Retained products of conception (POC) complicates nearly 1% of all pregnancies, occurring with greater frequency after termination of pregnancy than after vaginal or caesarean delivery. The presenting symptoms of retained products of conception are similar to those of gestational trophoblastic disease and hence accurate differentiation is difficult based on clinical history and physical examination alone. The distinction between these two entities is extremely important as the treatment differs dramatically. These patients often need to be further evaluated with either ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI) of the pelvis. Hence, radiologists play a vital role in clinching the diagnosis although at times it may be challenging to differentiate between these two entities. Herein, we discuss a case of degenerated retained products of conception which was initially misdiagnosed as invasive trophoblastic disease in a 41-year-old woman whom last known pregnancy was 10 years ago.

OBJECTIVE:To observe clinical efficacy and safety of Shuxuening injection in the adjunctive treatment of traumat-ic subarachnoid hemorrhage. METHODS:96 patients with traumatic subarachnoid hemorrhage were randomly divided into control group and observation group with 48 patients in each group. Control group was given Tranexamic acid injection,Nimodipine injec-tion and Citicoline injection,daily lumbar punctrive and determined intracranial pressure and drained cerebrospinal fluid via lumbar puncture;observation group was additionally given Shuxuening injection 20 ml added into 5% Glucose injection 250 ml,ivgtt,qd. Both group were treated for consecutive 2 weeks. Clinical efficacy of 2 groups were observed,and GCS and MCA were also ob-served before and after treatment;ADR of 2 groups were recorded. RESULTS:Excellent rate of observation group(60.42%)was significantly higher than that of control group(31.25%),with statistical significance(P<0.05). Before treatment,3 and 5 days af-ter treatment,there was no statistical significance in GCS and MCA between 2 groups(P>0.05);7 and 14 days after treatment, GCS of 2 groups increased significantly while MCA decreased significantly,and the observation group was better than the control group,with statistical significance (P<0.05). The incidence of cerebral vasospasm,cerebral infarction and cerebral hemorrhage were 8.33%,4.17%and 4.17%in observation group,and those of control group were 16.67%,12.50%and 16.67%;the observa-tion group was significantly lower than the control group,with statistical significance(P<0.05). CONCLUSIONS:Shuxuening in-jection shows significant therapeutic efficacy in the adjunctive treatment of traumatic subarachnoid hemorrhage,with low incidence of ADR.

Objective To analyse the prognostic value of serumal copeptin in patients with acute exacerbation of COPD compli-cated withrespiratory failure.Methods The serumal copeptin were detected in 60 hospitalized AECOPD patients before and after the treatment and in 30 healthy controls.Results Comparing with control groups,the serumal levels was significantly elevated in the patient with AECOPD before thetreatment and declinied two months later(P <0.05).The level of serum copeptin wereincreasing with the increase in the severity of the disease in acertain extent;The serumalcopeptin were positively correlated with lung function and CAT (r=0.058 and 0.821,P =0.00)and were negativelycorrelated with 6MWD(r=-0.652,P =0.00).Conclusion Serum copeptin could as-sess the incidence of acute exacerbations ofchronic obstructive pulmonary disease and its therapeutic effect;Serum copeptin can reflect the se-verity of AECOPD patients in a certain extent,and has certain clinical value to evaluate the quality of life in patients.

Objective To assess the effect of rhein on diabetic nephropathy in rats with type 2 diabetes mellitus. Methods Diabetes was induced by high-lipids and high-sucrose diets (20% sucrose, 10% lard, 2.5% cholesterol, 1% cholic acid and 66.5 % regular chow, w/w) for 1 month and then intraperitoneal injection with 25 mg/kg streptozoticin(STZ) in female inbred Wistar rats. Rhein was continuously given 100 mg?kg-1?day-1 for 6 months 1 week after STZ injection in rhein-prevented group, and 1 month after STZ injection in rhein-treated group. Blood and urinary biochemistry and renal morphology were evaluated at divers times. Results Rhein ameliorated hypertriglyceridemia and hypercholesterolemia, but had few effect on the level of plasma glucose in both rhein-prevented group and rhein-treated group. Excretion of urinary protein reduced markedly and stable-state plasma glucose (SSPG) level decreased in both groups as compared with diabetic group. Examination of kidney sections from both rhein-prevented group and rhein-treated group showed that the structural lesions of glomeruli including mesangial expansion, diffuse glomerulosclersis and thickening of glomerular basement membrane, as well as artery injury such as arteriolar hyalinosis, atherosclerosis were markedly improved as compared with diabetic group. Morphometry of glomeruli from both rhein-prevented group and rhein-treated group showed that glomerular grow and mesangial hypertrophy occurred in diabetic group were ameliorated. The accumulation of fibronectin examined by immunostaining in glomeruli was reduced in both groups. Conclusion Therapeutic intervention with rhein can halt the progression of diabetic nephropathy and prevent the development of glomerulosclerosis and vascular injuries in this animal model of type 2 diabetes mellitus.

Animals ; Asthma ; drug therapy ; immunology ; metabolism ; physiopathology ; Child, Preschool ; Humans ; Infant ; Leukotrienes ; immunology ; metabolism ; pharmacology ; Respiratory Sounds ; drug effects ; immunology ; physiopathology

Huaier (Trametes robiniophila) has been widely used as an adjuvant drug for cancer treatment in China. The anti-cancer effect of Huaier extract has been confirmed in liver cancer, lung cancer, breast cancer, ovarian cancer, gastric cancer, and so on. The main mechanisms by which Huaier exerts an anti-neoplastic effect include inhibition of the growth and proliferation of cancer cells, induction of apoptosis of cancer cells, suppression of angiogenesis, inhibition of the invasion and migration of cancer cells, regulation of oncogenes and tumor suppressor genes expression, improving immunity, and reversal of drug resistance in cancer cells. In order to provide references for further study and clinical application on anti-tumor effect of Huaier, the latest research progress on anti-tumor effect of Huaier in recent years is summarized in this paper.
Animals ; Antineoplastic Agents ; pharmacology ; Humans ; Trametes

ObjectiveTo evaluate the reliability and clinical value for detecting paraquat (PQ)concentration in serum by spectrometry. MethodsThe determinations of wave length for detecting serum PQ concentration by ordinary spectrometry and second-derivative spectrometry were carried out. When the second-derivative spectrometry was used for detecting PQ in serum, the linear range and precision for PQ concentration were well defined. The results of serum PQ concentration determined by second-derivative spectrometry and by HPLC (high performance liquid chromatography) were compared in 8 patient with PQ poisoning. A total of 21 patients with acute poisoning after PQ ingestion over 4 hours admitted from October 2008 through September 2010 were retrospectively studied. Patients were divided into two groups as per the serum concentrations more than 1.8 μg/mL or less than that by second-derivative spectrometry on the day of admission. The severity of clinical manifestations between two groups was analyzed with t-test or Fisher's exact probabilities analysis. Results ( 1 ) The absorption peak of 257 nm could not be found by using ordinary spectrometry to detect the PQ concentration in serum. (2) The calibration curve in the 0. 4 ～ 8.0μg/mL range for detecting PQ concentration by second-derivative spectrometry observed the Beer's law (r =0. 996) . The average retrieval rate of PQ was within the range of 95.0％～ 99. 5％ with relative standard deviation (RSD) within 1.35％～ 5.41％ ( n = 6), and the lowest detection limit was 0. 05μg/mL. (3) The results of PQ concentrations from 8 patients with PQ poisoning detected by second-derivative spectrometry were consistent with those of the quantitative determinations by HPLC ( r = 0. 995,P＜0. 01 ) . (4) The survival rate of patients with serum PQ concentration more than 1.8 μg/mL was 22. 2％ ,and the incidences of acidosis, oligouria and pneumomediastium in these patients were 55.6％,55. 6％ and 77.8％, respectively. These clinical manifestations were significantly different from those in patients with serum PQ concentration less than 1.8 μg/mL ( P ＜ 0. 05 ) . Conclusions ( 1 ) It was inappropriate to take 257 nm as the determination wave length for detecting serum PQ concentration by ordinary spectrometry. (2) The method of second-derivative spectrometry was reliable for detecting serum PQ concentration. (3) Serum PQ concentration detected by second derivative spectrometry could be used to predict the severity of clinical manifestations of patients with PQ poisoning and was an important predictive factor for poor prognosis if the serum PQ concentration more than 1.8 μg/mL after PQ ingestion over 4 hours.

Objective To investigate the functional outcome in patients with mild ischemic stroke and to identify its risk factors for poor outcome.Methods The patients with mild ischemic stroke treated within 72 hours after onset were enrolled prospectively.According to modified Rankin Scale (mRS) scores at day 90 after onset,the patients were randomly divided into either a poor outcome group (mRS score ＞2) or a good outcome group (mRS scores 0-2).Univariate analysis and multivariate logistic regression analysis were used to compare and analyze the demographic data,vascular risk factors,clinical data,laboratory data,imaging data,and follow-up data.The risk factors for poor outcome in patients with mild ischemic stroke were identified.Results A total of 253 patients with mild ischemic stroke were enrolled,and 71 of them (28.1％) had poor outcome.Univariate regression analysis showed that the patients' proportions of age (t =2.037,P =0.043),baseline National Institutes of Health Stroke Scale (NIHSS) score (U =4 610.000,P =0.000),baseline mRS score (U =5 723.000,P =0.000),as well as previous history of ischemic stroke (x2 =4.950,P =0.026),severe symptomatic artery stenosis or occlusion (x2 =49.037,P =0.000),large artery atherosclerotic stroke (x2 =34.359,P =0.000),early neurologic deterioration (x2 =45.804,P =0.000),complicated by pneumonia (x2 =12.121,P =0.000) and recurrent ischemic stroke (x2 =14.305,P =0.000) of the poor outcome group were significantly higher than those of the good outcome group.Multivariate logistic regression analysis showed that advanced age (odds ratio [OR] 1.049,95％ confidence interval [CI] 1.012-1.086; P =0.008),higher baseline mRS score (OR,2.130,95％ CI 1.212-3.743;P=0.009),higher baseline NIHSS score (OR 1.532,95％ CI 1.064-2.206; P=0.022),severe symptomatic large artery stenosis or occlusion (OR 7.569,95％ CI 3.497-16.380; P=0.000),early neurological deterioration (OR 7.369,95％ CI 2.648-20.510; P =0.000) and recurrent ischemic stroke (OR 10.450,95％ CI 3.071-35.564; P =0.000) were the independent risk factors for poor outcome.Conclusions More than one fourth of the patients with mild ischemic stroke had poor outcome.Advanced age,higher baseline mRS score,higher baseline NIHSS score,severe symptomatic large artery stenosis or occlusion,early neurological deterioration,and recurrent ischemic stroke were the independent risk factors for poor outcome.

Objective To establish the national standard materials for haemiglobincyanide (HiCN) for the traceability assays of hemoglobin. Methods HiCN national standard materials were established according to the document of International Committee for Standardization in Haematology (ICSH). The standard materials were certificated according to ISO Guide 35, including homogeneity and stability. Then they were characterized by the calibrated spectrophotometer which can be traceable to National Institute of Standards and Technology (NIST). The international reference materials of HiCN were compared with the result of the WHO reference laboratory to confirm the reliability. Results The uncertainty of the HiCN standard materials was 0.000 4 g/L and the variation coefficient (CV) was 0.09%. The uncertainty of long-term stability was 0.000 6 g/L; the certificated value of the standard materials was 0.615 9 g/L with uncertainty of 0.000 4 g/L. The combined uncertainty was 0.000 9 g/L and the expanded uncertainty was 0.001 8 g/L when the cover factor was 2. The relative error was 0.08% between the result of the standard materials and the international certificated value. Conclusion The homogeneity and stability of the standard material is acceptable and the method of characterization is accurate and reliable.

ObjectiveTo investigate the effect of all-trans retinoic acid (atRA) on the renin-angiotensin system (RAS) in 5/6 renal ablation model. MethodsAtRA was administered to 5/6 renal ablation rats by three dosages: 5 mg·kg-1·d-1 (n=8), 10 mg·kg-1d-1 (n=8) and 20 mg·kg-1 d-1 (n=8) and vehicle (vehicle group, n=8) for 10 weeks. Healthy rats consisted of shamoperation group (n =8). The level of renin and angiotensin Ⅱ in renal tissues were measured by radioimmunoassary. The level of angiotensin type 1 receptor (AT1R) in remnant renal cortex was measured by Western blot. The mRNA expression levels of two subunits of activative protein 1(AP-1),c-jun and c-fos was quantitated by real-time PCR. ResultsAfter 10 weeks of atRA treatment by gavarge, artery blood pressure decreased (P＜0.05). AtRA reduced the levels of renin (P＜0.05) and angiotensin Ⅱ (P＜0.05) in kidney and down-regulated the expression of AT1R protein in renal cortex. Larger dose of atRA (20 mg·kg-1·d-1) performed higher activity in inhibiting renin and AT1R. Compared with vehicle group, atRA could significantly inhibit the expression of renal c-jun and c-fos mRNA (P＜0.05). Conclusion atRA can decrease the over-expression of main components of RAS.