ObjectiveTo explore the content of isorhynchophylline in different medicinal parts of Ramulus Uncariae Cum Uncis.MethodsHPLC was adopted to determine 8 batches of different Ramulus Uncariae Cum Uncis of different origin and different medicinal parts. The Waters Symmetry C18 color(4.6 mm×250 mm, 5μm) was used with mobile phase of methanol -0.01 mol/L ammonium acetate buffer(pH 8.0)(60∶40), column temperature of 25℃ , 20μl sample volume, velocity of 1.0 ml/min, and detection wavelength of 246 nm. ResultsIsorhynchophylline can be detected in all 8 batchs of Ramulus Uncariae Cum Uncis in different regions, and different content were found among different origins. The content of isorhynchophylline in different parts of the same origin showed a decreasing sequence of the rhabd, stem with hook, stem without hook, and twig without hook and leaves.ConclusionMost of medicinal part of Ramulus Uncariae Cum Uncis contains isorhynchophylline, which provide a lab basis for exploring medicinal parts of this herbal medicine.

Objective To compare the effects of sedation induced with propofol and midazolam on anterior pituitary hormone in mechanically ventilated patients with traumatic brain injury.Methods Eighty-four patients with acute traumatic brain injury,aged 20-60 yr,weighing 50-70 kg,undergoing mechanical ventilation during sedation induced with propofol or midazolam,were randomly divided into 2 groups ( n =42 each):propofol group (group P) and midasolam group (group M).Ramsay sedation score was maintained at 2-4.In group P,propofol was continuously infused at the initial infusion rate of 1.5-6.0 mg·kg-1 ·h-1 and propofol 50 mg was injected intravenously to increase the depth of sedation when needed.In group M,midazolam was continuously infused at the initial infusion rate of 0.10-0.35 mg· kg-1· h-1 and midazolam 7.5 mg was injected intravenously to increase the depth of sedation when needed.The patients were ventilated for 70-120 h.Glasgow Coma Scale scores were assessed before sedation and Glasgow Outcome Scale scores were assessed 4 weeks after admission to the intensive care unit.Venous blood samples were collected at 24 and 72 h of sedation and 4 weeks after admission to the intensive care unit for determination of the levels of serum cortisol,thyroid-stimulating hormone,prolactin,and growth hormone by ELLSA.Results Compared with group M,the levels of serum cortisol and growth hormone were significantly decreased and the level of thyroid-stimulating hormone was significantly increased at 24 and 72 h of sedation in group P ( P ＜ 0.05 or 0.01 ),and the parameters mentioned above were in the normal range.There was no significant difference in the serum prolactin level and outcome between the two groups (P ＞ 0.05).Conclusion The effects of sedation induced with propofol and midazolam on anterior pituitary hormone are comparable in mechanically ventilated patients with traumatic brain injury.

Objective To compare the effect of sevoflurane and propofol on cerebral metabolism in patients undergoing intracranial aneurysm clipping.Methods Sixty-eight ASA Ⅱ or Ⅲ patients aged 22-62 yr weighing 52-81 kg with Hunt-Hess Ⅱ or Ⅲ undergoing intracranial aneurysm clipping were randomly divided into 2 groups( n =34 each): group propofol(group P) and group sevoflurane (group S).Anesthesia was induced with target-controlled infusion(TCI) of propofol (target plasma concretration 2.0 μg/ml,group P) or inhalation of 8％sevoflurane (group S) and iv injection of remifentanil 0.8 mg/kg and atracurium 0.5 mg/kg.Anesthesia was maintained with TCI of propofol(target plasma concretration 1.5 μg/ml,group P) or inhalation of 2％ sevoflurane (group S) and TCI of remifentanil (target plasma concretration 2.0-3.5 ng/ml) and infusion of atracurium (4μg· kg- 1 · min- 1 ).Samples of dialysate in brain were collected at 5 min before temporary arterial occlusion (T0 ),5 min (T1),10 min (T2 ),15 min (T3) of temporary arterial occlusion,and 10 min (T4),20 min (T5),40 min (T6 ) after cerebral aneurysm clipping for determination of glucose,lactate and pyruvate concentrations.Lactate/pyruvate(L/P) ratio was calculated.Results Compared with group P,the concentrations of glucose,lactate and pyruvate were significantly increased at T1 -06,and L/P ratio was decreased at T2-T4 in group S( P ＜ 0.05).The glucose concentration was significantly lower,and lactate concentration higher at T1 -T6,pyruvate concentration was lower at T1 -T4,and higher at T5 and T6,and L/P ratio was higher at T1 -T5 in both groups than that at T0 ( P ＜0.05).The concentrations of glucose and pyruvate were higher and L/P ratio was lower at T4-T6,and lactate concentration was lower at T5,T6 in both groups than that at T3 ( P ＜ 0.05).Conclusion Compared with propofol,sevoflurane can better improve cerebral metabolites in patients undergoing intracranial aneurysm clipping.

A survey of the compensation for senior medical talents in four public tertiary hospitals in Jiangsu province was made,to probe into defects found with their compensation mechanism,and come up with a better compensation incentives practice, including both currency and non-current compensation.These aim at maximization of the incentives.

BACKGROUND: Choriocarcinoma is a kind of trophoblastic neoplasm with highly aggressive phenotypes. Forkhead box D3 (FoxD3) is an embryonic and trophoblastic stem cel transcription factor. It plays important roles in different physical and pathological situations such as embryogenesis, carcinogenesis and tumor progression.
OBJECTIVE:To investigate the role of FoxD3 in choriocarcinoma malignancy and the possible mechanism.
METHODS:The human choriocarcinoma JAR cel line was employed in this study. The mRNA and protein expressions of genes were measured by quantitative RT-PCR (qRT-PCR) and western blot, respectively. The FoxD3 specific short hair RNA was applied to down-regulate gene expression. The cel proliferation was evaluatedin vitro by cel counting assay andin vivo by tumor growth. The migration/invasion was determined by transwel assay. The profile of FoxD3 targeted genes was investigated with an Agilent microarray and verified by qRT-PCR.
RESULTS AND CONCLUSION: The FoxD3 mRNA and protein expressions in JAR cells were significantly higher than those in primarily cultured normal trophoblastic cells. Knockdown of FoxD3 by short hair RNA in JAR cells could inhibit cell proliferation and migration/invasionin vitro, and suppress thetumor growth with decreased β-human chorionic gonadotropin secretionin vivo. A profile of seven focal adhesion molecules (ITGA5, ITGB6, THBS4, COL6A3, VTN, NRXN3 and NLGN1) was verified to be targeted by FoxD3. Furthermore, knockdown of FoxD3 by short hair RNA could decrease the activation of focal adhesion kinase. All these findings suggest the overexpression of FoxD3 can contribute to the aggressive phenotype of choriocarcinoma JAR cells by regulating the profile of focal adhesion molecules and focal adhesion kinase.

Irritable bowel syndrome( IBS)is a common functional gastrointestinal disease,relevant investigations on pathogenesis of IBS mainly focus on genetic susceptibility, social psychological stress, visceral hypersensitivity, dysregulation of brain-gut axis,dysbiosis of intestinal flora,and dysimmunity of intestinal mucosa. This article reviewed the correlation between dysbiosis of intestinal microbiota and dysregulation of brain-gut axis in IBS.

Esophageal collision tumor is an extremely rare tumor which defined as the concrescence of two distinct primary neoplasms.The pathobiological mechanism of collision tumors is yet to be understood.Clinical symptoms,endoscopic examination and imaging are all lack of specificity.Diagnosing a collision tumor prior to surgery is difficult.Careful pathological examination is crucial for accurately diagnosing the neoplasms in a collision tumor and ensuring appropriate management and a favorable prognosis.Esophageal collision tumors have been increasingly reported in recent years.With the aim of improving the knowledge level of esophageal collision tumor,the clinical and pathological features of this tumor is needed to be summarized.

Functional gastrointestinal disease is a group of clinical syndrome of non-organic disease. Its various clinical symptoms have a certain specificity and overlap phenomenon, and the mechanism is not clear. TCM believes thatphychological factorsare an important cause. Emotion failurecan effect spleen and stomach functionthrough liver and heart directly or indirectly.At present, the phychological factors and the relationship between functional gastrointestinal disease are getting attentiongradually. It is recognized that the mechanism of phychological factorsmay be related to brain axis dysfunction, mast cell activation, intestinal flora and so on. This article expounded the above-mentioned mechanism and reviewed the detailed TCM intervention measures to functional gastrointestinal disease in recent years.

Objective To investigate the expression and significance of Th9, Th17 and CD4+CD25+Foxp3+regulatory T (Treg) cells as well as the related cytokines (IL-9, IL-17, TGF-β) in peripheral blood of patients with adult primary immune thrombocytopenia ( ITP) . Methods Peripheral blood samples were collected from 47 patients with ITP and 39 age-and sex-matched healthy subjects. The percentages of Th9, Th17 and CD4+CD25+Foxp3+Treg cells in peripheral blood samples were detected with flow cytometry. The levels of IL-9, IL-17 and TGF-βin serum samples were detected by enzyme linked immunosorbent assay ( ELISA) . Results Compared with healthy subjects, the percentages of Th9 and Thl7 cells and the concen-trations of IL-9 and IL-17 in patients with ITP were significantly increased [(1. 27±0. 31)% vs (0. 71± 0. 26)%, P<0. 05;(2. 01±0. 42)% vs (0. 97±0. 32)%, P<0. 05. (26. 52±7. 48) ng/L vs (16. 16± 5. 27) ng/L, P<0. 05;(10. 97±3. 94) ng/L vs (7. 14±2. 73) ng/L, P<0. 05]. The percentages of CD4+CD25+Foxp3+ Treg cells and the concentrations of TGF-β in patients with ITP were lower than those in healthy subjects [(4. 69±0. 85)% vs (7. 16±1. 92)%, P<0. 05. (3. 76±1. 28) μg/L vs (6. 41±1. 83)μg/L, P<0. 05]. Moreover, the blood platelet counts in patients with ITP were negatively correlated with the percentages of Th9 and Th17 cells and the concentrations of IL-9 and IL-17 (γs=-0. 349, P=0. 037;γs=-0. 392, P=0. 031;γs=-0. 436, P=0. 014;γs=-0. 401, P=0. 027), but were positively correlated with the percentages of CD4+CD25+Foxp3+ Treg cells and the concentrations of TGF-β (γs=0. 411, P=0. 024;γs=0. 407, P=0. 026). Conclusion The imbalanced distribution of Th9, Th17 and Treg cells and the abnormal expression of related cytokines (IL-9, IL-17 and TGF-β) in patients with ITP might be the possible immunological pathogenesis of ITP.

Objective To investigate the anti-inflammatory and analgesic effects of toothache drop pills. Methods The acute inflammatory models such as xylene-induced ear edema and egg white-induced paw edema and the chronic inflammatory model granuloma induced by cotton pellet implantation were used in researching the inflammatory effects of toothache drop pills. Meanwhile, the analgesic effects of toothache drop pills were observed by hot plate and acetic acid writhing test. Results Compared with the blank control group,the degree of ear swelling in mice in the positive control group, toothache drop pills middle and high dose group (2.56 ± 1.35 mg, 4.26 ± 1.21 mg, 3.23 ± 1.25 mg vs. 8.25 ± 1.21 mg) were lower than the blank control group (P<0.05). 120 minutes after administration,compared with the blank control group, the degree of paw swelling in mice in the positive control group, toothache drop pills middle and high dose group (23.54 ± 9.12 mg, 27.58 ± 9.14 mg, 21.25 ± 8.45 mg vs.39.54 ± 8.89 mg) were lower than the blank control group (P<0.05). Granuloma swelling quality in mice caused by cotton in the positive control group, toothache drop pills middle and high dose group (6.51 ± 2.58 mg, 7.82 ± 1.57 mg, 6.58 ± 3.47 mg vs. 13.58 ± 3.25 mg) were lower than the blank control group (P<0.05). The threshold of pain in mice in the positive control group, toothache drop pills middle and high dose group (20.86 ± 2.58 s, 20.25 ± 2.14 s, 20.75 ± 1.78 s vs.17.21 ± 3.31 s) were increased (P<0.05). The number of mice writhing in the positive control group, toothache drop pills middle and high dose group (23.47 ± 7.57, 28.65 ± 6.54, 24.36 ± 7.78 vs. 40.96 ± 6.58) were decreased(P<0.05). Conclusion Toothache drop pills had obvious anti-inflammatory and analgesic effects.