OBJECTIVE: To observe the effect of high-dose Astragalus injection and cyclophosphamide (CTX) on infection, urine protein and immune function of the patients with lupus nephritis. METHODS: Forty-three patients diagnosed as systemic lupus erythematosus (SLE) complicated by kidney damage and qi-deficiency syndrome were randomly divided into trial group (n=23) and control group (n=20). Patients in both groups were treated for 3 months. Intravenous drip infusion of 0.8 g CTX was administered to all patients once a month, while intravenous drip infusion of 20 ml Astragalus injection was only administered to patients in the trial group every day for 12 days in each month. RESULTS: The decrease of active clinical symptom score after the treatment in the trial group was greater than that in the control group (P<0.05). The infection rates of the trial group and the control group were 4.35% and 25% respectively. The decrease of 24-hour urine protein and CD8, and the increase of red blood cell count and serum albumin in the trial group were greater than those in the control group, and there were significant differences between the two groups (P<0.05). White blood cell count in the trial group was decreased less than that in the control group after the treatment (P<0.05). CONCLUSION: High-dose Astragalus injection used together with CTX is more effective than CTX alone in decreasing infection rate and urine protein and improving immune function for patients with lupus nephritis.

Objective To expound the mechanism and the clinical features of Tong-Du-Huo-Luo exercise in treating ankylosing spondylitis.Methods Besides taking SASP per os,the patients in treatment group did Tong-Du-Huo-Luo exercise twice daily. Patients in control group took SASP only.The patients in both groups had accepted the treatments for 6 months.Results Compared with western medicine treatment,the Tong-Du-Huo-Luo exercise can bring better effects on ability of expanding chest,finger-floor distance,pulvinar-wall distance,and improving the results of Schober test and blood sedimentation test.Conclusions Tong-Du-Huo-Luo exercise is an effective method in treating ankylosing spondylitis patients.

Objective To explore self-emulsifying particle size characterization methods and compare the regularity of various methods. Methods By setting the clarity level of turbidity standard solution, with two less soluble drugs-diterpene lactone compounds Chuanhuning and dihydropyridine drug nifedipine as model drugs, 10-12 clarity level prescriptions were selected from six different ternary phase diagram. Laser particle size scanner was used to determine the particle size, and UV-visible spectrophotometry to determine its absorbance. Three methods of particle size characterization rules were compared by drawing charts. Results There was a positive correlationship among droplet particle size, absorbance and clarity grade of emulsion formed by prescription in the same phase diagram. But, there was no regularity among droplet particle size, absorbance and clarity grade of emulsion formed by prescription in different phase diagram. Conclusion The droplet particle size of emulsion formed by prescription containing the same drugs and excipients in different proportions can be compared by clarity with visual method or absorbance with UV-visible spectrophotometer.

Objective To explore the change in anatomical volume during intensity?modulated radiotherapy (IMRT) for different stages of nasopharyngeal carcinoma (NPC) and its influence on dose distribution, and to assess the necessity to modify the IMRT plan. Methods Twenty?four patients with newly diagnosed NPC who received IMRT and chemotherapy were enrolled in the study, and were divided into early?intermediate group ( 12 cases ) and locally advanced group ( 12 cases ) according to the 2008 staging system for NPC. Each patient had a repeated CT scan at week 5 of radiotherapy, and target volume and organs at risk ( OAR) were contoured. The dose distribution of the original plan shown on CT was calculated. Changes in target volume, OAR anatomical volume, and dose distribution were analyzed, and paired t?test and Spearman correlation analysis were performed. Results In the early?intermediate group, gross target volume of neck positive lymph nodes (GTVnd) was reduced during radiotherapy (P=0. 059), and gross target volume of nasopharynx ( GTVnx ) , high?risk clinical target volume ( CTV1 ) , and parotid volume were reduced significantly during radiotherapy ( P= 0. 001, 0. 012, 0. 002, and 0. 000, respectively) . In locally advanced group, GTVnx , GTVnd , CTV1 , and parotid volume were significantly reduced during IMRT (P=0. 000, 0. 000, 0. 003, 0. 003, and 0. 000, respectively). Compared with the values before radiotherapy, the parotid dose increased significantly in the two groups during IMRT ( P=0. 044, 0. 026, 0. 033, and 0. 026, respectively;P=0. 024, 0. 016, 0. 030, and 0. 015, respectively) , and the increase in GTVnd dose was observed in the locally advanced group ( P= 0. 029 and 0. 049 ) . Conclusions It is recommended to perform another CT scan for patients with locally advanced NPC at week 5 of radiotherapy and formulate a new IMRT plan to maintain target volume dose and guarantee a safe parotid dose.

This study was aimed to prepare solid dispersions of Acanthopanax leaves total flavonoids in order to im-prove its bioavailability. PEG4000, PEG6000, F68, PVPK30 were used as carrier materials in the preparation of four different types of solid dispersion to screen the best type of carrier material and evaluate the amount of carrier mate-rial and its influence on the drug dissolution. Rutin was used as reference substance. NaNO2-Al(NO3)3-NaOH was used as the color system, with a UV spectrophotometer measured absorbance at 500 nm. The dissolution characteris-tics of different proportions of solid dispersions were examined in vitro. The results showed that compared with raw material, the in vitro drug release rate with PVPK30 as carrier material in the obtained solid dispersion of the pro-portion of the raw material was significantly improved, and the cumulative release rate was also increased significant-ly. It was concluded that the solid dispersion prepared by solvent method significantly improved in vitro drug release in water.

Objective To explore the significance of palpation-negative breast tumor resection with ultrasound-guided methylene blue labeling and percutaneous suture traction.Methods 46 cases of small breast tumors with the diameter from 0.5 cm to 1.0 cm were double labeled with methylene blue under the guide of ultrasound l hour preoperatively.The tumors were fixed,drew outward with percutaneous suture and resected accurately.All the 46 cases were rechecked by ultrasound to verify whether residual or false resection occurred 1 month later.Results All the 58 tumors of the 46 patients were accurately resected.No residue or false resection occurred.The average operation duration was 10 min to 20 min.Conclusion Palpable-negative breast tumor resection with ultrasound-guided methylene blue labeling and percutaneous suture traction has the advantages of small invasion,accurate positioning and short operation duration.

Objective To investigate the application value of breast scale membrane marking method to locate breast tumor lesion in neoadjuvant chemotherapy.Methods Before neoadjuvant chemotherapy for 120 cases of breast cancer,adopt scale membrane marking method was used to mark the position and boundaries of breast tumor lesion in the mean time.For non-protuberant breast tumor lesion,scale membrane was adhered directly to the breast and positive mark was made.For tumor lesion with vague boundaries,its boundaries was defined under the direction of ultrasound.For protuberant breast tumor lesion,scale membrane was only adhered to normal mammary skin beyond the tumor lesion and reverse mark was made.After two courses of treatment of TEC scheme,mark was made again and combined with ultrasound,molybdenum target and MRI results to comprehensive judgment of clinical curative efficacy so as to decide whether operation or change to TP scheme for continuous chemotherapy.Before operation,the first marking results were reset and then operation was conducted according to the position and boundaries of the marked tumor lesion.Results There were 26 cases of complete remission,76 cases of partial remission,10 cases of stabile disease and 8 cases of progressive desease.According to mark by scale membrane,breast conserving operations were conducted in 24 cases of complete remission and in 18 cases of partial remission according to position+ boundaries of the tumor lesion and tumor lesion position+ 1.5-2.0 cm beyond the original boundaries of tumor lesion marked by scale membrane,respectively.The simplified radical mastectomy was conducted in other 78 cases according to boundaries of the tumor lesion marked by scale membrane,in which 13 cases had insufficient locally advanced skin edges and adopted abdominal full-thickness free skin flap to cover the wound.Conclusion Tumor lesion location in neoadjuvant chemotherapy for breast cancer and scale membrane positioning method have the advantage of precision and non-invasion,which effectively save normal breat tissues and skin around tumor lesion with high patient compliance and tremendously outmatches traditional coordinate method,body surface tattoo method and mental marker method.Scale membrane marking method is easy to be operated with low cost,which is convenient for popularization and generalization.

Objective We invented mammary lump skin-positioning membrane (named scare membrane) to facilitate localization of mammary lump during ultrasound scan.This study is to measure the radius of mammary of Chinese adult women for designing different types of skin-positioning membrane.MethodsThe radius of mammary glands in 236 cases of adult females was detected with color Doppler ultrasound at 5 different clock positions:12:00,3:00,6:00,9:00 and 10:30 or 1:30.SPSS 16.0 statistical software was used to analyze the data.The cut-off values of mammary glands radius at 99％,95％,75％ and 50％ were calculated.Paired t tests or nonparametric tests (relative sample rank sum tests) were used to verify the consistency of mammary gland radius between left and right sides.ResultsThe cut-off value of 95％ mammary gland radius was:7.700cm at 12:00,7.810 cm at 13:00,8.100 cm at 3:00,5.330 cm at 6:00 and 6.300 cm at 9:00 for left mammary gland ; 7.500 cm at 12:00,6.015 cm at 3:00,5.500 cm at 6:00,8.510 cm at 9:00 and 7.930 cm at 10:30 for right mammary gland.In comparison of left and right mammary gland radius,the difference had statistical significance between the group of left side at 1:30 and right side at 10:30,the group of left side at 3:00 and right side at 9:00(P ＜0.05).The right mamma was relatively larger.The cut-off values of the right mamma at the above two clock points were taken as radius of scale membranes while the average of percentage cut-off values at 12:00,3:00 of both mammas,left side at 9:00 and right side at 3:00 are taken as radius of scale membranes.ConclusionsAccording to the cut-off values of 99％,95％,75％ and 50％ radius of adult female mammary glands,mammary lump skin-positioning membrane radius can be classified into 4 size-types:extra large,large,medium and small.The precise classification of radius of mammary scale membranes according to mammary glands of adult females provides convenience for production,manufacture and clinical application of mammary lump skin-positioning membrane.

BACKGROUND:Bioactive glass bone repair material has bone-bonding ability,bone induction ability and bone conduction characteristics.However,the performance of bioactive glass does not meet the requirements of clinical application,and the addition of boron is expected to improve the performance of bioactive glass. OBJECTIVE:To study the effect of different contents of B2O3 replacing SiO2 on the mechanical properties and bioactivity of bioactive glass. METHODS:Based on bioactive glass containing phosphorus nitrogen and oxygen(composition:SiO2-CaO-ZnO-Na2O-Si3N4-P2O5),B2O3 was used to partially replace the SiO2.The basic glass containing B2O3 with a mass fraction of 0%(group A),5%(group B),10%(group C),and 15%(group D)was fired using the high-temperature melting method(the total mass fraction of SiO2 and B2O3 in the basic broken glass was 41%).Porous bioactive glass scaffolds were fabricated by the organic foam impregnation method.Uniaxial compression and three-point bending method of universal mechanical testing machine were used to test mechanical properties.Four groups of scaffolds were immersed in simulated body fluids to detect the degradation performance of scaffolds.Scanning electron microscopy was used to observe the morphological changes of scaffolds before and after soaking.X-ray diffraction was used to analyze the phase composition of scaffolds before and after soaking. RESULTS AND CONCLUSION:(1)With the increase of the mass fraction of B2O3,the compressive strength and bending strength of the porous bioactive glass scaffold increased,and there was a significant difference between the compressive strength and bending strength of the four groups(P≤0.05).(2)After soaking in simulated body fluids,the porous bioactive glass scaffolds degraded gradually with the extension of time.At the same soaking time point,the degradation rate of the scaffolds was accelerated with the increase of the mass fraction of B2O3,and the compressive strength and bending strength of the scaffolds in the four groups were significantly different(P≤0.05).(3)Scanning electron microscopy after soaking in simulated body fluids showed that a large number of granular materials were deposited on the surface of group A and group B after soaking for 1 day.After 3 days,the granular materials on the surface fused with each other to form film-like deposits.After 7 days,the films on the surface fused with each other to form pieces,basically covering the entire surface of the specimen.After soaking for 1 day,film-like material deposition was formed on the surface of group C,and after 3 days,the films on the surface were fused into pieces,basically covering the whole surface of the specimen.After soaking for 1 day in group D,flake material covering the whole surface of the specimen could be seen.(4)X-ray diffraction analysis after 1 day of immersion in simulated body fluids showed that the deposits on the surface of the four groups of scaffolds were crystallized hydroxyapatite.(5)B2O3 replacement of SiO2 can enhance the mechanical properties,degradation properties and in vitro mineralization activity of porous bioactive glass scaffolds.

Objective:To report embryonic testicular regression syndrome(ETRS) caused by DHX37 heterozygous variant for the first time in China and summarize the clinical manifestations of ETRS as to improve the understanding of doctors for this disease.Methods:The clinical data and whole exome sequencing results of five cases of ETRS from Shenzhen Children′s Hospital were collected. The reported cases of DHX37 heterozygous variant were reviewed.Results:Five patients with ETRS visited the doctors at the age of 2 months to 5 years and 5 months. Three patients raised as males came to hospital due to virilition and 2 female patients visited a doctor due to clitoral hypertrophy. No uterus was detected by ultrasound in all patients. The gonadal pathologies from 4 cases displayed no testicular tissue or gonadal dysgenesis, complicated with gonadoblastoma in one case. The genetic testing revealed that the heterozygous variant(c.923G>A, p. R308Q) in DHX37 was found in 2 cases, without variant in other 3 cases. According to the review, ETRS and 46, XY gonadal dysgenesis due to DHX37 herozygous variant was firstly reported in 2019. A total of 40 cases, including 21 cases of ETRS, presented with the virilition or female phenotype, with the disappearance of testicular tissue as the main pathologies. There is no report in China.Conclusion:The article summarized the clinical manifestations and whole exome sequencing results of 5 patients with ETRS, among which two cases were caused by DHX37 variants and one was complicated with gonadoblastoma.