Objective To investigate the correlation between serum tumor necrosis factor (TNF)-α,neuron-specific enolase (NSE)and the degree of hypoxic-ischemic encephalopathy (HIE).Methods Forty-six HIE patients in acute and convalescent stage and 30 full-term newborn infant were enrolled in this study.The level of serum of TNF-α and NSE were detected.The relationship between TNF-α,NSE level and severity of HIE was analyzed.Results The level of serum TNF-α and NSE in acute stage of HIE group were (156.3 ± 28.8) ng/L and (21.5 ± 3.6) μg/L,in convalescent stage of HIE group were (80.7 ± 26.1) ng/L and (10.6 ± 1.7) μ g/L,and in control group were (76.3 ± 24.4) ng/L and (9.4 ± 1.6) μ g/L.The level of serum TNF-α and NSE in acute stage of HIE group were significantly higher than those in convalescent stage of HIE group and control group (P ＜ 0.05).The level of serum TNF-α and NSE in convalescent stage of HIE group had no significant difference compared with those in control group (P ＞ 0.05).The level of serum TNF-α and NSE in mild HIE group were (88.5 ± 25.6) ng/L and (9.7 ± 2.4) μ g/L,in moderate HIE group were (150.1 ± 16.5) ng/L and (17.8 ± 3.6) μ g/L,and in severe HIE group were (197.3 ± 30.2) ng/L and (23.6 ±4.3) μg/L.The level of TNF-αand NSE were increased with the aggravation of HIE and there had significant difference among different degree of HIE(P ＜ 0.05).The level of serum TNF-α and NSE in mild HIE group and control group had no significant difference (P ＞ 0.05),and there had significant difference between moderate HIE group,severe HIE group and control group (P ＜ 0.05).Spearman rank correlation analysis showed that the level of TNF-α and NSE had positive correlation with the degree of HIE (r =0.54,0.57,P ＜ 0.01 or ＜ 0.05).Pearson correlation analysis showed that the level of TNF-α had positive correlation with the level of NSE (r =0.46,P ＜ 0.05).Conclusions The variation of TNF-α and NSE level in HIE newborn infant is parallel to the severity of the disease,which can sensitively reflect the severity of HIE.Therefore,TNF-α and NSE may be used as vital indexes for the evaluation of the severity of HIE.

Objective:To study the clinical pathologic characteristics and differential diagnosis of rare type carcinoma of the breast. Methods:According to the new World Health Organization Classification of Tumors(2003),42 cases of rare type carcinoma of the breast were studied by clinical data and correlated investigation of pathology.Results: All the slides of the breast carcinoma in our department were reviewed,9 cases of glycogen-rich,clear cell carcinoma,4 cases of mucinous carcinoma,2 cases of tubular carcinoma,18 cases of metaplastic carcinoma,6 cases of apocrine carcinoma,1 case of secretary carcinoma,and 2cases of lipid-rich carcinoma were found.Different histologic type has different appearance in the light microscopy,special staining and electromicroscopy.Conclusion:Definite histological classification of breast carcinoma will be helpful in guiding the clinical treatment and estimating patients' prognosis.

Objective To explore the clinical value of serum cathepsin L (CL),matrix metalloproteinase-9 (MMP-9) and heparanase (Hpa) detection in determining the degree of ovarian cancer invasion and metastasis.Methods Enzyme-linked inmunosorbent assay (ELISA) and electrochemiluminescencl immunoassay (ECLIA) were used to detect the serum content of MMP-9,Hpa,CL in 217 cases with untreated ovarian cancer before surgery( in FIGO Ⅰ - Ⅱ stage 83 cases,Ⅲ-Ⅳstage 134 cases),100 cases with benign ovarian tumors and 101 healthy women control.All of the patients from Guangxi Medical University Affiliated Tumor Hospital,from September 2003 to October 2009.The relationship between the clinical pathological factors of ovarian cancer and serum content of MMP-9,Hpa,CL was analyzed.On the basis of clinical pathological diagnosis as “gold standard”,the ROC curves was drawed to evaluate the clinical value of serum CL,MMP-9,Hpa combined detection in determining the degree of ovarian cancer invasion and metastasis before surgery.Results The serum content of CL,MMP-9 and Hpat in patients with ovarian cancer were (21.23 ± 8.17),( 193.95 ± 42.49),(7.68 ± 2.32) μg/L respectively,which was higher than that in patients with benign ovarian tumors [ ( 10.97 ± 3.84),( 143.66 ± 28.47),( 4.86 ± 1.37) μg/L respectively ] and normal control [ (5.59 ± 1.75),( 57.99 ± 1 1.42),( 2.77 ± 0.80) μg/L respectively ],there was difference statistically significant ( t value CL was - 13.242,- 13.498 respectively; MMP-9 was - 14.521 and - 21.290 respectively; Hpa was - 10.896 and - 18.280 respectively,P ＜ 0.001).The serum content of CL [ ( 21.59 ± 8.24) μg/L ] in patients with epithelial ovarian cancer ( EOC) was significantly higher than that [ ( 19.57 ± 7.69) μg/L ] in non-epithelial carcinoma ( F =1 1.209,P =0.048).The serum CL,MMP-9 and Hpa content in FIGO Ⅰ -Ⅱ stage patients was (19.66 ± 7.83),(182.63 ±42.30),(7.21 ±2.05) μg/L,which was lower than that (22.64 ±8.31),(202.81 ±39.74),(8.51 ± 1.92) μg/L in FIGO Ⅲ-Ⅳ stage patients ( F value was 12.452,70.565 and 195.122respectively,P value was 0.030,0.002 and 0.000 respectively).In patients with EOC,the serum CL,MMP-9 and Hpa content in eases with poorly differentiated was ( 23.04 ± 7.67),( 200.12 ± 40.82),(8.22 ± 1.92) μg/L respectively,which was also higher than that in cases with high-moderate differentiated [ ( 18.54 ± 7.30),( 173.43 ± 39.37),(7.20 ± 2.51) iμg/L respectively;F value was 24.545,60.286 and 9.077 respectively; P was 0.004,0.035 and 0.001 respectively ].The serum content of CL and MMP-9(22.96 ± 8.41),(200.44 ±43.82) μg/L respectively in patients with invasion and metastasis in the abdominal cavity was higher than that without invasion and metastasis in the abdominal cavity [ ( 19.07 ±7.36),( 181.04 ± 36.10) μg/L,F value was 12.210,18.084 ; P value was 0.030,0.010 ] ; There was statistically significant relatioship between serum levels of Hpa and patients with distant metastasis ( F =9.430,P =0.042).On base of pathological diagnosis as gold standard,ROC curve showed the sensitivity was 60.9％ (70/115),69.6％ ( 80/115) and 72.2％ ( 83/115) and specificity was 57.4％ ( 26/62),67.2％(20/62) and 68.9％ (19/62),as serum levels of CL,Hpa,MMP-9 preoperative were detected as tumor markers to determine whether there was cancer invasion and metastasis outside the pelvis.Conclusions There is related with CL,MMP-9 and Hpa levels increase and tumor occurrence and progression in ovarian cancer.The serum content of MMP-9,Hpa,CL detection would be certain clinical reference value to determine extent of invasion and metastasis of ovarian cancer before surgery.

ObjectiveTo evaluate the effect of Rhubarb associated preparations (rhubarb or prescriptions of traditional Chinese medicine including rhubarb) on sepsis patients with acute gastrointestinal dysfunction (AGI).Methods The retrieval of databases from libraries including PubMed, Medline, Cochrane Central Register of Controlled Trials, CNKI, CBMdisc, Wan Fang Database, VIP database were searched to identify randomized controlled trials (RCTs) about Rhubarb associated preparations for treatment of sepsis patients with AGI from the foundation of the various databases to March 2016. And in the mean time, the references of the studies accepted were also retrieved. The retrieving and screening of literatures were performed independently by two researchers, the methodological quality and data extraction of the enrolled literatures were assessed by Jadad scale, and Cochrane Collaboration 5.3 software was used to perform Meta analyses to observe the effects of rhubarb associated preparations on gastrointestinal function score, acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) score and 28-day mortality in sepsis patients with AGI; the bias of published literatures was evaluated by funnel plot.Results ① Finally, 16 studies involving 1 171 patients (610 in rhubarb preparation group and 561 in the control group) were identified and enrolled. 12 studies had a Jadad score ≥ 3 and 4 studies < 3. The random method was used in classification of groups in all the studies in which the intergroup baseline data being comparable was clearly indicated. The blind method was applied in 5 contained RCTs.② The results of Meta-analyses showed that rhubarb associated preparation could improve gastrointestinal function score [mean difference (MD) = -0.52, 95% confidence interval (95%CI) = -0.55 to -0.48, P < 0.000 01], reduce the APACHEⅡ score (MD = -3.66, 95%CI = -5.00 to -2.33,P < 0.000 01) and 28-day mortality [odds ratio (OR) = 0.46, 95%CI = 0.30 to 0.71,P < 0.000 01] compared with those in the control group, the differences being statistically significant. No publication bias was seen in 16 literatures containing RCTs from the funnel plot.Conclusions Compared with the control group, the rhubarb associated preparations combined with conventional theraph can significantly improve the gastrointestinal function score, reduce APACHE Ⅱ score and 28-day mortality of sepsis patients with AGI, which suggests the rhubarb associated preparations have better efficacy. In addition, the result of sensitivity analysis has not substantially changed the results of Meta-analysis.

AIM: To study the bioequivalence of two tadalafil tablets in Chinese healthy male subjects. METHODS: A randomized, open-label, two-period, two-sequence, crossover study designing was adopted in the study. Thirty-six healthy male subjects were enrolled under fasting condition and fed condition, respectively. Each subject was given a single oral dose of tadalafil tablet (20 mg). The concentration of tadalafil in plasma was determined by LC-MS/MS. The pharmacokinetic parameters were calculated by WinNonlin 8.0 program, and statistical analysis was performed by using SAS 9.4 statistics software. RESULTS: Under fasting condition, the pharmacokinetic parameters of tadalafil of the test (T) and reference (R) preparation were as follows: C