OBJECTIVE To explore the optimal parameters of simmered Rhei Radix et Rhizoma and the correlation between the chroma values and the intrinsic composition of simmered Rhei Radix et Rhizoma decoction pieces powder.METHODS The single-factor-response surface method was used to investigate the simmering temperature,simmering time,paper dosage and plant ash dos-age,the response surface experiment was carried out on the basis of the single factor experiment,the appearance traits,total anthraqui-nones,free anthraquinones,leachables,sennoside A and B contents were taken as indicators,the analytic hierarchy process(AHP)was used to give weights to each index,and the process was optimized.The chroma values of raw and simmered products were deter-mined by electronic eye,the correlation and regression analysis were carried out by SPSS22.0 software,and the chroma-component re-gression equation was constructed.RESULTS The optimal process of simmering Rhei Radix et Rhizoma was 140 ℃,5 times of plant ash,2 layers of wet paper wrapped and being simmered for 2.5 h.CONCLUSION The simmering process of Rhei Radix et Rhizoma optimized by AHP combined with response surface method is reasonable and feasible,the color of decoction pieces has a significant correlation with the component content,and the regression equation constructed is reliable,which can predict the intrinsic component content of decoction pieces through chroma values.

OBJECTIVE To explore the optimal parameters of simmered Rhei Radix et Rhizoma and the correlation between the chroma values and the intrinsic composition of simmered Rhei Radix et Rhizoma decoction pieces powder.METHODS The single-factor-response surface method was used to investigate the simmering temperature,simmering time,paper dosage and plant ash dos-age,the response surface experiment was carried out on the basis of the single factor experiment,the appearance traits,total anthraqui-nones,free anthraquinones,leachables,sennoside A and B contents were taken as indicators,the analytic hierarchy process(AHP)was used to give weights to each index,and the process was optimized.The chroma values of raw and simmered products were deter-mined by electronic eye,the correlation and regression analysis were carried out by SPSS22.0 software,and the chroma-component re-gression equation was constructed.RESULTS The optimal process of simmering Rhei Radix et Rhizoma was 140 ℃,5 times of plant ash,2 layers of wet paper wrapped and being simmered for 2.5 h.CONCLUSION The simmering process of Rhei Radix et Rhizoma optimized by AHP combined with response surface method is reasonable and feasible,the color of decoction pieces has a significant correlation with the component content,and the regression equation constructed is reliable,which can predict the intrinsic component content of decoction pieces through chroma values.

Hypothyroidism is a common adverse reaction in clinical multi-target tyrosine kinase inhibitor (TKI) and may be used as a predictor of efficacy of TKI drugs.Studies show that hypothyroidism is significantly associated with good prognosis in patients with renal cell carcinoma treated with multi-target TKI,which may be related to inhibition of vascular endothelial growth factor receptor pathway,potential off-target effects and inhibition of cell proliferation.Whereas in the patients with hepatocellular carcinoma who received multi-target TKI therapy,hypothyroidism is an indicator of poor prognosis,which is related to the T3/TR pathway regulating liver cancer growth and invasion.The predictive function and mechanism of thyroid hormone levels in different tumor patients receiving multi-target TKI drugs are different,and further research is still needed.

Objective To formulate effective safety management method for falls and reduce inpatients' fall occurrence rate and fall injury rate. Methods Setting up a multi-sectoral fall management team and the failure mode and effect analysis (FMEA) was used to form a fall assessment, education, prevention and disposal management system. Taking the inpatients of Changshu Hospital Affiliated to Soochow University from January 2014 to December 2017 as the research object, the incidence and injury rate of falls of inpatients before and after FEMA implementation were compared. Results After implementation, fall occurrence rate reduced from 0.091‰ in 2014 and 2015 to 0.076‰ in 2016 and 2017, however there was no statistical significance (P＞0.05). The rate of injury above Grade 2 caused by falls decreased from 42.86% to 21.25%. The difference was statistically significant (P＜ 0.05). Conclusions Using FEMA quality improvement tools to form a fall management system can effectively reduce the fall injury rate of hospitalized patients.

Objective:To explore the traits of gray matter volume in general anxiety disorder (GAD)and ob-sessive compulsive disorder (OCD)by using magnetic resonance imaging (MRI)technique.Methods:Twenty-eight GAD,25 OCD and 39 normal controls were recruited.All patients were met the Diagnostic and Statistical Mannal of Mental Disorders,Fourth Edition,Text Revision (DSM-IV-TR)or the International Statistical Classifica-tion of Disease and Related Health Problems Tenth Revision (ICD-10)diagnostic criteria for GAD or OCD.All subjects underwent structural MRI scan.The severity of anxiety and OCD symptoms were rated in all patients with the Hamilton Anxiety Rating Scale (HAMA)and the Yale-Brown Obsessive Compulsive Scale (Y-BOCS).The gray matter volume (GMV)was compared between all groups by using the voxel-based morphometry (VBM)a- nalysis.The correlation analysis between GMV and total scores of HAMA and Y-BOCS was performed in GAD and OCD.Results:The GMV was increased in regions including left anterior cingulate cortex in GAD (P =0.016,small volume correction),while only decreased GMV was observed in OCD in bilateral orbitofrontal cortex (OFC)(P <0.001,uncorrected).GAD had larger GMV than OCD in several regions including bilateral OFC (P <0.001,un-corrected).The higher total score of HAMA was associated with increased GMV of right temporal cortex in GAD, and with the GMV of OFC in OCD (P <0.001,uncorrected).Conclusion:No sharing of GMV abnormalities in GAD and OCD was observed in the current study.The traits of brain structure and the potential neural substrate of anxiety symptom in GAD and OCD may be significantly different.

Objective To explore the immunomodulatory effects of 1,25-dihydroxyvitamin D3 (1,25 (OH)2D3) in the treatment of experimental colitis induced by dextran sulfate sodium (DSS) in mice.Methods According to random number table,thirty BALB/c mice were randomly divided into control group,model group,low dose,moderate dose,and high dose intervention group.Mice of model group,low dose,moderate dose and high dose intervention group drank 5％ DSS solution for seven days to create colitis model.On the 1st,3rd,5th,7th day,the mice of low dose,moderate dose and high dose intervention group were intraperitoneal injected with low,moderate,and high dose of 1,25(OH)2D3 (50,100 and 200 ng/each mouse,respectively).Mice of control group and model group were intraperitoneal injected with sterile soybean oil as control.The observed indicators included disease activity index (DAI) and colonic histopathological score (HPS).On the 8th day,all mice were sacrificed.The expression of interferon (IFN)-γ,interleukin (IL-17) and IL-21 in mice colon tissues and spleens at mRNA and protein level were measured by reverse transcription-polymerose chain reaction (RT-PCR) and flow cytometry,respectively.The data were analyzed by one way ANOVA.LSD-test or Tamhane test were performed for comparison in groups.Results Compared with the control group,the DAI and colitis HPS of mice in the model group significantly increased (0.33±0.52 vs 7.33±1.03,0.17±0.41 vs 12.00±0.63).Compared with the model group,the DAI and colonic HPS of intervention groups treated with 1,25 (OH)2 D3 declined with varying degrees (2.83 ± 0.40,2.83±0.75,2.33±0.52 and 10.83±0.98,7.50±0.84,6.67±0.52,LSD-t=0.39 and 0.41,all P＜0.01).The expression of IFN-γ,IL-17 and IL-21 of the model group were significantly higher than those of the control group.The expressions of IFN-γ,IL-17 and IL-21 of intervention group were signifiantly lower than that of the model group (mRNA:LSD-t =0.12,0.13,0.09; protein:F =20.61,22.46,4.80,all P＜0.01).Conclusion 1,25 (OH)2D3 might have a direct role on T-cell phenotype,down-regulate effective cytokines IFN-γ,IL-17 and IL-21 and then play an interventional role.

1.The external features and arterial supply of the papillary muscles of the leftventricle were studied in 54 human,52 dogs' and 110 rabbits' hearts.Radiopaquemedium or Chinese ink were injected into coronary arteries.After injection,arter-iography of some hearts were taken,and serial celloidin sections of the papillarymuscles of other hearts were made.The diameters of the papillary arteries and thedensity of the vessels were measured.2.The papillary muscles could be divided into three patterns,depending on theextent of their attachment to the ventricular wall and the relative length of theirfree part protruding into the ventricular cavity.The three patterns were as follows:(1)The attached type,the papillary muscle was largely adherent to the sucbjacentventricular myocardium,with only one third or less of its length protruding into theventricular cavity(34% in human hearts,100% in dogs' and 38% in rabbits').(2)The free type,the free end of the papillary muscle was one half of its length ormore(28% in human hearts,10% in rabbits').(3)The intermediate type,thelength of the free protruding part of the papillary muscle was intermediate between(1)and(2)(38% in human hearts,52% in rabbits').3.In the human and the dogs' hearts the anterolateral papillary muscle receivedbranches from the anterior descending artery and the diagonal left ventricularbranches or the left circumflex artery;while in the rabbits' it received branchesmainly from the anterior branches of the left ventricular artery.The posteromedialpapillary muscle received a variable supply from the left circumflex artery and orthe branches of the right coronary artery in the dogs' hearts and in the human hearts,while in the rabbits' hearts,it mainly received branches from the posteriorbranches of the left ventricular artery.4.The arrangement of the arterial vasculature of the papillary muscle seemedto be related to the different patterns of the papillary muscles.The free typereceived a large central artery which coursed through the entire papillary muscle toits apex(87.5%).The attached type had a segmental supply of 3～9 long penetrat-ing intramyocardial vessels(94.29%).The intermediate type had a combination ofboth types of vascular arrangement(98.5%).5.The average diameter of the central arteries was 617.50 ? in human hearts atits entry into the base of the papillary muscle,and 236.05 ? in rabbits.The dia-meters of the segmental arteries were 323.60 ? in human hearts,300.05 ? in dogs',121.78 ? in rabbits' respectively.The diameters of the capillary vessels were 5～8 ?in human hearts,3～6 ? in dogs',2.5～6 ? in rabbits' respectively.The numbersof capillaries that observed in a length of 200? were 15.45 in human hearts,16.2in dogs',19.3 in rabbits'.The specific values of the density of vessels per unitarea were 34.4% in human hearts,34.1% in dogs',56% in rabbits'.