Objective To investigate the clinical efficacy of paeoniae decoction (PD) add and subtract or modified PD combined with mesalazine for treatment of patients with ulcerative colitis (UC).Methods A prospective study was conducted, 98 patients with UC admitted to the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from August 2015 to August 2016 were enrolled, and they were divided into an observation group and a control group by random number table, 49 cases in each group. The control group was treated with mesalazine 1 g, 3 times daily; the observation group was treated with paeoniae decoction (ingredients: paeonia 30 g, coptis chinensis 15 g, Chinese angelica 15 g, betel nut 6 g, Chinese rhubarb 6 g, baikal skullcap 6 g, cinnamon 6 g, licorice 6 g) add and subtract, on the basis of treatment of the control group ,1 dose daily, each dose was decocted 2 times and warm decoction was taken once in the morning and once in the evening; the therapeutic course in both group was consecutive 6 weeks. The contents of different inflammatory factors, interleukin (IL-1, IL-8), tumor necrosis factor-α (TNF-α), C-reactive protein (CRP)in serum were compared before and after treatment between the two groups, and the clinical curative effects and adverse reactions were observed in two groups.Results After treatment, the levels of serum IL-1, IL-8, TNF-α, CRP in two groups were significantly lower than those before treatment, and the degrees of decrease were more significant in the observation group than those in the control group [IL-1 (ng/L): 8.48±3.05 vs. 9.38±3.37, IL-8 (ng/L): 10.15±2.23 vs. 11.94±2.30, TNF-α (μg/L): 122.13±6.40 vs. 137.02±7.35, CRP (mg/L): 7.16±1.93 vs. 8.02±2.63, allP < 0.05]. After treatment, the total effective rate in observation group was significantly higher than that in control group [91.84% (45/49) vs. 77.55% (38/49),P < 0.05]; the adverse reactions of observation group and control group had no statistical significant difference [4.08% (2/49) vs. 6.12% (3/49),P > 0.05].Conclusion The clinical efficacy of add and subtract of paeoniae decoction combined with mesalazine for treatment of ulcerative colitis is prominent, and no increase of adverse reaction occurrence was seen.

Objective To observe the clinical effects of Yiyi Fuzi Baijiang powder for treatment of patients with ulcerative colitis (UC) accompanied by yang-deficiency of spleen and kidney.Methods Eighty patients with UC admitted to the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine (TCM) from January 2012 to December 2015 were enrolled, and they were divided into an integrated TCM and western medicine group (combined group) and a control group by random number table method, 40 cases in each group. The control group was treated by normal saline 100 mL with dexamethasone 10 mg enema, whilethe combined group was given Yiyi Fuzi Baijiang powder 100 mL (coix seed 30 g, aconitum carmichaeli debx 6 g, herba patriniae 15 g, radix paeoniae alba 15 g, frankincense 6 g, myrrh 6 g, glycyrrhiza uralensis 6 g) combined with dexamethasone 10 mg enema, one therapeutic course was 10 days, and after 3 courses, the clinical efficacy was observed in the two groups. The differences of erythrocyte sedimentation rate (ESR), the number of red blood cell (RBC) and white blood cell (WBC) positive patients in stool routine were compared before and after treatment, and the clinical therapeutic effects were observed in the two groups.Results After treatment, the ESR was reduced in both groups compared to that before treatment, the numbers of RBC and WBC positive patients in stool routine were decreased in both group compared to those before treatment, and the degrees of changes were more significant in combined group than those in the control group [ESR (mm/1 h): 15.00±3.07 vs. 20.55±3.87, the number of RBC positive patients: 7 cases vs. 21 cases, the number of WBC positive patients: 14 cases vs. 21 cases, allP < 0.05]. The total effective rate of combined group was significantly higher than that of the control group [92.5% (37/40) vs. 75.0% (30/40),P < 0.05].Conclusion The clinical effect of Yiyi Fuzi Baijiang powder combined with dexamethasone enema was superior to that simply using hormone enema therapy for treatment of patients with UC accompanied by yang deficiency of spleen and kidney, this combined method is simple, and its curative effect is definite.

Objective To analyse the clinicopathologic factors affecting prognosis and fertility of patients with malignant ovarian germ cell tumor (MOGCT).Methods The medical records and follow up data of 106 patients with MOGCT treated at Affiliated Tumor Hospital of Guangxi Medical University between January 1986 and December 2010.Kaplan-Meier method was used to analyse survival curves.The different prognoses between different clinicopathologic factor was evaluated by univariate analysis and log-rank test.The multivariate analysis was performed by the Cox proportional hazard regression method.Logistic regression analysis was used to evaluate the influence of different factors on the prognoses and fertility.Results The median age at primary treatment was 22 years old (range:9-61 years old),59 patients received fertility-preserving surgery,45 patients received radical surgery,only 2 cases performed biopsy; 94 patients received postoperative adjuvant chemotherapy.Median follow-up time was 56.5 months (range:2-309 months),there were 11 cases recurrences,23 cases died from cancer.Of 47 patients live without tumor,45 patients had normal menstrual.Of the 39 patients desiring pregnancy,31 cases got 33 successful pregnancies,resulting in 33 live births.There is no statistically significant difference (P ＞0.05) in progression free survival (PFS ; 67.6％ versus 63.3 ％) and overall survival (OS ; 70.0％ versus 64.1％) and mortality [15％ (9/59) versus 31％ (14/45)] between fertility-preserving surgery patients and radical surgery patients.The univariate analysis showed that the pathological types,postoperative residual tumor size,lymph nodes and omental resection were associated with OS (P ＜ 0.1),and postoperative residual tumor size,chemotherapy cycles,lymph nodes and omental resection were associated with PFS (P ＜0.1).The multivariate analysis showed only the postoperative residual tumor size was independent prognostic factor of OS (P =0.039),and postoperative residual tumor size,chemotherapy cycles,lymph nodes resection were independent prognostic factors of PFS (P ＜ 0.05).There is no statistically significant difference in OS,PFS and fertility between fertility-preserving surgery patients treated with or without a comprehensive staging surgery (P ＞ 0.05).Conclusions MOGCT can achieve a good prognosis after surgery combined chemotherapy.Postoperative residual tumor size is independent prognostic factor of PFS and OS.Comprehensive staging surgery could not improve prognosis.Fertility-preserving surgery plus adjuvant chemotherapy appeared to have little or no effect on prognosis and fertility.

The important function of the gastrointestinal tract in monitoring and sealing the host intestine from intruders is called the gut barrier.A variety of specific and nonspecific mechanisms are in operation to establish the host barrier,including luminal mechanism,secretion of the digestive enzymes,the epithelial cells together with tight junctions between them and the gut immune system.The pathogenesis of gut barrier dysfuntion is multifactorial.They can lead to the translocation of the intestinal bacteria.Sometimes,even the multiple organ dysfunction syndrome can happen.Nitric oxide,one of the smallest products of the cell,is known to have a very large role in diverse physiologic and pathological processes.Recent study shows its toxic metabolite,peroxynitrite(ONOO~(-)),play a major role in the intestinal mucosal injury.The purpose of this literature review is to provide a better understanding of the mechanism of the protection and injury to the gut barrier function about nitric oxide and peroxynitrite.

OBJECTIVE To investigate the antibiotic resistance of Staphylococcus aureus isolates from the clinical samples from 2005 to 2007.METHODS The susceptibility tests and D-test were performed by the disk diffusion method and their results were analyzed by the software WHONET 5.4.RESULTS The rate of MRSA isolates accounted for 64.1%.The resistance rate to 12 kinds of the antimicrobial agents,such as penicillins,cephalosporins and carbapenems was 100%.The MRSA and MSSA were susceptible to linezolid and vancomycin.No isolates were resistant to vancomycin in our hospital;the positive rate of D-test was 78.7%.CONCLUSIONS MSSA is still sensible to most of the antimicrobial agents,but MRSA shows multidrug resistance.The D-test is of great clinical importance.

Objective To evaluate the safety and efficacy of mesohepatectomy for large and centrally located hepatocellular carcinoma.Methods A retrospective study was carried out on 136 pa tients who underwent mesohepatectomy for large and centrally located hepatocellular carcinoma at Xiangya Hospital,Central South University,from 2001 to 2007.Intraoperative/post operative data and long-term survivals were analyzed.Results Vascular occlusion time,operative time,intraoperative blood loss,intraoperative blood transfusion and hospital stay were (13.3 ± 9.1) min,(173.1 ±41.1)min,(548.7±320.5)ml,(511.4±231.7)ml and (18.6±8.8)d,respectively.Four patients developed major complications.There was no in-hospital death.The 1-,3-,and 5-year overall survival rates and disease-free survival rates were 71％,46％,29％ and 65％,40％,24％,respectively.Conclusions Mesohepatectomy for large and centrally located hepatocellular carcinoma preserved the maximum amount of functional liver parenchyma.It is safe and reliable and may be used as the treatment of choice.

Objective To evaluate the feasibility of a low-dose contrast medium protocol for 64-slice CT angiography (CTA) of head using a low-tube-voltage setting.Methods ① Phantom study:64-slice spiral CT respectively sets 80,100,120,140 kV and 100,200,300,400,500 and 600 mA as scanning parameter lines.Analysis of the best Signal-to-noise ratios (SNR) and contrast to noise ratios (CNR).②Clinical study:to prospectively continuous select sixty-six patients with suspected intracranial aneurysm and arteriovenous malformation and so on from April to October of 2012 to perform hand CTA inspection.The random number table method for A,B two groups,33 patients in each group.Group A (conventional group)scanning parameters:120 kV,400 mA and amount of contrast agent:1 ml/kg; Group B(test group) scanning parameters:80 kV,600 mA,amount of contrast agent 0.5 ml/kg.Using independent samples t test for each group radiation dose,SNR,CNR were statistically analyzed.By two experienced radiologists to 5 points on two groups of image quality subjective evaluation.Mann-Whitney U test was used for statistical analysis of subjective evaluation.Results Group A and B group CTDIvol respectively is 59.1,27.5 mGy.Group B than in group A,CTDIvol decreased by 53.5％.A,B groups of the SNR,CNR were 71.5 ± 10.7,92.0 ± 7.4; 58.5 ± 10.5,79.6 ± 7.7,Group B than in group A SNR,CNR were enhanced by 22.3％,26.4％,differences were statistics significance (t =584.0,388.6,P ＜ 0.01).The subjective image evaluation of group B was bigher than group A (Z =31.2,23.4,P ＜ 0.05),differences were statistics significance.Two physicians on CTA images to assess the consistency of uniform height(Kappa =0.904,P ＜0.05).Conclusion In the head CTA examination,use of low tube voltage combined with low contrast dose not only can improve the image quality but also radiation dose were significantly lower.

Objective:To analyse viable Enterococcus faecalis(E.faecalis)in root-well-filled teeth associated with failed endodontic treatment by using propidium monoazide (PMA)in combination with real time qPCR.Methods:Bacterial samples were extracted from 34 root-canal-treated teeth with post-treatment apical periodontitis.Each sample was separated into 2 different tubes.PMA was added to one of the tubes,and the other was left untreated.Then,DNA extraction and qPCR were performed.Results:E.faecalis was found in 20 of the 34 samples(58.8%).In PMA treated and none-treaten samples the Ct value of E.faecalis was 25.1 2 ±2.04 and 24.62 ± 2.02 respectively(P =0.001 ).Conclusion:PMA may be feasible in differentiating viable and dead Enterococcus faecalis cells.

This study was aimed to investigate the effects of Chai-Hu Shu-Gan Tang (CHSGT) on levels of TNF-α and 5-HT in lithium chloride–pilocarpine caused epilepsy–depression comorbidity rat model, in order to discuss the intervention effect of CHSGT on TNF-α and 5-HT in epilepsy–depression comorbidity. The lithium chloride–pilocarpine caused epilepsy–depression comorbidity rat model was established. After 6 weeks of animal establishment, rats were randomly divided into 5 groups, which were citalopram group (A), physiological saline group (B), CHSGT high dose group (C), medium dose group (D), and low dose group (E). Intragastric administration was given for 4 weeks, twice a day. Before and after the treatment, RT-PCR was performed to detect hippocampal TNF-αlevels. Liquid chromatography-mass spectrometry was performed to detect hippocampal 5-HT levels. Both forced swimming test (FST) and saccharin preference test were carried out to monitor the depressive behaviors of rats. In the meantime, 24 hours a day video camera surveillance were performed to record the number of seizures of rats. The results showed that after treatment, the number of seizures of rats were significantly reduced, the accumulative immobility time in FST was shortened, and the consumption of sucrose increased significantly (P < 0.01) in group A, C and D. Compared with group B, after the treatment, the expressions of hippocampal TNF-α mRNA of rats in group A, C, D were distinctly downregulated, with the level of 5-HT significantly increased (P < 0.05,P < 0.01). Compared with group A, group C and D showed no significant changes. It was concluded that TNF-α played a role in the pathogenesis of epilepsy–depression comorbidity through mediating the level of 5-HT. High and medium doses of CHSGT can downregulate the expression of TNF-α mRNA in depression comorbidity of chronic temporal lobe epilepsy, increase 5-HT level, reduce the number of seizures of rats, and improve depressive behaviors.

To enhance the capacity for extending and applying appropriate health technologies in rural areas in China,this paper proposes a supportive policy system that incoperates macro,average and microlevels. Thepolicysystemfocusesonorientation, incentives, regulationsand standardization,and its objectives and measures of each level are described.The policy system will contribute to the sustainable development rural health work.