Objective:To observe clinical therapeutic effect of Deng Tietao's Yuzu Recipe on hypertension.Methods:240 cases of inpatients of hypertension were randomly divided into a trial group and a control group,establishing database,and descriptive analysis,t-test,x~2 test and rank test methods were adopted.Results:(1)There was significant difference between the two groups in the decreasing effect of blood pressure(P

Purpose To study the clinicopathological features of the phosphaturic mesenchymal tumors. Methods The clinicopatho-logical data, histology and immunohistochemical findings of 12 cases of phosphaturic mesenchymal tumors were retrospectively analyzed with review of the relevant literature. Results Among the 12 patients studied, 8 were males and 4 were females. Their age at the time of operation ranged from 23 to 63 years (mean=40. 5 years). The duration of symptoms ranged from 1 to 14 years (mean =5. 6 years) . A history of long-standing bone pain, arthralgia, limitation in movement, accompanied with hypophosphatemia and hyperphos-phaturia were present in all cases. The tumors size ranged from 1 to 7. 5 cm ( mean size=2. 7 cm) . The tumors were primarily com-posed of spindle cells, and were accompanied with osteoclast-like giant cells partly. Their background were rich in blood vessels. In addition, there were scattered tufed thick vascular anomaly, thin vascular, islands of mature adipocytes and chondroid cells. In 7 of the 12 cases, there were dystrophic calcification in an unusual flocculent. Spindle epithelium were noted in 2 cases. Mitotic figures were rare in 10 cases. In 2 of the 12 cases however, mitotic figures were commonly encountered, and in 1 of the 2 cases, heterotypic cells were notablely observed as well. On immunohistochemical study, the tumor cells were all positive for vimentin and CD56. The positivi-ty for NSE, CD99, BCL-2 in 11, 8 and 7 cases were expressed in 12 cases. In 4 and 6 of the 12 cases, CD34 and SMA were positive in various degree. Ki-67 proliferation index were less than 5% in 10 cases, and 10% and 25% in 2 cases. The duration of follow-up ranged from 2 to 108 months ( mean=22 months) . 2 cases were recurred at 72 and 84 months after the operation, respectively. So far, the remaining 10 cases had no recurrence and metastasis. Conclusioin The phosphaturic mesenchymal tumors are either benign or low-grade malignant. Their histomorphology are multivariable and short of specificity. It is important to make the correct diagnosis in combination with their common features and clinical datas.

Objective To study the clinical feature and original diseases of bone marrow granulomas. Methods A total of 5217 bone marrow biopsies were retrospecitively analyzed in Peking Union Medical College Hospital from January 2001 to December 2007. Results Bone marrow granulomas were present in 20 cases, representing an incidence of 0.38% in the series and an annual incidence of 2. 9 cases per year. Finally, 13 of these cases (65%) were diagnosed with tuberculosis. Hematological neoplasms and viral hepatitis were found in 4 and 2 cases respectively. Acute interstitial nephritis was diagnosed in one case. Conclusions The finding of a granuloma in a bone marrow biopsy is not common and unspecific.Tuberculosis, hematological neoplasms and viral hepatitis are the most common underlying diseases. Bone marrow biopsy is an important method for the diagnosis of disseminated tuberculosis.

Objective To investigate the efficacy of preemptive analgesiawith ultrasound-guided modified dorsal penile nerve block combined ketorolac tromethamine for circumcision in pediatric patients.Methods Forty-five pediatric patients with ASA grade Ⅰ undergoing elective circumcision were randomly divided into 3 groups (n=15 each).The same intravenous compound anesthesia was used in the three groups.The pediatric patients underwent ultrasound-guided modified dorsal penile nerve block with a mixture of 0.1 ml/kg of 0.2% ropivacaine and 0.8% lidocaine before operation in group A and group B.The pediatric patients were given ketorolac tromethamine 1 mg/kg intramuscular injection before operation in group A and group C.The total consumption of propfol and sufentanil, occurrence of intraoperative body movement and respiratory depression, emergence time, time from waking up to going out of PACU and adverse reactions such as postoperative agitation, nausea, vomiting and pruritus were aslo recorded.The requirement for postoperative paracetamol suppositories was recorded.Results Compared with group C, the total consumption of propfol and sufentanil were significantly decreased, incidence of body movement andrespiratory depression were significantly decreased, the emergence time and time from waking up to going out of PACU was significantly shortened, requirement for paracetamol suppositories were significantly decreased in group A and group B(P<0.05).Compared with group B, incidence of requirement for paracetamol suppositories was significantly decreased in group A (P<0.05).No pediatric patients developed postoperative nausea, vomiting, pruritus and incidence of emergence agitation had no statistical difference in the three groups.Conclusion Preemptive analgesia with ultrasound-guided modified dorsal penile nerve block combined ketorolac tromethamine is safe and effective when used for circumcision in pediatric patients, and it has good efficacy of postoperative analgesia.

Objective To study the protective effect of intraaortic protamine injection on lung in infants undergwent opening heart operation by cardiopulmonary bypass surgery. Methods Sixty infants (age ≤ 1 year,weight ≤ 10 kg)who accepted opening heart operation by cardiopulmonary bypass surgery were randomly assigned into 2 groups ( n = 30 in each group) reciving intra-aortic and intra-venous protamine injection respectively. P-peak, P-plate, CL, Oxygenation Index, the number of WBC and neutrophil segregated in lungs were compared between two groups before injecting protamine and 10 minutes, 1 hour, 3 hours after injecting protamine. The time of mechanical ventilation were compared as well. Results P-peak, P-plate, the number of WBC and neutrophil segregated in lungs of intra-aortic injection group significantly decreased than intra-venous injection group at 1 hour, 3 hours after injecting protamine (t =2.743, 3.512; 3.218, 3.469; 3.716, 5.243; 3.853,4. 783 respectively, Ps ＜ 0. 05 ), while the CL and Oxygenation Index increased significantly ( t = 3. 976,4. 267; 4. 557,4. 265 respectively, P ＜ 0. 05 ). The duration of mechanical ventilation follow operation in intraaortic injection group ( [8. 03 ± 5. 14] h ) was shorter compared with intra-venous injection group ( [10. 56 ±6.95]h) (t =2.599,P＜0.05). Conclusion By intra-aortic protamine injection the lung injury decreased significantly. It shows good protective effect on lung in infants underwent opening heart operation by cardiopulmonary bypass surgery.

Objective To investigate the effects of ulinastatin-containing autologous cold blood cardioplegic solution on the cardiac function of infants after cardiopulmonary bypass surgery.Methods Sixty infants younger than 10 months old,who underwent ventricular septal defect repair under cardiopulmonary bypass,were randomized into autologous cold blood cardioplegia group (30 patients,Group A)and ulinastatincontaining cold blood cardioplegia group (30 patients,Group B).CI,SI and LCWI were monitored 1 and 6 hours after opening the aorta.The time and rate of cardiac resuscitation,as well as the dependence on the inotropic drugs,were intraoperatively monitored.Results The automatic resuscitation rate in two groups was not siynificantly ( P ＞ 0.05).The time for automatic resuscitation were (34.2 ± 4.7) s and (52.1 ± 6.5 ) s for Group B and Group A,respectively ( P ＜ 0.05 ).The rate of dependence on inotropic drug were 40.0％ (12/30) and 66.7％ (20/30)for Group B and Gro~p A,respectively (P ＜ 0.05).Mter the operation,the CI,SI and LCWI of group B were higher than that of group A ( P ＜0.05 ).Conclusion Ulinastatin-containing autologous cold blood cardioplegic solution is beneficial to the functional cardiac recovery of the infants after heart bypass surgery by protecting the immature myocardium.

Objective To observe and evaluate the changes in plasma C3a and C5a concentration after injecting protamine via two different pathways:ascending aorta and superior vena cava.Methods Sixty children with age under 1-year-old who underwent cardiopulmonary bypass were randomly divided into two groups:experimental group(injecting protamine via ascending aorta,n =30)and control group(injecting protamine viasuperior vena cava,n =30;).The plasma concentration of C3a and C5a were measured by ELISA at prior to protamine injected(Time 1)and 1 hour after the protamine injected(Time 2).Results In experimental group,there was no statistical difference on C3a and C5a concentration before and after injection of protamine[C3a:(18.762±3.792) μg/L vs(19.554±3.453) μg/L,t =-0.846,P =0.20; C5a:(0.843±0.159) μg/L vs (0.825±0.119) μg/L,t =0.496,P =0.31].In control group,C3 a concentration increased from(18.780±3.864) μg/L to(22.961±3.501) g/L,C5a concentration increased from(0.839±0.157) μg/L to(0.979±0.116)μg/L after injection of protamine,and the differences were significant(t =-4.392,-3.928,respectively,P ＜0.01).The level of C3a concentration in experimental group was significantly higher than that in control group[(19.554±3.453) μg/L vs.(22.961±3.501) μμg/L,ι =3.795,P < 0.01]after injection of protamine for 1 h and the level of C5a concentration exhibited the same change[(0.825±0.119) μg/L vs.(0.979±0.116)μg/L,t =-5.075,P ＜0.01].Conclusion The levels of C3a and C5a concentration of infants underwent cardiopulmonary bypass are decreased significantly after protamine injected via ascending aorta compated with via superior vena cava.

Objective: To investigate the effect of cold self-blood cardioplegia with ulinastatin on immature myocardial cell apoptosis and protein expressions of Bcl-2, Bax in ventricular septal defect (VSD) infants.
Methods: A total of 60 infants received VSD repairing operation with cardiopulmonary bypass (CPB) in our hospital were summarized. The patients were randomly divided into 2 groups:Test group, the infants received cold self-blood cardioplegia with ulinastatin when aortic cross-clamp was closed. Control group, the infants received cold self-blood cardioplegia when aortic cross-clamp was closed. n=30 in each group. The right atrium tissue was collected before CPB and 10 min after releasing aortic cross-clamp. The index of myocardial cell apoptosis was observed by TUNEL method, and the protein expressions of Bcl-2, Bax were examined by immunohistological method.
Results: Both groups showed the higher index of myocardial cell apoptosis at 10 min after releasing aortic cross-clamp than 5 min before CPB, and the apoptosis index in Test group was lower than that in Control group, all P<0.05. The protein expressions of Bcl-2 and Bax were obviously increased at 10 min after releasing aortic cross-clamp than 5 min before CPB in both groups. Compared with Control group, Test group presented the higher Bcl-2 protein expression and lower Bax protein expression, all P<0.05.
Conclusion: Cold self-blood cardioplegia with ulinastatin could protect immature myocardum from ischemia-reperfusion injury in VSD infants during CPB operation in clinical practice.

OBJECTIVETo determine the CARD11 expression and its prognostic value in diffuse large B cell lymphoma (DLBCL).

METHODSThis retrospective study included previously untreated patients diagnosed with DLBCL from January 2007 to December 2012. Formalin-fixed, paraffin-embedded blocks of these patients were collected. Tissue microarray was built and expression of CARD11 was examined immunohistochemically. Subtype of DLBCL was determined by Hans algorithm (CD10, BCL6, MUM1). The pattern of CARD11 was further studied and their correlation with outcome was analyzed.

RESULTS79 patients with DLBCL were enrolled and two reactive lymph nodes were used as control. The positive rate of high CARD11 expression in DLBCL was 65.33%, which showed no significant associations with patients' characteristics. Positive CARD11 expression was associated with an inferior event free survival (EFS)(2- year EFS: 52.03%vs 86.12%,P=0.036). Even in patients with a high international prognostic index (IPI, 3-5 points), this difference still remained significant (Median EFS not reached vs 557 days,P=0.033).

CONCLUSIONDLBCL patients with high CARD11 expression had a shorter EFS compared with low level of CARD11. This difference remained significant when patients were in high IPI (3-5 points), which might indicate the value of CARD11 in stratification of high-risk DLBCL patients.

CARD Signaling Adaptor Proteins ; genetics ; metabolism ; Disease-Free Survival ; Guanylate Cyclase ; genetics ; metabolism ; Humans ; Lymphoma, Large B-Cell, Diffuse ; diagnosis ; genetics ; metabolism ; Prognosis ; Retrospective Studies

OBJECTIVETo optimize the combination modes of medical materials in extract of Huanglian Jiedu decoction.

METHODDivided the medical materials of Huanglian Jiedu decotion into 15 groups and extracted by semi-bionic estraction (SBE), the contents of berberine, baicalin, geniposide, total alkaloid, total flavonoid, total integral calculus area of HPLC and extract of 1 000 were determined, standardized, weighted and evaluated, respectively.

RESULTThe maximum evaluated value Y for the extracting technique was AD + BC.

CONCLUSIONThe optimal combination mode of the perscription is that Rhizoma Coptidis and Fructus Gardeniae, Radix Scutellariae and Cortex Phellodendri Amurensis are decocted together respectively then the two decoctions are merged.

Coptis ; chemistry ; Dosage Forms ; Drugs, Chinese Herbal ; analysis ; isolation & purification ; Gardenia ; chemistry ; Phellodendron ; chemistry ; Scutellaria baicalensis ; chemistry