Objective To observe the effects of Buyang Huanwu Decoction(BHD)on collateral circulation of patients with acute cerebral infarction(ACI)through transcranial Doppler sonography(TCD). Methods The randomized controlled trial methods were applied, and 80 ACI patients were randomly divided into treatment group and control group, 40 cases in each group. Two cases from each group were dropped out, and the left 38 cases of each group were included into the analysis. The control group was treated with the standardized western medicine regimen, and the treatment group was given BHD orally on the basis of treatment for the control group. The treatment for the two groups covered 7 days. On treatment day 3 and 7, TCD was adopted to investigate the blood flow velocity of the responsible vessels and the improvement of collateral circulation compensation. On treatment day 7, the scores of National Institute of Health Stroke Scale(NIHSS) in the two groups were compared. Results (1) On treatment day 3, collateral circulation improvement occurred in 12 patients(accounting for 31.58%)from the treatment group , and on treatment day 7 , the improved cases increased to 16(accounting for 42.11%). In the control group , 3 cases(7 . 89%) were improved on treatment day 3 , and 4(10 . 53%) improved on treatment day 7. The treatment group had better effect on improving collateral circulation than the control group, the difference being significant(P<0.01). (2) In the treatment group, 9 cases had increased blood flow velocity(Vm) of the responsible vessels on treatment day 3, and 11 cases had the increase on treatment day 7. In the control group, Vm increase occurred in one case both on treatment day 3 and 7. The treatment group had better effect on increasing Vm than the control group, the difference being significant(P<0.05). (3) On treatment day 7, NIHSS scores were decreased in both groups(P<0.05 or P<0.01), and the decrease of the treatment group was superior to that of the control group(P<0.01).(4) No adverse event was shown in the two g roups during the treatment. Conclusion BHD can constantly improve the blood flow velocity of the responsible vessel and promote collateral vessel building , which results into the recovery of the impaired neural function.

The objective of this article was to deliberate the relationship between trace elements and "Qi and blood" theory of traditional Chinese medicine by studying the similarities and differences in the contents of trace elements in SiJunzi decoction and Siwu decoction. Experiments indicate that there were some similarities and differences in the contents of trace elements in SiJunzi decoction and Siwu decoction, and it is very similar to "Qi and blood" theory of traditional Chinese medicine. When the Chinese herbs were decocted, the trace elements of Chinese herbs do not get into medicated solution uniformly. Different elements enter into the medicated solution in different periods of time and batches. It point out that the theory of methods of decocting Chinese herbs has a certain basis. These experiments remain existing some questions and doubts,it is worth to do some further related experiments and to be researched furthe.

Objective To probe the differences and similarities of clinical feature between alcoholic and biliary chronic pancreatitis (CP) and their therapy. Methods Retrospective analysis of the clinical features was made in 110 cases of CP in Peking Union Medical College Hospital from 1991 to 2000. Results ① In 110 cases of CP, the clinical manifestations were abdominal pain (85.4%), diarrhea (22.7%), calcification of pancreas (13.6%), and pseudocyst of pancreas (28.2%); 3 cases (2.7%) complicated with pancreatic carcinoma. ② The frequency of the different kind of clinical manifestations in alcoholic CP was higher than in biliary CP.③The frequency of diarrhea (29.1%),diabetes mellitus (41.9%) and calcification of pancreas (22.6%) in alcoholic CP was also higher than in those caused by bile duct system diseases (16.7%, 19.1% and 9.5%).④The response rate of medical treatment was 81.2%. Conclusions The clinical features and complications are more typical and occur earlier in alcoholic CP than those in biliary CP. With regard to management, medical treatment is less used than surgical therapy.

Aiming for improving the understanding of enteral nutrition(EN)in active and remittent Crohn’s disease (CD),this paper reviewed the history of EN,clarified the mechanisms of nutritional treatment,with emphasis on the effectiveness and key points of EN in the treatment of active and remittent CD.

Objective To evaluate the feasibility of testing the high methylation of ppENK gene in stool with methylation-specific polymerase chain reaction (MSP) assay in pancreatic cancer diagnosis.Methods Twenty-four fresh stool samples of pancreatic cancer patients and six healthy control samples were collected.The methylation status of ppENK gene in all the stool samples was detected by MSP assay.The positive rate of wild-type ppENK gene in all the stool samples was determined by polymerase chain reaction (PCR).And 10 non wild-type ppENK gene negative pancreatic cancer samples were collected,and K-ras gene mutation was detected by PCR-restriction fragment length polymorphism (RFLP).The single cell suspension of pancreatic cancer PC3 cell line was added into stool sample from the same healthy individual,the positive rate of ppENK gene methylation was detected by MSP assay.The minimum number of pancreatic cancer cell was calculated when methylation was positive.Results The rate of methylation detection in 30 samples was 0 (0/30); and the rate of non-methylation detection was 10％ (3/30).The rate of wild-type ppENK detection was 6.7％ (2/30).By PCR-RFLP assay,eight were successfully amplified and seven had mutation in 12th code of K-ras gene in 10 selected wild-type ppENK gene negative pancreatic cancer samples.The minimum number of pancreatic cancer cells needed for ppENK methylation band positive detected by MSP was 50 cell/ml.Conclusion Detecting ppENK gene methylation status in stool samples of pancreatic cancer patients by MSP assay has not yet become the method of pancreatic cancer screening and diagnosis.

Objective To identify the main clinical characteristics helpful for diagnosis and differential diagnosis of Crohn s disease (CD) from primary intestinal lymphoma (PIL). Methods Ninety cases of CD and 46 cases of PIL during 1983-2004 in Peking Union Medical College Hospital were investigated retrospectively. Results The average age of PIL was nearly 10 years elder than that of CD (45. 0?16. 2 vs. 36. 7?15. 7, P

Objective To develop a new multi-purpose face mask for oxygen provision in first aid,which can be used in both war time and peace time.Methods The structure,operating principle and application of a multi-purpose face mask,whose transparent silicone mask body has even the entrance of nested endoscopy and oxygen concentration regulating twist,are introduced in this paper.Results This mask can be used in painless endoscopy and emergent oxygen supply in tracheal intubatton.Conclusion The mask can greatly enhance the safety of painless endoscopy and it can also be used as mask for the use of general anesthesia.

Objective To comprehend the clinical characteristics and treatment of primary hepatic amyloidosis.Methods A total of 10 cases of primary hepatic amyloidosis included. 4 cases from Peking Union Medical College Hospital and 6 cases from other hospitals.reported in the literature in recent 20 years were reviewed,Results (1)The frequent clinical symptoms related to primary hepatic amyloidosis presented as hepatomegaly(90%),abdominal distension(80%),shifting dullness(60%),anorexia(50%),fatigue(40%),edema(40%),weight loss(40%) and abdominal pain(30%).(2)Laboratory tests revealed elevated serum alkaline phosphatase which was (558.3?517.2)U/L,and other liver function involvement were rare:six patients(85.7%)had either a serum or urine monoclonal protein.(3)Liver biopsy is golden standard.The amyloid deposition was mainly located at sinusoida(4 casese,57.1%),and only 2 cases was at vascular(28.6%).Complication of bleeding after liver biopsy was reported(1 case).(4)The classical therapy scheme was melphalan and prednisone,four cases died from liver function failure and infection.Conclusion The clues to the diagnosis of primary hepatic amyloidosis include elevated monoclonal protein,hepatomegaly and an unexplained elevated serum alkaline phosphatase level which is not parallel with other liver functions.Live biopsy is golden standard.The treatment scheme include melphalan and prednisone,but its prognosis is poor.

Objective To detect the methylation status of ppENK and its role in the pathogenesis of pancreatic carcinoma.Methods The ppENK methylation status in human tissues of pancreatic cancer,pancreatic carcinoma cell lines and normal pancreas was detected by methylation-specific RT-PCR(MSP).The association of methylation status of ppENK gene with clinicopathological parameters was analyzed. The expression of ppENK mRNA was detected by RT-PCR.Two pancreatic carcinoma cell lines (PANC1,AsPC1 ) were treated with demethylating agent (5-aza-dC).The cell growth was measured by MTT.Apoptosis and cell cycle was analyzed by flow cytometry.The expression of DNMT3a was measured by Western blot.Results ppENK mRNA was expressed in normal pancreas.And methylation of ppENK was not detected in normal pancreas.Methylation of ppENK was detected in 90.3％ (28/31) of pancreatic carcinoma tissue,and there were no correlation between methylated ppENK with clinicopathological features of pancreatic carcinoma.There was no ppENK mRNA expression in SW1990,PANC1,PC3,AsPC1,PuPan-1,and ppENK was methylated.Methylated ppENK was associated with no ppENK mRNA expression.After 5-Aza-dC treatment,PANC1,AsPC1 was demethylated and ppENK mRNA expression was reversed.The proliferation of PANC1 and AsPC1 was inhibited in a dose dependent manner.The apoptotic rates of PANC1 and AsPC1 were increased [ (31.57 ± 6.76)％ts (3.21 ±1.43)％,P =0.002,(16.6 ±8.22)％ vs (3.82 ±1.71)％,P=0.058];the expression of DNMT3a protein was decreased; the PANC1 cells of G1 phase significantly increased [ (67.87 ± 2.72 ) ％ vs (54.57 ± 7.18) ％,P =0.040 ],but PANC1 cells of S phase significantly decreased [ ( 22.37 ± 4.31 )％ vs (33.73 ± 4.63)％,P =0.036 ].But the percentage of G1,S phase in AsPC1 cell line was not significantly changed ( P =0.236,0.075 ).ConclusionsppENK demethylation is an important molecular event in inducing ppENK expression inhibition,which can inhibit pancreatic cancer proliferation,promote apoptosis,arrest cell cycle at G1 and decrease the expression of DNMT3a protein.

Objective To investigate the safety of thalidomide in the treatment of immune-related bowel diseases for providing clinical reference.Methods Thirty-five patients with immune-related bowel diseases (31 Crohn's disease,2 ulcerative colitis and 2 Behcet's disease) treated with thalidomide were enrolled in this study.The incidence,type,severity,duration of thalidomide related adverse drug reaction (ADR) and the dose-effect relationship of neurotoxicity were analyzed.Results All the patients were treated with a mean dose of thalidomide (109.29 ± 30.37) mg/d for (18.8 ± 12.4) months,and 33 occurred ADR.The three most frequent ADR were numbness [51.4％ (18/35)],somnolence [48.6％ (17/35)] and dermatitis [37.1％ (13/35)].The median time to development of these three ADR were 6.50,0.25,and 1.00 months,respectively.Severe ADR leading to withdrawal accounted for 20.0％ (7/35),including reasons of peripheral neuritis (3/7),dermatitis (2/7) and myelosuppression (2/7).The incidence of peripheral neuritis was not significantly related to the maximal and initial dose of thalidomide (P ＞ 0.05).Conclusions Although the incidence of ADR was relatively high during the treatment of thalidomide,most of them were mild and well tolerated.Thalidomide can be safely used in patients with immune-related bowel diseases under close monitoring.