OBJECTIVE： To establish a method for simultaneous determination of albiflorin， paeoniflorin， liquiritin， liquiritigenin， cinnamic acid， cinnamaldehyde， ammonium glycyrrhetate and 6-ginger phenol in Guizhijiashaoyao decoction. METHODS： HPLC method was adopted. The determination was performed on Kromasil C18 column with mobile phase consisted of acetonitrile-0.1％ phosphoric acid solution （gradient elution） at the flow rate of 1.0 mL/min. The detection wavelengths were 235 nm（0-35 min，albiflorin， paeoniflorin， liquiritin）、280 nm（35-65 min，liquiritigenin， cinnamic acid， cinnamaldehyde， ammonium glycyrrhetate and 6-ginger phenol）. The column temperature was 25 ℃， and the sample size was 20 μL. RESULTS： The linear range of albiflorin， paeoniflorin， liquiritin， liquiritigenin， cinnamic acid， cinnamaldehyde， ammonium glycyrrhetate and 6-ginger phenol were 2.125-34.000 μg/mL（r＝0.999 9）， 28.700-459.200 μg/mL（r＝0.999 7）， 3.675-58.800 μg/mL（r＝0.999 7）， 1.235-19.760 μg/mL（r＝0.999 8）， 2.300-36.800 μg/mL（r＝0.999 8）， 0.955-15.280 μg/mL（r＝0.999 7）， 36.000-576.000 μg/mL（r＝0.999 7） and 1.500-24.000 μg/mL（r＝0.999 7）， respectively. The quantitative limits were 0.135， 0.102， 0.096， 0.033， 0.013， 0.023， 0.663， 0.198 μg/mL； the detection limits were 0.041， 0.031， 0.029， 0.010， 0.004， 0.007， 0.201， 0.059 μg/mL. RSDs of precision， stability and reproducibility tests were all lower than 3％ （n＝6）. The recovery rates were 97.47％-100.76％（RSD＝1.33％，n＝6）， 98.15％-103.50％（RSD＝1.82％，n＝6）， 95.65％-100.84％（RSD＝2.38％，n＝6）， 96.75％-100.32％（RSD＝1.31％，n＝6）， 95.88％-102.75％（RSD＝2.52％，n＝6）， 95.63％-100.63％（RSD＝2.00％，n＝6）， 96.78％-100.45％（RSD＝1.35％，n＝6）， 95.71％-100.48％（RSD＝1.80％，n＝6）. CONCLUSIONS： The method is accurate， reliable and exclusive， and suitable for simultaneous determination of 8 ingredients in Guizhijiashaoyao decoction.

Objective To investigate the features of time distribution in the onset of aortic dissection (AD).Methods The retrospective cross-sectional study was conducted.The clinical data of 476 AD patients who were admitted to the First Affiliated Hospital of Anhui Medical University from January 2009 to June 2017 were collected.The patients were divided by the following criteria:gender,age [youth(＜45 years),middle-age (45-59 years) and elderly (≥ 60 years)],Stanford types (type A and type B),with or without hypertension.All variables were analyzed by circular distribution statistics to illuminate the features of time distribution in the onset of AD (monthly rhythm and circadian rhythm).Observation indicators:(1) overall time distribution of AD;(2) time distribution of subgroups with different genders;(3) time distribution of subgroups with different age;(4) time distribution of subgroups with different Stanford types;(5) time distribution of subgroups with or without hypertension.Measurement data with normal distribution were represented as (x)±s and count data were described as constituent ratio.The circular distrbution statistics were used to calculate time data of onset after trigonometric function transformation.The monthly rhythm and circadian rhythm were done using the Rayleigh test (Z value).Results (1) Overall time distribution of AD:the AD patients had the monthly rhythm and circadian rhythm (Z=14.79,31.60,P＜0.05).The months with the maximum and minimum cases were November (59 cases) and August (24 cases) respectively,the peak day was on January 12.AD often occurred from 16:00 to 17:00 (37 cases) but barely occurred from 3:00 to 4:00 (8 cases),with a peak of 14:55.(2) Time distribution of subgroups with different gender:male subgroup had the monthly rhythm and circadian rhythm (Z =11.28,27.81,P＜0.05);female subgroup had the monthly rhythm and circadian rhythm (Z=3.48,4.37,P＜0.05).(3) Time distribution of subgroups with different age:patients in the youth subgroup had no monthly rhythm (Z=1.33,P＞0.05),and there was the circadian rhythm (Z=4.29,P＜0.05);patients in the middle-age subgroup had the monthly rhythm and circadian rhythm (Z =7.48,17.41,P＜0.05);patients in the old-age subgroup had the monthly rhythm and circadian rhythm (Z =6.62,11.04,P ＜ 0.05).(4) Time distribution of subgroups with different Stanford type:patients inthe type A subgroup had no monthly rhythm (Z=1.60,P＞0.05),and there was the circadian rhythm (Z=10.51,P＜0.05);patients in the type B subgroup had the monthly rhythm and circadian rhythm (Z=13.94,21.70,P＜0.05).(5) Time distribution of subgroups with or without hypertension:subgroups with hypertension had the monthly rhythm and circadian rhythm (Z =12.08,29.81,P＜ 0.05).Subgroups without hypertension had no monthly rhythm (Z=3.84,P＞0.05),showing a statistically significant difference in the circadian rhythm (Z=4.78,P＜0.05).Conclusion AD often occurs in cold months and afternoon.

Objective To explore clinical implications of pleural effusion in thoracic endovascular aorta repair (TEVAR) of type B aortic dissection.Methods Clinical data of 28 patients (23 males,5 females) hospitalized from Jan 2015 to Dec 2016 were analyzed retrospectively.There were ruptured aortic dissection (RAD) (n =7) and the contained aortic dissection (CAD) (n =21).26 patients underwent TEVAR,and two patients received conservative treatment.Results 26 patients received TEVAR and operations were successful.2 patients treated conservatively died.Six patients had bilateral pleural effusion,while 20 had left pleural effusion and two had right pleural effusion.The distribution of pleural effusion was significantly different between CAD and RAD group (x2 =10.4,P ＜ 0.05),and the rupture risk was the highest in right sided pleural effusion.The median volume of pleural effusion on right side in RAD group are higher than that in CAD group (Z =-3.293,P =0.001).One patient died of sudden death on post-op 9th day.Pleural effusion disappeared in all 24 patients who were followed-up for more than 3 months.There were no ensuing pleural thickening,pulmonary atelectasis,and lung consolidation.Conclusious Pleural effusion on left side are common in type B aortic dissection,while bulk right pleural effusion may indicate impending rupture.Endovascular therapy is a feasible,safe and effective therapy for aortic dissection with pleural effusion.

Based on the analysis of definition and the causes of excessive medical treatment, this paper discus-ses the harm of excessive medical treatment concretely, including increased health care costs, the waste of medical resources, worsening doctor-patient conflicts that influence the development of holistic medicine. And in the per-spective of ethics, professional spirit and the humanistic quality, it puts forward the prevention and countermeasures to solve the problem of excessive medical treatment.

To reveal the relationship between endophytic fungi and the functional components, saccharides and flavonoids in the mycelia or fermented liquor of 21 endophytic fungi in D.officinale were detected using HPLC and UV spectrophotometer.The results showed that the ethyl acetate extracts from 21 fungal strains all contain flavonoids.According to the chromatographic retention time of HPLC and UV spectra characteristics of flavonoids, strain DO49 was found produce naringenin, strains DO23, DO81 and DO83 were found produce rutin.The water-soluble extracts from 21 strains all had polysaccharides.However, there was difference in the composition of monosaccharides derived from polysaccharides among different strains.According to the composition of monosaccharides and the peak area ratio of mannose and glucose, the fungal strains including DO23, DO26, DO81, DO54, DO55, DO83 product polysaccharides associated with D.officinale were selected.In conclusion, based on the saccharides and flavonoids, the excellent endophytic fungal strains DO23, DO81 and DO83 were selected, which could produce the same flavonoids and similar polysaccharides in D.officinale.

Objective To study the features of ventilation function in patients with flail arm syndrome (FAS).Methods The clinical data of 351 patients with sporadic amyotrophic lateral sclcrosis (ALS) fron 2009 to 2013 were retrospectively reviewed.Among them,329 were classical ALS and 22 were FAS.The differences of forced vital capacity (FVC) between FAS and classical ALS were analyzed.Results The percent predicted FVC (FVC％pred) values were (88.0 ±9.5)％ in FAS and (84.3 ± 16.8)％ in classical ALS including 4 and 128 patients with abnormal FVC％ pred (＜80％) in FAS and classical ALS,respectively.The FVC％ pred levels were significantly higher in FAS subjects [(88.0 ± 9.5) ％] than in classical ALS subjects of bulb [(80.0 ± 14.8) ％] or those of upper limb [(80.8 ± 16.0) ％] onset with duration over 12 months (All P ＜ 0.05).The proportion of subjects with FVC％pred ＜ 80％ was statistically lower in FAS [18.2％ (4/22)] than in both classical ALS of upper limb onset [42.8％ (80/187);P=0.037] and classical ALS with duration over one year [48.5％ (48/99);P =0.009].Conclusions Impaired ventilation function occurs less and later in FAS than that in classical ALS of upper limb onset with duration over one year,suggesting later and less requirement for non-invasive positive pressure ventilation treatment for FAS patients.Differentiation of FAS subjects from ALS helps assess prognosis and make treatment plan for these patients.

Objective To investigate effect of genetic variants in angiogenin (ANG) on the susceptibility of familial amyotrophic lateral sclerosis (FALS) in Han Chinese.Methods Thirty-one FALS families from 2009 to 2012 were collected and ANG gene was screened in the probands using PCR and direct sequencing.Results All 31 ALS families were autosomal dominant inheritance.No mutations and single nucleotide polymorphism were detectable in ANG gene in the 31 probands.Conclusion Our study suggests that ANG gene variations may be rare in Chinese Han FALS.

Objective To study the clinical efficacy of axillary incision and thoracoscopic surgery for spontaneous pneumothorax.Methods 106 cases of spontaneous pneumothorax in our hospital were given axillary incision surgery(axillary incision group) and thoracoscopic surgery(thoracoscopy group).The intraoperative blood loss,operative time,chest tube drainage time,postoperative hospital stay and surgery costs were compared between the two groups,and the occurrence of complications were observed.Results The armpit small incision group,intraoperative blood loss was (44.5 ± 5.2) ml,the thoracoscopic amount of blood loss was (38.3 ± 6.5) ml (t =6.378,P ＜ 0.01) ;armpit operation time of the small incision group was (68.0 ± 5.3) min,thoracoscopic operative time was (60.8 ±6.0)min; armpit chest tube drainage time of small incision group was (2.8 ± 0.8)d,thoracoscopic group of chest tube drainage time was (2.0 ± 0.5) d; axillary small incision group,length of stay was (4.8 ± 0.7) d,the thoracoscopic group hospitalization time was (4.0 ± 0.6) d,(t =3.552,4.215,3.076,all P ＜ 0.05) ; axillary incision surgery costs was (1 550 ± 348) Yuan,the thoracoscopic group cost of surgery was (4 290 ± 573) Yuan (t =-24.823,P ＜ 0.05).Two groups of patients with no surgical complications,chest X-ray review of lung reexpansion good thoracoscopic group one cases of recurrence of pneumothorax,axillary incision group without recurrence (P ＞ 0.05).Conclusion Axillary small incision and thoracoscopic surgery for spontaneous pneumothorax have the similar efficacy,thoracoscopic surgery is less trauma,faster recovery,shorter hospital stay,but the high cost of surgery,if patients physical condition is acceptable,which can be used axillary incision surgery.

Objective To identify the patterns of population distribution and the relationship of copper-zinc superoxide dismutase 1 (SOD1) mutations and clinical phenotypes in Chinese patients with familial amyotrophic lateral sclerosis (FALS).Methods The clinical data of 43 FALS families from 2008 to 2011 were collected,SOD1 gene mutations in the probands were screened with PCR and direct sequencing,and the correlations of genotype-phenotype were analyzed.Results All 43 FALS families were autosomal dominant inheritance.The male to female ratio for probands was 1∶0.6,and the average onset age was (48.1 ± 11.8) years.Upper limb onset accounted for 53.5％,lower limb onset 41.9％,and bulbar onset 4.6％.Nine mutation types including 8 missense mutations and 1 deletion mutation were detected in 10 probands.The detection rate of SOD1 mutations in this cohort was 23.3％.Conclusions The study reported the correlations of genotype-phenotype of SOD1 in a larger group of Chinese FALS patients.Two novel mutations were found including one deletion mutation.SOD1 mutations increased from 11 to 19 in Chinese FALS.For SOD1 patients,lower motor neuron signs usually predominated.Most clinical phenotypes of one mutation varied greatly in different families even in the same family.

A good funds budget can optimize efficiency of the research funds. Through the implementation of a National Science and Technology Major Project, the authors analysed the budget management proposed some skills and suggestions for the planning and management of budget.