From the beginning of 1980 to the end of 1992, 125 patients with Cushing disease were undergone transsphenoidal microsurgery. 41 patients were operated by selective adenoma resection and 62 patients by radical surgery. 103 cases were available to be analyzed. The results of a long-term follow-up showed: (1) The cure rates were 63. 1% and 48.1% with positive and negative pathological study, respectively. (2) The cure rates were 72.6% and 41. 5% with radical and selective surgery respectively. In cured patients the plasma cortisol level dropped to normal or subnormal within 48 hours after the surgery. However, in uncured patients, it was still above the normal. After operation, 1. 6% of cases (1/60) had secondary hypothyroidism and 62.5 % of cases (30/48) who had abnormal menstruation preoperatively restored normal menstrual cycle. The recurrent rate was 11.4%. Conclusion: (1) The outcome of radical surgery is better than the selective adenoma resection; (2) The pathological study and the analysis of the plasma cortisol level within 48 hours after the surgery may have predictive value for efficacy of the surgery.

AIM: To investigate the changes of alkaloid in Rhizorrm Coptidis and Fructus Evodiae before and after combination. METHODS: The content of berberine hydrochloride,palmatine hydrochloride,jatrorrhizine hydrochloride in Rhizoma Coptidis and Fructus Evodiae before and after combination were determined by TLCS.RESULTS : After combination of Rhizoma Coptidis and Fructus Evodiae,contents of berberine hydrochioride,palmatine hydrochloride,jatrorrhizine hydrochloride significantly reduced,among which the reduction of berberine hydrochloride was more obvious.CONCLUSION: In decoction,Fructus Evodiae appears to restrict the alkaloid from Rhizoma Coptidis in order to lower the side effect of Rhizoma Coptidis.

BUMwith high insulin level.

AIM:To investigate the changes of alkaloid in Rhizoma Coptidis and Fructus Evodiae before and after combination.METHODS:The content of berberine hydrochloride,palmatine hydrochloride,jatrorrhizine hydrochloride in Rhizoma Coptidis and Fructus Evodiae before and after combination were determined by TLCS.RESULTS:After combination of Rhizoma Coptidis and Fructus Evodiae,contents of berberine hydrochloride,palmatine hydrochloride,jatrorrhizine hydrochloride significantly reduced,among which the reduction of berberine hydrochloride was more obvious.CONCLUSION:In decoction,Fructus Evodiae appears to restrict the alkaloid from Rhizoma Coptidis in order to lower the side effect of Rhizoma Coptidis.

Objective To investigate the best protective solution that could maintain the cell activity and prolong the survival time of the human retinal pigment epithelium (hRPE) cells after break away in vitro culture case. Methods hRPE cells (stored in our laboratory) culture in DMEM/F12, added 10% FBS, EGF 20?g/L and bFGF 20?g/L, which had been cultured for more than five generations. When these culture hRPE cells had been confluenced more than 80%, the hRPE cells were harvested and placed into six kinds of protective solutions (balanced salt solution, Quinn's advantage medium, physiological salt solution, 18-amino acid solution, 5% glucose solution, artificial cerebrospinal fluid), then the cells were stained with the Annexin V /FITC, and the numbers of cell death and cell apoptosis were detected with the fluorescence activated cell sorter (FACS). The hRPE cells were in six kinds of protective solutions and were investigated at three different times from 2 hours to 8 hours. Results The result presented as follows: At the room temperature, the hRPE cells in all six kinds of protective solutions occurred necrosis within 30 minutes. To investigate the state at 4℃, in a duration of 2 hours, the apoptosis rate in the group of balanced salt solution was lowest (0.9%); As compared with the group of balanced salt solution, the apoptosis rate of artificial cerebrospinal presented a great difference (P

Objective:To systematically evaluate the predictive value of neutrophil-lymphocyte ratio (NLR) in acute kidney injury (AKI).Methods:All studies about the predictive effect of NLR on AKI were searched in the National Medical Library of the United States PubMed Database, the Embase database in the Netherlands, the Chinese Biology Medicine disc (CBMdisc) and the Chinese Evidence Based Medicine Cochrane Centre Database (CEBM/CCD). The data updated by October 2020, and regardless of language, region or whether blind method was used. Two authors independently extracted data and evaluated the quality of the studies. Data extracted from the studies were analyzed with RevMan 5.3 to assess the predictive value of NLR on AKI. A subgroup Meta-analysis was conducted to assess the predictive value of NLR on AKI according to different countries, different disease types (cardiovascular surgery, infectious diseases, other diseases including burns, cirrhosis, and emergency), and different sample sizes (≤ 300 cases and > 300 cases). The publication bias of included studies about the predictive effect of NLR on AKI were assessed by funnel plots.Results:A total of 11 studies were included in this Meta-analysis, including 4 997 patients, 1 308 patients in AKI group, and 3 689 patients in non-AKI group. The Meta-analysis results showed that: increased NLR had predictive value for the occurrence of AKI [mean difference ( MD) = 2.73, 95% confidence interval (95% CI) was 1.78-3.68, P < 0.000 01]. Subgroup analysis showed that increased NLR had predictive value for the occurrence of AKI in patients from Southeast Asia ( MD = 4.04, 95% CI was 1.09-6.99, P = 0.007) and Eurasia ( MD = 2.51, 95% CI was 1.12-3.90, P = 0.000 4). Increased NLR had predictive value for the occurrence of AKI in patients undergoing cardiovascular surgery ( MD = 0.77, 95% CI was 0.34-1.20, P = 0.000 4), infectious diseases ( MD = 4.74, 95% CI was 1.51-7.96, P = 0.004) and other diseases ( MD = 8.53, 95% CI was 6.26-10.80, P<0.000 01). Increased NLR had predictive value for the occurrence of AKI in studies with a sample size of ≤ 300 cases ( MD = 6.02, 95% CI was 4.90-7.14, P <0.000 01) and > 300 cases ( MD = 1.32, 95% CI was 0.61-2.03, P = 0.000 3). There was no significant publication bias in the included studies assessed by funnel plots. Conclusion:NLR is an important predictive tool for AKI.

Objective:To observe effects of Huanglian Jiedu Decoction on expression of insulin receptor substrate 1(IRS-1)and the level of tyrosine phosphorylation in skeletal muscles to explore the molecular mechanism in improving insulin resistance.Methods:Wistar system insulin resistance model rats were developed with injection of small dose of streptozotocin into the caudal vein plus feeding by forage with high sugar and high lipids,and they were treated with Huanglian Jiedu Decoction for 10 weeks.Then blood sugar and serum insulin level were determined,and the changes of IRS-1 protein expression and tyrosine phosphorylation level in the skeletal muscles of the rat with insulin resistence after treatment of Huanglian Jiedu Decoction were detected with immuno- precipitation and Western Blot methods.Results:After treatment with Huanlian Jiedu Decoction,IRS-1 expression and IRS-1 tyrosine phosphorylation level in the muscular tissue increased as compared with those of the model group.Conclusion Huanglian Jiedu Decoction improves IRS-1 protein expression and tyrosine phosphorylation level in the skeletal muscle tissue of the rats with insulin resistance,which is possibly one of the mechanisms of decreasing blood sugar and improving sensitivity of insulin in tissues.

Objective To investigate the efficacy ,safety and compliance of mesalazine sustained‐release (SR) granules taking once daily or multi‐times daily in the treatment of patients with mild to moderate active ulcerative colitis .Methods Sixty patients with mild to moderate active ulcerative colitis were divided into group A ,B and C with 20 patients in each group .Group A received mesalazine SR granules 4 g once daily ,Group B with 2 g each time and twice daily ,Group C with 1 g each time and four times daily . The total course was eight weeks . The vital signs ,Mayo score ,compliance and adverse effects of patients were monitored at 0 ,4th ,8th weeks .At 0 and 8th weeks ,colonoscopy were performed . The parameters of efficacy assessment were clinical complete remission rate , clinical remission rate , efficacy rate ,mucosal healing rate ,remission time and safety .The F test ,t test or Chi‐square test was performed for comparison among groups .Results The clinical complete remission rate of group A ,B and C was 20% (4/20) ,10% (2/20) and 10% (2/20) ,respectively .The clinical complete remission rate was 70% (14/20) ,65% (13/20) and 70% (14/20) ,respectively .The efficacy rate was 95% (19/20) ,85%(17/20) and 90% (18/20) ,respectively .The mucosal healing rate was 70% (14/20) ,60% (12/20) and 50% (10/20) ,respectively .The side effects rate was 20% (4/20) ,15% (3/20) and 20% (4/20) .There was no significant difference between groups (all P > 0 .05) .The remission time of group A and B was (15 .4 ± 3 .7) days and (15 .6 ± 2 .9) days ,which were both shorter than that of group C (18 .4 ± 3 .6) days ,and the differences were statistically significant (t= 2 .661 and 2 .710 ,both P< 0 .05) .There was no significant difference among three groups in gender ,disease course , severity , location and clinical remission rate of sub‐groups .Conclusions The efficacy and safety of mesalazine SR granules taking once daily or multi‐times daily are similar in the treatment of patients with mild to moderate active ulcerative colitis .Once daily have better compliance than other regimens .

Objective To assess the effect of continuous renal replacement therapy (CRRT) on severe acute pancre-atitis (SAP). Methods According to the collaborative search strategy, MEDLINE (1966-2013.9), Embase(1974-2013.9), Chinese Wanfang database(1996-2013.9), CNKI(1979-2013.9) and the clinical control test database of Cochrane Library were searched.Published and unpublished literature and meeting summary were searched manually.Quality assessment and data extraction were conducted by two independent investigators. Meta-analysis was performed using RevMan 5.2. Results A total of 15 reports were identified which met the inclusion criteria, in which include data of 652 patients.Com-pared with control group, serum amylase decreased in CRRT group (WMD=-140.76, 95%CI was-212.42 to-69.11, P=0.000 1). Mediators of inflammatory mediators were scavenged effectively and APACHEⅡscore decreased in CRRT group (WMD=-2.97, 95%CI was-4.01 to-1.93, P<0.001). The overall survival rate was significantly higher in CRRT group than that in control group (RR=1.35, 95%CI 1.19-1.52, P<0.001). Conclusion Continuous renal replacement therapy could ef-fectively improve the survival rate of patients with severe acute pancreatitis.

Objective To evaluate the role of autophagy in hydrogen-induced reduction of lung injury in septic mice.Methods Sixty pathogen-free healthy male ICR mice,aged 6 weeks,weighing 20-25 g,were divided into 5 groups (n =12 each) using a random number table:sham operation group (group Sh),sepsis group (group Sep),sepsis plus hydrogen group (group Sep+H2),sepsis plus autophagy inhibitor 3-methyladenine (3-MA) group (group Sep+3-MA) and sepsis plus 3-MA plus hydrogen group (group Sep+3-MA+H2).Sepsis was produced by cecal ligation and puncture.At 1 h before operation,3-MA 10 mg/kg was intraperitoneally injected.The mice inhaled 2％ H2 for 1 h starting from 1 and 6 h after operation.Blood samples were collected from the common carotid artery at 24 h after operation for measurement of arterial oxygen partial pressure,and the oxygenation index (OI) was calculated.Pulmonary specimens were obtained for examination of the pathological changes which were scored.Pulnonary mitochondria were isolated for determination of mitochondrial membrane potential (MMP) and ATP content using fluorescence spectrophotometry and a bioluminescence assay,respectively,and the respiratory control rate (RCR) was calculated.The expression of autophagy-related protein microtubule-associated protein 1 light chain 3 (LC3) was determined by Western blot,and the ratio of LC3-Ⅱ to LC3-Ⅰ expression (LC3-Ⅱ/LC3-Ⅰ ratio) was calculated.Results Compared with group Sh,the pathological scores were significantly increased,the OI and contents of mitochondrial RCR,MMP and ATP were decreased,and the LC3-Ⅱ/LC3-Ⅰ ratio was increased in Sep and Sep+H2 groups (P＜0.05).Compared with group Sep,the pathological scores were significantly decreased,the OI and contents of mitochondrial RCR,MMP and ATP were increased,and the LC3-Ⅱ/LC3-Ⅰ ratio was increased in group Sep+H2,and the pathological scores were significantly increased,the OI and contents of mitochondrial RCR,MMP and ATP were decreased,and the LC3-Ⅱ/LC3-Ⅰ ratio was decreased in group Sep+3-MA (P＜0.05),and no significant change was found in each parameter mentioned above in group Sep+3-MA+H2 (P＞0.05).Compared with group Sep+H2,the pathological scores were significantly increased,the OI and contents of mitochondrial RCR,MMP and ATP were decreased,and the LC3-Ⅱ/LC3-Ⅰ ratio was decreased in group Sep+3-MA+H2 (P＜0.05).Conclusion The mechanism by which hydrogen ameliorates lung injury is related to enhanced level of autophagy in septic mice.