Abdominal pain is a common presentation to the family physician clinic and emergency departments and although common, it is often a symptom of serious disease, with many diagnostic challenges that the physician has to overcome. The missed surgical abdomen often results in high morbidity and mortality to the patient, and high medico-legal risk to physicians. In certain patient groups, such as the elderly, the women of childbearing age and the immunocompromised, presentation of abdominal pain can be atypical, and hence additional caution and consideration should be taken. In order to mitigate risk in the challenging primary healthcare environment that the primary physician faces where investigative resources can be limited, a careful diagnostic approach with regards to history taking and physical examination is used, coupled with good documentation of findings and patient discussion.

Antigens, CD ; metabolism ; Antigens, Differentiation, Myelomonocytic ; metabolism ; Breast Neoplasms ; metabolism ; pathology ; surgery ; Carcinoma, Lobular ; metabolism ; pathology ; surgery ; Female ; Histiocytoma, Malignant Fibrous ; metabolism ; pathology ; surgery ; Humans ; Immunohistochemistry ; Middle Aged ; Receptors, Progesterone ; metabolism ; Retroperitoneal Neoplasms ; metabolism ; pathology ; surgery

OBJECTIVE:To establish an LC-MS method for determination of picamilon in human plasma. METHODS:Picamilon and repaglinide(as internal standard)were separated on Agilent C18 column,using methanol-water(85 ∶ 15) as the mobile phase at a flow rate of 0.2 mL?min-1. Column temperature was set at 20 ℃. SIM was used for determination of picamilon in human plasma.Ion mass spectral(m/z) of 207.0→121.1 was selected for picamilon and 451.3→379.2 for repaglinide.RESULTS:The linear range was 50～10 000 ?g?L-1(r=0.999 1); the method recovery was within 99.14%～104.27%. The RSD of inter-day and intra-day validation were 2.12%～5.94% and 7.30%～8.44%,respectively. CONCLUSION:The method is sensitive and accurate for the determination of picamilon in human plasma and its pharmacokinetic study.

Objective: To study the preparation technology of glycyrrhetinic acid (GA)-tanshinone IIA (Tan IIA) compound liposomes (GT-Lip). Methods: The compound liposomes were made of soybean phosphatidylcholine (SPC) and cholesterol (Ch) by film dispersion ultrasonic probe method. Hydration temperature and ultrasonic power were optimized by single factor tests and the optimum formulation was selected by orthogonal design. The encapsulation efficiencies (EE) of GA and Tan IIA were determined by low-speed centrifugation. The particle size and Zeta potential of liposomes were detected by dynamic light scattering particle size meter. Transmission electron microscopy was used to observe morphous. Results: The optimal preparation conditions were as follows weight ratio of SPC-Ch 6:1, molar ratio of SPC-Tan IIA and SPC-GA was 30:1 and 24:1, hydration temperature 30 °C, and ultrasonic power 380 W for 5 min. Using the optimal method, the EE values of GA and Tan IIA in GT-Lip were (81.50 ± 0.76)% and (98.63 ± 0.90)% (n = 3), and the average particle size of liposomes was (120.5 ± 1.62) nm and the Zeta potential of liposomes was (-19.00 ± 0.98) mV (n = 3). Conclusion: The optimal preparation method of GT-Lip in this study is stable and feasible.

Objective To perform the comparative analysis on the test results acquired from three different types of hematology analyzers ,to explore their results comparability or whether their deviations being within the allowable range .Methods The 30 d in‐ternal quality control results collected from the three types of analyzers ,Sysmex XE2100 ,Sysmex XN3000 and Sysmex XT4000i , were analyzed and analyze .The XE2100 hematology analyzer with excellent results in repeatedly participating in the national exter‐nal quality control assessment was taken as the reference instrument ,while the Sysmex XN3000 and Sysmex XT4000i analyzers served as the contrastive instruments .Four blood samples from different patients with high ,medium and low values were randomly selected and detected for 5 d .The results of white blood cell(WBC) ,red blood cell(RBC) ,hematocrit(HCT) ,hemoglobin(HGB) and platelet(PLT) were performed the comparative analysis .Then the accuracy and comparability of the detection results were judged by F test ,regression equation and correlation coefficient .Results The detection result of WBC ,RBC ,HCT ,HGB and PLT had no statistical differences among three instruments (P> 0 .05) .The correlation of various indexes had close correlation (r≥0 .975) .The deviations conformed to the related requirements with comparability .Conclusion When conducting detection by multi‐ple instruments ,the quality control of experimental instrument should be paid attention to ,the different detection instruments should be conducted the calibration and comparison at regular intervals for ensuring the accuracy and consistency of detection re‐sults ,thus better serve clinic .

Objective To observe the protection of Caspase inhibitor(zVAD-fmk,benzyloxycarbonyl-Val-Ala-Asp-fluoromethyl ketone) on neonatal rat with hypoxic-ischemic brain damage(HIBD).Methods Thirty-six neonatal rats,7 days old,were randomly divided into hypoxic-ischemic(HI) control group(A),zVAD-fmk treated group(B) and sham group(C).Before HI insult,a pan-Caspase inhibitor,zVAD-fmk or normal buffer solution was injected into the cerebral ventricle.The water content of cerebral hemisphere was measured and the percentage of apoptofic cells in hippocampal neurons was measured by Flow cytometer(Annexin V/PI) at 24 hours after HI insult.The effect on body weights(percentage of increased weight,WIP) and macroscopical changes(percentage of cortox and hippocampal dead neurons) were assessed at 14 days.Results Compared with group A,the water content of ischemic hemisphere and apoptosis percentage of hippocampal neurons in group B reduced significantly.The difference of percentage of increased weight at 14 days in group B was not significantly.Microscopic examination showed that cortox and hippocampus neural death rate in group B was proved significantly reduced compared with that in group A.Conclusion Intracerebral administration of zVAD-fmk has protective effects on hypoxic-ischemic brain damage in neonatal rat.

Cardiovascular disease is a major cause of morbidity and mortality in the contemporary society. Cardiac gene therapy has already been investigated in clinical studies profoundly. Adenovirus vector could transfer the gene efficiently, but low organ specificity and immuno- genie properties limited its application, With adenovims vector improved in the last few years, the third adenovims vector is probably the most potential vector systems for cardiovascular disease. This review will give a broad overview of the molecular basis of the adenovims vectors, their advantages, the development of increasingly efficient gene transfer approach, and experimental and clinical studies targeting the heart, application barriers and modified strategies.

Background Wearing of soft contact lens,as one of the important methods to correct ametropia,has been widely applied at present.The clinically deleterious effects of soft contact lens have been reported,but researches about influence of apoptosis of corneal epithelial cells are scant.Objective This study was to detect and compare the ratio of apoptosis of corneal epithelial cells between the patients with contact lens wearing and without contact lens wearing,and explore the influence of soft contact lens wearing for long term on growth of corneal epithelial cells after injury.Methods A retrospective nest case-controlled study was designed.Forty eyes of 20 myopic patients with wearing of soft contact lens for ≥5 years and 40 eyes of 20 myopic patients without wearing of soft contact lens were included in Affiliated Hospital of Guiyang Medical College.All the patients received the off-flap epipolis laser in situ keratomileusis (Epi-LASIK) from 2010 October to 2011 June.The corneal flaps were collected during the surgery.The apoptosis of corneal epithelial cells was detected by flow cytometry(FCM),and the difference of apoptotic proportion between the two groups was compared using independent sample t test.Results The FCM scatter plot showed that compared to the without contact lens wearing group,the early stage of apoptotic cells with high staining annexin V and low staining proaium iodide (PI) were much more,and survival cells with low staining annexin V and PI were less,and necrotic and late stage of apoptotic cells with high staining of annexin V/PI were more in the with contact lens wearing group.The early stage of apoptosis proportion of corneal epithelial cells was (11.23 ± 5.31)％ in the with contact lens wearing group,and that in the without contact lens wearing group was (7.31± 5.43)％,showing a significant difference between them (t=2.754,P=0.008).Conclusions A long term wearing of contact lens induce more apoptosis of corneal epithelial cells,which can result in a disorder of structure and function of ocular surface during the wound healing stage.

The aim of the experimental study is to investigate shortterm toxicity of an initial domestic Methotrexate microspheres(MTX-ms)by hepatic arterial infusion in rats,provide some experimental bases for clinic interventional treatment of liver carcinoma with this new chemoembolization agent.Compareing with control group and MTX group, MTX-ms of largedoses could result in temporal rise of GPT and AKP,deterioration or necroses of animal's liver at different degrees,12 days later a number of microspheres could still be found in the small arteries of the necrotizing area.No pathological changes related to microsphere could be found in other main organs(heart,spleen,lung and kidney).Results suggested that chemoembolization effect of MTX-ms is relatively strong;for effectively oc- cluding blood flow of hepatic arteries on the level of small arteries.Meanwhile MTX-ms oc- clud blood supply of liver carcinoma,they may also cause damages of normal liver tissue. Clinically more attention ought to be paid to the dosage of MTX1 microspheres and thus avoid the overflow of more microspheres to the normal liver tissue causing damage.