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.

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.

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 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 .

Acute kidney injury ( AKI) is a clinical syndrome associated with increased morbidity and mortality, and early recognition is critical .In an attempt to engage laypeople and non-experts,the term kidney attack has been introduced to refer to acute kidney injury (AKI),and AKI with functional loss and tubular damage can be diagnosed both with functional criteria ( CRIAKI, creatinine increase AKI ) and damage criteria ( NCRIAKI, non-creatinine increase AKI ) according to the most recent ADQI consensus .This comprehensive definition of Acute Kidney Syndromes may be a major advancement in terms of early referral , prevention of progression and therapeutic strategies for AKI .

Background and purpose:The prognosis in patients with early breast cancer(EBC) was poorly defined by clinical and histopathological features.There were more than 200 genes that might be correlated with development,progression,recurrence and prognosis of breast cancer in the published literature.This study evaluated the prognosis of patients with EBC at molecule level according to the protein expressions of 16 selecting genes(HER2,ER,PR,BCL2,Ki-67,BMYB,Cyclin B1,STK15,MMP11,BAG1,NM23,PTEN,P53,P27,VEGF,PCN A).Methods:The immunohistochemical method was used to detect the protein expressions of these genes in 76 patients with EBC and the statistical analysis was performed by COX proportional hazards model.Results:COX proportional hazard model revealed that BCL2,VEGF and STK15 were independent prognostic factors for patients with EBC.A formula of PI was set up according the three genes.The predictive outcomes with PI were compared with the actual follow-up outcomes in 48 patients with EBC.As a result,the predictive accuracy of good and bad prognosis was 86.67% and 91.67%,respectively.Conclusion:A formula of PI derived from protein expressions of the 16 genes correlated with breast cancer was ultimately set up and might be used to predict the outcomes of the patients with EBC.

Objective To compare the advantages between CT and MRI examination and to evaluate the applied value of diffusion weighted imaging(DWI) in acute cerebral trauma.Methods 54 cases with cerebral trauma were undergone CT and MRI simultaneously,the advantages and disadvantages of both examination were analysed using self-comparative method. Results In showing subarachnoid hemorrhage, ultra-acute cerebral bleeding and bone fracture,CT was better than MRI,but cerebral contusion in 5 cases,laceration of white matter in 5 cases,acute white matter swelling in 2 cases and subdural haematoma in one case were misdiagnosed by CT.DWI was much better to show laceration of white matter and acute cerebral matter swelling than CT and conventional MRI.Conclusion In diagnosing acute cerebral bleeding and bone fracture, CT is better than MRI, for other diagnoses MRI better than CT. DWI should be applied to be a common scan method in diagnose of acute cerebral trauma.