Objective There is close relationship between ubiquitin-specific protease 9X(USP9X) and the biological behav-ior of some tumor.The aim of this study is to investigate the expression and clinical significance of USP 9X in pancreatic carcinoma of elderly patients. Methods The expression of USP9X was detected in 30 pieces of surgically resected primary pancreatic carcinoma tissue and adjacent nontumorous pancreatic tissue of elderly patients by streptavidin -perosidase immunohistochemical method . Results The rate of USP9X positive expression was 56.7%, there was not positive expression in adjacent nontumorous pancreatic tissue .There was no relation between the expression of USP 9X with gender, age, the tumor positin, the tumor size and degree of differentiation (P>0.05), while it was significantly correlated with lymph node metastasis and TNM stages (P<0.05).By using Cox proportional haz-ards analysis, multivariable analysis revealed that TNM stages , lymph node metastasis and USP9X expression were independent risk factor(P<0.05). Conclusion The results indicated that USP9X may play a role in the pathogenesis and prognosis of pancreatic cancer of elderly patients .

Objective To investigate the clinical effect of endovascular embolization in treating spinal dural arteriovenous fistulae, and to discuss its imaging manifestations. Methods A total of 7 patients with spinal dural arteriovenous fistulae were included in this study. Endovascular embolization was carried out in all the 7 patients. The clinical data, including epidemiology, spinal MRI and DSA manifestations, therapeutic method and follow-up findings, were retrospectively analyzed. Results Abnormal MRI manifestations of spinal cord were demonstrated in all 7 patients. After the diagnosis was confirmed by DSA, endovascular embolization was carried out. All patients were followed up for 6 months, and their clinical symptoms were improved in different degrees. N-butyl cyanoacrylate (NBCA) glue was used as embolization agent in 4 cases, and no recurrence was observed in them. Onyx liquid glue was used in 3 patients, and in one of them the arteriovenous fistula recurred. Conclusion For the treatment of spinal dural arteriovenous fistulae, endovascular embolization is effective and safe although further investigation is still needed.

OBJECTIVE To discuss the efficacy and safety of Onyx embolization for the treatment of maxillofacial arteriovenous malformation(mAVMs). METHODS Between February 2013 to May 2014, 16 patients with mAVMs received embolotherapy in our department. Eight cases' mAVMs located in mandibular region, 5 cases located in the maxillary region and the other 3 cases located near the orbital region. Embolotherapy with Onyx was carried out in all patients and all the patients were followed-up. The effect of embolization was evaluated according to the deformity arteriolar blood flow. RESULTS After the embolization, angiograpy showed that complete occlusion of mAVMs was achieved in 3 cases, 50%-90%occlusion in 10 cases, <50% occlusion in 3 cases, and the overall response rate was 81.25% (13/16). After operation, temporary decreased vision was obtained in one patient and recovered after 20 days, no permanent visual abnormality was found in all of the cases. Complications as distending pain, fever disappeared in 13 patients, improved in 2 patients and became worse in one patient. There was no case of skin necrosis occurred. Follow-up for 6 months after treatment, the deformity arteriolar blood flow larger than before was found in 2 cases and the others were stable. CONCLUSION Onyx embolization for the treatment of maxillofacial arteriovenous malformation is a safe and effective method, the short term curative effect has been confirmed while the long term curative effect should be further evaluated.

Objective To investigate the relationship between HbA1c in blood and IL-6 in tear fluid of the elderly patients with diabetic retinopathy ( DR ) in Shijiazhuang urban communities , and the relationship between IL-6 in tear fluid and the severity of DR. Methods The elderly people who lived more than 5 years , older than ≥45 year old. in nine urban communities of Shijiazhuang were stratified randomly sampled and received cross-sectional epidemiology questionnaire survey and OGTT. A total of 1 447 subjects (509 males and 938 females) were included. Each participant underwent epidemiological surveys and oral glucose tolerance test (OGTT), according to the 1999 WHO diabetes mellitus (DM) diagnostic criteria established. For patients who were newly or previously diagnosed as DM. HbA1c level, tear fluid IL-6 and serum IL-6 tested.The severity of DR was evaluated by fundus examination, the people were divided into normal group(NGT), non-diabetic retinopathy ( NDR ) , non-proliferative diabetic retinopathy ( NPDR ) , and proliferative diabetic retinopathy ( PDR ) . The correlation of serum IL-6 and tear fluid IL-6,blood HbA1c and tear fluid IL-6 were assessed by SPSS 19.0 statistical software. Results Concentrations of tear fluid IL-6 were (3.10 ± 1.25)pg/mL in the NGT group, (10.25 ± 3.22)pg/mL in the NDR group,(16.80 ± 5.76)pg/mL in the NPDR group,(25.11 ± 5.20)pg/mL in the PDR group(P < 0.01). SNK-q test revealed significant differences between every two groups (P < 0.01,P <0.05,P < 0.05) Concentrations of serum IL-6 were (88.04 ± 17.06)pg/mL in the NGT group,(126.38 ± 20.73) pg/mL in the NDR group, (239.83 ± 40.33)pg/mL in the NPDR group, (268.36 ± 27.72)pg/mL in the PDR group(P < 0.01). SNK-q test revealed significant differences between every two groups (P < 0.01). Tear fluid IL-6 level was positively correlated with serum IL-6 level(R = 0.756,P < 0.01). Tear fluid IL-6 level was positively correlated with blood IL-6 level (R = 0.338, P < 0.01). Conclusion The tear fluid IL-6 levels of the elderly patients with DM in Shijiazhuang urban communities , increased; with the increased severity of DR , the levels of tear fluid IL-6 gradually increase. The level of tear fluid IL-6, serum IL-6, HbA1c closely correlates with the severity of DR.

To establish an HPLC mehod for the analysis of pharmacokinetics of salvianolic acid B in rats. METHODS: The biological samples were extracted with acetic ether. The chromatographic conditions were as follows: Hypersil ODS column (200 mm×4.6 mm, 5μm) was used. The mobile phase was acetonitrile-water(with Ammoniom Acetate 0.25 mol/L) was set at 328 nm. RESULTS: Salvianolic acid B was injected intravenously at doses of 1.6, 3.2, 6.4 mg/kg. The terminal elimination half-life(t1/2) of α phase and β phase was (3.1±0.1) min and (31.5±3.2) min. The extents of excrement,urine and biliary excretion of salvianolic acid B were 1.43%±0.90%, 0.77%±1.01% and 8.82%±4.11%. The tissue concentration of salvianolic acid B was as followed in order: Cheart>Cliver>Clung>Cintestine>Ckidney>Cspleen>Cstomach. The plasma protein binding rate of salvianolic acid B in human plasma and in rat was similar(89.2%±1.8%,92.5%±1.5%). CONCLUSION: The method is accurate, stable and reliable, and can be used for the investigation of salvianolic acid B in pharmacokinetics research. Salvianolic acid B eliminates fast and it shows a high plasma protein binding rate, the mainly excretion way of salvianolic acid B is from biliary.

BACKGROUND: Hemorrhagic cystitis remains a common complication of hematopoietlc stem cell transplantation.Granulocyte-macrophage colony stimulating factor (GM-CSF) affects proliferation and differentiation of hematopoietic stem/progenitor cells, adjusts functions of monocytes, granulocytes, lymphocytes and endothelial cells.OBJECTIVE: To investigate the protective effects of GM-CSF bladder irrigation in hemorrhagic cystitis after allogeneic hematopoietic stem call transplantation.DESIGN: Case analysis.PARTICIPANTS: A total of 15 hematopathy patients undergoing allogenic hematopoietic stem cell transplantation at the Zhongshan Hospital of Sun Yat-sen University from January 2004 to August 2006 (routine treatment group). A total of 16 hematopathy patients undergoing allogenic hematopoietic stem cell transplantation from September 2006 to December 2008 (GM-CSF group).METHODS: In the routine treatment group, patients received mesna, hydration, alkalization and forced diuresis in the prevention of hemorrhagic cystitis. In the GM-CSF group, GM-CSF was infused into the bladder in addition to mesna,hydration, alkalization and forced diuresis in the prevention of hemorrhagic cystitis 24 hours before cyclophosphamide treatment. Catheter was extracted 3 days following cyclophosphamide withdraw. Following washing with saline, the bladder was emptied. 10 mL of saline and 5 mL of lidocaine were added into 300 μg of GM-CSF. The mixture was infused into the bladder for 60-120 minutes.MAIN OUTCOME MEASURES: The following parameters were measured: occurrence of hemorrhagic cystitis and its correlation to graft versus host disease, as well as the occurrence of cytomegalovirus infection and urinary system infection.RESULTS: Compared with routine treatment group, the occurrence rate of hemorrhagic cystitis was significantly decreased in the GM-CSF group (x2=4.39, P < 0.05), mean duration of hemorrhagic cystitis and duration of hospitalization were significantly shortened (t=3.97, P < 0.05; t=3.13, P < 0.05), and the occurrence rate of over grade HI hemorrhagic cystitis was significantly reduced (x2=5.04, P < 0.05). Cystitis degree was associated with degree and duration of graft-versus-host disease (r = 0.76).Compared with the routine treatment group, cytomegalovirus infection rate was slightly decreased in the GM-CSF group (x2=0.28, P> 0.05), and occurrence rate of over grade Ⅲ hemorrhagic cystitis was higher in patients with cytomegalovirus infection.Compared with the routine treatment group, the occurrence rate of urinary system infection was slightly reduced in the GM-CSF group (x2=0.28, P > 0.05).CONCLUSION: GM-CSF bladder irrigation is well tolerated and often effective, and should be considered as a preparative regimen of hemorrhagic cystitis after allogeneic hematopoietic stem call transplantation.

In this study, the internal transcribed spacer 2 of nuclear ribosomal DNA (ITS2) sequence was used for i-dentifying A nemone raddeana and its adulterants to ensure the quality of medicines and clinical efficacy. Genomic DNA was extracted from 36 samples using Genomic DNA kit and used as templates for Polymerase Chain Reaction (PCR). Sequence assembly and consensus sequence generation were performed by CodonCode Aligner. The intraspe-cific and interspecific genetic distances were computed and the neighbor-joining tree was constructed by MEGA 5.1 in accordance with the Kimura 2-Parameter (K-2P) model. Results: The length of ITS2 sequence of A nemone rad-deana was 216 bp. The Maximum intraspecific genetic distance was 0.014, the minimum interspecific genetic dis-tance was 0.021. The NJ tree showed that A . raddeana differ from its adulterants obviously. Conclusion: ITS2 se-quence was able to identify A . raddeana and its adulterants correctly stably and correctly, which provides a new tech-nique to its identification.

This study aimed to design a pair of primers for amplifying internal transcribed spacer 2 region which was used to identify Gastrodia elata through optimizing of DNA extraction and PCR amplification process. Two sequences are used for research object by amplification of universal primers. Design three pairs of specific primers by Primer Premier 5.0 and select the highest specificity through the study of 22 samples. The results showed that identification efficiency of the primer named TM2F-2R is as high as 90.9% when Annealing Temperature is equal to 54 degrees Celsius. Therefore, TM2F-2R can be used as primers ITS2 sequences of G. elata, this article provides a set of accu-rate and stable identification methods for G. elata in the molecular identification.

Objective:To study the effect of intravenous injection with butorphanol at different time points on stress response, recovery time after drug withdrawal, emergence agitation and postoperative pain in lung cancer patients undergoing thoracoscopic lobectomy.Methods:A total of 90 lung cancer patients who underwent elective thoracoscopic lobectomy from September 2019 to May 2020 in the Second Hospital of Shanxi Medical University were selected and randomly divided into three groups according to random number table, 30 cases in each group. Group A was set as a preemptive analgesia group, and 20 μg/kg butorphanol was injected intravenously at 15 min before anesthesia induction; group B was injected with 20 μg/kg butorphanol at 30 min before the end of operation; and the blank control group (group C) was given with the same volume of 0.9% NaCl injection at the same time points. The following data including blood glucose, cortisol, heart rate and mean arterial pressure (MAP), recovery time after skin suture and drug withdrawal, emergence agitation score and incidence rate of restlessness, postoperative pain visual analogue scale (VAS) were observed.Results:The level of blood glucose [(5.25±0.32), (5.17±0.58) mmol/L] and cortisol [(253.63±48.29), (222.17±35.73) ng/ml] in group A were lower than those in group B [(5.85±0.53), (5.52±0.48) mmol/L; (302.83±48.63), (274.87±47.93) ng/ml] and group C [(6.07±0.70), (5.68±0.52) mmol/L; (319.97±32.05), (295.57±46.83) ng/ml] immediately after skin suture and 6 h after the operation (all P < 0.05). There were no significant differences in MAP and heart rate at intubation among the three groups (all P > 0.05). The levels of MAP and heart rate in group A at intubation were higher than those before anesthesia induction (all P < 0.05); there were no statistical differences of the levels of MAP and heart rate at 30 min after one-lung ventilation and at extubation compared with those before anesthesia induction (all P > 0.05). In group B and group C, heart rate and MAP at intubation, 30 min after one-lung ventilation and extubation were higher than those before anesthesia induction (all P < 0.05). Among them, the recovery time after drug withdrawal in group B [(16.53±3.64) min] was longer than that in group A [(13.83±3.24) min] and group C [(12.47±3.35) min] (all P < 0.05), while there was no significant difference between group A and group C ( P > 0.05). In addition, in terms of emergence agitation score and agitation incidence, group A [(3.20±0.41) scores, 0 (0/30)] was lower than group B [(3.73±0.74) scores, 7% (2/30)] and group C [(4.00±0.79) scores, 10% (3/30)] (all P < 0.05). The pain VAS in group A [(3.10±0.61) scores, (3.27±0.52) scores] at 3 h and 12 h after operation were lower than those in group B [(3.53±0.86) scores, (3.70±0.53) scores] and group C [(4.00±0.83) scores, (4.10±0.71) scores] at the same time points (all P < 0.05). However, there was no significant difference in pain VAS among the three groups at 24 h and 48 h after operation (all P > 0.05). Conclusions:For lung cancer patients who underwent thoracoscopic lobectomy, preemptive analgesia with butorphanol not only can reduce the stress response and increase the stability of hemodynamics, but also can effectively reduce the incidence of postoperative pain and restlessness without prolonging the recovery time after stopping drug.

In this study,Polygalae radix and its adulterants were identified by psbA-trnH sequence.The genomic DNA was extracted from forty-six samples, the psbA-trnH sequences were amplified and sequenced Bi-directionally, and then assembled sequences by Codoncode Aligner V 3.7.1. The genetic distances were computed by kimura 2-parameter (K2P) model, and the Neighbor-Joining tree was constructed by MEGA 6.0. Results showed that minimum intra-specific K2P distance of Polygala tenuifolia and Polygala sibirica were 0.004 and 0, which were smaller than the maximum intra-specific K2P. The NJ tree showed Polygalae radix can be distinguished from its adulterants by psbA-trnH sequences. Therefore, using psbA-trnH sequences can distinguish Polygalae radix from its adulterants.