OBJECTIVE:To establish an HPLC method for the determination of dextromethorphan and dextrophan in human urine and to discriminate phenotype of CYP2D6.METHODS:The urine samples were hydrolyzed by enzyme,distilled and purified by acid and alkali before direct introduction.HPLC system was adopted using Waters Nova-Pak Phenyl column with mobile phase consisted of acetonitrile-water(60∶40)at a flow rate of 1.0 mL?min-1.The fluorescence detection was performed with excitation wavelength at 280 nm and emission wavelength at 310 nm.The column temperature was 25℃.RESULTS:The linear ranges of dextromethorphan and dextrophan were 0.065～4.148 ?g?mL-1(r=0.998 5)and 0.353～22.592 ?g?mL-1(r=0.999 7),respectively.The lower detection limits were 0.016 ?g?mL-1 and 0.018 ?g?mL-1,respectively.The average recoveries were 90.5% and 93.5%,resepctively;the intra-day RSD were no more than 3.26% and 3.47% and inter-day RSD were no more than 3.65% and 4.05%,respectively.All the 8 subjects were extensive metabolizers(EM).CONCLUSION:The method is simple and reliable,and suitable for the determination of both dextromethorphan and dextrophan in human urine and as well as the study of the phenotype of CYP2D6 polymorphisms.

Objective To study the clinical effect of the minimally invasive surgery for treating recurrent lumbar disc protrusion . Methods Thirty operative cases of recurrent lumbar disc protrusion treated with the minimally invasive surgery from July 2009 to July 2013 were retrospectively analyzed for statistically describing the age ,body mass index ,recurrent segment ,operating time ,intr-aoperative bleeding volume and postoperative painless walking time .The recurrence segments were 1 case of L34 ,10 cases of L45 and 19 cases of L5 S1 ;the visual analogue scale (VAS) was adopted to evaluate the operative effect .Results The operating time was 65 min on average (50-100)min;mean intraoperative bleeding volume was 145 mL(100-180)mL ;average length of hospital stay was 13 d (9-16)d;average hospitalization costs were 7 300 Yuan;average postoperative painless walking time was 11 d (7-15)d;post-operative non-manual labor work time was 27 .3 d .The VAS score was reduced from (7 .3 ± 1 .3) before operation to (3 .1 ± 0 .9) after operation and (2 .2 ± 0 .6) at the last follow-up ,which was statistically significant(P<0 .05) .Followed up for 6-33 months , average 16 .5 months .Superior efficacy in 16 cases ,gord in 7 cases ,average in 5 cases ,bad in 2 cases ,the rate of good efficacy was 76% .Conclusion The minimally invasive surgery is one of effective methods to treat postoperative recurrence of lumbar disc pro-trusion .

Objective To assess right ventricular(RV) regional and global function in patients with repaired tetralogy of Fallot (TOF) by speckle tracking imaging (STI).Methods 36 asymptomatic patients with repaired TOF whose postoperative period is more than one year and 35 healthy controls were studied.RV longitudinal peak systolic strain (ε),strain rate (SRs) were measured in RV free wall and interventricular septum(IVS) for basal,mid and apical segments by STI from the apical 4-chamber view,RV global longitudinal peak systolic strain (GLS),strain rate (GLSRs),early diastolic strain rate (GLSRe) and late diastolic strain rate (GLSRa) were measured from the above view.The correlations between RV systolic functional parameters and the postoperative period,degree of pulmonary regurgitation (PR) and QRS duration were explored.Results ①Compared with controls,εand SRs of RV free wall and IVS for most segments,GLS,GLSRs,GLSRe,and GLSRa were significantly impaired in patients with repaired TOF (P ＜ 0.05 for all).Both GLS and GLSRs were lower in postoperative patients with transannular patch than in those with RV out tract patch.②In comparison with controls,GLS,GLSRs,GLSRe and GLSRa were decreased in postoperative patients with mild,mid and severe PR,Whereas,there was no difference in RV global function among the patients with varying degree of PR.③GLSRs of RV was correlated inversely with postoperative period and QRS duration(r1--0.431,P1 =0.009 ; r2 ==-0.469,P2-0.004),RV GLS and GLSRs had no correlation with PR.Conclusions RV regional and global function in patients with late repaired TOF are decreased,STI can early detect right ventricular dysfunction in asymptomatic patients with repaired TOF.The type of operation impacts on late prognosis,RV abnormal deformations are associated with electrical depolarization abnormalities.

4-fold elevation in renal cortex in plasma aldosterone as compared to those of the SHAM rats. The above pathologies were markedly improved in bi-ectomised rats with significantly lower aldosterone level. Being constantly infused exogenous aldosterone, bi-ectomized rats manifested greater proteinuria, hypertension, glomerulosclerosis and increased level of TGF-?1 compared to bi-ectomised rats. Indeed, these features were similar in exogenous aldosterone rats and 5/6 nephrectomized rats. Furthermore, the expression of mineralocorticoid receptor (MR) mRNA was remarkablely enhanced in SNX group and was decreased in ADX group. However, the mRNA expression of 11 ?-hydroxysteroid dehydrogenase II (11?-HSD2) in each group was opposite to that of MRmRNA. Ccr and kidney/body weight showed no differences among four experimental groups. Conclusion Aldosterone contributes to the progression of ablative nephropathy in the rat through mechanisms other than systolic blood pressure.

Objective To investigate the effects of antisense Smad2 oligodeoxynudeotides(ODN) on fibronetin(FN) and collagen Ⅳ(ColⅣ) secretion of rat mesangial cells cultured with high glucose, explore the action of Smad2 in the glomerulosclerosis and to find a new method to retard the progress of glomerular fibrosis. Methods 20-mer antisense, sense and random ODNs were designed and synthesized that were phosphorothioate modified to increase stability. The antisense ODN encompassed the ATG of the rat Smad2 gene. ODN was tranferred transiently into rat mesangial cells through liposome. Rat cells were treated with high glucose. mRNA and protein of Smad2 were detected by RT-PCR and cytochemistry. FN and ColⅣ were examined by ELISA. Results Antisense ODN significantly decreased mRNA and protein expression of Smad2 in rat mesangial cells treated with high glucose(P

Objective To observe and compare the curative effects of zoledronic acid (ZA) combined with radiotherapy and ZA combined with chemotherapy in the treatment of bone metastasis of non-small cell lung cancer (NSCLC). Methods Seventy-eight patients with NSCLC bone metastasis treated by radiotherapy or chemotherapy were taken in our hospital from January 2010 to June 2014, including 39 cases of ZA combined conventional fractionation radiotherapy (radiotherapy combined group), and 39 cases of ZA combined with chemotherapy (paclitaxel liposome + cisplatin) (chemotherapy combined group). Each group had 39 cases. WHO objective evaluation standard, efficacy evalulation of solid tumor metastasis and curative effect standard grading of pain, anticancer agent toxicity classification standard, Karnofsky standard were used for evaluating and analyzing the patients with primary lung tumor, bone metastasis, degree of pain, adverse reactions and functional status (once before and after the treatment). Results The efficiency rate of primary lung tumor, the efficiency rate of bone metastasis, the total effective rate of pain relief and the improvement rate of functional status (Karnofsky score increased by 10 points or more)in the radiotherapy combined group and chemotherapy combined group were 82.05 % (32/39) vs. 79.49 % (31/39), 48.72 % (19/39) vs. 51.28 %(20/39), 82.05 % (32/39) vs. 84.62 % (33/39), 66.67 % (26/39) vs. 71.79 % (28/39) respectively, and the differences were not statistically significant (the values of x2 were 0.224, 0.237, 0.195, 0.259 respectively, all P> 0.05); Although the two groups showed low-grade fever, bone marrow suppression, esophagitis, liver and kidney damage, gastrointestinal reactions and other adverse reactions, the adverse reactions of two groups were close to [28.21 % (11/39) vs. 30.77 % (12/39)] (x2 = 0.314, P> 0.05). Fortunately, these reactions were controlled well after symptomatic treatment. Conclusion ZA combined with radiotherapy or chemotherapy is a safe and effective way for bone metastasis of NSCLC, which should be taken based on the individual condition of the patients.

Objective To examine the expression of protein kinase signaling cascade protein kinase B (Akt)-which plays an im-portant role in a number of key biological functions in cellular processes after spinal cord injury (SCI) in rats ,and its effects on SCI induced motor function defects ,and to provide the molecular mechanism for repairing SCI .Methods SCI was produced by extra-dural contusion using modified Allen′s stall with damage energy .The rats were divided into three groups :sham-operated group (Sham) ,interference group (Int) ,and control group (Con) .Using immunostaining studies ,Western blot analyses and real-time qualitative RT-PCR analyses ,we detected the changes of Akt expression at the protein and mRNA level in spinal cord tissues at 1 , 7 ,and 14 d after surgery ,and evaluated the presence and extent of neurological impairment after SCI by the BBB locomotor rating scale .Results The sham operated groups exhibited low expression of the Akt signaling at the protein and mRNA level ,and the ex-pressions increased following SCI .Compared to the animals in the sham operated groups ,prominently elevated level of Akt signaling was detected in the injured spinal cords of SCI group .LY294002 ,an inhibitor of phosphatidylinositol 3-kinase (PI3K) that initiates Akt phosphorylation ,prominently inhibited the expression of Akt produced by SCI and the spontaneous recovery of motor function after SCI .Conclusion Activated protein kinase signaling cascade Akt might be the important intervention aspects of involving in neuroprotective and repair process after SCI .

Objective To explore the value of echocardiography in the diagnosis of the parachute mitral valve(PMV).Methods The echocardiographic characteristics of 12 patients with PMV between 2005 and 2012 were reviewed retrospectively,including the morphology,movement and blood flow of mitral valve apparatus,and other associated cardiac abnormalities.Results Of the mitral valve leaflets in these 12 cases,all were thickened and opened restricted in diastole.Axial view showed that in all cases mitral valves opened eccentrically and in 2 cases they didn't close tightly.Each patient only had single papillary muscle in left ventricle,which received all chords of mitral valves.Of papillary muscles in these patients,4 were located at posteromedial wall,3 at anterolateral wall,2 at middle posterior wall,2 at apical wall,and 1 at posterolateral wall.Of the 12 patients,only one were simple PMV,11 had associated cardiovascular anomalies,2 had mild regurgitation in systolic period and 11 had increased trans-valve peak flow velocity.Conclusions Echocardiography is reliable in the diagnosis of PMV,which could provide a comprehensive evaluation of valvular lesions and other associated cardiovascular anomalies.

AIM: To study the effects of chronic metabolic acidosis on glomerulus, mesangial cells and the production of extracellular matrix. METHODS: Chronic metabolic acidosis was induced by addition of 0.28 mol/L NH_4Cl to drinking water for 3, 7, or 14 days in male Wistar rats (n=10). Light microscope combined with computer software (Motic Images Advanced 3.2) was used to determine the effect of chronic acid loading on renal morphologic changes. The expressions of proliferation cell nuclear antigen (PCNA) and p27 in glomeruli were detected by Western blotting or immunohistochemistry. Fibronectin (FN) mRNA was detected by real-time PCR. The proliferation of mesangial cells in vitro was determined by ~3H:-TdR incorporation. The concentration of FN in cultured supernatant was detected by ELISA. RESULTS: On day 1, 3, 7 and 14, the arterial pH and plasma HCO_3~-: in experimental rats were significantly decreased. There was a significantly increased in the kidney weight and the ratio of kidney to body weigh in experimental rats on day 3, 7 and 14. The glomerular area and cell numbers also increased significantly. Immunoblotting demonstrated decreased p27 expression and increased PCNA expression in isolated glomeruli, and the expression of PCNA increased in a time-dependent manner following the time of chronic metabolic acidosis. Immunohistochemistry showed increased positive PCNA expression mainly localized to mesangial cells. The expression of FN mRNA was significantly elevated in experimental rats on day 7 and 14. In vitro, acid loading induced mesangial cell proliferation and synthesis of FN. CONCLUSION: These results suggest that chronic metabolic acidosis induces mesangial cell proliferation, and its mechanism may be associated with the downregulation of cell cycle kinase inhibitor p27.

Objective To understand the predictors and prognostic significance of cranial nerve impairment in non-acquired immune deficiency syndrome (AIDS) patients with cryptococcal meningitis.Methods A total of 145 non-AIDS patients with cryptococcal meningitis admitted to Huashan Hospital,Fudan University from Jan 2000 to Dec 2010 were reviewed retrospectively.Clinical characteristics,initial antifungal therapies and outcome of these patients were analyzed.Continuous variables were analyzed using t test and categorical variables were compared by x2 test or Fisher's exact test.Multivariate analysis was performed by binary Logistic regressions.Results Out of 145 patients,52 (35.9％) patients had cranial nerve impairment at enrollment.Optic (25/52,48.1％) and oculomotor (22/52,42.3％) nerves were the most commonly involved,followed by auditory (12/52,23.1％),abducens (6/52,11.5％),olfactory (4/52,7.7％) and facial (3/52,5.8％) nerves.The best predictive factor of cranial nerve injury was duration of diagnosis (OR =1.056,95％ CI:1.002-1.111).The risk of cranial injury would increase by 5.6％ with one-week delay of diagnosis.Intracranial hypertension and low cerebrospinal fluid cell count were also the independent predictive factors (both P＜0.05).In the follow-up period,73.3％ patients who had cranial nerve injuries were fully recovered,with a median time of 3 (0.5-24.0) months.The independent predictors of recovery were numbers of nerve involved (OR =0.230,95 ％ CI:0.066-0.800,P=0.021) and amphotericin B (AmB) plus 5-fluorocytosine,triazole antifungal agent therapy (OR=10.317,95％CI:2.086-51.025,P=0.004).Conclusions Cranial nerve impairment occurs in one-third of non-AIDS patients with cryptococcal meningitis.Delay in diagnosis,intracranial hypertension and low cerebrospinal fluid cell count are independent predictive factors.Less cranial nerve involvement and AmB plus triazole therapy predict recovery.