OBJECTIVE:To compare the effects of2different treatment methods on the assaying of triptolide alcohol in tripterygium wilfordii cut crude drug.METHODS:After concentration,tripterygium wilfordii cut crude drug water decoction underwent column chromatographic separation after adsorption with neutral alumina(Method1)and neutral alumina column chromatographic separation after ethanol precipitation and extraction by chloroform(Method2),respectively.Triptolide alcohol was determined by HPLC and the assaying result underwent pairing and t tests.RESULTS:There was significant difference between the2methods with the content determined by Method1significantly higher than that by Method2(P

Objective To investigate the diagnostic value of volume imaging for breast assessment (VIBRANT) dynamic enhanced MR for benign and malignant breast mass.Methods Ninety-eight patients with breast mass underwent both bilateral molybdenum target radiography and VIBRANT dynamic enhanced MR examination.The sensitivity,specificity,positive predictive value,negative predictive value and diagnosis accuracy between two methods were compared.Results There were 113 lesions including 65 lesions in 57 malignant cases and 48 lesions in 41 benign cases.The sensitivity,specificity,positive predictive value and negative predictive value of molybdenum target radiography were 67.69％ (44/65),68.75％ (33/48),74.58％ (44/59) and 61.11％ (33/54),respectively.The values of VIBRANT dynamic enhanced MR were 84.62％ ( 55/65 ),89.58％ (43/48),91.67％ (55/60) and 81.13％ (43/53),respectively.The difference of the diagnosis accuracy between two methods had statistical significance (P ＜0.05).Conclusion The diagnostic value of VIBRANT dynamic enhanced MR for benign and malignant breast mass is higher than molybdenum target radiography.

Purpose:To study the efficacy and the side effect of morphine sulphate controlled release tablets by rectal administration in the treatment of cancer pain. Methods:40 patients with cancer pain were randomly divided into two groups. The rectal administration of morphine sulphate controlled release tablet (30 mg,q12h) was given in group Ⅰ, oral in group Ⅱ. The effect were compared. Results:The analgesic effect was good and no significant difference was found in the 2 groups. Conclusions:The rectal adminstration of morphine sulphate controlled release tablets may be used successfully to provided relief of cancer pain.

Objective: To investigate whether the signaling of PI3K/Akt is involved in epithelial-mesenchymal transdifferentiation (EMT) of human kidney tubular epithelial cell (HKC) promoted by transforming growth factor (TGF)-?_1. Methods: the HKC was cultured on plastic plates in the presence or absence of recombinant human TGF-?_1 and PI3K inhibitor wortmannin. The expression of total- and phosphor-Akt and ?-SMA was assessed at different time point by Western blot. Results: In HKC, basic level of p-Akt, ?-SMA expression was found in the normal condition. Profound increase of p-Akt was seen at 0.5 h after induction of 10 ng/ml TGF-?_1 in HKC.?-SMA increased markedly at 48 h after the treatment of TGF-?_1. Adding PI3K inhibitor wortmannin (10 nmol/L) largely abrogated the effect of TGF-?_1. Wortmannin was shown to down-regulate ?-SMA and p-Akt expression in response to TGF-?_1. Conlusion: PI3K/Akt is a downstream mediator in EMT of HKC promoted by TGF-?_1, and PI3K inhibitor wortmannin can significantly inhibit EMT induced by TGF-?_1.

Objective To investigate the effect of activated PI3-K on epithelial-mesenchymal transdifferentiation of HKCs induced by transforming growth factor?1 (TGF-?1). Methods The human kidney proximal tubular epithelial cells (HKCs) cultured on plastic plates were divided into following groups: cultured with free serum medium (FSM); culture in the different concentrations of TGF-?1; cultured in the presence of recombinant human TGF-?1 and PI3-K inhibitor Wortmannin. The expression of total and phosphor-Akt (t-Akt and p-Akt) was assessed at different time points by Western blot,? smooth muscle actin(?-SMA) and E-cadherin were detected by Western blot. Results A marked increase in p-Akt was seen in HKC at 1h after being induced by TGF-?1, and its protein level was enhanced in a TGF-?1 concentration-dependent manner. Protein level of ?-SMA was increased markedly at 48 hours after the treatment of TGF-?1, but protein level of E-cadherin was decreased 48 hours after treatment of TGF-?1. Addition of PI3-K inhibitor Wortmannin (10nmol/L) largely abrogated the effect of TGF-?1. Wortmannin was showed to down-regulate ?-SMA and p-Akt expression and in response to TGF-?1 and up-regulate E-cadherin expression. Conclusion PI3-K was activated in epithelial-mesenchymal trans-differentiation of HKCs promoted by TGF-?1, and PI3-K inhibitor Wortmannin can significantly inhibit TGF-?1 induction of EMT.

The authors first expound the connotations and origin of the legal person management structure and then discuss the following issues: the dual relation of agency by agreement characteristic of medical institutions, the need to take management structure as the priority of hospital reform in delegating powers to lower levels, the primary strategies and major means of the legal person management structure of corporations, and questions related to the management structure of the medical industry abroad: who should become the agent of the patient, how to unify the interests of the agent and the consignor by means of reasonable remuneration designs, etc. Finally the authors give an account of the inspiration that can be drawn from the legal person management structure to the public hospital property right system reform in China.

BACKGROUND: The renal transplanted recipients were in poor immunosuppressive state. Compared to common person, the bladder transitional carcinoma in recipients was aggressive and easy to recurrence. Looking for a more effective therapy method to decrease the recurrence of recipients' bladder transitional carcinoma is the hot and difficult problem in clinical study.OBJECTIVE: To analyze the efficacy and safety of submucosal injection epirubicin following transurethral resection of bladder tumor (TUR-Bt) to treat the recurrence of bladder transitional cell carcinoma in renal transplantation recipients.METHODS: Totally 9 renal transplantation recipients with transitional cell carcinoma of bladder were retrospectively studied. The patients' periods without cancer, the frequency of recurrence within one year, the rates of side effect, the changes of tumor grading following recurrence and allograff function were recorded when the routine method and submucosal injection epirubicin following TUR-Bt were used in different period respectively.RESULTS AND CONCLUSION: Submucosal injection epirubicin following transurethral resection of bladder tumor was safe and effective to treat bladder transitional cell carcinoma recurrence in renal transplantation recipients. Compared to the routine perfusion, periods without cancer and the frequency of recurrence within 1 year were significantly decreased, which can elevate recipients life quality and long-term survival rates.

Objective To explore the early diagnosis,surgical treatment and clinical effect of acute superior mesenteric artery embolism.Methods Base on the retrospectively study of the clinical data of 10 patients with acute superior mesenteric artery embolism,all the patients were treated with routine blood test,D -dimer,abdominal ultrasound,abdominal CT examination.At the same time,partial selective superior mesenteric artery angiography was performed.Patients with definite or highly suspected of mesenteric artery embolism,such as no absolute surgical procedure, were treated by immediate surgical fixation.Superior mesenteric artery embolism was confirmed in the surgery.Then Operation was decided according to intestinal necrosis.Fogaty catheter removal was applied to the main trunk of the superior mesenteric artery.At the same time,such as the discovery of branches of vascular embolism,the therapy using direct injection of urokinase in local embolism was performed because of difficulty in embolectomy for narrow vessels. Then anticoagulation therapy was performed after surgery.Results Among them,1 case gave up treatment from the hospital,2 cases died of multiple organ failure after operation,and 7 cases recovered well after operation.Conclusion Early diagnosis of acute superior mesenteric artery embolization combined with early surgical treatment is the key to the treatment of acute superior mesenteric artery embolism.The cure rate can be significantly improved and the mortality rate can be reduced.Fogaty catheter was applied to treat acute superior mesenteric artery embolism with the therapy using direct injection of urokinase in local embolism has the characteristics of quick effect and curative effect.

OBJECTIVE:To explore the effects of risperidone combined Ningxin yizhi capsule on the cognitive function,neuro-logic function and living quality of cerebral infarction. METHODS:110 patients with cerebral infarction were randomly divided in-to control group(55 cases)and observation group(55 cases). All patients received aspirin,statins,penicillins,physical rehabilita-tion and other conventional treatment;based on it,control group orally received Risperidone tablet with initial dose of 0.5 mg, once a day,1 week later,the amount of drugs was adjusted according to the patient's tolerance and conditions,0.5 mg was in-creased every week,with maximum dose of less than 2 mg,no other antipsychotic drugs except risperidone. Observation group ad-ditionally received 0.9 g Ningxin yizhi capsule,3 times a day. The treatment course for both groups was 2 months. Montreal cogni-tive assessment (MoCA) score,neurobehavioral cognitive status tests scale (NCSE),National Institutes of Health Stroke Scale (NIHSS)score,activities of daily living scale(ADL)score and table of daily living-Barthel Index(Barthel-Index)before and af-ter treatment,and the incidence of adverse reactions in 2 groups were observed. RESULTS:Before treatment,there were no signifi-cant differences in the MoCA scores,NCSE scores,NIHSS scores,ADL scores and Barthel-Index in 2 groups (P>0.05). After treatment,the MoCA scores,NCSE scores,ADL scores and Barthel-Index in 2 groups were significantly higher than before,and observation group was higher than control group,NIHSS scores were significantly lower than before,and observation group was lower than control group,the difference was statistically significant(P<0.05). And there was no significant difference in the inci-dence of adverse reactions(P>0.05). CONCLUSIONS:Based on the conventional treatment,risperidone combined Ningxin yizhi capsule can significantly improve the cognitive function,neurologic function and living quality of cerebral infarction,with good safety.

Objective To evaluate the effect of Dachengqi decoction,omeprazole and cisapride in the treatment of gastric cancer radical operation in serum gastrin and motilin.Methods 88 cases of gastric cancer after radical gastrectomy from May 2013 to July 2015 in our hospital were selected and divided into control group and treatment group with each 44 cases.Patients in both groups were given routine treatment and symptomatic treatment.Control group received omeprazole Enteric-coated capsules 20mg,qd,cisapride tablets 10mg,tid,treatment group received more Dachengqi decoction 200mL,bid,respectively by intragastric injection and retention enema,two times a day,a total of 21 days of treatment.The clinical efficacy,serumgastrin,plasma gastric motility,gastric juice volume and adverse reactions were compared between the two groups.Results The total effective rate in the treatment group was significantly higher than that in control group(P<0.05); After treatment,gastric juice volume of two groups was significantly lower than before treatment,the gastric juice volume in the treatment group were significantly lower than control group(P<0.05);Compare with pre-treatment,after treatment,the serum gastrin,plasma gastric motility levels of two groups were significantly higher,and the treatment group were significantly higher than the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion Omeprazole,cisapride combined with Dachengqi decoction in the treatment of gastric cancer radical operation was obvious and high safety.