AIM:To establish a simple RP-HPLC method for determining levodopa in Mucuna pruriens var.utilis,and study the levodopa content in different parts of Mucuna pruriens var.utilis and in various growth periods two cultispecies(white flower and purpleflower). METHODS: A RP-HPLC method was used for the determination of levodopa on a Polaris RP-C18(250 mm?4.6 mm,5 ?m) column.The mobile phase was methanol-potassium dihydrogne phosphate(10∶90,pH3.38)for seed,flower,leaf,stem and root,and methanol-potassium dihydrogne phosphate(5∶95,pH3.17)for pod.The detection wavelength was at 280 nm,and flow rate was 1 mL/min. RESULTS: The levodopa content in seed and white-flower cultispecies were higher.In the growth periods,the levodopa content was higher in the sample collected when the pod matured and became dry. CONCLUSION: White-flower cultispecies of M.pruriens var.utilis is the good cultispecies.matured and dry pod is the optimal harvesting time for this herbal medicine.

Objective Compare the analgesia effects of using different intervention method among neonatal infants, and then find out the most effective method. Methods Divided 120 neonatal infants into the control group, the NNS group and the position group, there were 40 cases in every group. Using the N-PASS scale evaluated the pain degree at the points of 1 and 5 minutes respectively after stimulation among the 3 groups. Results There was significant difference between the 3 groups on the pain degree,P

Objective To explore the therapeutic effect and application value of the self-made spinal positioning equipment and percutaneous pedicle screw fixation system in the treatment of thoracic and lumbar fracture. Methods To determine the fractured vertebra and pedicle screws entrance point with spinal positioning equipment, 67 patients with thoracic and lumbar fractures were performed percutaneous pedicle screw fixation by using self-made percutaneous pedicle screw fixation system. By contrasting the perioperative indicators, and imaging indicators, to evaluate the therapeutic effect and application value of the system. Results For the spinal positioning equipment, the location time were (15.85±2.45) min and the location accuracy were 95.03%±3.27%. But for the open reduction internal fixation, the location time were (35.46±5.39) min and the location accuracy were 94.02%±2.95%. There was no significant difference in location accuracy, but were significant differences in location time (P＜0.05). Percutaneous pedicle screw fixation had the same effect on three sides with open reduction internal fixation in vertebral height restore,kyphosis deformity and correction and lumbar spinal stenosis's correction. The perioperative indicators of the preoperative and postoperative grope had significant difference (P＜0.05). There were significant differences in all perioperative indicators between the percutaneous pedicle screw fixation and the open reduction internal fixation (P＜0.05). Conclusion The spinal positioning equipment is helpful to determine the fractured vertebra and pedicle screws entrance point accurately and reduce the radiation. The percutaneous pedicle screw fixation system has the advantage of convenient manipulation and accurate implantation. The system can not only reduce surgical damage and post-operation reaction but also make patients recover quickly and face less complications.

Objective To explore the clinical application and follow-up results of minimally invasive percutaneous plate osteosynthesis (MIPPO) in treating proximal humeral fractures. Methods From December 2006 to September 2008, MIPPO using locking plate was employed to treat 36 patients (23 males and 13 females) with proximal humeral fracture. According to AO classification, there were four patients with type A2 fractures, 10 with type A3 fractures, five with type B1 fractures, 11 with type B2 fractures, three with type C1 fractures and three with type C2 fractures. Longitudinal or transverse incision was made through anterolateral acromial approach to separate the deltoid muscle and expose the fracture fragments. The direct and indirect reduction of the fractures were performed under direct vision. The locking plate was inserted distally beneath the deltoid muscle and a longitudinal incision was made at the lateral end of the plate. Locking screws were inserted to the proximal and distal plates. Postoperative follow-up was done to provide guidance to functional exercise and evaluate the clinical results. Results The operation lasted for (50.1±11.3) minutes, with intra-operative blood loss of(76±18.7) ml and average operative incision of (4.5±0.8) cm. All the patients were followed up for 12-17 months (average 14 months), which showed that the time of bone healing was (10. 1 ±1.2) weeks. Neer scoring standards showed the total excellence rate of 86%. Conclusion MIPPO is an ideal method for treatment of proximal humeral fractures, for it has the advantages such as safety, minor trauma, short bone healing time, alleviation of pain and good X-ray reduction.

Objective:To compare the clinical efficacy of oxycodone hydrochloride controlled-release tablets (OHCT) and pa-tient-controlled intravenous analgesia (PCIA) in the treatment of intractable cancer pain. Methods:Retrospective analysis was conduct-ed to evaluate the intractable cancer pain of 89 elderly patients who were admitted to the medical oncology departments of The Second Affiliated Hospital of Fujian Medical University and the Fuzhou General Hospital of Nanjing Military Command between September 2012 and March 2014. Among the 89 patients, 47 were treated with OHCT, and 42 received PCIA. The total dosage ranged from 60 mg/d to 400 mg/d PO q12h for patients in the OHCT group, whereas abackground dose+patient-controlled dosemode was adopted for patients in the PCIA group. The therapeutic efficacy, presence of adverse reactions, cost of treatment, and degree of patient satisfaction were compared between the two groups. Results:The average dosages of analgesics in the two groups were almost the same (P>0.05). Visual analogue scale (VAS) values and daily average VAS values were both lower in the PCIA group than in the OHCT group at 24 h after analgesia (P<0.05). The incidence of adverse reactions, such as nausea and vomiting, was also lower in the PCIA group than in the OHCT group (P<0.05). The cost of treatment and degree of patient satisfaction were the same in both groups (P>0.05). Conclusion:Pa-tients who received PCIA attained better analgesia and exhibited less adverse reactions than those who received OHCT whereas the treatment cost and patient satisfaction did not differ in both groups.

Objective To observe the quantity change of autophagosomes in podocytes and expressions of autophagy-related gene Beclin-1 and microtubule-associated protein 1 light chain 3 (LC3) in different pathological stages of idiopathic membranous nephropathy (IMN),and to explore how autophagy is related to podocyte injury,the occurrence of proteinuria and the disease progression in IMN.Methods Clinical data of 26 patients who were diagnosed as IMN (14 IMN stage 1 and 12 IMN stage 2) admitted to Zhejiang Provincial people's Hospital from January 2013 to December 2014 were retrospectively analyzed.Normal renal tissue from 15 cases of kidney neoplasms with nephrectomy was collected as control.The changes of kidney tissue pathology were detected after PAS and PASM staining by light microscope.The autophagosomes of podocyte were detected by transmission electron microscopy.Expressions of Beclin-1 and LC3 protein were detected by immunohistochemistry.Expressions of LC3 and synaptopodin were detected by immunofluorescence.The correlation of autophagosomes and clinical pathologic factors in IMN patiens was analyzed.Results There were fewer autophagosomes of podocytes and lower expression of Beclin-1 and LC3 protein in IMN group than those in control group (P=0.034,P=0.011,P=0.013,respectively).Moreover,these effects were more obvious with the development of IMN.Compared with those in control group,autophagosomes,Beclin-1 and LC3 protien were reduced in IMN stage 2 group (P=0.009,P=0.030,P=0.015);the number of autophagosomes and the expressions of LC3 and Beclin-1 were decreased in IMN stage 1 group as well,however statistically insignificant (P=0.352,P=0.087,P=0.128);Comparisons between IMN stage 2 patients and IMN stage 1 patients shown significant difference in the number of autophagosomes (P=0.030),but no significant difference in expressions of Beclin-1 and LC3 (P=0.355,P=0.181).Autophagosomes number was not correlated with serum creatinine,serum urea nitrogen,24-hour urinary protein and eGFR (all P ＞ 0.05).The expressions of synaptopodin and LC3 protein were lower in IMN group than those in control group.Conclusion Autophagy may contribute to podocyte injury and the production of protein urine in IMN,and may be closely related to the progression of disease.

Objective: To examine the alteration of pathologic structure and endogenous hydrogen sulfide pathway in rats with pulmonary hypertension induced by high pulmonary blood flow. Methods: Sixteen SD rats were randomly divided into shunting group and control group. An 11 week aortocaval shunting was produced in rats of shunting group, and pulmonary artery mean pressure (mPAP) was evaluated using right cardiac catheterization. The ratios of right ventricular mass to body weight (RV/BW) and right ventricular mass to left ventricular plus septal mass[RV/(LV+S)] were also detected. Pulmonary vascular micro and ultra structures were examined. Meanwhile the concentration of plasma hydrogen sulfide (H 2S) was measured by spectrophotography. The gene expression of cystathionine ? lyase (CSE)was detected by in situ hybridization, and the activity of CSE in lung tissues was measured by H 2S production according to chemical analysis. Results: After 11 weeks of aortocaval shunting, pulmonary artery mean pressure was significantly increased. Muscularization of small pulmonary vessels and relative medial thickness of pulmonary arteries were obviously increased in shunting rats compared with controls. Ultrastructure of intrapulmonary arteries changed obviously in shunting rats. Meanwhile, plasma H 2S concentration was decreased and the activity of CSE (according to H 2S production) in lung tissues decreased in shunting rats. CSEmRNA expression by pulmonary arteries was significantly suppressed. Conclusion: Pulmonary vascular structural remodeling is the important pathologic basis for pulmonary hypertension induced by high pulmonary blood flow. The down regula tion of endogenous H 2S pathway might play an im portant role in the development of high pulmonary blood flow induced pulmonary hypertension.

ObjectiveTo evaluate the clinical efficacy of bladder hydrodistention and intravesical sodium hyaluronate in the treatment of interstitial cystitis (IC).Methods Twenty-one IC patients received intravesical sodium hyaluronate therapy under combined blockage or intravenous anesthesia.Bladders were perfused with normal saline under 100 cm H2O perfusion pressure and expanded for 10 min,the bladders were then injected through a catheter with 40 mg/50 ml sodium hyaluronate which was released after 1 h.Intravesical perfusion was applied once every week four to six times in a course of treatment.Results The average bladder capacity was extended from 191.6 ± 88.7 ml before expansion to 425.3 ± 79.8 ml after bladder expansion ( P =0.000).The extension was done under anesthesia.There were two suspected bladder ruptures after starting the bladder expansion at 6.5 min and 7.2 min.There was significant gross hematuria in 19 cases,10 min after bladder expansion.After treatment,the catheters were removed 24 h after manipulation in 17 patients; the catheters were removed 72 h after manipulation in two cases with hematuria;the catheters were removed four days after manipulation in the two cases of suspected bladder rupture.Pain was significantly reduced after the catheters were removed and the maximum urinary output increased slightly.The day before the second injection of sodium hyaluronate,the urinary frequency decreased significantly than before start of treatment (32.8 vs 18.5 times/24 h).The maximum urinary output increased significantly compared with the output before treatment (86.7 vs 151.9 ml).Pain was reduced significantly after treatment (8.7 vs 3.0).The O'Leary-Sant IC score and the QOL were significantly improved (30.0 vs 17.0,5.9 vs 2.4,respectively) (P =0.000).After the third treatment,the symptoms continued to improve.The treatment results were best in the fifth week at the time of the sixth injection of sodium hyaluronate.Symptoms rebounded at six months.However compared with that before treatment,the difference was still statistically significant ( P =0.000).ConclusionsBladder hydrodistention under anesthesia for severe intractable IC patients produces immediate effectiveness.Sodium hyaluronic infusion can alleviate urinary frequency and pain,and the effectiveness and duration of treatment are positively correlated.

[Abstrict]Objective To explore the key points and clinical value of combined direct and indirect extracranial-in?tracranial (EC-IC) bypass in patients with adult moyamoya disease. Methods Retrospective analysis of combined revas?cularization surgery in 25 adult patients with moyamoya disease. The frontal branch and parietal branch of the superficial temporal artery (STA) were dissected. Combined revascularization surgery consisted of direct (anastomosis between the su?perficial temporal artery and cortical branch of the middle cerebral artery) and indirect (encephalodurogaleosynan-giosis EDAS) surgeries. Clinical status was evaluated using the modified Rankin Scale and NIHSS score at 1 day before, 1 week and 3 months after surgery. Results Thirty lateralities were successfully performed on 25 patients. Postoperative angiogra?phy or CTA and cranial computer tomography perfusion imaging(CTP) were conducted to examine the patency of the di?rect anastomosis and cerebral blood flow in 23 patientswithin 1 weeks after surgery . The results showed that the anasto?motic vascular patency was excellent and the cerebral blood flow increased in parallel to the relief of the patients’s isch?emic symptoms. The median mRS scores were 3 (1,3) before surgery, 2 (1,3) 1 week and 1 (0,3) 1 month after surgery.The median mRS scores were significantly improved (Z=15.14, P<0.01). The median NIHSS scores was 5 (4,8) preopera?tively and 4(2,7) postoperation 1 week and 3(1,4) 3 months. The median NIHSS scores were also significantly improved (Z=11.36, P<0.01). Unfortunately, two patients had complication and left hemiparesis. One patient complicated with con?tralateral hemisphere infarction and the another one complicated with ipsilateral hemispheric hemorrhage after operation. Conclusions Combined revascularization surgery may result in satisfying improvement in clinical, angiographic, and he?modynamic states and prevention of recurrent stroke. The stabilized hemodynamic is the key point in peroperative period for moyamoya patients.

Objective To investigate the clinicopathological characteristics of colon cancer patients with different mismatch repair gene (MMR) status and evaluate the value of MMR status combined with preoperative blood neutrophil-lymphocyte ratio (NLR) in predicting postoperative recurrence of colon cancer. Methods We retrospectively analyzed the pathological MMR immunohistochemistry results of 125 colon cancer patients after radical resection. Patients were divided into deficient mismatch repair (dMMR) group (n=55) and proficient mismatch repair (pMMR) group (n=70), and further divided into four groups according to MMR status and NLR level. Results Compared with the pMMR group, the patients in the dMMR group had younger onset age, larger tumor size, lower differentiation and more nerve invasion, and were more likely to occur in the right hemicolon (P < 0.05). According to the ROC curve, the NLR threshold was determined as 3. The proportion of low NLR in dMMR group was significantly higher than that in pMMR group (P < 0.05). The 3-year recurrence-free survival rate of the dMMR with low NLR group was 85.0%, significantly higher than those of the other three groups (P < 0.05); Survival analysis showed a significant advantage of the dMMR with low NLR group comparing with the pMMR with high NLR group. Conclusion dMMR colon cancer has unique clinicopathological characteristics. MMR status combined with NLR value can be used to evaluate the postoperative recurrence risk of colon cancer patients.