Objective To explore the technique and clinical value of percutaneous lung puncture and injection of drug under CT-guided in the treatment of multi-drug resistant cavitary pulmonary tuberculosis(MDR-TB).Methods 84 patients of positive sputum smear with MDR-TB were undergone injecting drugs into the pulmonary cavities by percutaneous lung puncture under CT-guided.The treatments were carried out by self-made locating mark which could confirm the appropriate puncture point,puncture angle and the puncture line.Results The operations of puncture in all cases were successful,the complications included pneumothorax in 3 cases,pulmonary hemorrhage in 1 case and subcutaneous emphysema in 1 case.After treatment,the mean rate of sputum negative,improvement of pulmonary cavity and cavity closure was 91.7%,89.3% and 66.7% respectively.Conclusion The percutaneous pulmonary puncture and injection of drug under CT-guided was a simple,visualized,right localization and less complications method in the treatment of the MDR-TB.

AIM: To establish HPLC method for separation and determination of rhein, emodin and crysophanol in Jiekangshu lotions(Radix et Rhizoma Rhei, Cortex Phellodendri, Radix Sophorae Flavescentis,etc.). METHODS: The chromatographic column: Symmetry C 18 column(3.9mm?150mm,5?m) and in advance column: Symmetry C 18 (5?m) were used with the mobile phase of methanol-water-phosphate acid(80∶20∶0.1), 1.0mL?min -1, flow rate, column temperature at 24℃ and detection wavelength at 432nm. RESULTS: Rhein, emodin and chrysophanol in Jiekangshu Lotion showed the good linear relationships at the range of 7.60～ 38.00?g?mL -1 (r= 0.9994), 1.75～8.75?g?mL -1 (r=0.9999), 2.40～12.02?g?mL -1 (r=0.9999), respectively. Their average recoveries: Rhein was 98.02%, Emodin 96.63% and Chrysophanol 97.05%, respectively. CONCLUSION: This method is simple. The results are accurate and reproducible.It can be used in the quality control of Jiekangshu lotion.

Objective To realize the actuality and analyze the problem of the hospital medicine preparation in Beijing,then to discuss its developing methods.Methods By summarizing questionnaire of the hospital medicine preparation and combining with the problem showed in daily supervision,we analyzed the main existing problems and reasons for hospital medicine preparation and put forward the developing methods.Results The main existing problems of hospital preparation are the decreasing variety of medicine preparation,insufficient infrastructure and software.Conclusion Therefore we should enhance the input on the infrastructure,set up the software,improve the quality of the staff,and consummate the regulation means and system.

0.05).Subsequent stratification revealed that MICA*A5 was present at significantly lower frequency in patient group with chronic granulocytic leukemia(CML)(RR=0.635,P=0.038 0);MICA*A4 at significantly lower frequency in patient group with lyphololastic leukemia(ALL)(RR=0.120,P=0.029 7);MICA*A5 at significantly higher frequency in patient group with acute non-lyphololastic leukemia(ANLL)(RR=2.229,P=0.021 8),all compared with control group.Conclusion:MICA-STR allelic variation is associated with leukemia in Hunan Han population;The data also suggest the heterogeneity of MICA-STR allele associated with different clinical types of leukemia.

Objective To evaluate the clinical effectiveness of laparoscopic (LDP) versus open distal pancreatectomy (ODP) using meta-analysis.Methods Comprehensive literature search was conducted on articles only in English published from 2006 to 2012 on MEDLINE,EMbase,Cochrane Central Registry of Controlled Trials to compare LDP with ODP for Pancreatic disease.Data were extracted and evaluated by two reviewers independently.The quality of the included trials was evaluated.Meta-analyses were conducted using the Cochrane Collaboration's RevMan 5.1 software.Results Fourteen controlled clinical trials (n=1417) were included.The LDP group was significantly longer than the ODP group in operation time,and was significantly larger in the number of patients with spleen preservation [(MD-273.10,95％ CI-354.39-191.081,P＜0.01),(OR 2.42,95％ CI 1.78-3.30,P＜0.01) respectively].The LDP group was significantly less than the ODP group in intraoperative blood loss,time to oral intake,and length of hospital stay [(MD-273.10,95％ CI -354.39-191.81,P＜0.01),(MD-1.78,95％ CI-2.36-1.20,P＜0.01),(MD-3.15,95％ CI-3.97-2.33,P＜0.01) respectively].There were no significant differences in blood transfusion,pancreatic fistula rate,and mortality between the two groups.Conclusions LDP is feasible and safe in treating pancreatic disease.When compared with ODP,LDP has the advantages of having less intraoperative blood loss,quicker recovery and more patients with spleen preservation.

Objective To investegate the effect of ginsenoside Rg1 on the apoptosis related protein FLICE-inhibitory protein(FLIP),Fas-associated death domain protein (FADD)and Caspase-3 in the subatania nigra(SN)of 1-methyl-4-phenyl-1,2,3,6-tetrahyd-ropyridine (MPTP)-induced mouse models of Parkinson’s disease(PD), and to investigate the role of FADD and FLIP in the pathogenesis of PD and the protective effect of ginsenosides Rg1 on dopaminergic neurons.Methods 45 C57BL/6N mice were randomly divided into control group,model group and ginsenoside Rg1 group (n=15).The mice in model group were injected with MPTP by intraperitoneal,the mice in Rg1 group were injected with ginsenoside Rg1 before injecting MPTP,and the mice in control group were injected with normal saline by intraperitoneal. The behavioral changes of the mice in various groups were observed, and immunohistochemistry and Western blotting methods were used to observe the expressions of tyrosine hydroxylase (TH),FADD,FLIP and Caspase-3 in substantia nigra of the mice.Results Compared with control group,the mice in model group presented with typical symptoms of PD, the TH-positive neurons in the subatania nigra was significantly reduced (P<0.01 ), the number of FADD, FLIP and Caspase-3 positive cells was significantly increased(P<0.01),and the cytoplasm was deeply stained;the protein expression levels of FADD,FLIP and Caspase-3 were significantly increased (P<0.01).Compared with model group,the PD symptoms of the mice in ginsenoside Rg1 group reduced, the number of TH-positive neurons was significantly increased, the number of positive cells of FLIP,FADD and Caspase-3 were significantly reduced(P<0.01),and the cytoplasm was lightly stained;the protein expression levels of FADD, FLIP and Caspase-3 were significantly reduced (P<0.01 ). Nonlinear correlation analysis found that there was a positive relationship between the number of FADD and Caspase-3 positive cells (r=0.791,P<0.05).Conclusion Ginsenoside Rg1 may play a neural protective effect dopaminergic on neurons by modulating the FADD and FLIP expressions in SN of PD model mice.

Objective To investigate the effects of Furong-Tongmai capsules on the expressions of interleukin-1 (IL-1) and tumor necrosis factor-α (TNF-α) in the sciatic nerve in diabetic rats.Methods A total of 50 rats were randomly divided into the normal control group,model group,and low-,medium-,and high-dose of Furong-Tongmai groups,10 rats in each group.Diabetes mellitus in rats were induced by intraperitoneal streptozotocin injection (60 mg/kg).The rats in the low-,medium-,and high-dose of Furong-Tongmai groups were intragastric administrated with Furong-Tongmai suspension 0.7,1.4 and 2.8 g/kg daily for 8 weeks,respectively.The rots in the normal control group and model group were intragastric administrated with equal-volume normal saline daily for 8 weeks.The expression levels of IL-1 and TNF-α in the sciatic nerve were detected with immunohistochemistry staining.Results The expression levels of IL-1 (1.43％ ± 0.17％ vs.0.21％ ± 0.09％;P＜0.05) and TNF-α (1.98％ ± 0.12％ vs.0.35％ ± 0.03％;P＜0.05) in the model group were significantly increased than those in the normal control group.The expression levels of IL-1 (0.54％ ± 0.14％,0.51％ ± 0.13％ vs.1.43％ ± 0.17％;all P＜0.05) and TNF-α (0.57％ ± 0.17％,0.49％ ± 0.15％ vs.1.98％ ± 0.12％;all P＜0.05) in the medium-,and high-dose of Furong-Tongmai groups were significantly decreased than those in the model group and low-dose of Furong-Tongmai group (1.08％ ± 0.18％ in IL-1,1.11％ ± 0.09％ in TNF-α;all P＜0.05).Conclusion Furong-Tongmai capsules can reduce the expressions of IL-1 and TNF-α in sciatic nerve in diabetic rats.

Objective To evaluate the response of the lung tumor xenografts in nude mice to antiangiogenic treatment from perspectives of anatomic,vessel function,cellular and molecular level using the multimodality imaging techniques including optical imaging,dynamic contrast enhanced MRI(DCE-MRI)and diffusion weighted imaging(DWI).Methods The green fluorescent protein(GFP)was transplanted labeled using GFP-expressing NCI-H460 cells.After the transfection of GFP,NCI-H460 cells were implanted subcutaneously into nude mice.Ten days after implantion,12 nude mice whose tumor xenografts grew to 0.5-1.0 cm in the maximum diameter were randomly divided into 2 groups,and injected with phosphate-buffered saline and recombinant human endostatin respectively.Then the nude mice in the two groups underwent optical imaging,DCE-MRI and DWI.The volumes,photon counts,the quantitative MR vessel functional parameters including volume transfer constant(Ktrans),rate constant(Kep),volume of extravascular extracellular space(Ve)and maximum area under the enhancement curve(iAUC),and apparent diffusion coefficient(ADC)values of the tumors were recorded.Then tumors were collected and observed using the transmission electron microscopy and pathology examination,including HE staining,microvessel density(MVD)and the expressions of vascular endothelial cell growth factor(VEGF).The Kep and VEGF expressions in experimental group and control group were compared with x2 text,and other values were compared with t test.The Pearson and Spearman test were used for analyzing the correlation of values in the two groups.Results Seven days after inoculation,the fluorescence signals were detected and grew with the growth of the tumors.On the 7 day after starting therapy,the photon counts of experimental group and control group were(2.51 ± 2.43)× 1010(photon/sec)and(5.77 ± 3.25)× 1010(photon/sec),respectively with no significant differences(t =1.964,P ＞0.05).Two sample t test showed that the tumor volumes in experimental group were smaller than those in control group[(365 ± 56)vs(987 ± 265)mm3,t =0.001,P ＜ 0.01].There was a positive correlation(r =0.673,P ＜ 0.05)between the photon counts and the volumes of the tumors.The mean Ktrans,Kep,Ve and iAUC of experimental group were:(0.055 ±0.012)min-1,0.335(0.184—0.894)min-1,0.297 ± 0.041 and 7.334 ± 3.930,and those for control group were:(0.117 ± 0.027)rin-1,0.417(0.324-1.736)min-1,0.326:±:0.062 and 13.280 ± 4.245.There were significant differences of Krans and iAUC(t =5.155,2.518,P ＜ 0.05)between experimental group and control group.And there was a positive correlation(r =0.715,P ＜ 0.0 1)between the values of iAUC and MVD,but not the expressions of VEGF(r =0.484,P ＞ 0.05).The values of ADC in experimental group were higher than that in control group[(791 ± 38)× 10-6 vs(737 ± 43)×10-6 mm2/s],and there were significant differences(t =-2.299,P ＜ 0.05).Two sample t test showed that the MVD in experimental group were lower than that in control group[(11.9 ± 4.8)vs(19.2 ±4.3)item/hpf,t =2.774,P ＜ 0.05].The VEGF expressions in experimental group were lower than that in control group(x2 =4.000,P ＞ 0.05).It was observed that some cells in experimental group had degenerated and apoptotic signs by the electron microscopy.Conclusions Evaluating the response of lung tumor xenografts to antiangiogenic treatment at anatomical,vessel functional,cellular and molecular level using the multimedality imagings is applicable.And it will be in favour of evaluating the therapeutic effect promptly.

BACKGROUND: One of mechanisms involved in treating cerebral ischemia with bone marrow mesenchymal stem cells (BMMSCs) implantation is paracrine action. However, few studies have reported this mechanism.OBJECTIVE: To observe the inhibitory effect of BMMSCs paracrine action on apoptosis and its mechanism after cerebral ischemia. METHODS: BMMSCs were isolated from rats with adherent culture. Rat cerebral ischemia model was established by the middle cerebral artery occlusion. A total of 24 rats were divided into 4 groups, with 6 animals in each group. Cell implantation medication group: rats were received U0126 medication after BMMSCs implantation; Non-implantation medication group: rats were received U0126 medication after PBS injection; Cell implantation control group: received solvent medication after BMMSCs implantation; Non-implantation control group: received solvent medication after PBS injection. At 7 days after operation, the expressions of vascular endothelial cell growth factor (VEGF) and p-ERK1/2 protein were measured by Western blot analysis, and the apoptosis cells in the area of ischemic penumbra and cortex were examined by TUNEL. RESULTS AND CONCLUSION: The VEGF protein content in the brain tissue was significantly greater in the cell implantation groups than that of the non-implantation group, with increased p-ERK1/2 and decreased apoptosis cells. The expression of p-ERK1/2 was down-regulated in rats which were administrated U0126 while the number of the apoptosis cells was increased, but the VEGF protein expression had no statistical difference. It suggested that BMMSCs can paracrine VEGF in the striatum of brain and play an inhibitory effect on apoptosis in the ischemia area via activating ERK1/2.

Objective To evaluate the application of Sigma stent in treatment for esophagn-tracheal fistula. Methods Clinical data of 22 cases of esophago-tracheal fistula treated with Sigma stent were retrospectively analyzed, including 17 cases of esophageal cancer and 5 cases of benign esophageal diseases, with length of 4 days to 2 months. One single stent was placed in 5 cases, two stents ( both in trachea and esophagus each) in 15 cases, and three stents in 2 cases, and 18 eases with tube-type trachea stent, 3 with obtuse angle L-type and 1 with Y-type. Placement of stent was by interventional method or/and endoscopy. Results Forty-one stents were successfully placed in 22 patients with no death in the procedure. And, all patients with fistula were healed successfully and could have normal eating 2 to 4 days after operation, except 1 patient who received a tracheal stent inserted first, but an esophageal stent inserted again due to incomplete seal of the fistula and another benign case who received surgical operation 1 year after stent placement due to protracted unsealed fistula, with an overall cure rate of 91% (20/22). Conclusions Placement of Sigma stent in the esophagus or/and trachea could effectively heal esophago-tracheal fistula. All the patients can eat normally after the procedure. Stent can be recycled and formation of secondary esophago-traeheal fistula can be prevented effectively with such procedure.