OBJECTIVE:To establish a HPLC method for determining the content of icariin in Liuweixianshenzhi tablets METHODS:The detecting conditions of HPLC were as follows:C18 column;mobile phase,methanol-0 1mol/L sodium dihydrogen phosphate(60∶40);flow rate,1ml/min;detecting wavelength 270nm RESULTS:The calibration curve revealed linearity in the range of 0 12～0 83?g/ml(r=0 9 997) The mean recovery was 100 2% and the repeatability was satisfactory(RSD=0 71%) CONCLUSION:This detecting method is simple,rapid and satisfactory in repeatability,and can be used for quality control of Liuweixianshenzhi tablets

Objective: To analyze the correlation of the statuses of different lumpectomy margins and the expression of estrogen receptor (ER), progestogen receptor (PR) and HER-2 in breast conserving surgery, so as to explore the suitable width for negative margin in different approximate molecular subtypes of breast cancer. Methods: A total of 80 patients who met the standard of breast conserving therapy were included in our study. The width of the surgical margin was 2 cm. Modified radical mastectomy was performed when the intraoperative frozen section examination showed positive margins. Margins of different widths (5 mm, 10 mm, 15 mm, and 20 mm) at six directions (superior, inferior, left, right, anterior, and posterior) were examined pathologically after operation. The patients were divided into four approximate molecular subtypes according to the lmmunohistochemical examination of ER, PR and HER-2. The widths of negative margins in the four subtypes were analyzed statistically to select the suitable width of surgical margin for different subtypes. Results: The negative rates of 5 mm, 10 mm, 15 mm, and 20 mm margin widths were 51.25%, 81.25%, 97.50% and 98.75%, respectively. The negative rates for 15 mm, 20 mm margins were significantly higher than those for 5 mm, 10 mm margins (P<0.05). The negative rate was 97.4% on the width of 10 mm in Luminal-A, significantly higher than that on the width of 5 mm (P<0.05) and not significantly different from that on the width of 15 mm. The negative rate was 100% on the width of 15 mm in patients with triple negative breast cancer, significantly higher than that on the width of 10 mm (P<0.05). There were no significant differences in the negative rates between different widths in both Luminal-B and HER-2+ groups. Conclusion: The widths of negative surgical margins are different for different subtypes: 10 mm might be suitable for margin width of Luminal-A and 15 mm for that of triple negative breast cancer. As for Luminal-B and HER-2 + types, 20 mm or even wider margins might be suitable.

Objective To investigate the associations between levels of perioperative biochemical markers of the liver,kidney,lung and heart and death within 3 months postoperatively in the senile patients with femoral intertrochanteric fracture.Methods A retrospective study was conducted on the 153 senile patients with femoral intertrochanteric fracture who had been treated at Nanfang Hospital from January 2010 to January 2012.They were 71 men and 82 women,with an average age of 83.1 years.There were 70 stable and 83 unstable fractures.At preoperation (within 24 h after admission),and 24 h,25 to 48 h and 72 h postoperation,all the patients had blood examinations of biochemical markers of the liver [alanine aminotransaminase (ALT)],kidney (creatinine and urea nitrogen),lung (PaO2) and heart [brain natriuretic peptide (BNP)].The levels of biochemical markers at all time points and clinical data were compared between the living patients and those who died within 3 months postoperatively.Univariate and multivariate logistic regression analyses were conducted to estimate the independent risk factors for mortality within 3 months postoperatively.Results Of the 153 patients,32 (20.9％) died within 3 months postoperatively,including 10 men and 22 women.In the dead and surviving patients,there were respectively 25 and 17 cases who were rated as level Ⅲ or Ⅳ by ASA (American Society of Anesthesiologists).The levels of ALT,creatinine,urea nitrogen,and BNP increased to different extents while the level of PaO2 decreased postoperatively in both the dead and surviving patients.The differences between the dead and surviving patients were statistically significant (P ＜ 0.05).Multivariate logistic regression analysis showed poor preoperative physical condition (ASA level Ⅲ or Ⅳ),increased creatinine level at 25 to 48 h postoperation,decreased PaO2 at 72 h postoperation,and increased BNP level at 24 h postoperation were independent risk factors for early mortality in senile patients with femoral intertrochanteric fracture.Conclusions Femoral intertrochanteric fracture in senile patients may lead to changes in the liver,kidney,lung and heart.Prompt and dynamic monitoring of the levels of PaO2,creatinine and BNP may provide timely prediction of the poor prognosis.

This paper introduces the wavelet transform with multiresolution for liver cancer CT image enhancement. As the wavelet transform with compact support, orthogonality and approximately symmetry, SymletsA (sym4) wavelet family is applied to the two-layer multiscale decompose of the CT image. The decomposed wavelet coefficients are processed with the threshold values of 550, 350 and 250, with the low -frequency region intensified and the high-frequency one weakened. Then the image is reconstructed and thus the image is enhanced. Wavelet transform proves efficient in CT image enhancement.

Modern fully automatic biochemical analyzer makes enzyme measurement accurate, specific and practical, but alarm failure happens sometimes and thus determinate error appears. To find out the inducement to alarm failure, Olympus AU2700 and ADVIA 1650 fully automatic biochemical analyzer are used to measure the serum liver enzyme from 450 cases of post-liver-transplantation patients.

[Objective] To evaluate and describe CT findings in patients with pathologically confirmed retroperitoneal fibrosis. [Methods] CT findings in 8 patients (6 males, 2 females) pathologically confirmed retroperitoneal fibrosis were retrospectively reviewed and pertinent literature was discussed. [Results] Retroperitoneal fibrosis showed similar features in CT imaging: retroperitoneal irregular mass around abdominal aorta embedding adjacent tissue, with mild or moderate enhancement, unilateral or bibateral ureterectasis with hydronephrosis. [Conclusions] The pristine clinical manifestation of retroperitoneal fibrosis is occult and nonspecific. CT examination is a valuable approach to diagnose retroperitoneal fibrosis.

Objective:To analyze the clinical application of navigation bronchoscopy system, and improve the accuracy during routine use.Methods:Through discussing ENB, System composition, clinical application and environment, the paper presents the clinical application standard and working environment standard of the navigation bronchoscopy system.Results:Electromagnetic navigation bronchoscopy(ENB) combined with the advantages of electromagnetic technology, virtual bronchoscopy and 3D CT reconstruction, which can perform the accurate localization of peripheral pulmonary lesion and mediastinal lymph node to acquire tissue samples for pathological diagnosis. ENB-guided localization can be used in interventional therapy(local injection or radioactive seed implantation).Conclusion:Navigation bronchoscopy system shows the merit of minimally invasive technique and medical visualization. It is a great progress in interventional pulmonology history.

Objective:To probe the correlation of intra-operative hyaluronic acid(HA) changes with hepatic allografts cold ischemia reperfusion injury in liver transplantation.Methods:The patients with orthotopic liver transplantation were assigned to 3 groups:① group A :liver allografts were stored in University of Wisconsin's solution(0℃) for 5-6 h before implantation;② group B :liver allografts were stored in U W's solution(0℃) for 8-9 h before implantation;③ group C :liver allografts were stored in U W's solution(0℃) for 12 h before implantation.The serum samples were taken up at 5 min,60 min,120 min,180 min after the donor liver was transplanted and reperfused to detect the concentration of HA.Results:After donor liver was transplanted and reperfused,serum HA concentration decreased immediately and gradually.HA decreased rate :group A 4.58 ?g/L?min-1,group B 4.16 ?g/L?min-1,group C 2.26 ?g/L?min-1.Serum HA decrease rate was faster in group A and B than that in group C(P

Objective　To examine the intraindividual reproducibility of the octanoic acid breath test in normal subjects and diabetics and to investigate whether cardiovascular autonomic neuropathy and delayed gastric emptying influence the intraindividual reproducibility.Methods　Nine normal subjects (six men, three women,mean age 38 years) and 15 diabetics with insulin treatment ［nine men, six women; mean age 47 years; six had cardiovascular autonomic diabetic neuropathy (CADN) and/or delayed gastric emptying time］ were, after a nocturnal fasting period, given a standard test meal (labeled with 13C-octanoic acid, 1 046 kJ). Breath samples were taken at ten minute intervals over first one hour and at fifteen minute intervals over the following three hours and examined for 13CO2 by isotope ratio infrared spectrometry. Using a regression method gastric emptying half times (t1/2) and lag phase (tlag) were determined.Results　There was not a significant difference of t1/2 and tlag between two measurements in normal subjects and diabetics. The coefficients of variation of day-to-day reproducibility were 11.7% for t1/2, 19.4% for tlag in normal subjects and 17.8% for t1/2, 28.2% for tlag in diabetics, but there was not significant difference between normal subjects and diabetics. There was not significant difference of intraindividual coefficient of variation of t1/2 and tlag between diabetics with/without CADN and between diabetics with normal gastric emptying time and diabetics with delayed gastric emptying time.Conclusions　 The 13C-octanoic acid breath test has a high intraindividual reproducibility which is not affected by the cardiovascular autonomic neuropathy and delayed gastric emptying. It can be recommended as a non-invasive test for assessing gastric emptying time after a solid test meal in diabetics.

The last ten years have witnessed a rapid development in laparoscopic surgery for urology, but there are still many specific problems need to be discussed concerning the operation procedures. From October 1998 to August 2006, 509 patients have received laparoscopic surgery in our department. Our experience is summarized as following: (1) Compared with the peritoneal approach, the retroperitoneal approach is faster in exposing the operative field and more experience from the open operation could be used, so retroperitoneal approach should be recommended unless for a few difficult cases or cases need to be treated bilaterally. (2) In radical nephrectomy, the kidney should be completely removed including the lymph nodes. Open operation should be considered if the diameter of the tumor is more than 10 cm. Adrenal gland resection should not be considered unless the tumor locates in the upper pole. In radical resection of the renal pelvic carcinoma, attention must be paid to prevent tumor metastasis into the ureter. The kidney vessels must be separated in the nephrectomy operation and the use of hemo-lock is recommended to block the kidney artery. (3) Laparoscopy is a golden standard for adrenalectomy; the operation procedure should be chosen according to the property, location, involvement, and blood supply of the tumors. (4) Whether to use laparoscopic surgery or not for patients warranting difficult surgeries such as radical prostatectomy should be decided considering the general condition of the patients and the skills of the surgeons. As for operations for varicocele, we do not recommend laparoscopic surgery because it can be readily treated with open operation.