Objective To compare the accuracy of diagnostic peritoneal lavage (DPL),abdominal computed tomographic(CT) scanning,and abdominal B ultrasound for the diagnosis of blunt abdominal trauma. Methods Prospective study was made on 61 hemodynamically stable abdominal injury patients.The patients received both CT and B ultrasound before DPL ,A laparotomy was done on the condition that one of the three examinations had positive finding.The surgical findings were compared with that of the diagnostic studies. Results The sensitivity,specificity and accuracy were 97.4%,81.7% and 91.8% for DPL; 97.3% 91.3% ,and 95.1% for CT;and 92.3%,90.9% and 91.8% for B ultrasound.Although the sesitivity,specificity,and accuracy of B ultrasound in the diagnosis of blunt abdominal trauma were similar to DPL and CT, B ultrasound had more advantages than DPL and CT. Conclusions B ultrasound can replace DPL.CT as a supplementary method in the diagnosis of blunt abdominal trauma.

Objective To investigate advantages and disadvantages of endoscopic thyroidectomy.Methods A total of 61 consecutive patients with thyroid diseases from December 2003 to August 2004 in this hospital were freely divided into two groups: the Endoscopic Group(30 patients) and the Open Group(31 patients).The operating time,blood loss,hospital stay,postoperative pain assessment,jugular sensation 3 months after operation, swallowing function,and cosmetic outcomes between the two groups were compared.Results The operating time in the Open Group was significantly shorter than that in the Endoscopic Group(78?34 min vs 126?53 min;t=4.125,P=0.000).The intraoperative blood loss was less in the Endoscopic Group(20?13 ml) than in the Open Group(34?19 ml)(t=-3.313,P=0.002).The postoperative pain in the Endoscopic Group was slighter than that in the Open Group 24 and 48 hours after operation(t=3.255,P=0.002;t=-2.598,P=0.012).Three months after operation,jugular hypesthesia and discomfort at swallowing occurred in 1 and 2 patients in the Endoscopic Group,respectively,whereas jugular hypesthesia or paresthesia occurred in 11 patients(?~2=10.594,P=0.001) and discomfort at swallowing happened in 9 patients((?~2=5.773),P=0.016) in the Open Group.All patients in the Endoscopic Group were satisfied with the cosmetic results,but 19 patients in the Open Group complained of unsatisfactory cosmetic outcomes(?~2=52.141,P=0.000).Conclusions Endoscopic thyroidectomy gives little blood loss,mild postoperative pain,and good cosmetic results,being a feasible and safe procedure.

Objectives To study ho to make an accurate diagnosis of ectopic pregnancy in the early stage through different ultrasonic checking ways, so as to decrease the misdiagnosis and missed diagnosis rates. Methods 195 cases of ectopic pregnancy patients, which were diagnosed by abdominal ultra-sound (TAS) or by vagina ultra-sound (TVS), were collected, then compared with the operational pathological results and anzlyzed the reasons of the misdiagnosis and missed diagnosis, so as to find out the best ultrasonic way. Results 195 cases of ectopic pregnancy patients were diagnosed by ultrasound, the positive coincidence rate was 95.4% (186/195), misdiagnosis rate was 4.1% (8/195) and missed diagnosis rate was 0.5% (only 1 case). Among 186 cases of ectopic pregnancy, which totally conformed to the operational pathological results, 82 cases were pelvic adhesion, 51 cases (62.2%) were diagnosed ectopic pregnancy by TAS. 104 cases were not pelvic adhesion, in which 48(46.2%) cases were diagnosed ectopic pregnancy by TAS, then the significant differences were being shown. Conclusions When in pelvic adhesion, the ultrasonic checking way is mutually related to the positions of the oviduct and ovary in the pelvic cavity. When the oviduct and ovary are pressed close to the anterior abdominal wall, TAS is the best way while they are pressed close to posterior pelvic wall, TVS is the best way. The ultrasonic checking way for ectopic pregnancy is varied upon different patients.It is the main reason of misdiagnosis and missed diagnosis, that the clinical material and dynamic observation were not taken into consideration

Objective To evaluate sleeve gastrectomy with ileal interposition and duodenojejunal bypass for the treatment of nonobese Type 2 diabetes mellitus.Methods Forty one patients of nonobese Type 2 diabetes mellitus underwent sleeve gastrectomy with ileal interposition and duodenojejunal bypass.Fasting glucose ( FPG ),glycosylated hemoglobin ( HbAlc ),fasting insulin and C-peptide,triglycerides (TG),high density lipoprotein(HDL),low density lipeprotein(LDL) were measured preoperatively and on postoperative first,3rd,6th month.Results Mean postoperative follow-up was 9.6 months (range 6-21 months).95％ patients achieved adequate glycemic control (HbAlc ＜ 7％ ) without antidiabetic medication.Fasting glycemia decreased from ( 9.7 ± 0.4 ) mmol/L to ( 6.2 ± 0.3 ) mmol/L ( P ＜ 0.01 ).Glycosylated hemoglobin decreased from 8.1％ ± 1.4％ to 5.8％ ± 0.6％ ( P ＜ 0.01 ).2-hour postprandial blood glucose decreased from ( 13.6 ± 0.7 ) mmol/L to ( 10.6 ± 0.2 ) mmol/L ( P ＜ 0.01 ).Insulin resistance (Homa-R) decreased from 4.8 ± 1.3 to 1.2 ±0.4 (P ＜0.01 ).Fasting C-peptide increased from ( 3.3 ± 1.7 ) ng/ml to (4.9 ± 0.2 ) ng/ml ( P ＜ 0.01 ).Fasting insulin increased from ( 10.2 + 1.4 ) mlu/L to (15.6±0.7) mlu/L(P＜0.01 ).Triglycerides (TG) decreased from (3.1 ±0.5) mmol/L to (1.9 ±0.4) mmol/L ( P ＜ 0.01 ).High density lipoprotein (HDL) increased from ( 1.2 ±± 0.2 ) mmol/L to ( 1.9 ±0.8 ) mmol/L( P ＜ 0.01 ).Low density lipoprotein (LDL) decreased from (3.5 ± 0.3 ) mmol/L to (2.4 ±0.6) mmol/L (P ＜0.01 ).Hypertension was controlled in 3/7 cases.Microalbuminuria resolved in 78％ patients.Retinopathy was improved in 53％ cases.Conclusions Sleeve gastrectomy with ileal interposition duodenojejunal bypass is effective for treatment of nonobese type 2 diabetes mellitus as showed by 6 month's follow-up.

To study the chemical constituents of the Entada phaseoloides (L.) Merr., seeds of Entada phaseoloides were extracted with 70% ethanol at room temperature. Isolation and purification were performed by silica gel, reversed-phase silica gel column chromatography and semi-preparative HPLC. Structures of the pure compounds were established on the basis of spectral analysis. Four sulfur-containing amide compounds were isolated from the n-BuOH-soluble fraction and identified as entadamide A-beta-D-glucopyranosyl-(1-->3)-beta-D-glucopyranoside (1), entadamide A (2), entadamide A-beta-D-glucopyranoside (3) and clinacoside C (4). Compound 1 is a new compound. Compound 4 is isolated from the genus Entada for the first time.

A 1-year-old boy developed multiple skin-colored nodules on the forehead and extremities when he was 4 months old.Physical examination revealed that his general condition was well with no hepatomegaly,splenomegaly,lymphadenectasis,testicle abnormality or gingival hypertrophy.Pathologically,the epidermis was normal,while the dermis and subcutaneous tissue were diffusely infiltrated with medium-to large-sized deformed cells,which had a small amount of cytoplasm,oval nucleus,irregular shape and fine chromatin.Some infiltrating cells had nuclear groove and nucleoli.Immunohistochemical studies showed that the tumor cells were positive for S-100 protein,CD56,CD123,CD163,CD68,Ki-67 (40％),weakly positive for CD4 (some),but negative for myeloperoxidase,CD1,CD21.Bone marrow smears showed a 24.5％ infltration by monoblasts and promonocytes.A diagnosis of monoblastic sarcoma cutis preceding acute monoblastic leukemia was made.

OBJECTIVE:To compare antioxidant activity of different extraction parts from flower buds of Buddlejae flos in vi-tro. METHODS:Ethanol crude extract (ET) was extracted from flower buds of B. flos with 60% ethanol and diffused by water;and petroleum ether,ethyl acetate and n-butanol were used to extract ET to obtain PE,EA,BU and water samples(SH). Using di-butyl hydroxy toluene(BHT)as positive control,the antioxidant capacity of PE,EA,BU and SH were investigated by using 1, 1-diphenyl-2-picrylhydrazyl(DPPH),2,2′-azino-bis(3-ethyl benzothiazoline-6-sulfonic acid)diammonium salt(ABTS)free radi-cal scavenging method and ironion reduction/oxidation resistance ability (FRAP) method. IC50 and antioxdant equivalent TEAC were calculated. RESULTS:Compared with other samples,ET and EA had stronger antioxidant activity,and IC50 of EA scaveng-ing DPPH and ABTS free radical were 13.75,9.78 μg/ml,and those of ET were 14.93,11.41 μg/ml;scavenging ability of EA to DPPH free radical was stronger than that of BHT(IC50 was 18.71 μg/ml). TEAC of EA,ET and BHT were 1 657.67,1 586.25 and 1 581.68μmol/g. CONCLUSIONS:The ethyl acetate extract from flower buds of B. flos has good antioxidant activity.

2', 3', 5'-Tri-O-acetyl-N6-(3-hydroxylaniline)adenosine (WS070117) is a derivative compound of natural product cordycepin. It has significant lipids regulating activity and low toxicity which has been proved by in vitro and in vivo experiments. In this study, 1H NMR-based metabolomics was used to investigate the dose-related effects of WS070117 on hyperlipidemia of high-fat-fed hamsters. The hyperlipidemic hamsters were administrated with six different doses of WS070117, including 3, 12, 50, 100, 200 and 400 mg x kg(-1) x d(-1). 1H NMR spectra of hamster serum were visually and statistically analyzed using two multivariate analyses: principal component analysis (PCA) and orthogonal partial least squares-discriminant analysis (OPLS-DA). As a result, WS070117-treated groups showed dose-related regulation of metabolites associated with lipid metabolism, choline metabolism and glucose metabolism. The dose of 3 mg x kg(-1) x d(-1) of WS070117 only exhibited a little lipids regulating activity. However, the doses of 12 and 50 mg x kg(-1) x d(-1) of WS070117 both regulated the contents of metabolites to reverse significantly toward normal levels. When the dose of WS070117 reached 100 mg x kg(-1) x d(-1), it was more effective than positive control drugs. The work suggested that NMR-based metabolomics might be a valuable approach to evaluate dose-related effects of lipids regulating compounds.

Objective To study the chemical structure of a pure glycoprotein I_(1-2-1) from Irpex lacteus.Methods Based on chemical and spectral analysis,the structural characterization of I_(1-2-1) was investigated.Results I_(1-2-1) was composed of Ara,Xyl,Man,Gal,and Glu with its mean molecular weight of(40 000.) Methylation analysis showed that the main chain of I_(1-2-1)was all 1→2,1→6 linked Manp.Conclusion I_(1-2-1) is a complicated glycoprotein obtained for the first time from I.lacteus.