Objective To study the effect of gallbladder puncture and drainage guided by ultrasound in the treatment of elderly patients with acute severe cholecystitis.Methods 71 elderly patients with acute severe cholecys-titis were selected.All patients were treated with gallbladder puncture and drainage guided by ultrasound.The preoper-ative and postoperative signs were compared.The success rate of the tube,the rate of inflammation control,the number of patients with disease onset and selective cholecystectomy were recorded.Results The success rate of intubation of the acute non -calculous cholecystitis group and acute calculous cholecystitis group was 100.00%.The inflammatory control rate of acute non -calculous cholecystitis group was 97.29%,which of the acute calculous cholecystitis group was 97.05%,the difference was not statistically significant(χ2 =0.004,P =0.952).The average control rate of inflammation was 97.18%.The acute non -calculous cholecystitis group had no elective cholecystectomy,and the acute calculous cholecystitis group had 10 patients undergoing elective cholecystectomy,there was significant differ-ence(χ2 =10.086,P =0.001).The acute non -calculous cholecystitis group had no complications,the acute calcu-lous cholecystitis group had 2 cases of bleeding,but the difference was not statistically significant(χ2 =2.240,P =0.135).Conclusion Gallbladder puncture and drainage guided by ultrasound can quickly relieve clinical symp-toms,improve the success rate of surgery and reduce the clinical risk for the elderly with acute severe cholecystitis,it is a clinical priority and worth to be promoted in clinical.

Three-dimensional conformal radiotherapy with intensity-modulated radiation beams significantly enhances the ability to produce sharp dose gradients in the boundaries between a tumor and nearby critical structures.Small uncertainties in the daily repositioning of patients can lead to the overdose of the critical structure and the escape of the target volume.It emphasizes the need to improve the ability to localize the target for treatment. And the image-guided radiotherapy was development.Although steady streams of enhanced new methods of imaging are being introduced to improve treatment guidance and treatment verification,the development of kilovoltage cone-beam CT integrated with the medical linear accelerator for the specific purpose of guiding therapy will permit localization and targeting of soft-tissue structures at the time of treatment.In this review,we focus on the clinical application of CT in the image-guided radiotherapy.

BACKGROUND:Studies have shown that apoptosis is closely related to the pathogenesis of steroid-induced femoral head necrosis. The release of cytochrome c plays a very important role in the process of apoptosis.
OBJECTIVE:To observe the effects of cytochrome c on early steroid-induced femoral head necrosis.
METHODS:Twenty-four healthy adult male New Zealand rabbits at 5 months old were randomly divided into model group and control group (n=12 per group). Models of early steroid-induced femoral head necrosis were established by intragluteal injection of hormone combined with ear vein injection of horse serum. In the control group, rabbits were given ear vein injection of the same amount of physiological saline. At 2, 4 and 6 weeks after model establishment, histopathological changes of bilateral femoral head were observed by optical microscope, and the ratio of empty lacuna was calculated. Apoptosis of osteocytes was determined by TUNEL assay, and apoptotic index was calculated. Immunohistochemical method was used to determine cytochrome c and to calculate cytochrome c-positive expression rate.
RESULTS AND CONCLUSION:(1) The ratio of empty lacuna and apoptotic index:The model of early steroid-induced femoral head necrosis was successful y established in the experiment. Compared with the control group, ratio of empty lacuna, apoptotic index and expression rate of cytochrome c in osteocytes were significantly higher in the model group (P<0.05 or P<0.01). (2) Correlation analysis:Ratio of empty lacuna was significantly positively associated with apoptotic index at various time points in the model group (r=0.856, P<0.01). Expression rate of cytochrome c was significantly positively associated with apoptotic index at various time points in the model group (r=0.824, P<0.01). (3) These findings confirm that cytochrome c-involved apoptosis of osteocytes may play an important role in steroid-induced femoral head necrosis. Expression rate of cytochrome c in osteocytes is remarkably positively associated with the occurrence of steroid-induced femoral head necrosis in rabbits.

OBJECTIVE:To observe the antifungal activity of azone against dermatophytes and candida albicans.METHO_ DS:The MIC of azone was determined by NCCLS M27,M38method and MTT assay.MFC was also determined.RESULTS:MIC and MFC of azone against dermatophytes were0.02%and0.08%respectively.CONCLUSION:Azone has significant action in inhibiting candida albicans and fungicidal effect on dermatophytes.

Objective:To provide the basis of single nucleotide polymorphism(SNPs)for identification and analysis of ABCA4 gene related etiologic studies in Han Chinese in Beijing(CHB).Methods:SNPs of ABCA4 gene were analyzed for minor allele frequencies (MAFs),haplotype frequencies,linkage disequilibrium patterns,and tag SNPs by Haploview program using the HapMap data.Re-sults:129(37.6%)of 343 SNPs were monotonic.95 tagging SNPs were identified in 214 eligible SNPs with 3 haplotype blocks identi-fied.The frequencies of the top 2 haplotypes among each of the 3 haplotype blocks were between 91.1% and 94.0%.Conclusion:SNPs in ABCA4 gene were analyzed by Haploview program.The analysis provides clues for future studies involving this gene.

Objective To establish a method for the determination of catalpol in Zengye Chengqi Syrupus by HPLC. Methods High performance liquid chromatography was performed on an Eclipse XDB C18 column (150 mm×4.6 mm, 5 μm) with acetonitrile-0.1%phosphoric acid (1∶99) as the mobile phase at a flow rate of 1.0 mL/min, 210 nm as the detection wavelength, the temperature of column was set at 30 ℃. Results Catalpol showed good linear relationship at the range of 0.052-0.258 μg (r=0.999 9), the average recovery (n=5) was 98.23% (RSD=0.76%, n=9). Conclusion The method was accurate, reliable and specific. It can be used for the quality control and evaluation of Zengye Chengqi Syrupus.

Aminoacyl-tRNA synthetase is a class of ancient proteins, catalyzing the first reaction of protein biosynthesis. It has been found that they also participate in a lot of other cellular processes such as editing, tRNA maturation and transfer, RNA cleavage and function as cellular factors. Recent studies showed that some mitochondrial aminoacyl-tRNA synthetases are closely related with human diseases. A single point mutation in intervening sequence 2 (IVS2) of human mitochondrial arginyl-tRNA synthetase gene causes abnormal cleavage of its transcript, resulting in pontocerebellar hypoplasia. A series of mutations in human mitochondrial aspartyl-tRNA synthetase gene cause rapid decay of its mRNA or alteration in protein primary sequence, leading to leukoencephalopathy with brain stem and spinal cord involvement and lactate elevation. A single nucleotide polymorphism in human mitochondrial leucyl-tRNA synthetase is significantly associated with type 2 diabetes. These results further enhance our understanding about the cellular function of aminoacyl-tRNA synthetase and promote studies toward the mechanism and therapy of aminoacyl-tRNA synthetase-causing mitochondrial diseases.

Afatinib is an irreversible inhibitor for the ErbB family of tyrosine kinases with oral administration. In two randomized, open-label and multinational phase III trials, the progression-free survival was significantly prolonged by afatinib compared with peme-trexed plus cisplatin (LUX-Lung 3) or gemcitabine plus cisplatin (LUX-Lung 6) in the treatment-naive patients with advanced non-small cell lung cancer ( NSCLC) with activating EGFR mutations. The patient-reported symptoms such as cough and dyspnoea, and certain health-related quality of life after the treatment by afatinib were also better than those treated by control dugs. Afatinib was ap-proved by FDA in July 2013 as the first-line treatment drug for the patients with metastatic NSCLC with EGFR exon 19 deletions or exon 21 (L858R) mutations. The action mechanisms, pharmacokinetics, clinical trials and adverse events were reviewed in this paper.

BACKGROUND: There are currently few studies regarding the pharmacokinetics of vancomycin via intravitreous injection.OBJECTIVE: To determine the concentration of vancomycin injected into the vitreous chamber of conscious rabbits.METHODS: A microdialysis probe was implanted into vitreous chamber of normal rabbit eyes and rabbit eyes infected withbacterial endophthalmitis for 24 hours, and 10 g/L vancomycin 0.1 mL was administered intravitreally. The drug concentration inthe vitreous chamber of rabbit eyes was determined at 0.5, 1, 2, 4, 6, 12, 24, 48, 72 and 84 hours after injection, through themicrodialysis and high performance liquid chromatogram-ultraviolet detection.RESULTS AND CONCLUSION: The metabolism of vancomycin showed an open two-compartment model in normal rabbit eyes.Its half-life was 51.66 hours and the peak concentration was 695.92 mg/L. The metabolism of vancomycin in the infected vitreouschamber showed a one-compartment model. Its half-life was 11.91 hours and the peak concentration was 713.35 mg/L. All rabbitswere injected with drugs for 84 hours and the intravitreous concentration of vancomycin was higher than minimal inhibitoryconcentration. The experimental findings indicate that microdialysis coupled to high performance liquid chromatography is apowerful tool to investigate the ocular pharmacokinetics of vancomycin, and the samples are harvested in a real-time, continuousand dynamic fashion when the experimental animals are conscious.

Objective To explore the correlation between pathologic findings of pancreatic ductal adenocarcinoma accompanied with cystic lesion and their radiological images .Methods The pathological and radiological data of 97 cases with cystic lesion of 560 patients who were diagnosed as pancreatic ductal adenocarcinoma based on postoperative pathology were retrospectively analyzed .All the patients underwent CT and MRI examinations .Results Postoperative pathological report showed that solid masses and cysts coexisted in all the lesions .Solid masses had compact structures and consisted of innumerable fibrous collagen mixed with tumorous tubular or acinar gland tissue but lack of vessels and inflammatory cells were infiltrated in tissues surrounding the tumors .As for the accompanied cystic lesions , 54 cases ( 56%) were pseudocysts , 22 cases (23%) were retention cysts, 12 cases (12%) were pancreatic intraductal papillary mucinous neoplasms ( IPMN) , and 9 cases (9%) were the necrosis and cystic changes of the tumors .Solid masses were hypodense or iso-hypodense in CT, and hypodense on T1 WI and isodense or iso-hyperdense on T2 WI in MR.The focal calcification was detected in only one mass .Seventy-eight cases displayed slight enhancement and 19 cases displayed no enhancement after enhancement .The tumor′s boundary were unclear in all cases .The cystic lesions which were located in masses were only observed in patients with tumors′necrosis and cystic degeneration, and other cystic lesions were adjacent to the solid masses .Single cyst was found in 70 cases (49 with pseudocysts , 12 with retention cysts , 9 tumors′necrosis and cystic degeneration ,) and multiple cysts were in 27 cases (5 with pseudocysts, 10 with retention cysts ,12 with IPMN).Exudation appeared surrounding the tumors in all cases accompanied with pseudocysts , and the cystic wall was attached to the spleen in 10 cases and the kidney in 5 cases.Hemorrhage appeared in 16 cases with pseudocysts .Pancreatic ducts were blocked by tumor masses and the proximal duct was dilated in 80 cases.Common bile ducts were obstructed with the proximal duct dilated in 18 patients.Splenic veins were infiltrated in 11 cases.Wall nodular lesions were seen in 5 cases with cystic degeneration .Conclusions Pancreatic ductal adenocarcinoma is a highly invasive tumor with compact structures , and the tumors′cystic degeneration is uncommon in such patients .Most of the cystic lesions accompanied with the tumors are pseudocysts or retention cysts , which are secondary changes caused by the obstruction in pancreatic ducts , and these pathological features are correlated the imaging findings .