OBJECTIVE:To observe clinical efficacy and safety of Shuxuening injection in the adjunctive treatment of traumat-ic subarachnoid hemorrhage. METHODS:96 patients with traumatic subarachnoid hemorrhage were randomly divided into control group and observation group with 48 patients in each group. Control group was given Tranexamic acid injection,Nimodipine injec-tion and Citicoline injection,daily lumbar punctrive and determined intracranial pressure and drained cerebrospinal fluid via lumbar puncture;observation group was additionally given Shuxuening injection 20 ml added into 5% Glucose injection 250 ml,ivgtt,qd. Both group were treated for consecutive 2 weeks. Clinical efficacy of 2 groups were observed,and GCS and MCA were also ob-served before and after treatment;ADR of 2 groups were recorded. RESULTS:Excellent rate of observation group(60.42%)was significantly higher than that of control group(31.25%),with statistical significance(P<0.05). Before treatment,3 and 5 days af-ter treatment,there was no statistical significance in GCS and MCA between 2 groups(P>0.05);7 and 14 days after treatment, GCS of 2 groups increased significantly while MCA decreased significantly,and the observation group was better than the control group,with statistical significance (P<0.05). The incidence of cerebral vasospasm,cerebral infarction and cerebral hemorrhage were 8.33%,4.17%and 4.17%in observation group,and those of control group were 16.67%,12.50%and 16.67%;the observa-tion group was significantly lower than the control group,with statistical significance(P<0.05). CONCLUSIONS:Shuxuening in-jection shows significant therapeutic efficacy in the adjunctive treatment of traumatic subarachnoid hemorrhage,with low incidence of ADR.

Objective:To provide specific suggestions for the reasonable application of various quality sampling inspection methods for Chinese herbal medicines in order to improve the scientificity of sampling inspection plan. Methods:The sampling inspection pro-gram and the overall quality of Chinese herbal medicines in Hubei province from 2014 to 2016 were reviewed and the existing problems were analyzed, finally, suggestions for improvement were proposed for the future work. Results and Conclusion:The current sampling inspection methods have made certain achievements;however, each method still needs optimization. It is suggested that the supervision sampling inspection be standardized to solidify the basis of sampling inspection, special sampling inspection be arranged periodically to target the complicated and recurring quality issues, and evaluation sampling inspection be strengthened for certain varieties to evaluate the overall quality status and discover the risk signals.

To establish an optimized determination method for the alkaloids peimine and peiminine in three varieties of Fritillaria. Methods:The samples were refluxed in a mixed solution, the pH value of the mixed solution was adjusted, and then the solution was extracted by ether to obtain the test solution. A Shim-pack VP-ODS column (4. 6 mm × 250 mm,5 μm) was used, the mobile phase consisted of acetonitrile-0. 02% diethylamine(75∶25), and the flow rate was 1. 0 ml·min-1. An Alltech 2000ES ELSD detector was used, the drift tube temperature and the flow rate of nitrogen carrier gas in the ELSD was set at 93℃ and 2. 4 L·min-1 , respectively. The regression equation was calculated between the logarithm values of the reference solution concentration and the corre-sponding peak area. Results:The method could effectively extract the alkaloids from the samples. Peimine and peiminine were well separated by the method, and showed good linearity within the respectively given ranges. The average recovery of the alkaloids in the three varieties of Fritillaria was within the range of 95. 22%-103. 51%. Conclusion: The method is simple,convenient and universal with easy operation,which provides references for the determination of alkaloids in the other varieties of Fritillaria.

Objective To isolate and identify stem-like cells (CSCs) from human ACHN renal cell carcinoma cell line.Methods ACHN cancer stem cells CSCs were enriched by serum-free culture condition.Methyl thiazolyl tetrazolium (MTT) method was performed to draw the growth curve.Flow cytometry was performed to evaluate the expressions of two CSCs markers,CD133 and CD44.Real-time polymerase chain reaction (RT-PCR) was performed to evaluate the expression of stem-related genes (Oct3/4,Bmi,Nanog,and 3-catenin).The tumorigenicity in vivo was also examined.Results ACHN CSCs were formed by sphere-forming culturing.The data demonstrated that there were stronger capacities of proliferation in ACHN tumor spheres than that of ACHN cells.And the expressions of CD133 and CD44 were also significandy enhanced in tumor spheres.The data showed that four genes (Oct3/4,Bmi,Nanog,and β-catenin)were upregulated in sphere-forming cells.Sphere-forming cells had a higher tumorigenic potential in vivo than incubated cells.Conclusions Human ACHN renal cell carcinoma cell line sphere-forming cells can be enriched by serum-free culture condition and exhibits several characteristic cancer stem cells properties.

Objective To detect the expression of p16 and discuss the significance in genesis and development of cervical cancer. Methods FQ-PCR method was used to detect the expression levels of p16 mRNA in cervical cancer(CC),cervical intraepithelial neoplasia(CIN),and normal tissues.And in situ hybridization was used to detect HR-HPV in these tissues.Results The expres-sion levels of p16 were 0.79±0.34,0.70±0.36,0.26±0.21 in CC,CIN and normal cervical tissues,respectively.The difference was significant (P <0.05).The expression level of p16 was significantly associated with FIGO stage (P <0.05),but it showed no significant relationship with age,tumor size,cell differential degree and lymphoid node metastasis (P >0.05).The expression level of p16 in HR-HPV positive cases was significantly higher than that in HR-HPV negative cases (P <0.05).Conclusion p16 shows high expression level in cervical cancer,which is closely related to the infection of HR-HPV infection.It suggests that the high ex-pression of p16 play an important role in genesis and development of cervical cancer.

ObjectiveTo improve the treatment of urethral stricture and evaluate the applicative effects of wire-guided supporting catheterization in clinical urology. MethodsDuring January 2004 and December 2005, the patients with urethral stricture were dwelled with the catheters using the traditional guideless catheterization (group A). If the dwelling failed,it will be replaced by the wire-guided supporting catheterization using the improved catheters. During January 2006 and December 2009, the patients with urethral stricture were dwelled with the improved catheters using wire-guided supporting catheterization ( group B) straightly. Compared the first-time dwelling success incidence,the incidence of catheter associated urinary tract infection and side-effect events. Then after 1 year, compared the urethral stricture recrudescence and the course of treatment. ResultsThe success incidence of first-time catheterization in group A was 48.98％ (24/49) ,and in group B was 97.94％ (95/97) ,there was significant difference between 2 groups;The incidence of catheter associated urinary tract infection in group A was 12.24％, and 8. 25％ in group B, there was significant difference between 2 groups; As for the course of treatment, group A was 46. 2w,group B was 32.7w;The urethral stricture recrudescence in group A and B were 16.33％ and 9.28％ respectively,and there was significant difference between 2 groups. ConclusionThe wire-guided supporting catheterization, which minimize the injury and simplify the operation of internal urethrotomy,could makes the improved catheter easy to induct and replace, improve the success rate of first time-catheterization and prevent the false tunnel damage and new scar expansion. It could make benefit to reduce of incidence of catheter associated urinary tract infection and urethral stricture recrudescence,but also could shorten the course of treatment significantly.

Objective To describe and analyze the misdiagnosis and mistreatment status of pulmonary alveolar proteinosis (PAP), especially cases with combination of severe infection. Method The misdiagnosis and mistreatment of 84 PAP patients and 6 cases with combination of severe infection before admitting to PUMCH was analyzed retrospectively. Results 66.7%(56/84) had experienced misdiagnosis before admission. 32.1% (27/84) were misdiagnosed with idiopathic interstitial pneumonia (IIP) and 14.3% (12/84) with pulmonary tuberculosis. 88.1%(74/84) had received anti-infection treatment, 33.3%(28/84) received eortieosteroids, and 19.0%(16/84) received anti-tuberculosis treatment. The percentage of the pa-tients who had taken the bronchoscopic examination outside the PUMCH was 53.6%(45/84). The PAP pa-tients diagnosis was established through bronchoscopic examination (including BAL and TBLB) in 86.9% (73/84) patients. There were 6 patients who had severe infection when PAP established. All of these 6 cases had been misdiagnosed with IIP and received corticosteroids treatment, 2 of whom died. Conclusions The misdiagnosis and mistreatment happens commonly in PAP patients. The misuse of corticosteroids makes some PAP cases get the severe infection. The image feature and the examination of bronchoscopy, BAL and TBLB are the key point in avoiding misdiagnosis. The administration of corticosteroids in uncertain patients should be avoided.

Objective To investigate the relationship of Vaneomycin serum concentration and drug adverse reactions (ADRs) in neonates.Methods Two hundred and thirteen neonates who were treated by Vancomycin and had their serum concentration monitored were recruited.The number of cases which had liver,kidney and hearing damage after treatment was calculated.The correlation between 3 different serum concentrations (＜5 mg/L,5-10 mg/L,＞ 10 mg/L) and ADRs were analyzed.Results The mean level of Vancomycin in serum was (4.36 ± 4.99) mg/L The total incidence of ADRs was 17.8％ (38/213 cases).The main ADRs were liver damage and hearing impairment,whose incidences were 9.9％ (21/213 cases) and 7.5％ (16/213 cases),respectively,and they were were significantly higher than kidney danage (0.5％,1/213 cases) (x2 =19.172,P =0.000;x2 =13.785,P =0.000).There was no significant difference be-tween the inidence ratio of liver damage and that of the hearing impairment (x2 =0.330,P =0.566).The ADRs ratio among 3 different serum concentrations was 17.0％ (24/141 cases),17.6％ (9/51 cases) and 23.8％ (5/21 cases).There was no significant difference between the ADRs ratios and distribution of different serum concentrations (x2 =0.576,P =0.750).Moreover,the ADRs rates didn't increase along with the serum concentrations (Z =0.648,P =0.517).Except for aspartate transaminase,the indicators of liver and kidney function varied significantly after vancomycin treatment (P ＜0.05).But there was no clinical significance because the mean value was in normal range.By Bivariate Correlation analysis,Vancomyein serum concentration had no significant influence on liver and kidney function (P ＞ 0.05).Conclusions Neonates treated by Vancomycin had reatively high ratio of the liver damage and the hearing impairment.There is no significant correlation between Vancomyein serum concentration and ADRs in neonates.

Objective To observe the damage of liver cells and to investigate the distribution and expression of glu-cose-regulated protein 78 (Glucose regulated protein78, GRP78/Bip) in liver tissue under the positive acceleration (+Gz) exposure.Methods Totally 24 wistar rats were randomly assigned to four groups:blank control,+6Gz,+9Gz and +12Gz.Each rat was clamped to the centrifuge arm , prone position, with the head of the rat facing the axis of the centrifuge for +Gz orientation.The onset rate was +0.5 Gz/s, which was used trapezoidal acceleration curve effect and controlled by computer .Blank control group rats were placed on the arm of centrifuge and under-went a process similar to that described above , but they were not exposed to acceleration .+6Gz group,+9Gz group and +12Gz group were subjected at peak time 3 min in animal centrifuge , acceleration rate 0.5 G/s, five times with interval 30 min between times.In addition, liver tissue of rats were respectively observed by H .E.staining.Mean while, plasma aspartate aminotransferase ( AST) and alanine aminotransferase ( ALT) were tested determine the damageofliverfunction.Results +GzaccelerationstressinjuryincreasedserumASTandALTlevel.Compared with the stress control, +9Gz group and +12Gz group significantly increased in plasma ALT and AST as compared with control group ( P<0.05 ) .+12 Gz stress induced the highest level in these groups .The level of ALT in+2 Gz group was higher than that in +6 Gz group ( P<0.05 ) .HE staining showed derangement of liver cells , irregular shape, the cell gap is not clear, vacuolar changes in +Gz groups, and with the increase of G value.Compared with the control group, the expression of GRP78/Bip was focused in the cytoplasm;the expression of GRP78 in the experimental group is higher than that in the control group ( P<0.05 ) .+12 Gz group was significantly higher than+6Gz group and the control group (P<0.05).The expression of GRP78/Bip in liver tissue increased with the in-creasing of G value levels;the expression level of GRP78/Bip in +12Gz and +9Gz groups were higher than that in +6Gz and control group (P<0.05).Conclusions There is positively related expression of GRP78/Bip, which was associated with exposure of increasing G values .

Objective To observe the effects of Yiqi Jiedu prescription drug serum on the apoptosis of human renal cell carcinoma ACHN cells and Notch1 gene in Notch signal pathway. Methods The healthy SD female rats were selected, which were divided into 4 groups, 8 rats in each group: the rats were fed with the normal saline 10 ml·kg-1·d-1 (the blank serum group); the rats were fed with the Yiqi Jiedu prescription decoctum of 50 g·kg-1·d-1 (the high-concentration of Yiqi Jiedu prescription serum group); the rats were fed with the Yiqi Jiedu prescription decoctum of 25 g·kg -1·d -1 (the medium-concentration of Yiqi Jiedu prescription serum group); the rats were fed with the Yiqi Jiedu prescription decoctum of 12.5 g·kg-1·d-1 (the low-concentration medicated of Yiqi Jiedu prescription serum group); then the serum would be extracted 10 days later in each group. ACHN cells at exponential phase were cultured in the above 4 groups. Theproliferation of ACHN cells in each group was observed by using CCK-8 method. The apoptosis of ACHN cells was detected by using flow cytometry (FCM). The expression levels of Notch1 mRNA of ACHN cells in each groups were detected by using real time fluorescence quantitative polymerase chain reaction (RT-PCR). Results The inhibition rates of ACHN cells in the high-concentration group, the medium-concentration group, the low-concentration group of Yiqi Jiedu prescription and the blank serum group 24 h later were (12.34±4.25)％, (7.47±1.40)％, (2.52±0.62)％, (1.05±0.31)％, respectively (F= 15.04, P< 0.01); after 48 h, the inhibition rates were (24.20 ±2.41)％, (14.23 ±1.56)％, (5.08 ±1.34)％, (1.16 ±0.14)％, respectively (F=227.36, P<0.01);after 72 h, the inhibition rates were (32.16±2.45)％, (25.05±3.69)％, (10.29±2.76)％, (1.07± 0.71)％, respectively (F=110.51, P<0.01). The results showed that Yiqi Jiedu prescription drug serum could significantly inhibit the proliferation of ACHN cells in a dose-dependent manner. Besides, the inhibition rate differences at all time points of the high-concentration serum group (F= 31.44, P< 0.01), the medium-concentration serum group (F= 49.61, P< 0.01) and the low-concentration serum group (F= 68.78, P<0.01) were all statistically significant, and they were in a time-dependent manner. The apoptosis rate of cells in the high-concentration group, the medium-concentration group, the low-concentration group of Yiqi Jiedu prescription and the control serum group was (34.5±1.5)％, (24.4±1.5)％and (13.1±0.5)％, (5.2±0.3)％, respectively, and the differences were statistically significant (F = 1153.36, P < 0.01). The relative expression level of Notch1 mRNA of cells in the high-concentration group, the medium-concentration group, the low-concentration serum group of Yiqi Jiedu prescription and the control serum group was 0.213 ±0.032, 0.432 ±0.049, 0.781 ±0.018, 1.013 ±0.047, respectively, and the differences were statistically significant (F=270.60, P<0.01). Conclusion Yiqi Jiedu prescription drug serum can induce apoptosis of ACHN cells, and its mechanism may be related to the down-regulation of the expression level of Notch1 receptors.