AIM:To investigate the effect of Ginsenoside Rh2 (Rh2) on the apoptosis of human osteosarcoma cell line MG-63.METHODS:The cell viability was determined by MTT assay .MG-63 cell apoptotic rate was examined by flow cytometry with Annexin V-PI double staining.The expression of Bcl-2, Bax, cytochrome C ( Cyt C) and cleaved caspase-3 were measured by Western blot .RESULTS: Rh2 enhanced the apoptosis of MG-63 cells in a dose-dependent manner.Furthermore, after treatment with Rh2, the release of mitochondrial Cyt C and Bax expression were increased , while Bcl-2 and the ratio of Bcl-2/Bax were decreased as compared with control group ( P<0.05 ) .The protein level of cleaved caspase-3 was also increased (P<0.05).CONCLUSION:Ginsenoside Rh2 accelerates the apoptosis of MG-63 cells through mitochondria-dependent pathway , suggesting that Rh2 is a novel approach for the treatment of osteosarcoma .

Objective: To establish a method for the simultaneous determination of glycohyodeoxycholic acid and glycochenodeoxycholic acid in pulvis fellis suis by HPLC-ELSD.Methods: The analysis of methanol extract of pulvis fellis suis was performed on a Welch Ultimate Plus C 18 (250 mm× 4.6 mm ,5 μm)column, and the mobile phase consisted of acetonitrile and 0.1% formic acid (40∶60).The flow rate was 1.0 ml ·min-1.Alltech ELSD 2000ES was used as the detector, the drift tube temperature was 105℃ and the nitrogen flow rate was 2.5 L·min-1.Results: Glycohyodeoxycholic acid and glycochenodeoxycholic acid had good linear relationships within the range of 0.306-4.590 μg (r=0.999 5) and 0.280-4.194 μg (r=0.999 4), respectively.The average recovery was 99.23% with RSD of 2.0% and 100.37% with RSD of 1.8% (n =9), respectively.Conclusion: The method is accurate, sensitive and repeatable, which can be used for the quality control of pulvis fellis suis.

Objective To analyze the effect of Ginkgo biloba extract on ischemic stroke and its influence on serum superoxide dismutase(SOD) and malondialdehyde(MDA). Methods 146 patients with ischemic stroke were divided into two groups. The two groups were treated routinely and one group plus Ginkgo biloba extract. Results After treatment,the clinical efficacy,SOD,MDA and ET-1 level,hemorheology,NIHSS scores and Barthel index of observation group was better than that in the control group(P<0.05).Difference of adverse reactions were not statistically significant. Conclusion Ginkgo biloba extract can improve the therapeutic effect of ischemic stroke and adjust the level of related factors.

Sleep disordered breathing (SDB) is common,especially the obstructive sleep apnea,and the severity increases as pregnancy progresses.The review identifies the risk factors,possible mechanisms and clinical manifestations for sleep disordered breathing in pregnancy through investigating pregnant women,approaches the relationship between sleep disordered breathing in pregnant women and the complications of the mother and fetus,especially between the obstructive sleep apnea and hypertensive disorder complicating pregnancy or gestational diabetes mellitus,and the treatment of sleep disordered breathing in pregnancy.

Three ASA Ⅱ patients, aged 24-32 yr, weighing 56-74 kg, undergoing caesarean section with nitroglycerine for uterine smooth muscle relaxation, from May 2005 to April 2007 in our hospital, were studied. Among the 3 cases, 2 cases (39 or 40 weeks of gestation) were singleton pregnancy and 1 case (34 weeks of gestation) was twin pregnancy.Combined spinal-epidural block with an injection was used in the 3 patients and the block level was at T4-6-S3-5. The excess contraction of uterine occurred in the patient at 40 week gestation about 140 s after uterus incision and it was difficult in delivery of the fetus, trananasal administration was then performed with nitroglycerine 0.5 nag, but it was inefficient after 60 s observation. Nitroglycerine 0.2 nag was injected intravenously, 32 s later the uterine smooth muscle relaxation was good and the fetus was delivered smoothly. In the patients at 39 and 34 week gestation, nitroglycerine 0.2 mg was injected intravenously when the excess contraction of uterine occurred about 140 s after uterus incision and the 2rid fetus started to be. delivered respectively. The uterine smooth muscle relaxation was good 45 or 35 s after injection and the fetuses were delivered smoothly. Apgar score was 6-8 and 10 at 1 and 5 min after delivery in the 3 patients. The duration from hysterotomy to delivery was 195-240 s. Intravenous drip of oxytocin 20 U was given immediately after delivery, and then uterus contracted. No obvious adverse reactions were found.

The trial of two-way referral enrolled 26 patients with hypertension, including 20 cases of refractory hypertension, 3 new cases and 3 cases of secondary hypertension, the average length of follow-up was 22 d (10-35 d). The family physicians in Huaihaizhong Road Community Health Service Center communicated with specialists in the medical center (Ruijin hospital), appointments were made and medical information and other materials were sent in advance. When investigations and adjustment of medication were made, and the blood pressure was under control, patients were referred back to the community. This two-way referral system promoted the information exchanges between two side, doctors got prior knowledge about patients' condition and would spend more time with the patients; and patients' feeling of satisfaction and compliance of the treatment were increased. From our experiences, we suggest that the therapeutic regime made by the medical center should be feasible to the community, and more convenience should be given to the referred patients, so that the effectiveness and efficiency of the two-way referral can be further improved.

Objective To investigate the effect of positive end expiratory pressure (PEEP) on thermo-regulatory function during general anesthesia in patients addicted to smoking. Methods Twenty adult male ASA Ⅰ or Ⅱ patients who had been smoking more than or equal to 10 cigarettes per day for more than or equal to 6 years were studied. The patients underwent intra-abdominal surgery under general anesthesia and were randomly divided into 2 groups ( n = 10 each): control group (group C) and PEEP group (group P). Anesthesia was induced with propofol, fentanyl and vecuronium and maintained with inhalation of 1%-2% isoflurane and continuous iv infusion of remifentanil and vecuronium. The patients were mechanically ventilated after tracheal intubation. In group P PEEP of 10 cm H2O was added. Temperature probe was inserted into the lower segment of esophagus and placed on the anterior chest wall, medial surface of thigh anterior surface of forearm and palmar surface of the tip of index finger. Mean skin temperature (TMSK) was calculated according to Roberts. MAP, HR, TES, TMSK and the difference between TES and TMSK (TES-MSK) were recorded before induction of anesthesia (T0 ,baseline) and every 30 min after tracheal intubation. Esophageal temperature was taken as threshold of thermo-regulatory peripheral vasoconstriction when the difference between forearm and finger tip temperature = 0 ℃. The gain in the threshold was calculated according to Sessler. Results TES and TES-MSK significantly decreased,while TMsK increased after tracheal intubation in both groups ( P ＜ 0.05). There was no signifieant difference in TES, TMSK, TES-MSK, MAP, HR, the threshold of vasoconstriction and gain between the 2 gronps ( P ＞ 0.05). Conclusion PEEP cannot improve thermo-regulatory function during general anesthesia in smoking-addicted patients.

OBJECTIVE To establish an optimal management procedure in order to minimize the nosocomial infection in a laminar airflow(LAF) operating theater.METHODS A comprehensive control strategy was taken to make the work-flow sequentially and effectively in the LAF operating theater.This strategy included reasonable architectural layout required for the strict standard of an LAF operating theater,daily environmental management and idealistic traffic patterns that limited the movement of personnel and supplies.RESULTS This strategy greatly improved the nosocomial infection management and effectively reduced the rate of nosocomial infection.CONCLUSIONS The good design with standard of the LAF operating theater should be firstly emphasized.A series of feasible and manageable measures must be carried out to optimize the nosocomial infection control in the LAF operating theater.

Clinical practice guidelines play an important role in practitioner and patient decisions regarding appropriate clinical health care and in health policy formation. In the guideline development process, inappropriate methodologies and development strategies significantly influence the quality of guidelines; therefore, research and evaluation of guidelines have great significance. The original Appraisal of Guidelines for Research and Evaluation (AGREE) instrument was published in 2003 by a group of international guideline developers and researchers. AGREE has important significance for the quality guarantee and successful implementation of guidelines, and has extensively achieved endorsement since 2003. In 2009, The AGREE Collaboration has developed the AGREE II by refining the original AGREE instrument. At present, the AGREE II has already replaced the original AGREE instrument; however, related introduction regarding AGREE II has not been found in China. The authors of this article briefly introduce the AGREE II, and believe that it will add value to research and evaluation of the guidelines as a whole.

The LHX3 and LHX4 LIM-homeodomain transcription factors play essential roles in pituitary gland.Nervous system developments play certain roles in some cancers,leukemia,and deafness disease.Mutations in the genes encoding these regulatory proteins are closely associated with combined hormone deficiency diseases in human and animal models,and related to nervous system defect,tumors,leukemia and deafness.Analysis of these diseases and the biochemical properties of the LHX3 and LHX4 protein will facilitate a better understanding of the pathogenesis of these diseases.LHX3 and LHX4 are reviewed in this paper.