Objective To compare the clinical efficacy of acupoint catgut-embedding therapy plus fundamental treatment versus fundamental treatment alone for the prevention and treatment of bone marrow depression in breast cancer patients induced by FEC(fluorouracil, epirubicin and cyclophosphamide) chemotherapy. Methods A total of 46 post-operation breast cancer patients accepting the first cycle of FEC chemotherapy were randomly divided into treatment group and control group, 23 cases in each group. The control group was given fundamental treatment including oral use of Chinese medicine of modified Xiangsha Liujunzi Decoction for regulating stomach and arresting vomiting, modified Guipi Decoction and Gui Lu Erxian Decoction for nourishing blood and generating blood, and western medicine of Batilol Tablets and Vitamin B4 Tablets. The treatment group was given acupoint catgut-embedding therapy on bilateral Zusanli(ST36) and Shenshu(BL23) plus fundamental treatment. The effect on bone marrow depression in the two groups was observed after treatment. Results(1) On post-chemotherapy day 7 and 8, the count of white blood cells (WBC) and neutrophils (NE) in the treatment group was higher than that in the control group, the difference being significant(P < 0.05 or P < 0.01).(2) The utilization of granulocyte colony-stimulating factor(G-CSF) in the treatment group was less than that in the control group, the difference being significant (P < 0.05). (3) On post-chemotherapy day 10, the effect on improving bone marrow depression in the treatment group was superior to that in the control group, the difference being significant (P<0.01) . Conclusion The acupoint catgut-embedding therapy plus fundamental treatment is more effective and safe for the prevention and treatment of bone marrow depression in breast cancer patients induced by FEC chemotherapy than fundamental treatment alone.

Aplastic anemia (AA) is a Tlymphocyte-mediated autoimmune disease. The research on AA was focused on three areas, which were the pathogenesis of immune dysfunction, hematopoietic stem cell damage and abnormal hematopoietic microenvironment. In recent years, more attentions have been paid on abnormal immune mechanisms in the blood. There are complex intracellular cytokine and signal transduction pathway of pathogenesis in AA. And T-bet/IFN-γ signaling pathway plays an important role in development and progression of AA. This article aimed to review T-bet/IFN-γ signaling pathways in AA.

BACKGROUND:Open reduction and internal fixation cause big trauma and many complications. With the progression of minimal y invasive concept, percutaneous pedicle screw fixation gradual y showed its obvious superiority. ＜br> OBJECTIVE:To compare clinical outcomes of minimal y invasive percutaneous pedicle screw fixation versus open surgery in the treatment of thoracolumbar fracture. ＜br> METHODS:From October 2012 to January 2014, 50 cases of thoracolumbar fractures, including 25 cases in the minimal y invasive percutaneous pedicle screw fixation group and 25 cases in the open surgery group, were retrospectively analyzed. The differences in length of skin incision, intraoperative blood loss, operation time, postoperation hospital stay, and visual analog scale scores were compared. Serum creatine kinase activity and C-reactive protein levels were measured before surgery and at 24 and 48 hours after operation. Imaging results were used to observe vertebral height and kyphosis Cobb’s angle changes. ＜br> RESULTS AND CONCLUSION:Compared with the open surgery group, the length of skin incision was smal er and intraoperative blood loss was less, operation time, bed time and hospital stay were shorter, and pain of the wound was lighter in the minimal y invasive group. No significant difference was found in serum creatine kinase activity and C-reactive protein levels between the two groups. Serum creatine kinase activity and C-reactive protein levels were higher at 24 and 48 hours after treatment compared with before treatment in both groups. Serum creatine kinase activity and C-reactive protein levels were higher in the open surgery group than in the minimal y invasive group at 24 and 48 hours. There were significant differences in vertebral height and kyphosis Cobb’s angle in both groups after treatment compared with before treatment (P＜0.01). No significant difference in vertebral height and kyphosis Cobb’s angle was detected between the two groups after treatment (P>0.05). Results indicated that minimal y invasive percutaneous pedicle screw fixation and open surgery in repair of thoracolumbar fractures had similar outcomes. However, the trauma of minimal y invasive percutaneous pedicle screw fixation was apparently less than open surgery.

BACKGROUND: Bone marrow stromal cells(BMSCs) are the ideal gene target cells and will have a bright future in the gene therapy of spinal cord injury.OBJECTIVE :To detect the expression of glial cell line - derived neurotrophic factor(GDNF) gene after BMSCs were infected by adenovirus-medialed GDNF (Adv-GDNF) in vitro and to explore its biological activity.DESIGN: A randomized controlled trial study.SETTING: Laboratory of Orthopedic DepartmentMATERIALS: The experiment was completed in the Laboratory of Orthopedic Department, Affiliated Tongji Hospital of Tong ji Meidcal College,Huazhong University of Science and Technology. Twenty-four SD rats of either gender, weighing (180 ± 20) g.INTERVENTIONS: BMSCs were infected by Adv-GDNF in vitro and then cocultured with spinal cord dorsal root ganglion. The three methods, immunofluorescent chemistry, reverse transcriptase-polymerase chain reaction (RT-PCR) and enzyme linked immunosorbent assay(ELISA) were used to evaluate GDNF expression in the BMSCs. The biological activity of GDNF was observed by a phase contrast microscope.MAIN OUTCOME MEASURES:Primary outcomes:①RT-PCR;②results of immunofluorescent chemical examination;③biological activity of GDNF in vitro. Secondary outcomes:①culturing and identification of BMSCs②time-effect relationship of GDNF expression revealed by ELISA.RESULTS: Immunofluorescence displayed expression of GDNF in BMSCs 48hours after Adv-GNDF infection. RT-PCR analysis demonstrated expression of GDNF mRNA 24 hours after Adv-GNDF infection. ELISA confirmed the presence of GDNF in the liquid supernatant of BMSCs 24 hours after Adv-GDNF infectionn and showed that GDNF was secreted. The supernatant can promote the neurite outgrowth in the rat dorsal root ganglion(DRG).CONCLUSION: It is demonstrated that BMSCs infected by Adv-GDNF can express GDNF steadily and the expressed GDNF has the activity of promoting neurite outgrowth, which lays a foundation of the GDNF gene therapy for spinal cord injury.

Objective To study the efficacy of L-3,5-diiodotyrosine (DIT) and inorganic iodine (KIO3) in iodine-deficiency Wistar rats.Methods Sixty Wistar rats,weighting about 160-180 g,were divided into two groups according to body weight by the random number table method:iodine-deficiency model (40 rats) was fed with low-iodine food (the iodine content was 35.9 μg/kg);optimal-iodine model (20 rats) was fed with low-iodine food and given with KIO3 water (the iodine content was 18 mg/L) 0.5 ml by intragastric once a day.Model was established for 3 months.Iodine-deficiency model was subdivided into low iodine (LI) group,KIO3 group and DIT group,eight,nine,ten rats in each group;from optimal-iodine model,nine rats were randomly selected as optimal iodine (NI) group.LI group was fed with low-iodine food;KIO3 group was fed with low-iodine food and given with KIO3 water (the iodine content was 18 mg/L) 0.5 ml by intragastric once a day;DIT group was fed with low-iodine food and given with DIT water (the iodine content was 18 mg/L) 0.5 ml by intragastric once a day;NI group was fed with low-iodine food and given with KIO3 water (the iodine content was 18 mg/L) 0.5 ml by intragastric once a day.After 3 months,24-hour urine of the rats was collected.According to the method for determination of iodine in urine by As3 +-Ce4+ catalytic spectrophotometry (WS/T 107-2006),iodine content in urine was detected.Rats were anesthetized intraperitoneally with 25％ urethane,blood from abdominal aortic was collected to determinate the serum thyroid hormone [total triiodothyronine (TT3),total thyroxine (TT4),free triiodothyronine (FT3),free thyroxine (FT4)] level in rats by automatic electrochemical luminescence immunoassay.All the rats were sacrificed to analyze the thyroid weight.Results ① The urine iodine showed significant differences in the four groups (x2 =25.24,P ＜ 0.05).The median of urine iodine concentration in the LI,NI,KIO3 and DIT groups were 3.00,286.14,223.37,214.33 μg/L,respectively.The urine iodine concentration in LI group was significantly lower than those of other three groups (all P ＜ 0.05).② The serum TT3,TT4,FT3,FT4 levels showed significant differences in the four groups (F =63.48,140.73,130.20,365.27,all P ＜ 0.05).And the hormone levels in KIO3 group were lower than those of the DIT group [TT3:(1.57 ± 0.20) vs.(1.97 ± 0.18) mmol/L,TT4:(51.23 ± 4.90) vs.(71.94 ± 5.27) mmol/L,FT3:(5.34 ± 0.45) vs.(6.98 ± 0.33) pmol/L,FT4:(26.18 ± 2.30) vs.(35.47 ± 2.28) pmol/L,all P ＜ 0.05].③The color of thyroid in KIO3 and DIT groups became pale pink.The absolute and relative thyroid weight showed significant differences in the four groups (F =225.05,345.40,all P ＜ 0.05).The absolute thyroid weight [(31.76 ± 1.75) mg] and relative thyroid weight [(11.69 ± 3.47) mg/100 g] in DIT group was lower than that of the KIO3 group [(36.31 ± 5.23) mg,(12.83 ± 4.38) mg/100 g,all P ＜ 0.05].Conclusion Animal experimental results show that DIT has a better iodine-supplementing efficacy than that of KIO3.

Objective To establish a arsenic cerium catalytic rate method for determination of urinary iodine,and increase the linear range of urinary iodine determination.Methods Standard series and urine samples after digestion treatment,were tested using dynamics function of spectrophotometer to record the curve of absorbance value (A) change with time (t) during arsenic cerium catalytic reaction for each measurement system,choice (A1,t1) and (A 2,t2) on this curve and calculating the reaction rate (v),v =(lgA1-lgA2)/(t2-t1).Through the determination of the standard series it could calculate regression equation of iodine concentration (C) with X:C =a ± bX,X =1 000 (v-v0),and the v0 is the reaction rate of reagent blank.Results (① C and X were positively correlated.The standard series linear range was 0-1 200 pμg/L and correlation coefficient r was higher than 0.999 1.The minimum detection limit was 3.9 μg/L (0.25 ml urine).②)Precision:5 urine samples (A,B,C,D,E) were selected within the range of 0-1 200 μg/L and the measured value were (72.3 ± 2.7),(148.2 ± 5.2),(210.5 ± 4.4),(562.7 ± 6.8),and (899.3 ± 8.0) μg/L.The relative standard deviation (RSD) was between 0.9％-3.8％.(③)Accuracy:4 samples (A,B,C,D) were measured for standard addition recovery test,recovery was between 94.2％-107.2％;urinary iodine standard material [the given values were (67.9 ± 9.0),(142.0 ± 10.0),(195.0 ± 10.0),(558.0 ± 17.0),(885.0 ± 28.0) μg/L] were determined and the results were in the range of uncertainty of the standard material.④Method contrast:with the national health standard method (method for determination of iodine in urine by arsenic cerium catalytic spectrophotometry) to determinate 120 urine samples,the results showed that there were 60 urine samples within 0-300 μg/L,60 urine samples were more than 300 μg/L.Then rate method was used to test the 120 urine samples.For the 60 samples within the scope of 0-300 μg/L,the determination results of the two methods were positively correlated (r =0.994,P ＜ 0.01);the results of the rate method were lower than those of the standard method and the difference was statistically significant (t =2.047,P ＜ 0.05).But the average deviation was only 2.1 μg/L,for the determination of urine iodine there was no practical significance;for the 60 samples higher than 300 μg/L,the determination results of the two methods were positively correlated (r =0.993,P ＜ 0.01) and the difference was not statistically significant (t =-1.092,P ＞ 0.05).Conclusions Arsenic cerium catalytic rate method has increased the linear range of urinary iodine determination.Using this method,the vast majority samples can be tested directly without dilution,thereby reducing the workload for determination of urine iodine.

This study was aimed to investigate the effect of Bu-Shen Y i-Sui Sheng-Xue (BSYSSX) method on pro-liferation and differentiation mechanisms of hematopoietic progenitor cells. The rat models were established by 60Co-γrays and cyclophosphamide. Compound Chinese medicine was gavaged to rats of the normal control group, model group, stanozolol group, Yi-Sui Sheng-Xue (YSSX) group, Wen-Shen Sheng-Xue(WSSX) group and Zi-Shen Sheng-Xue (ZSSX) group. Then, serum of rat was prepared. Rat bone marrow cells were incubated with AA rats serum ac-counted for 20% and the number of hematopoietic progenitor cells colony-forming units (CFU) were counted. The level of GATA-1 and PU.1 mRNA in colony cells were detected with RT-PCR. The results showed that compared with the normal control group, the number of bone marrow cells, CFU-E, BFU-E, CFU-GM, as well as the expres-sion of GATA-1 and PU.1 mRNA in the model group decreased significantly (P< 0.01). Compared with the model group, the number of bone marrow cells, CFU-E, BFU-E, CFU-GM of each treatment group were significantly in-creased (P< 0.01). CFU-E and BFU-E of the ZSSX group were better than the YSSX group (P < 0.01). CFU-GM of the ZSSX group was better than the YSSX group and the WSSX group. The expression of GATA-1 and PU.1 mR-NA in each treatment group were significantly higher than the model group (P< 0.01). The expression of GATA-1 mRNA in the ZSSX group was better than the YSSZ group and WSSX group (P< 0.05). The expression of PU.1 mR-NA in the ZSSX group was higher than the YSSX group and WSSX group. It was concluded that BSYSSX method may increase the expression of GATA-1 and PU.1 mRNA in order to promote the proliferation and differentiation of bone marrow hematopoietic progenitor cells. The ZSSX method was better than the YSSX method and WSSX method.

OBJECTIVE:To observe therapeutic efficacy and safety of Danshen chuanxiongqin injection combined with flunari-zine hydrochloride in the benign prevention and treatment of paroxysmal positional vertigo (BPPV) and lower extremity deep ve-nous thrombosis (DVT) in post-operative long-term bedridden patients with lower limb fractures. METHODS:300 post-operative long-term bedridden patients with lower limb fractures were selected and randomly divided into observation group and control group,with 150 cases in each group. Control group was given Flunarizine hydrochloride capsules orally 10 mg,qd;observation group was additionally given Danshen chuanxiongqin injection 10 ml+5% Glucose injection 250 ml,ivgtt,qd. The incidence of BPPV and DVT were observed in 2 groups after intervention,and the circumference of lower limb,blood coagulation indexes, blood rheology indexes and inflammatory factor were observed before and after intervention,and the incidence of ADR was com-pared. RESULTS:The incidence of BPPV and DVT in observation group were 18.0% and 16.7%,which were significantly lower than in control group(48.7% and 52.7%),with statistical significance(P<0.05);after intervention,the circumference of lower limb,blood rheology indexes and the levels of inflammatory factors in 2 groups were decreased significantly, while the coagula-tion indicators were significantly improved;the observation group was better than the control group,with statistical significance (P<0.05). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Danshen chuanxiongqin injection combined with flunarizine hydrochloride is effective in the prevention of BPPV and DVT in long-term bed-ridden patients with lower limb fractures,with low incidence of ADR.

Objective To establish and apply the procedure of survey on quality indicator in clinical laboratory and to analyze the status in quo of the 15 quality indicators in Zhejiang province .Methods A network platform for the survey on quality indicator in clinical laboratory was designed and developed by our center.The online questionnaires that should be reported back within one month were assigned to 473 laboratories.The developed software and SPSS 13.0 were used for statistical analysis .13 indicators expressed in rate were further evaluated with sigma scales .The 25th percentile, 50th percentile, and 75th percentile of the distribution of each quality indicator were regarded as the minimum , appropriate and optimum quality specifications, respectively.Results Totally 444 laboratories submitted the survey results.The overall sigma levels of 10/13 indicators were all >3, of which the inappropriate CV of internal quality control and unacceptable performances in EQA were still less than 3σin 15.8%and 9.2%of the laboratories.The rates of quality indicators in different scales of laboratories and diverse disciplines were significantly different .Pre-analytical TAT in routine examination for clinical chemistry and immunology was 50 min, on average.And the time for routine examination of blood , urine and stool was 30 min.Pre-analytical TAT in emergency examination for all four disciplines were all between 10 and 15 min. Intra-analytical TAT for clinical immunology was the longest , which was 154 min for routine examination and 40 min for emergency examination, respectively.The optimum quality specifications for 8 indicators were 6σ, while the minimum quality specifications were less than 1σfor 4 indicators.Conclusions According to the results of our survey, the pre-analytical quality indicator perform better than that of Intra-analytical and post-analytical phase.The laboratory should strengthen the laboratory information system technology construction to ensure the reliable data collection and long-time monitoring.

Objective To investigate an evaluation program for external quality assessment ( EQA) of quality indicators ( QIs) and develop a software .Methods According to GB/T 27043-2012 ( ISO/IEC 17043:2010,IDT) mode 3, 28 provincial centers for clinical Laboratories were organized by National Center for Clinical Laboratories to launch an investigation on “QIs in clinical laboratory” with the use of Clinet-EQA online .Participants were asked to collect data of April 2014 and report related results online .Mean, median, the 5 th, 25 th, 75 th and 95 th percentiles of defectpercentages for biochemistry , immunology, blood and body fluid and microbiology were calculated , respectively .Sigma values were also calculated . Meanwhile , 25 th of sigma value and 75 th of defect percentages were chosen as preliminary quality specifications for each QI so that laboratories can evaluate related process quality .Results Take incorrect sample type rates for example , 4 771 laboratories were involved in this study .Among four subjects , incorrect sample type rates were lowest (0.01%, 6σ) for immunology tests, followed by blood and body fluids tests (0.06%, 4.7σ) and biochemistry tests (0.06%, 4.7σ), and were highest for microbiology tests (0.33%, 4.2σ).Evaluation reports will besent back to participants so that they can understand national , provincial , and their own sigma levels well .Preliminary quality specifications of incorrect sample type for biochemistry, immunology, blood and body fluid, and microbiology tests were 0.08% (4.6σ), 0.03%(5σ), 0.09%(4.6σ) and 0.43%(4.1σ), respectively.Conclusion Clinical laboratories were advised to establish and monitor suitable QIs within laboratory and participate in QIs EQA schemes , thus they can improve their quality continuously .