OBJECTIVE:To establish the quality standard for Chaige ganmao mixture. METHODS:TLC was conducted to iden-tify the Scutellaria baicalensis and Paeonia lactiflora;HPLC was conducted to determine the content of puerarin. The column was Zorbax Eclipse XDB-C18 with mobile phase of methanol-water(25:75,V/V)at flow rate of 1.0 ml/min,detection wavelength was 250 nm,and column temperature was 25℃,and the injection volume was 5μl. RESULTS:TLC showed clear spots and good sepa-ration. The linear range of puerarin was 18-198 μg/ml(r=0.999 9);RSDs of precision,stability and reproducibility tests were low-er than 2%,recovery was 99.04%-99.75%(RSD=0.28%,n=6). CONCLUSIONS:The standard can be used for the quality con-trol of Chaige ganmao mixture.

Objective To investigate the expression and clinical significance of UL16 binding protein 3 (ULBP3) in human esophageal squamous cell carcinoma (ESCC) and its correlation with nature killer (NK) cells.Methods The relative expression of ULBP3 in the ESCC tissues and corresponding carcinoma adjacent tissues of 40 patients was detected by realtime-poly merase chain reaction (PCR),immunohistochemical staining and Western blot methods.The percentage of NK cells in peripheral blood of same patients was examined by flow cytometry.The correlation between ULBP3 and the percentage of NK cells was analyzed with Pearson method.Results The expression of ULBP3 at mRNA level in the tumor tissues ([4.96 ±-6.11]×10-3) was significantly higher than that of corresponding carcinoma adjacent tissues ([1.64 ± 2.96]× 10-3,t =3.656,P＜ 0.01).The immunohistochemical staining results indicated that the positive rate of ULBP3 in the tumor tissues was 60％ (24/40),however that of corresponding carcinoma adjacent tissues was only 32.5％(13/40,t=3.921,P＜0.01).The Western blot results indicated that the expression of ULBP3 at protein level in the tumor tissues was significantly higher than that in the corresponding carcinoma adjacent tissues.The relative expresssion ULBP3 at mRNA level in carcinoma tissues of ESCC patients with lymph node metastasis and at TNM stage Ⅲ was higher than that of ESCC patients without metastasis and at TNM stage Ⅰand Ⅱ (t=4.839,4.192,P＜0.05).There was no significant correlation between the expression and ages,gender,location of tumors and the differentiation degree of tumor (P＞0.05).At early and mid stage of the tumor,the expression of ULBP3 at mRNA level was positively correlated with the percentage of NK cells in peripheral blood (r=0.5233,P＜0.05),however there was no correlation at advanced stage.Conclusion ULBP3 was highly expressed in ESCC and may be involved in the immune regulation of NK cells.

Patients with metastatic prostate cancer are typically managed with androgen deprivation therapy. Most patients initially respond to treatment, but many eventually develop castration-resistant prostate cancer. Neuroendocrine prostate cancer (NEPC) is a highly aggressive subtype of castration-resistant prostate cancer, which often results from neuroendocrine differentiation of prostate cancer cells. NEPC has a dismal outcome with an average survival of less than 1 year and exhibits less response to radiochemotherapy. At least 25%of patients with lethal castration-resistant prostate cancer are predicted to eventually develop this type of highly-aggres-sive NEPC. However, research on the molecular mechanism of NEPC is limited;thus, further studies are needed to explore the develop-ment and application of anticancer drugs for NEPC.

Objective To study the expression of Gli1 protein and vascular endothelial growth factor (VEGF)-C in papillary thyroid carcinoma and their relationship with cervical lymph node metastasis.Methods The expression of Gli1 protein and VEGF-C were investigated by immunohistochemical EnVision method in 67 cases of papillary thyroid carcinoma and 32 cases of nodular goiter pathological specimen tissues.Nascent microvascular and micro-lymphatic of all pathological speimen tissues were examined by immunohistochemical monoclonal antibody CD34 and D2-40 staining assay respectively,and the microvascular density (MVD) and micro-lymphatic vessel density (MLVD) were calculated.The relationship between the positive expression of Gli1 protein and MVD,between the positive expression of VEGF-C and MLVD,and their relationship with cervical lymph node metastasis were analyzed.Results The positive rates of Gli1 protein,VEGF-C and MVD,MLVD were significantly higher in papillary thyroid carcinoma than those in nodular goiter [67.16％(45/67) vs.43.75％(14/32),70.15％(47/67) vs.31.25％(10/32),23.14 ± 2.06 vs.2.14 ± 0.31,13.36 ± 1.32 vs.3.53 ± 0.65,P ＜ 0.05].The positive expression of Gli1 protein was related to the patient' s age and the tumor size (P ＜ 0.05),while the positive expression of VEGF-C was not related to the patient' s age and the tumor size (P ＞ 0.05).The positive expression of Gli1 protein and VEGFC were significantly higher in TNM stage Ⅲ-Ⅳ of papillary thyroid carcinoma than those in TNM stage Ⅰ-Ⅱ (P ＜ 0.01) and also was significantly higher with cervical lymph node metastasis than without cervical lymph node metastasis (P ＜ 0.01).MVD and MLVD were significantly higher with cervical lymph node metastasis than without cervical lymph node metastasis (P ＜ 0.05).The positive expression of Gli1 protein was positively correlated with MVD (r =0.784,P＜ 0.01),the positive expression of VEGF-C was positively correlated with MLVD (r =0.529,P ＜ 0.01),the positive expression of Gli 1 protein was positively correlated with the positive expression of VEGF-C (r =0.586,P ＜0.01).Conclusions Gli1 protein which may participate in the formation of nascent microvascular is abnormally activated by the Hedgehog signaling pathway to express,VEGF-C which may be participate in the formation of nascent micro-lymphatic is mediated and started by the MAPK signaling pathways to express.Expressions of Gli1 protein is positively correlated with expressions of VEGF-C,therefore the Hedgehog signaling pathway may be associated with the MAPK signal pathway.Suppressing nascent microvascular and micro-lymphatic may become new target to blockingup papillary thyroid carcinoma cervical lymph node metastasis.

ABSTRACT:Objective To evaluate the expressions of cell adhesion molecules CD146 and transferrin receptor 1 (TfR1)in ovarian epithelial cancer and investigate their relationship with clinical pathological features of patients with ovarian epithelial cancer (OEC ) so as to further explore the pathogenesis of OEC. Methods Immunohistochemistry was employed to determine the expressions of CD146 and TfR1 in normal,benign and ovarian cancer tissues.Results The immunohistochemical results showed that the positive expressions of CD146 and TfR1 gradually increased with the changes of normal,benign and malignant tissues in OEC.There were significant differences between all the groups (P<0.05).The advanced the clinical stage,the higher the expression rate (P<0 .0 5 ).The lower the histopathological differentiation,the higher the expression rate (P<0 .0 5 ).The expressions of CD146 and TfR1 were not correlated with age or pathological patterns (P>0.05).There was a significant correlation between expressions of CD146 and TfR1 in OEC (P<0.05,rs=0.532).Combined detection sensitivity and specificity were 82.4% and 75.0%.Conclusion The high expressions of CD146 and TfR1 may play a key role in the occurrance,progression and metastasis of OEC.They may be used as potential markers for diagnosis,postoperative follow-up and targeted therapy.

Objective To investigate the clinicopathologic features and imaging findings of several kinds of rare and uncommon brain embryonal tumours. Methods MRI or CT appearance and clinicopathologic features in 10 eases of histopathology confirmed brain embryonal tumours were retrospectively analyzed.Results Among 10 cases,there were supratentorial primitive neuroectodermal tumour(sPNET) in 6,ependymoblastoma in 2,medulloepithelioma and atypical teratoid/rhabdoid tumour (AT/RT)in 1 respectively.Patients in 4 cases were infancy and childhood.There was characteristic of the clinicopathologic features of tumors that were the evidence of accurate diagnosis. All lesions were located in the supratentorial region.The tumors were large,usually lobulated in shape irregularly and showed heterogeneous density or signal intensity with some cystic and necrotic areas.The tumors parenchyma appeared slightly high density on CT imaging,iso-or high signal on T2WI and slight low signal on T1WI with intense enhancement after contrast injection.Conclusion MRI or CT findings of rare and uncommon brain embryonal tumours were not characteristic,it Was very essential to know the tumors combined with the clinical and pathologic features.

Objective To study the FDG SUVmax cutoff values in detection of metastases in mediastinal lymph nodes (MLN) and hilar/intralobar lymph nodes (HILN) in pre-operative patients with N0-2 stage NSCLC.Methods A total of 69 patients with stage N0-2 NSCLC (40 males,29 females,age 36-87 years) were included in this retrospective study.18F-FDG PET/CT was performed and followed by lung cancer resection with lymph node dissection in 1 month.The excised lymph nodes were compared one by one between their SUVmax and histopathology.The SUVmax cutoff value in detection of lymph node metastases was determined by the ROC curve.Mann-Whitney u test,x2 test,and Fisher exact test were used for data analysis.Results Metastatic MLN and (or) HILN were found in 21 of 69 NSCLC patients.The histopathologic results demonstrated metastases in 61 of 339 lymph nodes.The SUVmax of metastatic lymph nodes (4.95(3.46,7.19)) was significantly higher than that of benign lymph nodes (2.10(1.59,3.22);z=-7.576,P＜0.05).The SUVmax of metastatic HILN (6.32 (4.28,8.27)) was significantly higher than that of metastatic MLN (3.90(2.12,6.41);z=-2.921,P＜0.05).With cutoff of SUVmax ≥2.5,the sensitivity,specificity and accuracy in detection of all metastatic lymph nodes were 83.6％ (51/61),61.9％ (172/278)and 65.8％ (223/339) respectively,and the parameters were 74.2％ (23/31),79.6％ (160/201) and 78.9％ (183/232) for metastatic MLN,and 93.3％ (28/30),15.6％ (12/77) and 37.4％ (40/107) for metastatic HILN.The diagnostic sensitivities for metastatic MLN and for metastatic HILN were not significantly different (Fisher exact test,P＞0.05),while the specificities and accuracies between the two groups were significantly different (x2 values:96.7 and 56.1,both P＜0.05).According to ROC curves,cutoff values of SUVmax in detecting metastatic MLN and metastatic HILN were 2.78 and 4.93.With the specific cutoff value,the sensitivity,specificity and accuracy in detection of metastatic MLN were 71.0％ (22/31),87.1％ (175/201)and 84.9％(197/232),respectively.The corresponding data in detection of metastatic HILN were 73.3％ (22/30),77.9％(60/77) and 76.6％(82/107).Conclusion Different cutoff values of SUVmax in detecting metastatic MLN and metastatic HILN should be considered for more accurate lymph nodes staging in patients with NSCLC.

Objective To evaluate the possibility of elevating the age line for pregnant women with advanced age to conducted amniocentesis .Methods A retrospective cohort study was performed .The information of 5 176 advanced age pregnant women in July 2003 to August 2015 from Ningbo Women and Children Hospital were collected and analyzed .Grouped the patients by age , using chi-square analysis , comparing the difference of abnormal rate of target chromosomes (13, 18, 21) and sex chromosomes (X and Y) between the adjacent two age groups .Results Total of 15 408 cases were screened.Among these, 262 cases were diagnosed with abnormal chromosome .The positive rate was 1.70%.Total of 5 176 advanced age pregnant women were included , 82 women were found with abnormal target chromosomes (13, 18, 21) and sex chromosome.The positive rate was 1.58%(82/5 176).For age groups, the positive rates were 0.95%(11/1 156), 0.94%(9/954), 0.87%(10/1 144), 2.16%(14/648), 2.16%(10/464), 2.51%(10/399) and 4.38%(18/411) respectively.Chi-square analysis results showed that the positive rate between group of 37 and 38 was significant difference (chi-square value of 5.181,P value of 0.023).There were no significant differences among all remained groups ( chi-square value: <0.001, 0.028, <0.001, 0.117, 2.129 respectively, P value: 0.985, 0.868, 0.995, 0.733, 0.145 respectively ) .Conclusion It is worthwhile to elevate the age of pregnant women up to 38 years old as the age line for the indications of amniotic fluid chromosome analysis .

Objective To investigate the correlation between vertebral artery dominance (VAD) and posterior circulation ischemic stroke (PCIS).Methods The consecutive patients with acute ischemic stroke hospitalized from November 2013 to October 2015 were collected.All patients underwent MRI and magnetic resonance angiography (MRA).The dominant vertebral artery was defined as having the larger diameter if left and right diameter difference ≥0.3 mm or the vertebral artery connected to the basilar artery in a more straight fashion if the diameter difference ＜ 0.3 mm.They were divided into either an anterior circulation ischemia stroke (ACIS) group or a PCIS group according to the classification criteria of Oxfordshire Community Stroke Project (OCSP).A multivariate logistic regression analysis was performed to investigate the correlation between VAD and PCIS.Results A total of 226 patients withacute ischemic stroke were enrolled,including 172 patients (76.1％) in the ACIS group and 54 (23.9％) in the PCIS group.Fifty-four patients (23.9％) had VAD,including 38 (70.3％) on the left and 16 (29.7％) on the right.The proportion of the patients with VAD in the PCIS group was significantly higher than that in the ACIS group (55.6％ vs.14.0％;x2 =39.115,P ＜ 0.001).Multivariate logistic regression analysis showed that VAD was an independent risk factor for patients occurring PCIS (odds ratio,13.60,95％ confidence interval 6.90-27.01;P＜0.001).Conclusions VAD is closely associated with the occurrence of PCIS,and it is an independent risk factor for PCIS.

Objective To explore the curative effect of quetiapine combined with paroxetine in the treatment of bipolar depression,and to provide reference for the choice of clinical treatment.Methods According to the digital table,96 patients with bipolar disorder were randomly divided into observation group and control group,48 cases in each group.The control group was treated with quetiapine orally,the observation group was treated with quetiapine combined with paroxetine.After 6 weeks of treatment,the clinical curative effect,the Montgomery Asberg Depression Rating Scale and the Beck pull fan Sen Mania Rating table score before and after treatment were compared between the two groups.At the same time,the adverse reactions of the two groups were compared.Results After 6 weeks of treatment,the total effective rate of the observation group was 70.83％,which was significantly higher than 50.00％ in the control group,the difference was statistically significant(x2 =4.356,P =0.037).After 6 weeks of treatment,the Montgomery Asberg Depression Rating quantity score in the observation group was (14.01 ± 2.95) points,which was significantly lower than (18.07 ± 3.05)points in the control group,the difference was statistically significant (t =5.527,P =0.036).The Baker-pull fan Sen Mania Rating score before and after treatment between the two groups had no statistically significant differences.There were no serious adverse reactions in the two groups.Conclusion Quetiapine combined with paroxetine can effectively inhibit bipolar depressive episodes,avoid manic episodes,has good clinical efficacy and high safety,it is worthy of popularization and application.