Objective:To compare the clinical effect and safety of modified Simiao San and colchicines on the damp heat gout.Methods:120 patients with damp heat gout admitted in our hospital in 2015 were selected and randomly divided into group A,group B and group C with 40 cases in each group.Patients in group A were given modified Simiao San,patients in group B were given colchicine,patients in group C were given modified Simiao San combined with colchicine.Then the clinical effect,scores of symptoms,expression levels of inflammatory factors and other biochemical indexes,adverse reactions and recurrence rate of 3 groups were compared berween three groups.Results:The total effective rate and effectually effective rate of group A were 92.5％ and 57.5％ respectively,which were 95.0％ and 65.0％ in group C was,obviously higher than 77.5％ and 35.0％ of group B (P＜0.05).The symptom scores of 3 groups after treatment were all lower than those before treatment (P＜0.05).The variety of ESR and UA of group C were greater than other groups (P＜0.05).The incidence rate of adverse reaction in group A and group C were 5.0％ and 7.5％ respectively,obviously lower than 22.5 of group B with statistically signficance (P＜0.05).The SF-36 score of group C was obviously lower than those of group A and group B with statistically significance (P＜0.05).Conclusion:Modified Simiao San combined with colchicine had better effect and safety compared to single medicine,which could greatly improve the quality of life.

ObjectiveTo explore the cytogenetic characteristics of multiple myeloma (MM) patients,to evaluate the effect of a long-term culture stimulated by cytokines on cytogenetic study of MM,and to investigate the clinical detection value of RB1 and P53 deletion in interphase plasma cells by using fluorescence in situ hybridization (FISH).MethodsKaryotype analysis was performed in 81 MM patients by using the short-term culture of bone marrow cell and G-banding technique.Among the 81 MM patients,28 patients used two culture methods:one was the short-term culture and the other was to culture cells for 6 days with recombinant granulocyte-macrophage colony-stimulating factor (GM-CSF) (40 μg/L) and IL-6 (10 μg/L).RB1 and P53 deletion were detected on interphase plasma cells by using FISH in 31 patients.ResultsAmong the 81 patients,75 had enough metaphases for analysis.Among the 75 patients,31 (41.3％)had clonal karyotypic abnormalities including 4 numeric abnormalities,11structural abnormalities and 16 both abnormalities.Among the 28 patients using two culture methods,the clonal karyotypic abnormalities were detected in 6 patients(25.0％ ) in the group of cultured for 24 hours,and 14 patients (51.9％) in 6-day culture group with a significant difference (P =0.026).RB1 deletion and P53 deletion were detected in 10 patients (32.3％ ) and 11 patients(35.5％ ),respectively,with both RB1 and P53 deletions be detected in 5 patients ( 16.1％ ).ConclusionsMore than half of the tested MM patients have both numeric and structural chromosome abnormalities.The karyotype analysis using banding technique is basic cytogenetic study.Extended culture in the presence of IL-6 and GM-CSF could improve the efficiency of cytogenetic analysis to MM.Interphase FISH is a sensitive method of clinical application significance to detect the gene deletion of MM.

Objective: To establish a method to determine 5 hazardous elements in animal traditional Chinese medicines (TCM) by microwave digestion-inductively coupled plasma mass spectrometry (ICP-MS).Methods: HNO 3-H 2 O 2 was used to decompose animal TCM, the working parameters of ICP-MS were optimized, and the matrix effect and the mass spectrum interferences were corrected by the in-line addition of Ge, In and Bi internal standard solution and the collided reaction cell technology (KED mode), respectively.Results: The detection limits of 5 hazardous elements were within the range of 0.04-0.52 μg·L-1 , the relative standard deviations (RSD) were within the range of 1.1%-4.8% , and the recoveries were within the range of 92.4%-110.0%.The method was applied to determine the 5 hazardous elements in 40 batches of animal TCM.The results indicated that some kinds of hazardous elements in animal TCM were high, and more attention should be paid to the problems in the production and use of animal TCM.Conclusion: The analysis method is simple, rapid and accurate, and suitable for the determination of hazardous elements in animal TCM.

Objective To explore the distribution characteristics of monosomal karyotype (MK) in elderly patients with acute myeloid leukemia (AML).Methods The karyotype analysis was performed in 123 elderly patients with newly diagnosed AML in our center from Nov 2000 to Feb 2015.We retrospectively studied the distribution characteristics of monosomal karyotype in these patients.Results Among 123 elderly patients with AML,117 patients had enough metaphases chromosomes for analysis.Among the 117 patients,there were 16 cases with good-risk karyotype,54 cases with intermediate-risk karyotype,and 47 cases with adverse-risk karyotype.In the 47 patients with adverse-risk karyotype,43 cases had complex karyotypes (CK).In the 117 elderly AML patients,37 cases (31.6％) had monosomal karyotype (MK),22 AML cases were secondary to myelodysplastic syndrome (MDS-AML),among them 13 cases (55.0％) had MK.In the 95 cases with primary AML,the detection rate of MK was 25.3％ (24 cases).The detection rate of MK+ AML was higher in MDS-AML patients than in de novo AML patients (P=0.000).Among the 37 patients with MK+AML,35 cases had complex karyotypes.30 (81.1％) MK+AML patients had two or more distinct autosomal monosomies and 7 (18.9％) MK+ AML patients had one single autosomal monosomy in the presence of structural abnormalities,and the incidence of autosomal monosomies was higher than that of single autosomal monosomy.The presence of--5 (27.0％),-4 (18.9％),-7 (16.3％) and-6 (13.5％) chromosomes was the most common autosomal monosomy among MK+ AML patients.Conclusions The detection rate of MK is relatively high in elderly AML patients.Two or more distinct autosomal monosomies are more common.The detection rate of MK+AML is higher in patients with MDS-AML than in patients with de novo AML.

Objective To discuss an initial clinical application of three-dimensional reconstruction of ilium bone flap. Methods From December 2006 to June 2008, bone defects of 6 patients with frac-tures of femoral shaft and tibia were repaired using vascularized iliac bone flap. After injection of contrast a-gent, CT scan was performed. Amira 4.0 Software was applied to reconstruct personalized three-dimensional structures of the iliac bone flap. The points, lines, and surfaces were marked in the personalized three-dimensional images reconstructed to provide guidance for the actual surgery. Results The person-alized three-dimensional reconstruction of iliac bone flap for the 6 individual patients were successfully used in the actual surgery. The three-dimensional structures of blood vessels, bone and adjacent relationship which had been clearly shown in the reconstructed flaps were confirmed by the actual surgical findings. All the 6 lilac bone flaps survived uneventfully. Conclusion The preoperative three-dimensional reconstruction of lilac bone flap by CT scan, angiography and digital technology can provide a useful aid for actual surgical design and harvest of the flap, minimizing intraoperative injury to blood vessels and enhancing flap survival.

Objective To investigate the brain metabolic changes and evaluate their spatial distributions after traumatic axonal injury (TAI)in rats by using proton magnetic resonance spectroscopy(1H-MRS).Methods The TAI model was made by subjecting the head of the rats to the linear and angular accelerations.The multi-voxel MRS was employed to detect the tissue metabolic state at the levels of hippocampus-caudate and pons prior to injury and at 24 hours after injury.The alterations of NAA/Cr,NAA/Cho and Cho/Cr values as well as the spatial distribution of NAA/Cr reduction were accessed. Immunohistochemical staining for β-APP was used to observe the injured axons. Results A siguificantdecrease in NAA/Cr and NAA/Cho(P<0.05)and subtle increase in Cho/Cr(P>0.05)were observed in rats at 24 hours after TAI in comparison to the pre-injury levels.Notable decrease in NAA/Cr value was observed in the areas including the brain stem,hippocampus,internal capsule,corpus callosum and thalamus,where axonal injuries were confirmed by the histological examination. Conclusion Metabolic imbalances Occur in the brains of rats with TAI.with notable changes in the brain stem and the hippocampus.

Objective To investigate the optimal dose of oxycodone for severe pain in cancer patients so as to try to alleviate the suffering rapidly.Methods Totally 135 cases with severe pain in terminal cancer patients were randomly divided into groups A,B,and C,45 cases in each group.Groups A,B,and C were treated with oxycodone hydrochloride sustained-release tablets 20 ～ 140 mg/d,150 ～ 290 mg/d,300 ～ 640 mg/d,respectively.Pain relief and incidence of adverse reactions were evaluated 2 weeks later.Results Pain intensity scores (numerical rating scale,NRS) in 3 groups dropped with statistical difference (P ＜ 0.05).Pain relief rates in groups B and C were statistically significant compared to group A (P ＜ 0.05).Quality of life score (appetite,mental status,sleep,daily activities,and interpersonal life) in group C had statistical significance compared to groups A and B (P ＜ 0.05).Group C had slightly higher incidence of adverse reactions than that of groups A and B without significant difference (P ＞ 0.05).Conclusions Large dose and extra large dose of oxycodone hydrochloride sustained-release tablets can effectively relieve severe pain in advanced cancer patients.Extra large dosage can improve patient's quality of life in spite of the higher incidence of adverse reactions,and patients can still be tolerated well.

Objective: To examine the relationship between interpregnancy interval (IPI) and neurodevelopment among 6-month-old infants, so as to provide insights into the prevention of neurodevelopmental abnormalities among infants. Methods: Puerparas with full-term delivery at Anhui Province Maternity and Child Health Hospital from April 2017 to July 2018 and their babies were recruited. The demographic features, behaviors during pregnancy, IPI and birth outcomes were collected through questionnaires and medical records. The neurodevelopment was evaluated using the Ages and Stages Questionnaire (third edition) among infants at 6 months of age. The association between IPI and neurodevelopment was examined using multivariable logistic regression analysis. Results : Totally 485 maternal-newborn pairs were investigated, and the puerparas had a mean age of ( 29.43±4.40 ) years. There were 330 puerparas ( 68.04% ) with normal pre-pregnancy body mass index, 325 puerparas ( 67.01% ) with eutocia, 233 puerparas (48.04%) with the first delivery, 44 puerparas ( 9.07% ) with IPI of less than one year and 208 puerparas ( 42.89% ) with IPI of one year and greater. There were 246 male babies ( 50.72% ) and 437 babies ( 90.10% ) with normal birth weight. A total of 148 newborns were diagnosed with neurodevelopmental abnormalities, with a detection rate of 30.52%. Of all newborns with neurodevelopmental abnormalities, there were 45 babies with communication abnormalities ( 9.28% ), 87 babies with gross motor abnormalities ( 17.94% ), 73 babies with fine motor abnormalities ( 15.05% ), 68 babies with abnormalities of solving problems ( 14.02% ) and 60 babies with personal-social abnormalities ( 12.37% ). Multivariable logistic regression analysis showed a reduced risk of infant's communication abnormalities ( OR=0.273, 95%CI: 0.090-0.833 ), gross motor abnormalities ( OR=0.340, 95%CI: 0.150-0.770 ), fine motor abnormalities ( OR=0.266, 95%CI: 0.106-0.670 ), personal-social abnormalities ( OR=0.321, 95%CI: 0.121-0.851 ) and neurodevelopmental abnormalities ( OR=0.353, 95%CI: 0.171-0.730 ) among puerparas with IPI of one year and greater as compared to those with IPI of less than one year, and no significant difference was seen in infant's neurodevelopmental abnormalities between puerparas with the first delivery and with IPI of less than one year. Conclusion IPI is associated with neurodevelopmental abnormalities among 6-month-old infants.

BACKGROUND: According to present theories and our clinical experience, immune ablative and tolerance inducing theory is proposed. Immune ablative means to clear out mutate cell clones and without transfusion of hemopoietic stem cells afterwards; intolerance inducing means to induce animal models not to react to mutate somatic cells, which avoids relapse or new occurrence of autoimmune disease. OBJECTIVE: To explore the effects of immune-ablative and tolerance inducing therapy in treating animal model of immune polymyositis (PM). DESIGN, TIME AND SETTING: Randomized, controlled animal experiment was performed at the Animal Experimental Center of Nanfang Hospital from December 2008 to April 2009. MATERIALS: One New Zealand rabbit, female, weighing 4.1 kg and 36 England guinea pigs, female, weighing 400-500 g, were used. METHODS: New Zealand rabbit's muscle tissue homogenate and complete Freund's adjuvant (CFA) were injected into guinea pigs to make PM animal models. The 28 animal models were randomly divided into intense immune-ablative and tolerance inducing group (Busulfan 1 mg/kg, every 12 hours, totally 8 doses; followed by CTX 40 mg/kg per day for 4 days; then cyclosporine A (CsA) 3 mg/kg per day was given till animals were dead); cyclophosphamide (CTX) group: CTX was given, 10 mg/kg per day for 3days; immune-ablative and tolerance inducing group: Busulfan 0.8 mg/kg, CTX 30 mg/kg, CsA 3 mg/kg; the administration time and dose were the same as group 1. Control group was not treated.MAIN OUTCOME MEASURES: Full blood count (FBC) and biochemical index were tested before and after treatment, and surviving time was recorded. In addition, muscle pathological changes were observed.RESULTS: Compared with control group, number of white cells was significantly decreased in the other groups, and hematopoiesis function gradually restored after administration. The number of white cells in the immune-ablative and tolerance inducing group was the most, and striated muscle pathology showed PM. Following administration, the glutamic oxaloacetic transaminase and creatine kinase of intense immune-ablative and tolerance inducing and immune-ablative and tolerance inducing groups were significantly reduced (P < 0.05, P < 0.01), but no obvious striated muscle pathological changes were found. The glutamic oxaloacetic transaminase, lactic dehydrogenase and creatine kinase in the CTX and control groups remained unchanged. Survival time of intense immune-ablative and tolerance inducing group was the shortest among all groups, and there was no significant difference between CTX and control groups. The animals in immune-ablative and tolerance inducing group survived for the longest time. CONCLUSION: Immune-ablative and tolerance inducing therapy has preferable effect on treating animal models of PM, and its prognosis is better than intense immune-ablative and tolerance inducing therapy and regular CTX therapy.