This paper introduced the concept of accumulation-dispersing method and its theoretical basis as well as clinical application in the treatment of gland diseases. With three diseases, which were the Sjogren’s syndrome, cystic hyperplasia of breast and benign prostatic hyperplasia, as clues, common characteristics from etiology, pathology and pathogenesis were elaborated from the anatomical features, pathological characteristics and meridian pathways for the gland diseases. The disease pathogenesis always belonged to“mass” and“knot” of traditional Chinese medicine (TCM). The detailed clinical applications were as follows. For the pattern of blood stasis, the treatment principle was to promote blood circulation and to resolve masses. For the pattern of phlegm, the treatment principle was to reduce phlegm and to resolve masses. For the pattern of heat, the treatment principle was to clear heat, to relieve toxin and to resolve masses. For patients of“tumor” or“phthisis”, the treatment principle was to strengthen vitalqi and to eliminate stagnation. Worm medicine should also be combined during accumulation-dispersing. This paper provided referential ideas and methods for TCM treatment of gland diseases.

The latest progress of modern radiotherapy techniques in the management of breast cancer after breast-conserving surgery was introduced first.Then the clinical effect and the adverse effect of these advanced techniques were analyzed.Finally,in order to provide an up-to-date evidence based data on the role of modern radiotherapy techniques in the management of breast cancer,the importance of how to choose appropriate patients for these advanced techniques was discussed.

BACKGROUND: Changes of elastic fibers in middle cerebral artery(MCA)is close related withthe aged cerebrovascular disease.OBJECTIVE: To observe the changes of elastic fibers of MCA in different aging rats.DESIGN: A descriptive and controlled study based on experimental animals.SETTING: Department of anatomy and central laboratory in a university.MATERIALS: Totally 36 healthy Wistar rats with either gender, weighing 200 - 280 g, were selected from the Animal Institute of the third medical military university of Chongqing[certification SCXX (army) 2002-007].INTERVENTIONS: Changes of elastic fibers of MCA of different aging rats were observed with light microscope, transmission electron microscope and image analysis system. MAIN OUTCOME MEASURES: ①) Major outcome: changes of elastic lamella in MCA of different aging rats; ②) Secondary outcome: ultramicrostructural changes of internal lamella under the transmission electron microscope. RESULTS: With the increase of age, the folded extent and quantity of internal elastic lamella were decreased, and the content of elastic fibers were also decreased significantly( P ＜ 0.01 ). However, the ratio of collagen fibers to elastic fibers was increased significantly( P ＜ 0.01 ) . In the aging group above 24 months, the internal elastic lamina thinned, delaminated and disrupted, and the lipid deposited in it. Endothelial cells and smooth muscle cells passed through the internal elastic lamina. CONCLUSION: Changes of elastic fibers may be related with the increased susceptibility to the cerebrovascular disease in aged people.

Aim To investigate the ameliorative effects pseudoberberine(Y53), a berberine(BBR) analogue, on diabetic nephropathy( DN) in streptozotocin( STZ)-induced diabetic mice. Methods Diabetes mellitus ( DM) of the C57BL/6J mice was induced by intraper-itoneal injection of STZ at 120 mg·kg-1 . The diabetic animals were divided into 4 groups, which were orally treated with saline, 50 mg · kg-1 of BBR, 50 mg · kg-1 of Y53 or 5 mg · kg-1 of rosiglitazone ( ROSI ) , respectively. During and after the experiment, the u-rine, blood, serum and kidney of the animals were harvested for determination of relevant parameters by kits. Kidney tissues of the mice were subjected to pathological examination by hematoxylin & eosin( HE) staining;mRNA and protein expression levels of target genes in the kidney were determined by quantitative re-al-time reverse transcriptase-polymerase chain reaction ( qRT-PCR) and Western blot, respectively. Results Y53 greatly reduced the fasting blood glucose ( FBG ) and glycosylated hemoglobin( GHb) , improved diabet-ic symptoms such as polyphagia and polyuria in the di-abetic mice( P<0. 01 vs DM control group) . Y53 po-tently reduced the blood urea nitrogen ( BUN ) , serum creatinine( Scr) , 24 h urinary protein, kidney index, serum and kidney advanced glycation end-products ( AGEs) and nitric oxide( NO) , as well as kidney cho-lesterol( CHO ) and triglyceride ( TG ) contents ( P <0. 05 or P<0. 01 vs DM control group) . In the patho-logical examination, Y53 greatly restored kidney mor-phology and suppressed glomerular sclerosis( P<0. 001 vs DM control group). In addition, Y53 significantly reduced the renal expression of fibrosis-related genes, such as the transforming growth factor-β1 ( TGF-β1 ) and smad2(P<0. 01 vs DM control group). The reno-protective efficacies of Y53 were superior to those of BBR and ROSI in our study ( P<0. 05 or P<0. 01 ) . Conclusions The BBR analogue Y53 has potent ac-tivities in ameliorating renal injury and restoring renal function in STZ-induced diabetic mice. Y53 may be developed as a novel kind of agent for the treatment of DN in the future.

Transforming growth factor β (TGF-β) is a growth factor regulating cell proliferation, differentiation and the production of extracellular matrix. Vascular remodeling is a common pathological process of many cardiovascular diseases. TGF-β can accelerate vascular adventitial fibroblasts proliferation, induce the transdifferentiation of vascular adventitial fibroblasts into myofibroblasts, and promote the vascular remodeling and a series of changes in vascular injury sites. Smad proteins involved in TGF-β intracellular signal transduction can regulate the expression of TGF-β target gene by binding with differenot proteins, so as to perform multiple biological functions. This review introduces the influence of TGF-β on the proliferation, migration and phenotype traasformation of vascular adventitial fibroblasts. © 2006 Editorial office of Foreign Medical Sciences.

Objective To study the effect of once-weekly injection of recombinant human parathyroid hormone rhPTH(1-34) on the healing of bone fracture in rats.Methods Fifty male 3-month old SD rats were used in this study to produce unilateral tibial fracture and received internal fixation with a Kirschner needle.Based on the dose and frequency of rhPTH (1-34) injection, the rats were randomly divided into five groups (n=10 each) as follows: subcutaneous injec-tions of saline, and rhPTH in a dose of 10, 20, 10, and 20 μg/kg/d.After 4 weeks of treatment, the rats were euthana-tized and the fractured tibia were assessed by X-ray, dual energy X-ray absorptiometry ( DXA) ,micro-computed tomography ( microCT) and three-point bending test.Results The fracture healing in the 20μg/kg/w group was better than the saline group.The fracture healing in the 20μg/kg/w group was as well as the 10 μg/kg/dgroup.The BMD of 20μg/kg/w group was 26.2%higher than the saline group.The mineralized callus volume in the 20μg/kg/w group was 51.4%higher than the saline group.The total callus volume in the 20μg/kg/w group was 21.6%higher than the saline group.The ultimate load of the 20 μg/kg/w group was 29.3% higher than the saline group.There was no significant difference between the 20 μg/kg/w group and 10 μg/kg/d group in BMD, bone micro-architecture, and biomechanical strength ( P >0.05 ) . Conclusions Once weekly injection of rhPTH (1-34)can promote the bone fracture healing.

Objective To investigate the early surgical outcomes of 86 patients with complete atrioventricular septal defect.Methods Between January 2007 and December 2014,consecutive 86 cases received surgical repair in our department.There were 44 male patients,and 42 female patients.Two-patch repair was performed in 69 cases,and modified single-patch repair in 17 cases.The mean age,height,and weight at the time of operation were (32.3 ± 46.5)months with a range from 1 month to 17 years,(82.1 ±27.6) cm with a range from 53 to 165 cm,and (10.8 ± 8.7) kg with a range from 4.1 to 43 kg,respectively.Rastelli A type was found in 67 cases,B type in 15 cases,and C type in 4 cases.Down's syndrome was complicated in 6 cases.Preoperative mild regurgitation of common atrioventricular valve was shown in 32 cases,moderate regurgitation in 38 cases,and moderate to severe regurgitation in 16 cases.Mild pulmonary hypertension was observed in 15 cases,moderate in 54 cases,and severe in 17 cases.Results After operation,all patients were sent into intensive care units (ICU).The mean duration mechanical ventilation,ICU stay,and hospitalization were (30.9 ± 47.7) h with a range from 2.5 to 244 h,(87.7 ± 76.8) h with a range from 14 to 306 h,and (16.4 ±9.2)d with a a range from 6 to 50 d,respectively.We encountered 4 operatively mortalities (4.7％),including 3 in two-patch repair group,and 1 in modified single-patch repair group.The cause of death was mitral regurgitation.Conclusions Modified single-patch and two-patch technique have a satisfied early outcomes.

Objective The purpose of this study was to develop a high-throughput micro-plate radiobinding assay (RBA) of glutamic acid decarboxylase antibody (GAD-Ab) and to evaluate its clinical application. Methods 35labeled GAD65 antigen was incubated with sera for 24 h on a 96-well plate, and then transferred to the Millipore plate coated with protein A, which was washed with 4℃ PBS buffer, and then counted by a liquid scintillation counter. The GAD-Ab results were expressed by WHO standard unit (U/ml). A total of 224 healthy controls, 162 patients with type 1 diabetes mellitus(T1DM) and 210 patients with newly diagnosed type 2 diabetes (T2DM) were recruited. A total of 119 TI DM and healthy cases with gradually changing GAD-Ab levels were selected to compare the consistency of micro-plate RBA with conventional radioligand assay (RLA). Blood samples were obtained from the peripheral vein and finger tip in 32 healthy controls, 35 T1DM and 24 T2DM patients, and tested with micro-plate RBA and then compared with the conventional RLA to investigate the reliability of finger tip sampling. Linear correlation,student's t-test, variance analysis and receiver operating characteristic (ROC) curve were performed using SPSS 11.5. Results (1) The optimized conditions of micro-plate RBA included 2 μl serum incubated with3 ×104 counts/min 35S-GAD for 24 h under slow vibration, antigen-antibody compounds washed 10 times by 4℃ PBS buffer, and radioactivity counted with Optiphase Supermix scintillation liquid. (2)The intra-batch CV of the micro-plate RBA was 3.8%- 10.2%, and the inter-batch CV was 5.6%- 11.9%. The linearity analysis showed a good correlation when the GAD-Ab in serum samples ranged from 40.3 to 664 U/ml and the detection limit of measurement was 3.6 U/ml. The results from Diabetes Autoantibody Standardization Program (DASP) 2005 showed that the sensitivity and specificity for GAD-Ab were 78% (39 positive among 50 new-onset T1DM) and 98% (2 positive among 100 healthy controls). The results of GAD-Ab obtained with micro-plate RBA and RLA were closely correlated (r=0.915,P<0.001) with a high concordance level of 97.5% and a Kappa value of 0.95. (3)TI DM and T2DM patients showed higher positive rates for GAD-Ab than the healthy controls(46.9% and 5.2% vs 0.89% ,X2=123.5 and 10. 1 ,P <0.001 and <0.01, respectively). (4)The consistency of GAD-Ab measurement with RBA using finger tip blood and RLA measurement using venous blood was 96.7% (r =0.946,P <0.001, Kappa value: 0.905). Conclusions The micro-plate RBA of GAD-Ab has high sensitivity, specificity and reproducibility, and can be measured with finger tip blood sampling. It might be a better alternative for clinical practice.

Objective To explore the relationship between immune functions of patients with acute leukemia (AL) and invasive fungat infection (IFI). Methods T lymphocyte subpopulations and natural killer (NK) cells in 61 AL patients complicated with IFI at first visit, AL remission, the time of IFI onset and 4 weeks after antifungal treatment were measured by flow cytometry. Meanwhile,levels of IgG, IgM and IgA were detected by immunoturbidimetry. The statistical analysis was done using ANOVA, t test and chi-square test. Results CD3+ , CD3+ CD4+ , CD8+ CD28+ T lymphocyte as well as CD4+/CD8+ ratio at the time of IFI onset in AL patients were all lower than those at first visit, AL remission and 4 weeks after antifungal treatment (F= 25.6,26.6,13. 1,167.9; all P＜0.05), while CD8+ CD28- T lymphocyte were higher than those at first visit, AL remission and 4 weeks after antifungal treatment (F= 220.2,P＜0.01). CD3+ , CD3+ CD4+ and CD4 + /CD8+ ratio of patients who responded effectively to antifungal treatment were all higher than those of non-responders (t=3.75,8. 61,3.17; all P＜0.05). The serum levels of IgG, Igm and IgA at first visit, ALremission, the time of IFI onset and 4 weeks after treatment were similar (F=0.78,0.72,0.81; all P ＞0.05). The effect rate of antifungal therapy in AL remission group was higher than that in nonremission group (87% vs 53%,x2 = 7.62, P＜0.05). Conclusions The cellular immune functions are impaired severely in AL patients complicated with IFI, while the levels of IgG, IgM and IgA are similar during IFI. Therefore, the efficacy of antifungal therapy may partly depend on the recovery of cellular immune functions and remission of AL.

Objective To establish a treatment proposal of thyroid adenoma by using percutaneous radiofrequency ablation(RFA) and investigate its techniques and skills, means and steps, and safety and efficacy. Methods Contrast-enhanced ultrasound-guided percutaneous RFA of thyroid adenomas were conducted on 202 patients by using an auto-controlled bi-polar electrode system. The indications of thyroid RFA,the optimal puncture route,the ways of anesthesia administration, protection of vital neck vessels and recurrent laryngeal nerve(RLN) and reduction of bleeding from core biopsy, indicators of ending ablation procedure following a complete ablation were investigated and analyzed. Resalts An adenoma smaller than 20 mm in maximal diameter was the optimal candidate for RFA. Either of two puncture routes could be selected upon the target lesion's location. Areas surrounding to the thyroid capsule needed adequate local anesthesia to kill pain. Liquid-isolating maneuver could effectively protect carotid artery and RLN from core needle cutting and electrode heating injury. Advanced block of supplying arteries with heating markedly reduced bleeding involved in the biopsy. Multipoint and multicenter ablation was essential to a complete coagulation. Filling-defect in the ablated adenoma on CEUS was the key sign to terminate ablation procedure. Conclusions Percutaneous bi-polar RFA was proved feasible, effective, safe and supermicroinvasive for treating thyroid adenoma under the way stated here of puncture and technical points and use of CEUS for monitoring.