This paper summarizes clinical experience in treating acne based on the staged therapeutic principles of "eruption in warm diseases". It is considered that acne results from wind-heat retained in the lungs， invading the ying level and obstructing the blood collaterals， and is primarily a disorder involving both the wei and ying systems. In clinical practice， the treatment emphasizes the use of acrid-cool and sweet-cold methods. The core prescription is namely Yinqiaosan Qu Douchi Jia Xishengdi Danpi Daqingye Bei Xuanshen Fang （from Epidemic Warm Diseases ［《温病条辨》］）， and is adjusted according to the stage of disease. In the non-inflammatory stage， when the pathogen initially attacks the wei level， treatment focuses on acrid-cool herbs to release the exterior， with supplementary bitter-sweet ingredients such as Yejuhua （Chrysanthemum Indicum）. In the inflammatory stage， with pronounced heat toxin in the qi level affecting the ying and blood， and local stagnation of qi and blood， the approach is to clear heat and resolve toxin， using blood-cooling and stasis-resolving herbs early to prevent progression. Herbs such as Pugongying （Taraxacum Mongolicum）， Zihuadiding （Viola Yedoensis）， Tiankuizi （Semiaquilegia Adoxoides）， Chonglou （Paris Polyphylla）， Machixian （Portulaca Oleracea）， Zaojiaoci （Gleditsia Sinensis）， Chuanshanjia （Manis Pentadactyla） may be added. In the post-inflammatory erythema stage， when yin of the ying level is depleted and internal deficiency-heat arises， sweet-cold herbs are recommended to nourish the stomach and generate fluids， with the possible addition of Yiwei Decoction （益胃汤）.

The improvement of survival of osteosarcoma patients by the standard treatment strategy of osteosarcoma(neoadjuvant chemotherapy+surgical treatment+adjuvant chemotherapy)has been stabilized in the past 20 years,and the emergence of the slow(controlled)-release drug delivery system has provided a new strategy for the treatment of osteosarcoma.At present,thanks to the development of nanotechnology,great progress had been made to the technology of slow-release chemotherapy for osteosarcoma in China,but the clinical translation of the slow-release chemotherapy system has become the key to constrain its development.Based on this,this review summarizes the preclinical research progress of the main chemotherapeutic agents for osteosarcoma,including methotrexate,doxorubicin,cisplatin,and isocyclophosphamide,in the recent years,with the expectation of clarifying the safety and efficacy of the slow-release chemotherapy system for osteosarcoma,and facilitating the clinical translation of the slow-release chemotherapy system for osteosarcoma.

Germany owns the largest herbal market in Europe and has the world's leading R&D capabilities for herbal medicine products. Chinese herbal medicine (CHM) spreaded to Germany hundreds of years ago. Since the beginning of the 20th century, China and Germany have signed a series of agreements to support traditional medicine cooperation, and the exchange of herbs between China and Germany has become more frequent, bringing opportunities for CHM to enter into Germany. In recent years, China and Germany have gained progress in the fields of CHM research and trade, etc. However, there are differences in the understanding of herbal medicines, quality standard evaluation, usage, and medication rules between the two countries. By doing SWOT analysis of the development of CHM in Germany, this paper suggested to promote Sino-German medical exchanges and build a community of common health for mankind through strengthening the clinical application of CHM, finding new ways of CHM entering into German market, and building an international talent team of traditional Chinese medicine.

The association of Zika virus (ZIKV) infection with microcephaly has raised alarm worldwide. Their causal link has been confirmed in different animal models infected by ZIKV. However, the molecular mechanisms underlying ZIKV pathogenesis are far from clear. Hence, we performed global gene expression analysis of ZIKV-infected mouse brains to unveil the biolog-ical and molecular networks underpinning microcephaly. We found significant dysregulation of the sub-networks associated with brain development, immune response, cell death, microglial cell acti-vation, and autophagy amongst others. We provided detailed analysis of the related complicated gene networks and the links between them. Additionally, we analyzed the signaling pathways that were likely to be involved. This report provides systemic insights into not only the pathogenesis, but also a path to the development of prophylactic and therapeutic strategies against ZIKV infection.

Objectives: To examine the value of multi-slice spiral CT angiography (MSCTA) in the analysis of anatomical variation and structural classification of right colon vessels. Methods: From August 2015 to August 2017, 198 patients (96 of whom underwent laparoscopic radical resection of right colon cancer) at Department of General surgery of Peking University First Hospital were retrospectively collected, and the results of abdominal enhanced CT scan were collected and three-dimensional reconstruction of blood vessels was performed. There were 104 males and 94 females. The age was 64(27) years (M(Q_R), range: 19 to 87 years). Right gastroepiploic vein, anterior superior pancreaticoduodenal vein, right colonic vein (RCV), superior right colonic vein, ileocolon artery or vein (ICA or ICV), middle colon artery or vein (MCA or MCV) and Henle trunk were observed and recorded respectively. The anatomical relationship between the positions of blood vessels, the length of Henle trunk and surgical trunk were measured. Results: ICV and ICA were the most constant anatomic structures. The ICV/ICA of all patients came directly from SMV/SMA, 36.9% (73/198) ICV going in front of SMV and 63.1% (125/198) behind SMV. 72.2% (143/198) of the patients had RCV imported into Henle trunk and the rest into SMV. Middle colonic vein (MCV) could be observed in 81.3% (161/198) of the cases. 81.4% (131/161) of MCV were imported into SMV, 16.8% (27/161) into Henle trunk, 1.2% (2/161) into the first jejunal vein and 0.6% (1/161) into the splenic vein. Henle trunk was divided into 4 types, among which the occurrence probability of gastric node and pancreatic trunk was the highest. The dry length of Henle trunk was (0.82±0.39) cm (range: 0.37 to 1.68 cm). The length of surgical trunk was (2.54±0.83) cm (range: 1.57 to 3.95 cm). Accuracy of MSCTA results was 96.9%(93/96). Conclusions Anatomical variation of blood vessels in the right colon is common. Abdominal CT angiography can accurately determine the anatomical structure of the blood vessels in the right colon.

Objectives To investigate the homology and drug resistance gene of Group B Streptococcus ( GBS) Resistance induced by Clindamycin and provide basic data for clinical prevention and treatment of GBS Resistance infection induced by Clindamycin .Methods 921 strains of GBS were isolated at Obstetrics&Gynecology Hospital of Fudan University from January , 2014 to December , 2015.VITEK2-compact automatic bacterial susceptibility instrument was used to test their sensitivity to 7 antibacterial drugs.63 positive strains were chosen through D-inhibition zone trial which were drug resistant to Erythromycin and susceptible or intermediary to Clindamycin .The strain′s sequence type was identified by the method of multilocus sequence typing ( MLST typing ) .The drug resistance genes mefA & ermB to Erythromycin were detected by using PCR method .The analysis was carried out to reveal the relevance to drug resistance , multilocus sequence typing and drug resistance gene .Results Among 921 strains of GBS , the drug resistance rate was respectively 53.4％ ( 492/921 strains ) to Erythromycin , 50.2％ ( 462/921 strains) to Clindamycin, 34.7％ ( 320/921 strains ) to Levofloxacin and 7.5％ ( 69/921 strains ) to Nitrofurantoin.The drug resistance rate of Levofloxacin for 63 GBS strains was 27.0％(17/63 strains) and no drug resistant strain was found to Penicillin , Vancomycin & Nitrofurantoin.12 different ST types were involved in total, including a new ST type:ST1072.The most common ones were ST12 (30.1％) (20/63 strains) &ST19 (25.4％) (16/63 strains).The drug resistance rate of Levofloxacin with ST 19 (75.0％) (12/16 strains) was much higher than that of other ST types .The relevance ratio of mefA and ermB among 63 GBS strains was respectively 27.0％(17/63 strains) and 41.3％(26/63 strains).Conclusions The genetic diversity existed in Group B Streptococcus resistance induced by Clindamycin detected in this study . There was significant difference on drug resistance and relevant drug resistant genes among different ST types.

Objective To investigate the prevalence and transmission mechanisms of plasmid-mediated blaoxa-23 resistance genes in Acinetobacter baumannii.Methods One hundred and one Acinetobacter baumannii were collected from Obstetrics and Gynecology Hospital of Fudan University and Renji Hospital Shanghai Jiaotong University School of Medicine.Antibiotic susceptibility of carbapenems were determined by standard agar dilution method.Molecular typing of Carbapenem-resistant Acinetobacter baumannii (CRAB) was performed by MLST.blaoxa-23、blaoxa-24、blaoxa-51、blaoxa-58、blaIMP-1、blaVIM-1/2 and blaAmp-C were analyzed by PCR.The analysis of blaoxa-23 transposons for carbapenems resistant A.baumannii isolates was also performed by PCR.Plasmid was analyzed by gel electrophoresis.Conjugation experiments were performed to determine the transferability of blaoxa-23.Results The antibiotic susceptibility tests showed the resistant rates to carbapenems were extremely high , and the ones of imipenem and meropenem were 64.4%and 69.3%.Fifty-six (53%) isolates were carbapenems-resistant A.baumannii.Main clone ST208 includes 28 isolates(50%) in CRAB.A total of the CRAB isolates harbored blaoxa-23 and blaoxa-51 (100%), 44 for blaIMP-1(78.6%) and 54 for blaAmp-C(96.4%), while blaoxa-24, blaoxa-58 and blaVIM-1/2 was undetected.Two previously identified transposons ( Tn2006 and Tn2008 ) was found in the isolates.Plasmid gel electrophoresis results showed that the isolates carried 2-4 plasmids and blaoxa-23 were transferable by plasmids.Conclusions There is high carbapenems resistance of A.baumannii infections.ST208 was the most prevalent molecular type.The mainly drug-resistant genes of A.baumannii are blaoxa-23.Based on the findings, blaoxa-23 is plasmid mediated, suggesting that it may transfer by plasmids carrying Tn 2008 transposon, thus induced isolates resistant to carbapenemase.

Objective To investigate the resistance rates of the Candida albicans strains isolated from patients with vulvovaginal candidiasis to 5 antifungal agents and examine the mechanism of azole resistance in these strains.Methods A total of 1 646 C.albicans strains were collected in Obstetrics and Gynecology Hospital of Fudan University from January to December 2015.The resistance rates of these isolates to five antifungal agents were analyzed.Azole-resistant (n=30),dose dependent sensitive (S-DD) (n=13),and susceptible isolates (n=10) were randomly selected from the microbiology laboratories of three obstetrics and gynecology hospitals in Shanghai.The expression levels of drug efflux pump related gene CDR1,CDR2,MDR1 and drug target enzyme gene ERG11 were analyzed by real-time fluorescence quantitative polymerase chain reaction (PCR).At the same time,the ERG11 and ERG3 genes were amplified by PCR and sequenced,and analyzed for resistance-related mutations.Results Of the 1 646 C.albicans strains,5.2％,3.2％,2.5％ and 2.1％ were resistant to itraconazole,voriconazole,fluconazole and 5-fluorocytosine,respectively.All isolates were sensitive to amphotericin B.The expression of ERG11 gene was significantly higher in S-DD group and azole-resistant group than in azole-sensitive group (P＜0.05).The expression of CDR1,CDR2 and MDR1 did not show significant difference among the three groups.There were 13 missense mutations in the ERG11 gene,of which T123I,P98S and Y286D amino acid substitutions were newly discovered.Both T123I and Y132H were identified in 26 resistant isolates,of which 16 gene mutation was detected in two pan-azole-resistant isolates.Conclusions The C.albicans strains isolated from vulvovaginal candidiasis showed higher resistance rates to azole antifumgal agents than that to 5-fluorocytosine and amphotericin B.Mutation and over-expression ofERG11 gene may be one of the prevalent molecular mechanisms underlying azole resistance in C.albicans.were pan-azole-resistant.In addition,the ERG3 heterozygous

Objective To evaluate the effect of endoscopic management of foreign bodies in the upper digestive tract. Methods Clinical data and endoscopic treatment methods of 41 patients were retrospectively analyzed from October 2014 to May 2016. Patients with incomplete medical records were excluded. Results Foreign bodies in the upper digestive tract occurred high frequency in elderly. 53.6% of the foreign bodies were located in the esophagus. Date stones was the main type of foreign bodies (56.1%). 41 cases with foreign bodies in digestive tract were successfully extracted, while 1 case occurred perforation. Conclusion Endoscopic management of gastrointestinal foreign bodies is safe and effective.

Objective To explore the effects of the training the trainers model in the quality control circle training.Methods According to the training the trainers model, 27 nurses were involved as trainers and received quality control circle training by 6 mentors from 2013 to 2015. The training capacity of trainers and the training effect of the target group were assessed before and after training. The lasting effect after training were evaluated.Results The self-assessment score of 6 trainers′ training capacity after training (4.30±0.54) was significantly higher than before training (1.41±0.50) (t=-19.98, P<0.01). The self-assessment score of 189 circle members′ training capacity after training ( 27. 51 ± 4. 19 ) was significantly higher than before training (20.52±4.56) (t=-18.722, P<0.01). The percentage of nursing staff participating in the quality control circle significantly increased from 2.8% to 12.4% after the whole process (χ2=226.378, P<0.01).Conclusions The training the trainers model is effective in improving training capacity of trainers in quality control circle training and increasing effects of quality control circle training among target nurses and is an effective model in training quality control circle on nurses.