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Neuropathic pain(NP) is difficult to be treated since it has similar phenotypes but different pathogenesis in different pathological stages. Targeted intervention of the core regulatory elements at different pathological stages of NP has become a new direction of drug research and development in recent years and provides the possibility for the treatment of NP. The Mongolian medicine Naru-3(NR-3) is effective in the treatment of sciatica and trigeminal neuralgia, the mechanisms of which remain unknown. On the basis of the previous study of the priming stage, this study established the mouse model of spinal nerve ligation(SNL) and measured the changes of pain thresholds by behavioral tests. The network analysis, Western blot, immunofluorescence assay, ELISA, and agonist/antagonist were employed to decipher the mechanism of NR-3 in the treatment of NP in the maintenance stage. The results showed that NR-3 increased the mechanical and thermal pain thresholds of SNL mice, while it had no significant effect on the basal pain threshold of normal mice. NR-3 may relieve the pain in the maintenance stage of NP by blocking the matrix metalloproteinase 2(MMP2)/interleukin-1β(IL-1β) pathway in the astrocytes of the dorsal root ganglion(DRG) and spinal cord. The findings have enriched the biological connotation of NR-3 in the treatment of the maintenance stage of NP and provide reference for the rational use of this medicine in clinical practice.

Objective: To evaluate the hemostatic efficacy, safety and immunogenicity of recombinant human thrombin in the treatment of liver wounds that still ooze after conventional surgical hemostasis. Methods: A multicenter, stratified randomized, double-blind, placebo-controlled phase Ⅲ trial with a planned enrollment of 510 subjects at 33 centers, with a 2∶1 randomization to the thrombin group versus the placebo group. An interim analysis will be conducted after approximately 70% of the subjects have completed the observation period. The primary efficacy endpoint was the rate of hemostasis within 6 minutes at the point of bleeding that could be evaluated. Safety analysis was performed one month after surgery, and the positive rates of anti-drug antibody (ADA) and neutralizing antibody were evaluated. Results: At the interim analysis, a total of 348 subjects had been randomized and received the study drug (215 were male and 133 were female). They were aged 19-69 (52.9±10.9)years. Among them, 232 were in the thrombin group and 116 were in the placebo group, with balanced and comparable demographics and baseline characteristics between the two groups. The hemostasis rate at 6 minutes was 71.6% (95% CI :65.75%-77.36%) in the thrombin group and 44.0% (95% CI : 34.93%-53.00%) in the placebo group, respectively ( P <0.001). No grade≥3 drug-related adverse events and no drug-related deaths were reported from the study.No recombinant human thrombin-induced immunologically-enhanced ADA or immunologically-induced ADA was detected after topical use in subjects. Conclusion: Recombinant human thrombin has shown significant hemostatic efficacy and good safety in controlling bleeding during liver resection surgery, while also demonstrating low immunogenicity characteristics.

Objective: To investigate the effect and regulation of umbilical cord-derived mesenchymal stem cells (UC-MSCs) on islets function and NOD-like receptor family, pyrin domain containing 3 (NLRP3) and autophagy in type 2 diabetic mellitus (T2DM) mice. Methods: Experimental study. Twenty, 8-week-old, male C57BL/6J mice were selected and divided into a normal control group ( n =5) and a high-fat feeding modeling group ( n =15). The model of T2DM was established by high-fat feeding combined with intraperitoneal injection of low-dose streptozotocin. After successful modeling, those mice were divided into a diabetes group ( n =7) and a UC-MSCs treatment group ( n =7). The UC-MSCs treatment group was given UC-MSCs (1×10 6 /0.2 ml phosphate buffer solution) by tail vein infusion once a week for a total of 4 weeks; the diabetes group was injected with the same amount of normal saline, and the normal control group was not treated. One week after the treatment, mice underwent intraperitoneal glucose tolerance tests and intraperitoneal insulin tolerance tests, and then the mice were sacrificed to obtain pancreatic tissue to detect the expressions of interleukin-1β (IL-1β) and pancreatic and duodenal homeobox 1 (PDX-1) by immunofluorescence. The bone marrow-derived macrophages were stimulated with lipopolysaccharide and adenosine triphosphate (experimental group) in vitro , then co-cultured with UC-MSCs for 24 h (treatment group). After the culture, enzyme-linked immunosorbent assay was used to detect the secretion level of IL-1β in the supernatant, and immunofluorescence staining was used to detect the expression of NLRP3 inflammasome, and related autophagy proteins. Statistical analysis was performed using unpaired one-way analysis of variance, repeated measure analysis of variance. Results: In vivo experiments showed that compared with the diabetes group, the UC-MSCs treatment group partially repaired islet structure, improved glucose tolerance and insulin sensitivity (all P <0.05), and the expression of PDX-1 increased and IL-1β decreased in islets under confocal microscopy. In vitro experiments showed that compared with the experimental group, the level of IL-1β secreted by macrophages in the treatment group was decreased [(85.9±74.6) pg/ml vs. (883.4±446.2) pg/ml, P =0.001], the expression of NLRP3 inflammasome and autophagy-related protein P62 was decreased, and the expressions of microtubule-associated protein 1 light chain 3β (LC3) and autophagy effector Beclin-1 were increased under confocal microscopy. Conclusions: UC-MSCs can reduce the level of pancreatic inflammation in T2DM mice, preserving pancreatic function. This might be associated with the ability of UC-MSCs to inhibit the activity of NLRP3 inflammasomes in macrophages and enhance autophagy levels.

Objective: To investigate the feature and treatment of atrial tachycardia (AT) originated from right atrial appendage (RAA) in children. Methods: The data of 42 children with AT originated from RAA, who were admitted the First Hospital of Tsinghua University from January 2010 to September 2022 were analyzed retrospectively.The clinical characteristics, treatment and efficacy were analyzed. The children were divided into tachycardia cardiomyopathy group and normal cardiac function group. The differences in the ablation age and the heart rate during AT between two groups were compared by independent sample t -test. Results: Among 42 children, there were 20 males and 22 females. The age of onset was 2.7 (0.6, 5.1) years. Their age at radiofrequency ablation was (6.5±3.6) years, and the weight was (23.4±10.0) kg. Thirty-two children (76%) had sustained AT. The incidence of tachycardia cardiomyopathy was 43% (18/42). Compared to that of the normal cardiac function group, the ablation age and the heart rate at atrial tachycardia of the tachycardia cardiomyopathy group were higher ((8.1±3.8) vs. (5.3±3.1) years, t =-2.63, P =0.012; (173±41) vs. (150±30) beats per minute, t =-2.05, P =0.047. Thirty-eight children (90%) responded poorly to two or more antiarrhythmic drugs. The immediate success rate of radiofrequency ablation (RFCA) was 57% (24/42), and the AT recurrence rate was 17% (4/24). Twenty-two children underwent RAA resection, and their AT were all converted to sinus rhythm after the surgery. During the RAA resection, 10 cases of right atrial appendage aneurysm were found, 9/18 of which failed the RFCA. Conclusions: The AT originated from the RAA in children tend to present with sustained AT, respond poorly to antiarrhythmic drugs, and has a low success rate of RFCA as well as high recurrence rate. Resection of the RAA is a safe and effective complementary treatment.

Neuropathic pain(NP) has similar phenotypes but different sequential neuroinflammatory mechanisms in the pathological process. It is of great significance to inhibit the initiation of neuroinflammation, which has become a new direction of NP treatment and drug development in recent years. Mongolian drug Naru-3 is clinically effective in the treatment of trigeminal neuralgia, sciatica, and other NPs in a short time, but its pharmacodynamic characteristics and mechanism of analgesia are still unclear. In this study, a spinal nerve ligation(SNL) model simulating clinical peripheral nerve injury was established and the efficacy and mechanism of Naru-3 in the treatment of NPs was discussed by means of behavioral detection, side effect evaluation, network analysis, and experimental verification. Pharmacodynamic results showed that Naru-3 increased the basic pain sensitivity threshold(mechanical hyperalgesia and thermal radiation hyperalgesia) in the initiation of SNL in animals and relieved spontaneous pain, however, there was no significant effect on the basic pain sensitivity threshold and motor coordination function of normal animals under physiological and pathological conditions. Meanwhile, the results of primary screening of target tissues showed that Naru-3 inhibited the second phase of injury-induced nociceptive response of formalin test in mice and reduced the expression of inflammatory factors in the spinal cord. Network analysis discovered that Naru-3 had synergy in the treatment of NP, and its mechanism was associated with core targets such as matrix metalloproteinase-9(MMP9) and interleukin-1β(IL-1β). The experiment further took the dorsal root ganglion(DRG) and the stage of patho-logical spinal cord as the research objects, focusing on the core targets of inducing microglial neuroinflammation. By means of Western blot, immunofluorescence, agonists, antagonists, behavior, etc., the mechanism of Naru-3 in exerting NP analgesia may be related to the negative regulation of the MMP9/IL-1β signaling pathway-mediated microglia p38/IL-1β inflammatory loop in the activation phase. The relevant research enriches the biological connotation of Naru-3 in the treatment of NP and provides references for clinical rational drug use.

Objective: To investigate the effects and related molecular mechanisms of Astragalin on undifferentiated gastric cancer cell HGC-27., Methods: Astragalin was used to treat HGC-27 cells, the cell proliferation activity was detected by CCK-8 method, the cell morphology was observed under inverted microscope, hoechst 33342 and JC-1 staining were used to observe the changes of nucleus formation and mitochondrial membrane potential, the cell cycle and apoptosis rate were detected by flow cytometry, the reverse transcription level of the gene was analyzed by the second-generation sequencer., Results: Astragalin inhibited the proliferation of HGC-27 significantly ( P ＜0.01), down-regulated mitochondrial membrane potential, induced cell apoptosis, blocked the cell cycle in G1 prophase. At the same time, Astragalin up-regulated the transcription levels of genes bax and bad, down-regulated the transcription levels of genes egf, egfr, pik3cb, pdk1, akt3 and bcl-2. Western blot analysis also showed that the expressions of PI3K and Akt protein were decreased, and the proportion of Bax and BCL-2 protein was increased significantly ( P ＜0.01)., Conclusion: The apoptosis of undifferentiated gastric cancer cell line HGC-27 can be induced by Astragalin through inhibition of EGFR/PDK/Akt signaling pathway, and the cell cycle can be blocked in G1 phase, which has a certain therapeutic effect on undifferentiated gastric cancer.

Objective: To study the clinicopathological characteristics, diagnosis and differential diagnosis of bronchiolar adenoma (BA). Methods: Fifteen cases of BA were collected from the First Affiliated Hospital of Nanjing Medical University, from January 2016 to October 2019. The clinical data, imaging examination, morphology, immunostaining and molecular changes were retrospectively analyzed. Results: There were 3 males, 12 females, most of the patients were female, mainly in middle-aged to elderly (51-77 years). Three had smoking history. The patients usually had no clinical symptoms. Imaging findings were ground-glass and/or lobulated nodules. Grossly, the tumors were gray-whitish, taupe solid or focally microcystic nodules with distinct boundary but no capsule. The maximum diameter was 0.4-2.5 cm (mean 1.0 cm). Histologically, there were glandular, papillary, or flat patterns that were composed of basal cells, mucous cells, ciliated cells and type Ⅱ pneumocytes, some of which showed basal cell proliferation and squamous cell metaplasia. However, there were some cases with few or even without mucous and/or ciliated cells. Immunostaining highlighted the continuous basal cell layer (positive for p63, p40 and cytokeratin 5/6), which was the most important diagnostic evidence. Genetic tests did not show mutation in BRAF or EGFR genes. All patients were followed up for 1-41 months, and they were without recurrence or metastasis. Conclusions: BA is a benign neoplasm that develops in the peripheral lung with good prognosis. Definite diagnosis is very crucial for surgical treatment, especially in frozen consultation. Immunohistochemistry will be helpful if necessary.

Neural stem cell therapy, as a new therapeutic method for neural diseases, has aroused a wide concern for over 20 years since neural stem cells were first found in 1992. Ischemic stroke is highly concerned because of its high incidence, mortality and disability rates. Because the brain has a limited ability to repair itself, to improve neural function and promote neural regeneration may help to prevent occurrence and development of neurological diseases. It is noteworthy that some stroke patients showed an ability to repair brain several months after the stroke happened, suggesting an existence of endogenous nerve repair in these patients. The research advances in functions of endogenous neural stem cells in neural regeneration and the related regulators after ischemic stroke are summarized in this review to provide new views of the mechanism of neural functional recovery after ischemic stroke.

PURPOSE：To explore the clinical effect of continuous oral health education on elderly patients with chronic periodontitis treated with dual wavelength lasers., Methods: The clinical data of 150 elderly patients with chronic periodontitis treated with dual-wavelength laser in Shanghai Ninth People's Hospital between March 2016 and March 2018 were analyzed and divided into 2 groups according to the different intervention plans applied. Seventy-five cases receiving routine oral hygiene education were taken as the control group, and the other 75 patients receiving continuous oral health education were set as the experimental group. Oral behavior, gingival index and dental plaque index in the two groups were analyzed and compared using SPSS 21.0 software package., Results: The proportions of patients with correct brushing, taking regular oral examination and maintenance, and keeping good oral habits in the experimental were 97.33%, 93.33% and 92.00%, respectively, which were significantly higher than those in the control group (P<0.05). The gingival index and dental plaque index 3 and 6 months after intervention were (1.24±0.14) and (1.08±0.10), (1.50±0.10) and (1.69±0.26), respectively in the experimental group, which were significantly lower than those in the control group (P<0.05)., Conclusions: For elderly patients with chronic periodontitis treated with dual-wavelength laser therapy, application of continuous oral health education can improve their oral behavior and periodontal status, therefore is worthwhile to be popularized in clinical application.

Objective: To investigate the perioperative parameters and postoperative sexual function and complications in native Tibetans undergoing transurethral resection of the prostate (TURP) for BPH with different prostate volumes., Methods: From June 2015 to February 2017, 325 native Tibetans with BPH underwent TURP in the People's Hospital of Tibet Autonomous Region. The patients were aged 59－88 years, with a median oxygen saturation level of 84% in the normal status, 24% with hydronephrosis, 40.3% with the history of acute urinary retention, 61.8% with pulmonary hypertension, and 19.1% taking regular medication preoperatively. According to the preoperative prostate volume (PV), the patients were divided into a large PV (LPV) group (PV ≥80 ml, n = 124) and a small PV (SPV) group (<80 ml, n = 201). Perioperative parameters and postoperative sexual function and complications were analyzed and compared between the two groups of patients., Results: The operation time was significantly longer in the LPV than in the SPV group (［92.36 ± 26.35］ vs ［56.28 ± 24.61］ min, P < 0.05) and the intraoperative blood loss was higher in the former than in the latter (［401.12 ± 50.12］ vs ［385.15 ± 51.62］ ml, P < 0.05). Compared with the baseline, at 6 months after operation, the IPSS was significantly decreased in all the patients (22.13 ± 6.23 vs 5.29 ± 1.14 in the LPV group, P < 0.05; 23.04 ± 6.82 vs 5.12 ± 1.28 in the SPV group, P < 0.05), and the maximum urinary flow rate (Qmax) remarkably improved (［17.46 ± 5.82］ vs ［5.91 ± 1.86］ ml/s in the LPV group, P < 0.05; ［17.99 ± 5.86］ vs ［6.01 ± 1.92］ ml/s in the SPV group, P < 0.05). The incidence rate of retrograde ejaculation was markedly higher in the LPV than in the SPV group postoperatively (48.4% vs 20.9%, P < 0.05). No statistically significant differences were observed between the two groups of patients in the incidence of postoperative complications (13.71% vs 9.45%, P > 0.05)., Conclusions: TURP is effective and safe for the treatment of BPH native Tibetans with different prostate volumes.

Objective: To investigate the effect of SH2-containing inositol phosphatase-1 (SHIP-1) on the proliferation, invasion and migration of human leukemia cells as well as phosphatidylinositol-3 kinase (PI3K) / protein kinase B (AKT) signaling pathway., Methods: The overexpression vector pCDNA3.1-SHIP1 was transfected into THP-1 cells by Lipofectamine 2000. The experiment was divided into 3 groups: control group (untreated cells) and empty vector group (transfected with empty vector pCDNA3.1-NC) and overexpression group (transfected with overexpression vector pCDNA3.1-SHIP1). The cell proliferation was tected by CCK-8 assay, Transwell assay was used to evaluate the cell invasion and migration capabilities. The expressions of SHIP-1, AKT, phosphorylated AKT (pAKT), matrix metalloproteinase-9 (MMP-9) protein were analyzed by Western blot., Results: The expression of SHIP-1 in overexpression group was significantly higher than that in the control group(P<0.05). Compared with the control group, the absorbance of the cells in the empty vector group was not statistically different (P>0.05), and the absorbance in overexpression group decreased significantly(P<0.05). The cell numbers of invasion and migration were not significantly different between empty and control groups(P>0.05), but those in overexpression group were significantly lower than those in the control group(P<0.05). Compared with the control group, the expression of AKT, pAKT and MMP-9 in the empty vector group was not statistically different (P>0.05); the AKT protein in overexpression group was not significantly different (P>0.05), but the pAKT and MMP-9 significantly decreased(P<0.05)., Conclusion: SHIP-1 plays a role in inhibiting the proliferation, invasion and migration of leukemia cells, the mechanism probably relates with supressing the expression of MMP-9 by regulating PI3K/AKT signaling pathway.

Objective: To evaluate the efficacy and safety of anti-Interleukin-5 therapy in patients with asthma. Methods: Data were collected from PubMed, E-Mbase, Springer, Ovid, Cochrane Library, ClinicalTrials.gov, CNKI and Wanfang database (-Feb 2017). Bibliographies of the retrieved articles were checked and analyzed. Results: Twenty publications involving a total of 6 406 patients were used in the analysis, including 23 randomly controlled trials (RCTs) which compared anti-interleukin 5 monoclonal antibody with placebo. Pooled analyses showed that anti-interleukin 5 monoclonal antibody significantly reduced exacerbation risk [ RR =0.66, 95% CI (0.59, 0.73)], increased FEV(1)[ MD =0.10, 95% CI (0.07, 0.13)] and FEV(1)% predicted [ MD =3.90, 95% CI (1.86, 5.95)], and improved the scores on the Asthma Quality of Life Questionnaire (AQLQ) [ MD =0.24, 95% CI (0.16, 0.32)]. Anti-interleukin 5 monoclonal antibody was also associated with significantly decreased risk of adverse events than placebo[ OR =0.71, 95% CI (0.58, 0.87)]. Conclusion: Anti-interleukin 5 monoclonal antibody reduces the risk of exacerbations and improves quality of life in patients with asthma, and is tolerated well.

Objective: To investigate the change of plasma IL-16 level in patients with multiple myeloma(MM) and its clinical significance., Methods: Sixty-two patients with multiple myeloma were admitted in our hospital from June 2008 to June 2015. Forty healthy volunteers were selected as control group. The peripheral blood of all the patients and healthy volunteers were collected before the treatment of patients. The levels of IL-16, Cys-C, LDH and β2-MG were measured. ROC curve was used to analyze the optimal IL-16 thresholds in MM patients. Kaplan-Meier method was used to analyze the factors affecting overall survival., Results: The levels of IL-16, Cys-C, LDH and β2-MG in the MM group were significantly higher than those in the control group (P<0.05). The levels of IL-16, Cys-C, LDH and β2-MG in patients with different ISS were significantly different (P<0.05). The levels of IL-16, Cys-C, LDH and β2-MG in ISS III groups were higher than those in ISS I and ISS II groups(P<0.05). When the IL-16 concentration was 171.26 ng/L, the AUC was 0.787 (P<0.01), and the sensitivity and specificity were 82.25% and 75.80%, respectively, when the IL-16 threshold was predicted by ROC curve analysis. The 3-year overall survival rates of patients with IL-16≤171.26 ng/L and IL-16>171.26 ng/L were 91.93% and 51.61%, respectively (P<0.01). Multivariate analysis showed that the changes of IL-16 levels were significantly related with overall survival (P<0.01)., Conclusion: The level of IL-16 in peripheral blood of patients with multiple myeloma has been cofirmed to be significantly elevated, and the elevated IL-16 is closely related with the prognosis.

Objective: To compare the effects of different dosages of rhG-CSF on duration of aleucocytosis and white blood cell counts after chemotherapy of patients with hematologic malignancies., Methods: Ninety patients in our hospital from December 2011 to June 2016 were chosen as study objects, and all of them were divided into 3 groups: group A (rhG-CSF 200 µg/m 2 ), group B(rhG-CSF 300 µg/m 2 ) and group C(rhG-CSF 400 µg/m 2 ); 30 patients from January 2004 to January 2007 were chosen as control(control group). The WBC (min) and its duration, WBC (max) and its timepoint were compared among different groups. The infection rate, incidence of side reactions and total amount of rhG-CSF used in different groups were compared., Results: In control group, WBC (min) was(1.30±0.11)×10 9 /L, its duration was (3.2±0.7)d, WBC (max) was(5.14±0.41)×10 9 /L, and its time point was (26.1±1.8)d; these in group A were (3.14±0.23)×10 9 /L,(2.7±1.0)d, (10.08±0.69)×10 9 /L and (14.9±1.8)d respectively; these in group B were (3.11±0.32)×10 9 /L, (0.9±0.5)d, (10.17±0.75)×10 9 /L and(10.7±1.5)d respectively; these in group C were (3.15±0.30)×10 9 /L,(0.5±0.3)d, (11.95±0.86)×10 9 /L and (10.6±1.5)d, respectively. Compared with control group, the WBC (min) and WBC (max) were both increased significantly, the duration of WBC (min) was shortened and the timepoint of WBC (max) was moved up(P<0.05). The infection rate of group C (3.33%(1/30)) was significantly lower than that of control group(33.33%(10/30))(P<0.05), total used amount of rhG-CSF and incidence of side reactions were not statistically different among group A,B,C(P>0.05)., Conclusion: Compared with low dosage of rhG-CSF, medium/high dosage of rhG-CSF can help to shorten duration of a leukocytosis after chemotherapy of patients.

Objective: To study the safety and efficacy of Bushen Daozhuo Granules (BDG) in the treatment of type Ⅲ prostatitis., Methods: This multicenter randomized controlled clinical trial included 478 patients with type Ⅲ prostatitis, 290 in the trial group and 188 as controls, the former treated with BDG at 200 ml bid and the latter with tamsulosin hydrochloride sustainedrelease capsules at 0.2 mg qd, both for 4 weeks. Before treatment, after 4 weeks of medication, and at 4 weeks after drug withdrawal, we obtained the NIH Chronic Prostatitis Symptom Index (NIHCPSI) scores and compared the safety and effectiveness rate between the two groups of patients., Results: Compared with the baseline, the NIHCPSI score was markedly decreased in the control group after 4 weeks of medication (21.42 ± 4.02 vs 15.67 ± 3.65, P < 0.05) but showed no statistically significant difference from that at 4 weeks after drug withdrawal (19.03 ± 3.86) (P>0.05), while the NIHCPSI score in the trial group was remarkably lower than the baseline both after 4 weeks of medication and at 4 weeks after drug withdrawal (10.92 ± 2.06 and 12.91 ± 2.64 vs 21.58 ± 3.67, P < 0.05). The trial group exhibited both a higher rate of total effectiveness and safety than the control (P < 0.05)., Conclusions: BDG is safe and effective for the treatment of type Ⅲ prostatitis.

Objective: To analyze the clinical features and outcomes of congenital adrenal hyperplasia (CAH) with adenomatoid adrenal gland. Methods: Nineteen patients clinically confirmed as CAH with adenomatoid adrenal gland, from 2008 to 2015 in Deparment of Endocrinology of Chinese PLA General Hospital, were retrospectively analyzed, and the outcomes of the treatment were followed up. Results: Seventy-six patients were clinically confirmed as CAH, from 2008 to 2015 in PLA hospital. Nineteen of them have accompanied with adenomatoid adrenal gland. Of the 19 confirmed cases, 7 were male, and 12 were female. The mean age was (33.3±14.8) years old. Nineteen confirmed cases were consisted of 10 cases of 21-hydroxylase deficiency (OHD), 6 cases of 17α-OHD, and 3 cases of 11β-OHD. Of the 19 cases, 5 cases presented with adrenal hyperplasia with left side adenomatoid solid lesion, 2 cases presented with adrenal hyperplasia with right side adenomatoid solid lesion, and 8 cases presented with double side adenomatoid solid lesion. The proportion of adrenal hyperplasia with unilateral cystic or calcified changes was 21.1%. Nine of the 19 patients underwent operation or fine needle biopsy. The pathology showed 7 adenomas (21-OHD/17α-OHD 5/2) and 2 myelolipomas (21-OHD/17α-OHD 1/1). Four patients were admitted into hospital because of the incidentaloma, while others because of the clinical symptoms. The average follow-up time was 31 months. CT images were rechecked among 7 patients. After the treatment, 1 patient's tumor shrunk, 4 cases had no recurrence, 1 case's tumor disappeared, and the other one case had no change. Symtoms of eleven followed-up patients relieved. Conclusions: The image of adrenal of CAH with adenomatoid adrenal gland is various. It may occur in each type of CAH presented as unilateral or bilateral, adenoma or myelolipoma.

Identification accuracy of traditional Chinese medicine is crucial for the traditional Chinese medicine research, production and application. DNA barcoding based on the mitochondrial gene coding for cytochrome c oxidase subunit I (COI), are more and more used for identification of traditional Chinese medicine. Using universal barcoding primers to sequence, we discussed the feasibility of DNA barcoding method for identification commonly-used medicinal snakes (a total of 109 samples belonging to 19 species 15 genera 6 families). The phylogenetic trees using Neighbor-joining were constructed. The results indicated that the mean content of G + C(46.5%) was lower than that of A + T (53.5%). As calculated by Kimera-2-parameter model, the mean intraspecies genetic distance of Trimeresurus albolabris, Ptyas dhumnades and Lycodon rufozonatus was greater than 2%. Further phylogenetic relationship results suggested that identification of one sample of T. albolabris was erroneous. The identification of some samples of P. dhumnades was also not correct, namely originally P. korros was identified as P. dhumnades. Factors influence on intraspecific genetic distance difference of L. rufozonatus need to be studied further. Therefore, DNA barcoding for identification of medicinal snakes is feasible, and greatly complements the morphological classification method. It is necessary to further study in identification of traditional Chinese medicine.

Pollen is an important part of bioaerosols, and its complex refractive index is a crucial parameter for study on optical characteristics and detection, identification of bioaerosols. The reflection spectra of pear pollen within the 2. 5 - 15µm waveband were measured by squash method. Based on the measured data, the complex refractive index of pear pollen within the wave-band of 2. 5 to 15 µm was calculated by using Kramers-Kroning (K-K) relation, and calculation deviation about incident angle and different reflectivities at high and low frequencies.were analyzed. The results indicate that 18 degrees angle of incidence and different reflectivities at high and low frequencies have little effect on the results, and it is practicable to calculate the complex refractive index of pollen based on its reflection spectral data. The data of complex refractive index of pollen have some reference value for optical characteristics of pollen, detection and identification of bioaerosols.

To identify some medicinal animals of Lacertilia, in total 59 individuals belonging to 12 species 7 genera 3 families, we used the universal barcoding primers to sequence these species, compared with other homologous sequences (564 bp) obtaining from the GenBank and finally constructed phylogenetic trees using Neighbor-joining, Maximum parsimony and Bayesian inference, respectively. As a result, the mean content of G + C (46.5%) was lower than that of A + T (53.5%). As calculated by Kimera-2-parameter model, the whole individuals mean distance for interspecies and intraspecies was 35. 5% and 1.7%, respectively. The mean distance for interspecies was 21 times as much as that for intraspecies. The mean distance for intraspecies of Gekko swinhonis, Hemidactylus frenatus and G. gecko was greater than 2%, respectively. Further analyses suggested that geographical groups of the three species might be of different subSpecies, even species. Of course, incorporating morphological characters and other unlinked genetic markers in future studies will offer further insights into the divergence. On the basis of phylogenetic trees constructed by COI, our results indicated that the taxonomy of the category (family, genus, and species) by DNA barcoding is consistent with morphological characters. Therefore, DNA barcoding is a useful tool for both identification and phylogeny of medicinal animals of Lacertilia, particularly for nonprofessor identifying authentication of Chinese crude drugs of these species.

Objective: To establish HPLC fingerprint of Gekko gecko., Methods: The relative retention time and relative peak area of exteacts of Gekko gecko were determine by HPLC to confirm proper chromatographic condition and obtain the data., Results: Better distribution of relative retention time and relative peak area were shown under the chromatographic condition and the HPLC fingerprint was established., Conclusion: The established HPLC fingerprints of Gekko gecko can be used to identify Gekko gecko and its quality control.

Aim: To express recombinant structural protein VP1 of enterovirus 71 (EV71) in E.coli and prepare anti-VP1 monoclonal antibodies (mAbs)., Methods: With P1 gene as a template, EV71 VP1 gene was amplified by PCR and cloned into the expression vector pET-32a(+). After transformation into E.coli TG1, the positive clones were screened and sequenced. The recombinant plasmid was then transformed into BLgold (DE3) and the recombinant protein in inclusion bodies was induced by IPTG and detected by SDS-PAGE. After the inclusion bodies were solubilized with 6 mol/L guanidine hydrochloride, we purified VP1 protein using Ni-NTA affinity chromatography, and then immunized the mice with it to prepare the mAbs against VP1 protein., Results: Recombinant VP1 protein was expressed in E.coli. We obtained totally 24 VP1 monoclonal hybridoma cell strains, of which one was EV71 positive determined by Western blotting and five were positive for IFA., Conclusion: These mAbs are valuable reagents for the development of new vaccines and detection kits for EV71.

Background and Objective: Nasopharyngeal carcinoma (NPC), with a remarkable geographic distribution, is consistently associated with Epstein-Barr virus (EBV) infection, and almost all NPC patients have sustained high levels of serum antibodies against EBV. This study was to compare the levels of six anti-EBV antibodies in healthy natives of Zhongshan (a high-incidence area of NPC) with those in provisional migrants from foreign provinces (low-incidence areas of NPC), and to illustrate the relationship between EBV infection and the geographic distribution of NPC., Methods: The serum levels of EBNA1-IgA, EBNA1-IgG, VCA-p18-IgA, VCA-p18-IgG, Zta-IgA and Zta-IgG in 303 healthy Zhongshan natives and 92 provisional migrants were tested using ELISA, and presented by values of adjusted relative absorbance (ArA). The serum levels and positive rates of the six antibodies were compared between the two groups., Results: The mean ArA values of both Zta-IgA and VCA-p18-IgA were significantly higher in Zhongshan natives than in provisional migrants (0.84+/-0.03 vs. 0.42+/-0.04, P <0.05; 0.96+/-0.05 vs. 0.40+/-0.05, P<0.05). In addition, the positive rates of Zta-IgA and VCA-p18-IgA in subjects aged of 30-49, or of 50 and above were significantly higher in Zhongshan natives than in provisional migrants (29.27% vs. 3.03% and 48.28% vs. 6.67% for Zta-IgA, P<0.05; 28.46% vs. 9.09% and 43.10% vs. 13.33% for VCA-p18-igA, P<0.05)., Conclusion: Zhongshan natives are likely to have an elevation of serum IgA antibodies against EBV lytic antigens (Zta and VCA-p18), which represents reactivation of EBV latency infection and implies that Zhongshan natives may have higher risk to develop NPC than provisional migrants.

Objective: To investigate PTEN expression and mutation status in the development of cervical adenocarcinoma., Methods: Immunohistochemistry study of PTEN protein was performed on 42 cases of cervical adenocarcinoma, 20 cases of cervical glandular intraepithelial neoplasia and 28 cases of normal cervix tissue samples. Polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) was used to detect the presence of mutation of exons 5 and 8 of PTEN gene., Results: Positive expression rates of PTEN protein were 54.8% (23/42), 25.0% (5/20) and 100% (28/28) in cervical adenocarcinoma, cervical glandular intraepithelial neoplasia and normal cervix tissues, respectively. There were significant differences among the 3 groups (P < 0.05). Positive expression rates of PTEN protein were 47.4% (9/19), 20.0% (2/10) and 92.3% (12/13) in mucinous, endometrioid and the other variants of cervical adenocarcinoma, respectively. Mutation rates at exon 5 and exon 8 of PTEN gene were 19.0% (8/42), 45.0% (9/20) and 0 in cervical adenocarcinoma, cervical glandular intraepithelial neoplasia and normal cervix tissue, respectively. There were significant differences among 3 groups (chi(2) = 4.29, chi(2) = 12.70; P < 0.05). The mutation rates were 21.1% (4/19) and 40.0% (4/10) in mucinous and endometrioid variants of cervical adenocarcinoma, respectively. There was no mutation at exons 5 and 8 of PTEN gene detected in other variants of cervical adenocarcinoma., Conclusion: The development of cervical adenocarcionomas is correlated with the mutation and absence of the protein expression of PTEN, likely in the early phase of their carcinogenesis.

Objective: To elucidate the possible mechanism of oral carcinogenesis and to explore the value of clinical application of the detection of cytokeratin (CK) 19 for oral squamous cell carcinoma (OSCC) patients., Methods: The cancerous tissues, para-cancerous tissues and excised lymph nodes were collected from 20 operated patients with OSCC. The patients didn't receive radiotherapy and chemotherapy before hospitalization. The relative expression of CK19 mRNA in those tissues was detected by fluorescent quantitative polymerase chain reaction (FQ-PCR)., Results: The expression of CK19 mRNA in the cancerous tissues was 1.85 and 1.66 times higher than that in normal oral mucosa and in para-cancerous tissues, respectively. The expression of CK19 mRNA in lymph nodes from 9 patients with OSCC was positive and the positive rate was 45% (9/20). The positive rate of CK19 mRNA in all lymph nodes from 9 patients with OSCC was 81.8% (18/22), and the positive rate of CK19 mRNA in all lymph nodes from 20 patients with OSCC was 41.9%(18/43). CK19 mRNA level in the cancerous tissues relative to para-cancerous tissues and normal oral mucosa of the patients whose CK19 mRNA expression was positive was lower than that of the patients whose CK19 mRNA expression was negative in lymph nodes, respectively., Conclusion: The possible reason that the expression of CK19 mRNA in the cancerous tissues was higher than that in para-cancerous tissues and normal oral mucosa was that the CK19 synthesis in cancerous tissues increased obviously. The detection of CK19 mRNA in lymph nodes was regarded probably as one of the markers for detecting OSCC micrometastasis in lymph nodes. The detection of CK19 mRNA in lymph nodes by FQ-PCR was more sensitive than hematoxylin-eosin staining in diagnosing OSCC micrometastasis.

Objective: To evaluate the feasibility of localizing the internal auditory canal (IAC) and the facial nerve through the root of the zygoma, foramen spinosum and the head of the malleus in middle fossa approach with the assistance of high resolution computerized tomography (HRCT)., Methods: Eighteen human cadaveric temporal bones were scanned and measured by HRCT. Cadaver specimen were divided into two groups. Group A was studied first through a middle fossa approach to find out the relationship between the HRCT measurements and the anatomic measurements. Then 4 whole human cadaveric heads (8 temporal bones) of group B were dissected using a HRCT oriented middle fossa approach to localize IAC with the root of the zygoma, foramen spinosum and the head of the malleus as landmarks. The two measurement methods were analysed with the Paired-Sample T test, and the difference was thought to be statistical significant when P < 0.05., Results: In Group A, there were no statistical significant differences between the CT measurements and the anatomic measurements from the head of the malleus to other important anatomic structures. In group B, the operation was guided with CT measurements: the distance between the head of the malleus and the root of the zygoma, and the distance between the head of the malleus and foramen spinosum. Within the range 1.5 mm to 3.7 mm, the head of malleus was correctly localized. In seven out of the eight cases, the root of the zygoma, the head of the malleus and the internal auditory canal were in a straight line, whereas, in one case, there was an angle of 15 degrees between the root of zygoma -head of malleus line and head of malleus -internal auditory canal line., Conclusions: HRCT would provide more information on the distance relationship between the head of malleus and the root of the zygoma, foramen spinosum and the internal auditory canal. The head of the malleus could be localized through the root of the zygoma and foramen spinosum with HRCT and therefore the IAC could be exposed with the head of the malleus as a landmark in middle fossa approach when other landmarks were not recognizable.

Objective: To study the preparation of phenols gastric floating tablet., Method: The tablets which were prepared using Eudragit IV, HPMC(K4M), MCC101 and Octadecanol as excipients were evaluated by vitro floatation and releasing performance. The pressure of preparationg was also study to select the optimal preparation., Result: The tablets were successfully prepared in which the drug, Eudragit IV, Octadecanol were 31% respectively,and MCC101 was 7%. And 3-4 kg was found to be the eligible pressure., Conclusion: The study was found to be effective in the process of phenols gastric floating tablet.

Objective: To discuss the measures of gastric lavage for severe acute organophosphorus pesticides poison (AOPP) patients complicated with respiratory failure and treated with mechanical ventilation., Methods: 92 cases of respiratory failure due to severe AOPP treated with mechanical ventilation were treated for gastric lavage with nasal gastric tube or gastrotomy. Patients of each gastric lavage method were divided into fasting toxicosis group (fasting group) and post-meal toxicosis group (post-meal group)., Results: When treated for lavage with nasal gastric tube, the duration of coma, the time for reaching atropinization and the dosage of atropine needed, the total dosage of atropine used, the mechanical ventilation time, the time for restoring 50% of the normal value of choline esterase, the hospitalization time and charges, the relapse rate, the rate of atropine toxicosis and mortality were respectively: 13 (3 - 24) h, 180 (60 - 290) min, 150 (80 - 310) mg, 300 (90 - 870) mg, 17 (4 - 52) h, (5.0 +/- 2.3) d, 9 (7 - 18) d, (8080 +/- 2570) yuans, 0, 0, and 4.76% in the fasting groups; all the figures were superior to those of the post-meal group with the same treatment: 26 (4 - 55) h, 380 (110 - 690) min, 360 (90 - 730) mg, 3610 (1100 - 9070) mg, 36 (6 - 110) h, (7.8 +/- 3.6) d, 12 (9 - 35) d, (10 720 +/- 3350) yuans, 45%, 30%, and 30.00% (P < 0.01 or P < 0.05). There was no obvious difference between the fasting group and the post-meal group in curative effect, complication occurrence rate and mortality except for the charges when treated with gastrotomy. For the post-meal toxicosis patients gastrotomy showed a better effect than the nasal gastric tube and there was no difference in charges., Conclusions: It is suggested that severe AOPP patients complicated with respiratory failure and treated with mechanical ventilation should hare lavage with nasal gastric tube, if they were poisoned in fasting state, but they should be washed through gastrotomy if poisoned after meal.

Objective: To evaluate clinical application of improved percutaneous tracheostomy with dilatational technique., Methods: In 55 patients an improved percutaneous tracheostomy was used, and in another 52 patients an old technique of percutaneous tracheostomy was used., Results: The cost of the improved percutaneous tracheostomy was only (216.0+/-4.4) yuan, operation time was (5.0+/-3.5) minutes, while the cost of the old method was (3 011.0+/-5.3) yuan, and operation time was (10.0+/-6.9) minutes. The difference between them was significant (t=23.60, 4.76, both P<0.001), but there were no differences in the time of bleeding and healing (both P>0.05)., Conclusion: The improved percutaneous tracheostomy was more expeditious, costless, better healing, scar smaller. Therefore, it is useful in emergency care, and it can take the place of classical tracheostomy.