Tamoxifen has shown definitive effect when used as the adjuvant hormonal treatment in women with estrogen-receptor-positive breast cancer. However, long-term use of Tamoxifen can induce fatty liver disease. It has been proposed that tamoxifen may act throught mechanisms such as inducing triacylglycerol accumulation in mitochondria, abnormal fatty acid oxidation, and antagonizing actions of estrogen on hepatic lipid metabolism. Therefore, it is necessary to monitor lipid profile and liver function, conduct regular ultrasonography and CT examination in patients receiving tamoxifen treatment. Replacing tamoxifen with toremifene oraromatase inhibitors, or using lipid-lowering medicines may help prevent tamoxifen-induced fatty liver disease.

Orbital metastases rarely occur in the patients with cancer,especially from a primary pancreat-ic carcinoma.In patients presenting ophthalmologic symptoms such as local pain and periorbital edema,it is im-portant to consider orbital metastatic disease.And it is also crucial to determine the site of the primary tumor for better treatments.The mechanism underlying the orbital metastasis from pancreatic carcinoma remains to be clari-fied.In this report,we describe the clinical characteristics of a case with orbital and hepatic metastases from pri-mary pancreatic carcinoma,providing a reference for clinical diagnosis.Computed tomography of the abdomen and left orbit,in combination with intraorbital biopsy,suggesting a primary pancreatic malignancy with metastatic dis-ease.Surgical pathology and histopathological examination results confirmed the diagnosis.After single agent gem-citabine chemotherapy,the patient′s symptoms relieved.

OBJECTIVE:To establish a method for the simultaneous determination of psoralen,isopsoralen,epimedin B,epi-medin C and icariin in Chanlong dingchuan mixture. METHODS:HPLC was performed on the column of Welch Materials C18 with mobile phase of acetonitrile- methanol(1∶1,V/V)-water(gradient elution)at a flow rate of 0.9 ml/min,the detection wavelength was 246 nm(psoralen,isopsoralen)and 270 nm(epimedin B,epimedin C and icariin),column temperature was 30 ℃,injection volume was 20 μl. RESULTS:The linear range was 8.24-164.80 μg/ml for psoralen(r=0.999 7),5.15-103.00 μg/ml for isopso-ralen(r=0.999 3),4.06-81.20 μg/ml for epimedin B(r=0.999 6),5.88-117.60 μg/ml for epimedin C(r=0.999 5)and 4.90-98.00μg/ml for icariin(r=0.999 8);the limits of quantitation were 0.385 μg/ml,0.179 μg/ml ,0.124 μg/ml,0.218 μg/ml and 0.348 μg/ml, limits of detection were 0.127μg/ml,0.059μg/ml ,0.041μg/ml,0.072μg/ml and 0.115μg/ml;RSDs of precision,stability and re-producibility tests were lower than 2.0%;recoveries were 97.93%-100.06%(RSD=0.80%,n=6),96.91%-100.16%(RSD=1.37%,n=6),96.95%-99.63%(RSD=0.98%,n=6),96.69%-99.33%(RSD=1.03%,n=6) and 96.76%-98.53%(RSD=0.70%,n=6),respectively. CONCLUSIONS:The method is simple and reliable,and suitable for the simultaneous determination of psoralen,isopsoralen,epimedin B,epimedin C and icariin in Chanlong dingchuan mixture.

Objective:To determine the related substances in dienestrol tablets by HPLC. Methods:The separation was performed on a C18 column(250 mm × 4. 6 mm,5μm). The mobile phase consisted of methanol-acetonitrile(76∶24), the flow rate was set at 0. 8 ml·min-1 with the detection wavelength at 229 nm, and the sample size was 10 μl. Results:Under the established chromatographic conditions, the related substances and dienestrol were separated completely. The limit of detection was 2 ng. Conclusion:The method is simple, accurate, specific and sensitive in the determination of related substances in dienestrol tablets.

Dysarthria is collective name for motor speech disorders resulting from disturbance in the speech control mechanism due to the damage to the central or peripheral nervous systems. The speech intelligibility (SI) and communication ability of dysarthric patient are affected, impacting quality of life. Evaluation of dysarthric speech involves subjective and objective measurement which contains electrolaryngoscope, glottograph, electropalatography, nasalance evaluation, acoustic analysis including sonogram，spectrogram, perturbation and noise measurements. Multi-Dimensional Voice Program (MDVP) is a commonly used quantitative acoustic analysis of dysarthric speech. However, in the mainland of China, it is applied in researches on voice of normal people and patients with laryngological diseases and researches on voice characteristics of patients with Parkinson disease or cerebral palsy. To date, no study on the acoustic analysis using MDVP for dysarthric patients with cerebrovascular disease or traumatic brain injury is reported.

Objective To observe the characteristics of acoustic parameter of mandarin vowels in patients with spastic dysarthria and to explore the optimal mandarin vowel sample for the evaluation of acoustic characteristics of spastic dysarthria patients.MethodsTwenty-two male and six female patients with the age range from 19 to 62 years were recruited to patient group from the department of hearing and speech, China Rehabilitation Research Center. Another 28 normal subjects with comparable characteristics were recruited to control group. Computerized Speech Lab MODEL 4500 was employed to sample and to analyze the characteristics of the acoustic parameter. The data of the two groups were compared to detect the difference between groups.ResultsNo significances were found both between groups and within group in the fundamental frequency when pronouncing all the selected vowels. Significant difference was noticed between groups in the variation of both frequency and amplitude. Within the patient group significant difference was only found in the variation of amplitude when pronouncing all the selected vowels. Between groups, a significant difference was found in HNR (harmonic to noise ratio) when pronouncing vowel ［a］, whereas no significance was noticed in ［i］ and ［u］. Significances were noticed within the patient group among the vowels.ConclusionThe patient demonstrated greater variations in frequency, amplitude and noise component compared to control group. The vowel ［a］ is an appropriate examination variable for mandarin in China.

To analyze and discuss ethics of treatment in Heinophilic arhtropathy. Treatment of those patients not only could relieve their distress in thought, but also could improve their quality of life. And we raise operational contraindications are relative,not absolute.

Objective To establish a model for hypoxia-induced apoptosis of human adult cardiomyocytes in vitro. Methods The human adult heart cells of ventricular muscle were isolated by the digestion of trypsin and collagenase, cultured in Iscove's modified Dulbecco's medium (IMDM), and purified by means of differential attachment technique, adding Brdu and slicing fibroblasts by sterile needle. After 4 to 6 days, the cardiomyocytes were cultured in an incubator containing 3% O 2, 92% N 2 and 5% CO 2 for 6, 12, 24 and 48h to form hypoxia injury for cells. Morphological changes of apoptotic cardiomyocytes were measured by invertion microscopy and electronic microscopy. Apoptotic rate was measured by TUNEL staining. Results The cardiomyocytes occurred opoptosis after hypoxia injury, apoptotic rate of which at 6, 12, 24 and 48h after hypoxia was (3 3?0 9)%, (8 3?1 8)%, (16 1?2 6)% and (19 4?2 3)% respectively. Conclusion The apoptotic rate of cardiomyocytes increased with time of hypoxia lengthened. The model for hypoxia-induced apoptosis of human adult cardiomyocytes was successful and reliable.

ObjectiveTo investigate the preventive strategy of early post-operative complications of closed spinal dysraphisms in children.MethodsOne hundred and nine children with closed spinal dysraphisms underwent surgery from January 2004 to December 2008,were enrolled in this study.After dural closure,the wound was washed completely with saline to clear the tissue debris to prevent postoperative infection. We routinely made a horizontal incision to prevent postoperative infection. Results After operation,all patients were recovered and were discharged from hospitalNo post-operative complications,including cerebrospinal fluid leakage, wound infection and flap necrosis, were encountered. ConclusionThe sophisticated microsurgical technique and the delicate surgical manipulation is the prerequisite for the prevention of early operational complication of closed spinal dysraphisms in children.

Laparoscopic cholecystectomy is the gold standard for the treatment of gallstones and chronic cholecystitis.A patient with gallstone was admitted to the 88th Hospital of PLA in August 2012 and received laparoscopic cholecystectomy.She had bile leakage after operation,and had to accept reoperation.Pancreaticobiliary maljunction and aberrant duct upon gallbladder bed were found postoperatively by T-tube cholangiography and pancreatic amylase test in the bile,which led to a complicated treatment and a tortuous recovery.This article analyzed the treatment process for this disease and explore the proper diagnosis and treatment.