Objective To summarize the experience of multidisciplinary consultation for prenatal fetal deformity, and to explore the mode suitable for China. Methods The Obstetrics and Gynecology Hospital of Fudan University and Children's Hospital of Fudan University established a joint multidisciplinary consultation center, including obstetrics, pediatrics, pediatric surgery, ultrasound and other departments. A total of 3 378 pregnant women visited the consultation center from July 31, 2003 to August 1, 2013. After consultation, treatment was divided into three classes:pregnancy termination, pregnancy continuation and perinatal treatment. Follow-up was made through correspondence and telephone communication. Retrospective analysis on reasons for consultation, fetal structural abnormalities of the classification system, chronological order of abnormalities, gestational weeks of diagnosis, maternal-related factors, treatment and prognosis was performed. Results (1) Reasons for consultation:Among 3 378 women undertaking prenatal multidisciplinary consultation, 3 243 (96.00%) were due to fetal factors, and 135 (4.00%) were due to maternal factors. (2) Classification of fetal structural abnormalities:Among the 3 243 cases undertaking consultation with fetal factors, fetal abnormality was found in 80.85%(2 622/3 243). The most common were neurological abnormalities(23.19%, 608/2 622), followed by urinary tract malformation (20.25%, 531/2 622) and cardiovascular malformation (15.48%, 406/2 622). These were followed by digestive system malformation, limb deformities and space-occupying lesions. There were 156 cases of multiple malformations. (3) Average gestational weeks for diagnosis of fetal deformity:The 2 622 cases of fetal deformity were diagnosed at a mean (26.7± 2.1) of gestational weeks (21.1–30.4 weeks). Urinary tract malformations were detected at (24.0±0.7) weeks, whereas digestive system malformations were detected at (28.3±2.6) weeks. (4) Induced labor:Induced labor cases accounted for 35.66% (935/2 622), among which, 92 cases were fetal intrauterine death and 843 cases were active choice. The several highest induced labor rates resulted from multiple malformations (75.64%, 118/156), abdominal wall defects (62.22%, 28/45), diaphragmatic hernia (61.54%, 24/39), cleft lip and palate (55.32%, 26/47) and cardiovascular malformations (49.51%, 201/406). For nervous system (27.80%, 169/608), urinary tract (25.80%, 137/531) and digestive system malformations (26.94%, 66/245), induced labor rates were <30%. For abdominal lesions (14.04%, 25/178) and sacrococcygeal teratoma (13.64%, 3/22), induced labor rates were<15%. (5) Continuation of pregnancy in 1 687 cases:Cesarean section was conducted in 1 046(61.94%). Neonatal death occurred in 117(6.94%).(6) Perinatal treatment:Twenty-one cases were treated during pregnancy, including thirteen cases with fetal ascites and hydrothorax treated by drainage, five cases with fetal anemia treated by intrauterine transfusion and three cases with fetal tachycardia treated by digoxin. Ten cases were treated by ex-utero intrapartum treatment. After birth, 297 newborns immediately underwent neonatal surgery. Among these, 259 cases underwent radical surgery, eleven palliative surgery, and sixteen elective surgery after follow-up. Conclusions Prenatal multidisciplinary consultation can make comprehensive multidisciplinary assessment of fetal prognosis and improve the diagnosis and treatment of structural malformations.

An experiment was conducted using cultivated Glycyrrhiza uralensis in age of one year to study the effects of abscisic acid (ABA) on chemical components content and color of G. uralensis. By using different concentrations of ABA spraying on leaves, the change of the chemical component content was analyzed within 45 d after ABA stimulation, and the effects on quality were studied combined with colorimetric analysis data. It turned out that in some sense the content of glycyrrhizic acid and liquiritin had increased within 45 d, especially for liquiritin. After high concentrations of ABA (3.96 mg · L(-1)) stimulating, the content of glycyrrhizic acid rose 52% while liquiritin up 392% within 30 d. Then they both showed a decline in the content of glycyrrhizic acid and liquiritin on 45 d. Color index values of a* and b* were all significantly higher than that of the control group within 45 d, which meant the color of powders turned toward red and yellow. The conclusion was that ABA (3.96 mg · L(-1)) stimulating could not only improve the quality in the traditional sense through the color of G. uralensis, but also in the modern sense by improving the content of glycyrrhizic acid and liquiritin.
Abscisic Acid ; pharmacology ; Color ; Drugs, Chinese Herbal ; chemistry ; Flavanones ; analysis ; Glucosides ; analysis ; Glycyrrhiza uralensis ; chemistry ; drug effects ; growth & development ; Glycyrrhizic Acid ; analysis ; Plant Growth Regulators ; pharmacology

Objective To establish the in vivo models of adriamycin(ADR)-induced cardiotoxicity in rabbits, investigate the protective effect of oxymatrine (OMT) on ADR-induced cardiotoxicity, and explore the possible mechanism. Methods Twenty-six rabbits were randomly divided into ADR group (n=8, 2 mg/kg ADR), OMT group (n=5, 10 mg/kg OMT), ADR + OMT group (n=8, 10 mg/kg OMT was injected 30 min before ADR injection) and saline group (n=5, same quantity of normal saline), and rabbits in each group were infused with medicine or normal saline through ear marginal vein once a week for 8 weeks. The apoptosis of myocardial cells was detected by TUNEL methods, and the activity of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) was determined. Results After treatment, the body weight of ADR group was significantly lower than that of the other groups(P < 0.05), the activity of SOD and GSH-Px significantly decreased and the apoptosis index (AI) was significantly higher than that of the other groups(P <0.01). There were similar while minor changes in ADR + OMT group. There was no significant adverse effects in OMT group. Conclusion OMT protects heart from adriamycin-induced injury in rabbits, which may relate to the decrease in level of antioxidant and apoptosis of myocardial cells.

"Prescription embodied in Preparation", Chinese medicine preparation, aims to study the specific form of Chinese medicine from raw materials to preparation for acting on patients directly. Its development has gone through three stages according to the characteristics of raw materials pretreatment, including "direct smash and initial extraction for Chinese materia medica", "Extensive extraction and preliminarily impurity for Chinese materia medica" and "Refining and purification for Chinese materia medica". With the development of new technologies and new theories, Chinese medicine preparation emerged in a new stage: structural components of Chinese medicine, with the characteristics of definited material basis, clear mechanisms, determined ADME/T properties, reasonable drug release system designs and scientific productions quality controls. This requires multidisciplinary to solve systemly the problems of Chinese medicine preparation. In this article, we reviewed the development of Chinese medicine preparation in different times, and analyzed the development and the characteristics of Chinese medicine preparation; and mainly focused on a fact that multidisciplinary promoted the study and development of Chinese medicine preparation, especially in structural components of Chinese medicine. It provides development direction and theoretical basis for Chinese medicine preparation.
Materia Medica ; isolation & purification ; Medicine, Chinese Traditional ; Technology, Pharmaceutical

Objective To evaluate the clinical significance of CT angiography(CTA)in the diagnosis of arterioportal shunts(APS)associated with hepatocellular carcinoma(HCC).Methods One hundred and twenty-seven consecutive HCC patients accepted both dynamic enhancement CT and DSA examinations.The interval between CT and DSA exam was from 3 to 15 days.Based on transverse CT images in hepatic artery phase,CTA was performed for all the patients.By contrast with DSA results,the capabilities of transverse CT and transverse images combined with CTA in APS diagnosis were analyzed. Results In all 127 HCC cases,52 cases with APS were confirmed by DSA(40.94%),33 with central type of APS and 19 with peripheral type.Diagnostic sensitivity of APS based on transverse CT and combined CTA with transverse CT images were both 94.23%(49/52).However,specificity was 84.00%(63/75) and 97.33%(73/75),respectively,accuracy was 88.19%(112/127)and 96.06%(122/127),the predictive value of positive cases was 80.33%(49/61)and 96.08%(49/51),and the predictive value of negative cases was 95.45%(63/66)and 96.05%(73/76).Combined with CTA,false positive cases of 4 central type of APS and 6 peripheral type of APS were excluded which were demonstrated by transverse CT images.By contrast with DSA,the coincidence rate of the type of APS diagnosed by transverse images combined with CTA was 88.46%(46/52),including 90.91%(30/33)of central type of APS and 84.21%(16/19)of peripheral type.The supplying arteries of central type of APS were intuitively displayed by CTA in 23 cases,19 from proper hepatic artery and 4 from gastro-duodenal artery.Conclusion CTA techniques based on the dynamic enhancement CT exams could effectively promote the specificity and the accuracy of APS diagnosis.

The fruit of Lycium ruthenicum is a common folk medicine in China. Now it is popular for its antioxidative effect and other medical functions. The adulterants of the herb confuse consumers. In order to identify a new adulterant of L. ruthenicum, a research was performed based on NCBI Nucleotide Database ITS Sequence, combined analysis of the origin and morphology of the adulterant to traceable varieties. Total genomic DNA was isolated from the materials, and nuclear DNA ITS sequences were amplified and sequenced; DNA fragments were collated and matched by using ContingExpress. Similarity identification of BLAST analysis was performed. Besides, the distribution of plant origin and morphology were considered to further identification and verification. Families and genera were identified by molecular identification method. The adulterant was identified as plant belonging to Berberis. Origin analysis narrowed the range of sample identification. Seven different kinds of plants in Berberis were potential sources of the sample. Adulterants variety was traced by morphological analysis. The united molecular identification-origin-morphology research proves to be a preceding way to medical herbs traceability with time-saving and economic advantages and the results showed the new adulterant of L. ruthenicum was B. kaschgarica. The main differences between B. kaschgarica and L. ruthenicum are as follows: in terms of the traits, the surface of B. kaschgarica is smooth and crispy, and that of L. ruthenicum is shrinkage, solid and hard. In microscopic characteristics, epicarp cells of B. aschgarica thickening like a string of beads, stone cells as the rectangle, and the stone cell walls of L. ruthenicum is wavy, obvious grain layer. In molecular sequences, the length of ITS sequence of B. kaschgarica is 606 bp, L. ruthenicum is 654 bp, the similarity of the two sequences is 53.32%.
Berberis ; classification ; cytology ; genetics ; China ; DNA Barcoding, Taxonomic ; methods ; DNA, Plant ; chemistry ; genetics ; DNA, Ribosomal Spacer ; chemistry ; genetics ; Drug Contamination ; Drugs, Chinese Herbal ; isolation & purification ; standards ; Lycium ; classification ; cytology ; genetics ; Medicine, Chinese Traditional ; Phylogeny ; Sequence Analysis, DNA ; Species Specificity

OBJECTIVETo study the influence of Suspension Pancreatic-Duct-Jejunum End-to-Side Continuous Suture Anastomosis (SPDJCS) on the incidence of pancreatic fistula after pancreaticoduodenectomy, and to analyze its applicability, safety, and efficacies.

METHODSA prospective controlled trial was conducted with 165 cases receiving pancreaticoduodenectomy in the Department of Hepatopancreatobiliary Surgery from January 2010 to May 2012. The patients were divided into Group A (end-to-end/end-to-side invaginated anastomosis, n=52), Group B (end-to-side mucosal anastomosis, n=48), and Group C (SPDJCS, n=65). The preoperative data, intraoperative data, and operative outcomes (incidence of pancreatic fistula, operation time, intraoperative blood loss, peritoneal drainage, peritoneal hemorrhage, peritoneal abscess, delayed gastric emptying, pulmonary infection, postoperative infection, blood transfusion, and perioperative mortality) were compared among the 3 groups.

RESULTSThe total incidence of pancreatic fistula was 13.9% (23/165) in all the 165 patients. The incidence in Group A and Group B was 23.1% (12/52) and 18.8% (9/48), both higher than that in Group C [3.1% (2/65), both P<0.05]. Group C showed significantly better outcomes than group A and B in terms of the operation time (5.5±1.2 hours vs. 6.1±1.1 hours, 5.5±1.2 hours vs. 6.3±1.5 hours), volume of blood loss (412.0±205.0 mL vs. 525.0±217.0 mL, 412.0±205.0 mL vs. 514.0±217.0 mL), and postoperative drainage amount of plasma tubes (175.0±65.0 mL vs. 275.0±80.0 mL, 175.0±65.0 mL vs. 255.0±75.0 mL) (all P<0.05), while Group A and Group B displayed no difference in these aspects (P>0.05). As complications other than pancreatic fistula were concerned, the three groups were not different from each other (P>0.05).

CONCLUSIONSSPDJCS may have the effect of reducing the incidence of pancreatic fistula after pancreaticoduodenectomy. It could be safe, practical and convenient technique of anastomosis for pancreaticojejunostomy.

Adult ; Aged ; Anastomosis, Surgical ; methods ; Female ; Humans ; Jejunum ; surgery ; Male ; Middle Aged ; Pancreatic Ducts ; surgery ; Pancreaticoduodenectomy ; adverse effects ; methods ; Prospective Studies ; Suture Techniques

To optimize indices of molecular identification for authentication of Ginseng Radix et Rhizoma and Panacis Quinquefolii Radix, four indices, including sequence similarity, specific positions, genetic distance and phylogenetic tree, were compared based on trnL-trnF sequences. Total DNA was extracted from Ginseng Radix et Rhizoma and Panacis Quinquefolii Radix, and trL-trnF sequences were amplified and sequenced. Sequence similarity was calculated by BLAST analysis. Specific positions were compared by DNAman software. Genetic distance and phylogenetic tree were analyzed by Mega software. The results showed that the inter-specific and intra-specific similarity of P. ginseng and P. quinquefolius respectively was 100% and 99. 6%. There were four specific positions at G153A, T463A, C732G and T818C. The inter-specific genetic distance (0) of trL-trnF sequences was lower than intra-specific genetic distance (0. 004). P. ginseng can be distinguished from P. quinquefolius based on the phylogenetic tree. It is concluded that Ginseng Radix et Rhizoma and Panacis Quinquefolii Radix can be authenticated by identification indices of sequence similarity, specific positions, genetic distance and phylogenetic tree. Index of specific positions based on trnL-trnF sequences is the most efficient index to authenticate Ginseng Radix et Rhizoma and Panacis Quinquefolii Radix.
Chloroplasts ; genetics ; DNA Barcoding, Taxonomic ; methods ; Panax ; classification ; genetics ; Phylogeny ; Plant Proteins ; genetics ; Rhizome ; classification ; genetics

Objective To investigate the regional left ventricular function after mitral valve replacement with and without chordal preservation by strain rate imaging. Methods A total of 55 patients undergoing mitral valve replacement were enrolled. Twenty underwent complete excision of the subvalvular apparatus (group A), 20 preserved the posterior chordopapillary apparatus only (group B) and the other 15 underwent total chordal preservation (group C). Systolic peak strain rate (SRs) were measured preoperatively, at 7-10 days and 3 months after operation. Results Before operation, SRs had no differences between different segments of the left ventricular in each group (F=0.37, 0.74, 0.90, all P>0.05). At 7-10 days after operation, SRs in the most segments of left ventricular were signiifcantly lower than those of before operation (F=3.91, 8.12, 7.57, all P<0.05). At 3 months after operation, SRs in some segments of left ventricular were signiifcantly higher than those of preoperation in each group (t=2.12, 3.19, 3.25, 2.08, 2.78, 4.79, 2.81, 2.58, 2.87, 1.60, 0.34, 1.04, 0.73, 0.70, 1.68, all P<0.05). SRs had no signiifcant differences between each segment of left ventricular in group C (F=1.76, P>0.05). By contrast, SRs in some segments of left ventricular were different from those of other segments in group A and group B (F=17.8, 8.52, both P<0.05). Conclusion Comparing to conventional mitral valve replacement and mitral valve replacement with preservation of posterior subvalvular apparatus, mitral valve replacement with preservation of total subvalvular apparatus makes the papiltary function preserved completely, which are beneifcial for the motor coordination of left ventricular wall and the recovery of regional left ventricular function.

Objective To study the relationship of clinical manifestation and pathological changes and prognosis in Henoch-Schonlein purpura nephritis(HSPN)in children.Methods Clinical and pathological characteristics of 42 children with HSPN were analysed.Among them,40 children were detected of angiotensin-convertion enzyme(ACE)gene and had been followed up.Results Among them,there were 9 cases of level Ⅰof pathological types,21 cases of level Ⅱ,12 cases of level Ⅲ,but no cases of level Ⅳ.Ⅰand Ⅱ level were found in those cases of clinical manifestation with solitary hematuria and albuminuria.Pathological grades were Ⅰ,Ⅱ and Ⅲ levels in the cases of hematuria and albuminuria.Pathological types of nephrotic syndrome(NS)were Ⅱ and Ⅲ level,which were of more gross hematuria than those of other grades.ACE gene DD had serious pathological damnification.Conclusions Change of pathology cannot only be anticipated by clinical manifestation of HSPN.But if pathological damnification gets more serious,the albuminuria gets more serious.Gross hematuria and albuminuria can serve as indicators of biopsy.NS of ACE DD type have serious pathological damnification.Children with HSPN has favourable prognosis in the future.