Objective To evaluate the clinical appliance and significance of the technique of anorectal manometry. Methdos Different ways of anorectal manometry, domain of its appliance and its clinical appliance was summarized and reviewed. Results The technique of anorectal manometry not only has important value on the study of analrectal pathology and physiology, but also can be associated with other examinations to manage biofeedback therapy, diagnose all kinds of anorectal diseases and evaluate anorectal function. Conclusion Anorectal manometry is a safe, simple, harmless and impersonal examination technique. It is necessary in the examination of analrectal function, in the diagnosis and treatment of anolrectal diseases.

Objective To observe clinicopathological features and prognosis of suptypes in breast cancers. Methods SP method was applied on 509 operated breast cancer patients to examine ER,PR and Her-2 status which determined subtypes.Subtype definitions were as follows:Her-2-,ER+ and/or PR+ as Luminal A,Her-2+,ER+ and/or PR+ as Luminal B,Her-2-,ER-PR-as Triple-negative,Her-2+,ER-,PR-as ERBB2+. χ~2 test was applied to determine their association with clinicopathological features.Kaplan-Meier method was used to analyze disease free survival (DFS).Univariate regression and COX multivariate regression were preformed to analyze association between metastasis or recurrence and cliniopathological features. Results 40.5%of all cases (206/509) were identified as Luminal A,18.5%(94/509) as Luminal B,21.4%(109/509)as Triple-negative,19.6%(100/509)as ERBB2+.The rate of medulary type in triple negative breast cancer was higher than that in other subtypes(P<0.05).Significant difference in the rate of recurrence or metastasis was found among four subtypes(P=0.029).Cox regression analysis suggested that lymph node status and TNM stage were independent factors affecting the prognosis(P=0.000).DFS of ERBB2+and Triple-negative was 81.0% and 78.9% respectively,which was lower than that of Luminal A and Luminal B(88.8%、90.4%)(P=0.025).Conclusion Luminal A occurred at the highest prevalence.Triple-negative and ERBB2+ have a hiigher incidence of relapse or metastasis and poorer prognosis than Lurninal A and Luminal B.

BACKGROUND: The studies in recent years proved that the inflammatory reaction is of the main reasons in the damage of cerebral ischemia reperfusion. The nuclear factor κB (NF-κB), as a kind of transcription factor, plays an important role in regulating the expressions of various inflammatory cell factors in the inflammatory reaction of cerebral ischemia reperfusion. The previous experiments show that puerarin functions to resist the oxidated free radicals and the apoptosis of nerve cells. In case it has the functions of anti-inflammation, its brain protection can be explained further.OBJECTIVE: To study the effect of puerarin on NF-κB for the rats with the damage of ischemia reperfusion.DESIGN: A random parallel controlled study.SETTING: The Emergency Department of Beijing Hospital, Emergency Department of Tongji Hospital, Pathology Department and Experimental Animal Center of Tongji Medical College, and Health Statistics Department of Public Health College of Huazhong University of Science and Technology.MATERIALS: The experiment was started on April 12, 2003 in the Pathology Department of Tongji Medical College. The 75 healthy and clean Wistar rats were randomized into 3 groups with 25 in each, Sham operation group, cerebral ischemia reperfusion group, and puerarin group. Each group was reperfused at 2, 6, 12, 24, and 48 hours after ischemia and 5rats were used at each time point.METHODS: [1] Sham operation group: Without electric coagulation of bilateral vertebral arteries, without blockage of bilateral common carotid arteries, without medicinal administration. [2] Cerebral ischemia reperfusion group: Ten minutes after the blockage of bilateral common carotid arteries with non-invasive artery clamp, the reperfusion was given. At the beginning of reperfusion, the abdominal injection of normal saline 1 mL was applied and later every 6 hours the injection was repeated once. [3] Puerarin group:The procedure was the same as for the reperfusion group, only with normal saline changed to puerarin 100 mg/kg.MAIN OUTCOME MEASURES: At the time points of 2, 6, 12, 24, and 48 hours after reperfusion, the activity of NF-κB and inhibitory protein κB(IP-κB) in the hippocampus CA1 region was examined with immunohistochemical method; the expression of tumor necrosis factor-α (TNF-α) mRNA was measured with in situ hybridization method; and the number of surviving neurons was detected with hematoxylin-eosin (HE) staining.RESULTS: After supplement, 75 rats entered the result analysis. [1] Activity of NF-κB: In the ischemia reperfusion group, it was obviously increased at 2 hours after reperfusion, to the highest at 6 hours, and still higher than that of the sham operation group, (P ＜ 0.01). In the puerarin group, it was lower at each time point than that of the ischemia reperfusion group (P ＜ 0.01). [2] Expression of TNF-α mRNA: In the ischemia reperfusion group, it was obviously increased at 2 hours after reperfusion, to the highest at 12 hours, and still higher than that of the sham operation group at 48 hours (P ＜ 0.01). In the puerarin group, it was lower than that of the ischemia reperfusion group at 6-48 hours (P ＜ 0.01). [3] Activity of IP-κB:In the ischemia reperfusion group, it was obviously decreased at 2 hours after reperfusion, to the lowest at 6 hours, and then gradually increased to the level of 12 hours. In the puerarin group, it was higher than that of the ischemia reperfusion group at each time point (P ＜ 0.01 or 0.05). [4] Number of surviving neurons: In the ischemia reperfusion group, it was decreased gradually with the time prolonging after reperfusion (P ＜ 0.01). In the puerarin group, at each time point, it was higher than that of the ischemia reperfusion group (P ＜ 0.05 or 0.01).CONCLUSION: In the cerebral ischemia reperfusion, puerarin can protect the brain through decreasing the degradation of IP-κB, the activity of NF-κB, the expression of TNF-α mRNA, and the inflammatory reaction.

Objective: To investigate the lignans compounds constituents of Lavandula angustifolia. Methods: The chemical constituents were isolated and purified by TLC, silica gel, MCI-gel, and RP-HPLC, and their structures were identified by analysis of spectroscopic evidences and physicochemical properties. Results: A total of 11 constituents were isolated from L. angustifolia and elucidated as pinoresinol (1), syringaresinol (2), fraxiresinol-4'-O-β-D-glucopyranoside (3), syringaresinol-4'-O-β-D-glucopyranoside (4), 8-hydroxypinoresinol-4-O-β-D-glucopyranoside (5), rel-(2α,3β)-7-O-methylcedrusin (6), lariciresinol-4'-O-β-D-glucoside (7), (2S,3R)-2,3-dihydro-2-(4-hydroxy-3-methoxyphenyl)-3-hydroxymethyl-7-methoxybenzofuran-5-(trans) propen-1-ol-3-O-β-glucoside (8), (7S,8R)-dihydrodehydrodiconiferyl alcohol-9-β-D-glucopyranoside (9), (7R,8R)-7,8-dihydro-9'-hydroxyl-3'-methoxyl-8- hydroxymethyl-7-(4-hydroxy-3-methoxyphenyl)-1'-benzofuranpropanol-9'-O-β-D-glucopyranoside (10), and (E)-3-((2S,3S)-2-(4- hydroxy-3-methoxyphenyl)-3-hydroxymethyl-7-methoxy-2,3-dihydrobenzofuran-5-yl) allyl-2-hydroxyacetate (11). Conclusion: The 11 compounds are isolated from this plant for first time.

Objective:To observe neurotransmitter changes of post cerebral infarction depression (PCID) before and after being treated with amitriptyline or acupuncture of Baihui,in order to explore a good way with a less toxicity and good effect of treatment on PCID.Methods:The 60 patients were divided into treatment group and control group.Besides the basic treatment,the treatment group was given acupuncture of Baihui (DV20) and point injection therapy,the control group was given amitriptyline. Both before and after treatment,compared the two groups with HAMD score,neurologic impairment score,plasma 5-HT and NE,and observed the adverse events and side effects.Results:The results of two groups in monoamine neurotransmitter 5-HT(5-HT),norepinephrine (NE) and the HAMD scale were significantly improved.Conclusion:Acupunture of Baihui and point injection of Herba Erigerontis had equal effect to the amitriptyline on PCID.Furthermore,it had fewer venenosus side effects.It provided a new way for the use of the traditional Chinese medicine in treating PICD.

Objective This study aimed to investigate the effects of angiotensin Ⅱ and Losartan pretreatment on regulating insulin secretion in human islet ? cells.Methods We measured changes in intracellular calcium by confocal laser scanning microscopy using Flou3-AM-loaded human islet cells.RT-PCR was used to measure changes in intracellular CaM.Dynamic insulin secretory responses were determined by chemiluminescence following perfusion of human islets.Results Exposure of the isolated islets to angiotensin Ⅱ induced glucose-stimulated insulin release coupled with intracellular calcium ascending in first phase and descending in second phase.Intracellular CaM concentration could not be affected by angiotensin Ⅱ.Conclusion The change of free Ca2+is induced by the combination of AngⅡ with ATI receptors of islet B cells,which results in the damage to islet B cells.Losartan pretreatment protects the islet B-cell function by inhibiting calcium overload.

Objective To investigate the effect of esmolol on myocardial apoptosis and cardiac function in rats with sepsis .Meth‐ods Ninety six SD rats were randomly divided into sham group (n= 32 ,for sham operation) ,sepsis group (n= 32 ,sepsis model) and treatment group (n= 32 ,intravenous infusion with esmolol after sepsis modeling) .At 3 h ,6 h ,12 h ,24 h after operation ,sam‐ples were conserved to measure serum cardiac troponin I (cTnI) ,caspase‐3 ,cardiomyocytes apoptosis index ,and myocardial patho‐morphology was observed by optical microscope .At 24 h after operation ,echocardiography was performed .Results The serum cT‐nI ,caspase‐3 ,cardiomyocytes apoptosis index were increased significantly in sepsis group and treatment group compared with sham group (all P< 0 .05) .After using esmolol ,cTnI and cardiomyocytes apoptosis index were relatively decreased in treatment group compared with sepsis group at the four time‐points(all P < 0 .05) .Caspase‐3 of treatment group decreased at 12 h after operation compared with sepsis group (P< 0 .05) .Treatment group had a higher LVEF than sepsis group at 24 h(P< 0 .05) .Conclusion Es‐molol could inhibit myocardial apoptosis and mitigate the damage of cardiac function in rats with sepsis .The decrease in caspase‐3 may be the mechanism of anti‐apoptosis .

Objective To explore the organ doses and their distributions in different projections of CT scans.Methods The CT values were measured and the linear absorption coefficients were derived for the main organs of the anthropomorphic phantom to compare with the normal values of human beings.The radiophotoluminescent glass dosimeters were set into various tissues or organs of the phantom for mimic measurements of the organ doses undergoing the head,chest,abdomen and pelvis CT scans,respectively.Results The tissue equivalence of the phantom used in this study was good.The brain had the largest organ dose undergoing the head CT scan.The organ doses in thyroid,breast,lung and oesophagus were relatively large in performing the chest CT scan,while the liver,stomach,colon and lung had relatively hrge organ doses in abdomen CT practice.The doses in bone surface and colon exceeded by 50 mGy in a single pelvis CT scan.Conclusions The organ doses and their distributions largely vary with different projections of CT scans.The organ doses of colon,bone marrow,gonads and bladder are fairly large in performing pelvis CT scan,which should be paid attention in the practice.

Objective To investigate the relation of a lipopolysaecharide receptor CDl4C-159T gene polymorphism to severe sepsis outcome and cytokines in postoperative severe sepsis.Methods A prospective,consecutive entry study was made among 42 postoperative sevel'e sepsis admitted in neurosurgeon department,Second People～Hospital ShenZhen between Feb.2007 to Jul.2007.The genomie DNA of peripheral blood nucleated cells WaS extracted.CDl4-159C/T gene polymorphism patients was detected by restrictive fragment length polymorphism(RFLP)analysis.The relationship between genotypes and the production of eytokines TNF-α,IL-6,IL-10 and mortality rate of severe sepsis were evaluated.Results The mortality of sepsis in patients with CDl4 homozygous for the T allete(Tr)(69.2％)was significanfly higher than those with genotype CT(23.1％)and C allete(CC)(7.7％).In addition,TNF-a and IL-6 production ofTI'homozygore were markedly higher than those of the TC and CC genetypes.while IL-10 production were the lowest of the three(P<0.05).Conclusion The single base pair pelymorphism at position-159 in the CD14 gene promoter might influence the outcome of severe sepsis and may be related to production of pro-inflammatory cytokines TNF-α,IL-6,and decrease the anti-inflanunatiry factor IL-10.

Objective To study the histopathological characteristics and the correlations between the cortical tissues from ictal discharge (ID) area and interictal epileptiform discharge (IED) area in epilepsy patients due to focal cortical dysplasia (FCD), in order to further discuss the mechanism of epileptogenicity. Methods Twenty-two subjects who underwent epilepsy surgeries consecutively in our institute since April 2005 to August 2006. All patients underwent intracranial electrode implantations and long-term video-EEG monitoring before the resective surgeries and the postoperative pathologies proved to be FCD. According the long-term EEG monitoring results, the cortex with intense IED and the cortex with ID onset were resected separatively in the operation for further histopathologic studies. Twenty cases were collected. Based on the Palimini' s pathologic subtype classification for FCD as well as quantificational scoring for immunocytochemistry for the calcium-binding protein parvalbumin (PV) which we designed by ourself, the specimens of IED and ID were studied and compared. Results The resected specimens from 20 cases were examed. ID specimens showed more severe abnormalities in the laminar cortical architecture, alterations in the morphology of neurons and in the appearance of abnormal balloon cells. With the PV quantificational scoring, we found significant difference between IED (6.4±2.1) and ID (4.4±1.8) from FCD Ⅱ specimens (P=0.042). No difference was found between ID subtypes (F=2.734, P=0.093 ). Conclusions ID cortical area showed more severe abnormalities in histopathologic changes than lED area. Our results suggested that the ID area of FCD had more severe damage in inhibitory synaptic circuits and neural networks, which meant it was more epileptogenic than IED. No difference was identified between each ID subtype in term of epileptogenicity, which meant all of them should be resected during the surgery.