In recent years ,matrix-assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF MS) is a new organic soft ionization mass spectrometry which can identify and classify microorganism by directly using the sam-ple itself or cultivate colonies on petri dish in a few minutes .This new and simple method reduces the cost of consumables and the time of diagnosis greatly .Its reliability and accuracy have been shown in many studies and different system devices have al-ready been on the market .In the near future ,MALDI-TOF MS will have a broader prospect .This mass spectrometry will be-come an effective and fast microbial identification technology to replace the conventional method .In this article ,we will review the principles of MALDI-TOF MS ,its development and application ,its advantages and shortcomings which compared with tra-ditional methods at the present stage ,and the emphasis will focus on the application characteristics of MALDI-TOF MS in mi-crobial systems .

Objective To study the multi-slice spiral CT (MSCT) perfusion imaging in evaluating the changes of blood supply of hepatocellular carcinoma( HCC ) before and after transcatheter hepatic arterial chemoembolization (TACE). Methods Before and after TACE, MSCT perfusion was performed in 17 patients with HCC. The perfusion indexes such as hepatic blood flow (HBF), hepatic blood volume(HBV),mean transit time (MTT),hepatic arterial fracture (HAF),permeability surface (PS), hepatic artery perfusion (HAP), portal venous perfusion (PVP) were calculated. The hemodynamic changes of HCC after TACE were evaluated according to perfusion parameters. Results After TACE, HBF,HBV and HAP found in MTT and PS before and after TACE (P > 0.05). Conclusion The parameters of MSCT perfusion imaging( HBF, HBV and HAP) can effectively evaluate the hemodynamic changes of HCC after TACE, and has important value in chnical application.

Objective To investigate the chemical constituents of Lappula echinata and determine the antibacterial activity.Methods A new quinolone alkaloid was isolated from the BuOH extract of L.echinata by silica gel column chromatography and gel column chromatography.Its structure was identified by 1H-NMR, 13C-NMR, 2D-NMR, HR-MS, UV, and IR spectral data analysis.Its antibacterial activity was determined by KB method.Results A new quinoloe alkaloid named 8-methoxy-4-quinolone-2-caboxylic acid was isolated from L.echinata and was found to have antibacterial activity on Pseudomonas pyocyanea ATCC 27853, EPEC O111, pneumobacillus and Staphylococcus epidermidis.Conclusion This is a new compound with antibacterial activity.

BACKGROUND:Baloon kyphoplasty is effective in the treatment of osteoporotic vertebral compression fractures, but it is unclear that which one is proper, unilateral or bilateral approach, with better efficacy and fewer
complications.
OBJECTIVE:To assess the efficacy and safety of unilateralversus bilateral baloon kyphoplasty in the treatment of osteoporotic vertebral compression fractures.
METHODS: We searched the electronic bibliographic databases including Cochrane Library, PubMed, EMBASE, ISI Web of Knowledge, CBMdisc and other databases to colect clinical trials concerning unilateral versus bilateral baloon kyphoplasty. Two estimators independently evaluated the quality of these included studies and analyzed data by Cochrane Colaboration’s RevMan 5.2 software.
RESULTS AND CONCLUSION:Fourteen trials involving 876 patients were included. There were 442 cases of unilateral approach and 434 of bilateral approach. The meta-analysis showed that there were no significant
differences in pain score by visual analog scale, vertebral height, and kyphotic angle; while the unilateral approach had less operating time, lower amount of cement injected and lower risk of cement leakage
than the bilateral approach [mean difference (MD)=-19.33, 95% confidence interval (CI) (-24.42,-14.24);
MD=-2.07, 95%CI (-2.42,-1.71); odds ratio=0.47, 95% CI (-24.42,-14.240)]. These findings indicate that the unilateral baloon kyphoplasty can reduce the leakage rate of bone cement.

BACKGROUND:Fentanyl transdermal system has analgesic effect similar to oral sustained-release morphine and has been widely used in advanced cancer pain management in several years. However, recent literatures about some serious adverse events associated with fentanyl transdermal system have been published, and the long-term safety of fentanyl transdermal system treatment is stil chalenged. OBJECTIVE:To observe the long-term clinical efficacy and safety of fentanyl transdermal system for pain management in patients with advanced cancer. METHODS:A total of 309 patients with advanced cancer pain were enroled, including 166 females and 143 males. The age ranged from 26-72 years old. Patients received oral sustained-release morphine for 2 weeks, and then were subject to fentanyl transdermal system for pain management at the 3rd week until the 12th week. A prospective study with self-contrast method was conducted to compare the analgesic effects of these two drugs, as wel as patient's acceptability, adverse events and toxicity in the administration course. RESULTS AND CONCLUSION: Stable pain relief was harvested throughout the oral administration of both sustained-release morphine and fentanyl transdermal system therapy. During the use of oral sustained-release morphine, adverse reactions appearing in sequence were constipation, nausea, fatigue and anorexia. After converting to fentanyl transdermal system, the symptoms of constipation (χ2=5.22,P=0.02) and nausea (χ2=4.38, P=0.04) significantly reduced, and vomiting was abated but showed no significant difference (χ2=2.7,P=0.10). 2.3% of patients had skin reactions to the patches, and regressed after replacing the patch area. Skin reactions were aleviated at 2-10 weeks after oral administration of fentanyl transdermal system. Some uncommon adverse events including headache, diarrhea, dyspnoea, excessive sweating or other symptoms often occurred at the time of the initial dosage increase. Preference or strong preference for fentanyl transdermal system in comparison to previous oral sustained-release morphine was reported by 91% of patients. These results demonstrate that fentanyl transdermal patches can provide stable pain relief for advanced cancer patients with good acceptability, and mitigate the incidence of adverse events due to oral drugs.

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Objective To explore the predictive value of Kinetics of white blood cell (WBC) elimination following induction chemotherapy for eider with acute myeloid leukemia(AML). Methods 71 elder with AML were reviewed. Chi-square and the Kaplan-Meier methods were used to identify the relationship between the nadir WBC count and time to WBC nadir with efficacy and survival. Results 28 patients (39.44%) achieved a complete re-mission(CR),another 19 (26.76%) had a partial remission,17(23.94%) patients had a non-remission,and 7 pa-tients(9.86%)died. Overall survival over 3 years was about 11.27% (8 cases),over 2 years about 23.94 % (17 cases),and over 1 years about 47.89 % (34 cases). The low WBC nadir and high WBC nadir in the bone marrow CR (9.86% and 12.68%)and the total survival rate (8.45% and 11.27%)were lower than the median absolute WBC nadir (16.90%, 15.49%), but were no statistical discrepancy (χ23.32,1.22, P=0.77, 0.54). The pa-tients who achieved WBC nadir in less than or equal to 10 days in the bone marrow CR(12.68%) and the total sur-vival rate(8.45%) were statistical significantly higher than those achieved it in greater than 10 days(26.76%). The patients whose WBC attained at low level less than or equal to 3 days in the bone marrow CR(16.90%) and the total survival rate(12.68%) were statistical significantly higher than those greater than 3 days (22.54%) (χ2 15, 57,11.71,4.85,9.54,P=0.001,0.01,0.03,0.04). Conclusion WBC nadir in loss than or equal to 10 days and WBC attained at low level greater than 3 days may serve as a worse prognosis.

Objective To study the effects of Sinomenine on the dendritic cells after hepatic ischemia-reperfusion. Methods Forty-eight BN rats were equally divided into control group, low dose (40 μg/g) and high dose (80 μg/g) of Sinomenine groups after the liver transplantation models were established by two cuff tech-nique. Three days after the orthotopic liver transplantation, the livers were resected, then the dendritic cells were separated and purified. The phenotypes [OX62, major histocompatibility complex Ⅱ (MHC-Ⅱ) and CD86] of dendritic cells were examined by FACS, the expression of IL-12, IL-1, and TNF-a mRNA by RT-PCR, and the expression of Toll-like receptor 4 (TLR4) by Western blot. Results The dendritic cells treated with Sinomenine showed immature phenotypes. The expressions of MHC-Ⅱ and CD86 were significantly deceased. The expressions of IL-12, IL-1, TNF-a mRNA and TLR4 were low. Conclusions Sinomenine can significantly inhibit the maturity and immunologic function of dendritic cells after hepatic ischemia-reperfusion.

objective:To investigate the relationship between magnetic resonance spectroscopy (MRS) metabolism and Ki-67 expres-sion in high-(HGG) and low-grade gliomas (LGG) by analyzing Ki-67 expression and HGG and LGG metabolites. Methods:We consid-ered 56 pathologically confirmed glioma cases in our hospital. The Ki-67 expression and the MRS metabolism parameters in the tu-mors were analyzed simultaneously. Results:The tumor solid value of Cho was positively correlated with the Ki-67 expression level (rs=0.714, P<0.05). By contrast, the Ki-67 expression level was negatively correlated with the tumor solid value of NAA (rs=?0.708, P<0.05) in 35 cases of the LGG group. The tumor solid value of Cho was also positively correlated with the Ki-67 expression level (rs=0.624, P<0.05). By comparison, the Ki-67 expression level was negatively correlated with the tumor solid value of NAA in the HGG group (rs=?0.769, P<0.05). Conclusion:The MRS metabolism was correlated with the Ki-67 expression in high-and low-grade gliomas.

Objective To explore the dynamic expressions of interleukin-1 (IL-1)receptor associated kinase (IRAK)-M and IRAK-4 in rats with or without endotoxin tolerance (ETT)in acute liver failure (ALF).Methods Sixty-six male SD rats were divided into three groups:ALF group,ETT group and control group.The rats in ETT group received daily lipopolysaccharide (LPS)intraperitoneal injection for 5 days,while the rats in ALF group received daily injection with same volume of 0.75% NaCl solution.Both ETT group and ALF group received intraperitoneal injection with D-galactosamine (D-GalN)and LPS at 24 hours after the 5th injection of LPS or NaCl solution.At 2,6,12,24 and 48 h after D-GalN and LPS injection,the serum levels of tumor necrosis factor-α (TNF-α)and interleukin-6 (IL-6)were detected by enzyme-linked immunosorbent assay (ELISA).The liver pathologic changes were observed with HE staining by microscope.The mRNA expressions of IRAK-4,IRAK-M and NF-κB (p65)were detected by reverse transcriptase polymerase chain reaction (RT-PCR).The pairwise comparison between groups was done by lease significant difference (LSD)and Dunnet's t test.Results The liver pathologic changes in ETT group were much milder than those of ALF group.In ALF group,IRAK-4 mRNA/β-actin absorbance ratios at 2,6,12,24and 48 h after D-GalN and LPS challenge were 0.711 ±0.074,0.904±0.118,1.012 ±0.098,1.534±0.279 and 1.451±0.290,respectively,while the IRAK-M mRNA/β-actin absorbance ratios were 0.496±0.018,0.516±0.089,0.503±0.023,0.503±0.057 and 0.469±0.142,respectively.In ETT group,the IRAK-4 mRNA/β-actin absorbance ratios at 2,6,12,24 and 48 h after D-GalN and LPS challenge were 0.619±0.083,0.587±0.033,0.623±0.034,0.720±0.044 and 0.654±0.041,respectively,while the IRA'K-M mRNA/β-actin absorbance ratios were 0.929 ± 0.064,1.111±0.138,1.113±0.027,1.891±0.315 and 1.710±0.303,respectively.The IRAK-M mRNA expression level was significantly increased and IRAK-4 mRNA expression level was relatively decreased in ETT group compared to ALF group.The differences were all statistically significant at 2,6,12,24 and 48 h after D-GalN and LPS challenge (F= 17.305,54.921,121.031,67.607,55.279,respectively; F=19.506,43.777,110.823,302.681,202.822,respectively; F=172.003,59.519,987.055,68.463,96.601,respectively; all P＜0.05).Conclusion LPS pretreatment may induce ETT in rat model by downregulating the expression of IRAK-4 and upregulating the expression of IRAK-M.