243 rodents were captured,202 indoor and 41 outdoor,the capture rate was 4.90％ and 1.15％,respectively.Rodents captured belong to 9 species,4 genera,1 family and 1 order,Rattus flavipectus and Mus pahari were dominant species.Five rodents had body flea,the dyed flea rate was 2.06％;53 fleas were captured,total flea index was 0.218 1.Rat fleas were classified in 2 families,2 genera and 2 species,and Cheopis was the dominant species.Yersinia pestis and plague F1 were not detected.Conclusion The epidemic indication has not been found in Beipanjiang Basin,but the nurturing conditions for Rattus flavipectus plague foci along the coast are exist.

Objective To strengthen the quality control management and enhance the detection capacity of the experimental animal quality control laboratoriesin our country through the detection of serum esterase-1 (Es-1) in the experimental mice.Methods The samples were prepared according to the standard procedure, and then were randomly numbered and distributed to participating units by cold-chain transport.Before the deadline, the participants submitted the results and the copies of original records.When the results were completely consistent with the standard results,the results were regarded as satisfactory, otherwise were unsatisfactory.Results A total of 11 laboratories participated in this program, of which 10 laboratories were regarded as satisfactory (90.9%) and one laboratory obtained unsatisfactory result (9.1%).Conclusions The results of this proficiency testing project demonstrate that the overall detection level of Es-1 in laboratory mice is highof the participating laboratories.However, more attention still should be paid to standard specifications and some test details.

Objective To investigate the detection capacity of esterase-3 ( Es-3) in the laboratory animals monito-ring laboratories in China, and to improve the quality management of laboratories.Methods We prepared the test sam-ples according to the criteria of China National Accreditation Service for Conformity Assessment(CNAS), all the samples were certificated by homogeneity test and stability test.Then, samples with random numbers and standard operation instruc-tion were distributed to the participant laboratories.The laboratories should submit their reports before the deadline expires. When the results are the same as the standard results, the laboratories will receive excellent remark; when the results are the same as the standard results except the hybridization type, the laboratories will receive satisfactory remark;otherwise, it will receive unsatisfactory remark.If a laboratory did not submit report, the laboratory will also receive unsatisfactory re-mark.Results Ten laboratories participated in the program, and no laboratory received excellent remark.Nine laboratories (90.0%of enrolled laboratories) had satisfactory results, while one laboratory (10.0%of enrolled laboratories) had un-satisfactory results.Conclusions The nationwide overall detection level of laboratories in Es-3 is relatively high.Howev-er, some details should be noticed and several laboratories should improve their detecting ability.