The aim of this study was to the prepare the standard decoction of paeoniae radix rubra for its investigation of quality standard.The standard decoction of paeoniae radix rubra was dissolved by water using standardization method and the content of peoniflorin was determined by UPLC-DAD.Then the transfer rate and the rate of extractum were calculated,and the fingerprint analysis was carried out.As a result,the content of the standard decoction of paeonia lactiflora ranged from 3.79 to 5.68 mg·mL-1 from 15 paeoniflorin batches,while the transfer rate ranged from 56.58％ to 90.14％,and the average transfer rate was 73.97％ and the standard deviation was 10.91％.The rate of extractum ranged from 16.74％ to 29.24％,the average yield was 21.82％ and the standard deviation was 3.55％.There were eleven common peaks,four of which were identified,including oxypaeoniflorin,albiflorin,paeoniflorin and benzoylpaeoniflorin.In conclusion,it was demonstrated that the method was simple with good repeatability for the preparation and quality standard studies of the standard decoction of paeoniae radix rubra.

OBJECTIVE:The bioequivalence and pharmacokinetics of two kinds of domestic meloxicam tablets were studied in 20 healthy male volunteers METHODS:A dose of 15mg of domestic or imported meloxicam(test and reference preparation)was given according to arandomized 2-way cross-over design,blood samples were withdrawn up to 96 hours post administration,and plasma concentration of meloxicam was determined by high performance liquid chromatography(HPLC)method RESULTS:The peak plasma levels(Cmax)of meloxicam test drug and reference drug were (2 736 2?312 0)and(2 665 6?333 8)?g/L,respectively,the peak time(Tmax)were(4 25?1 16)h and(4 00?1 30)h,respectively,T1/2ke were(21 67?3 81)h and(21 05?3 30)h,respectively,and AUC0～t were(96 454 6?25 526 6)and(95 692 5?24 532 6)?g/(h?L),respectively There were no significant differences in AUC0～t,Tmax,Cmax and T1/2ke between two kinds of tablet CONCLUSION:The relative bioavailability data obtained in the study furnished definite proof of bioequivalence of both domestic meloxicam tablets and imported meloxicam tablets The relative bioavailablility of the test drug was(101 3?11 9)%

Objective:To preliminarily study the effect of Louqin Zhisou decoctions with the mechanism of clearing heat and resol-ving phlegm on the blood level of neutrophil elastase ( NE) in the rat model of acute exacerbation of chronic obstructive pulmonary dis-ease ( AECOPD) . Methods:The rat model of AECOPD was established by passive cigarette smoking, intratracheal instillation of li-popolysacchricle ( LPY) and intranasal instillation of staphylococcus aureus. Totally 60 AECOPD rats were randomly divided into 3 groups, the model control group (n=20), ambrohexel group (n=20), and Louqin Zhisou decoctions group (n=20). NE was detec-ted by ELISA. Results:Compared with that before the treatment, NE in ambrohexel group and Louqin Zhisou decoctions group was de-creased significantly(P<0. 01). Conclusion:Clearing heat and resolving phlegm method probably can decrease NE by reducing air-way mucus hypersecretion and obstruction in AECOPD rats.

Objective To evaluate the diagnostic value of ferritin,procalcitonin (PCT) and C-reactive protein (CRP) on infectious diseases.Methods A total of 190 patients with infectious diseases in our hospital from 2012 to 2017 were enrolled and analysed retrospectively.Among them,bacterial infection was found in 130 cases (bacterial infection group),and viral infection in 60 cases (viral infection group).Serum levels of erritin,CRP,PCT in 190 patients were deteceted for further statistical analysis.Results Among the 190 cases of infectious fever,serum levels of erritin,CRP,PCT in bacterial infection group were higher than that in the viral infection group,with significant difference.The receiver operating curve (ROC) curve analysis showed that area under curve (AUC) of CRP,PCT,ferritin were 0.797,0.803,0.883.Conclusions The present study identified ferritin,PCT and CRP that should be considered in the differential diagnosis of infectious diseases,providing useful information for future diagnosis.

Objective: To investigate the clinicopathologic characteristics, immunophenotypes, and differential diagnostic features of extra-pleural solitary fibrous tumor (SFT) with uncommon histology. Methods: Seven cases of extra-pleural SFT with uncommon histology were collected during January 2015 and December 2016 in Zhejiang Provincal People′s Hospital; the clinical and radiologic features, histomorphology, immunophenotype and prognosis were analyzed. EnVision method was used for immunohistochemical staining of STAT6, CD34 and other differential diagnosis associated markers. Results: There were five male and two female patients, age from 23 to 54 years (mean=39 years). Three tumors were located in the soft tissue of head and neck, two in trunk subcutaneous soft tissue, one in sella region, and one in the kidney. Grossly the tumors ranged from 0.4 to 8.0 cm (mean=3.1 cm). Microscopically, all three head and neck cases resembled giant cell angiofibroma/giant cell subtype SFT, and one case showed sheet-like pattern of the multinucleated syncytial cells, creating a biphasic arrangement similar to myofibroma. Both truncal tumor resembled lipomatous type SFT, with one similar to dermatofibrosarcoma protuberans and the other to atypical spindle cell lipomatous tumor. The sella tumor showed morphology of a conventional SFT with high grade sarcomatous transformation. The renal tumor demonstrated a malignant SFT with entrapped benign renal tubules, mimicking a biphase synovial sarcoma or a malignant mixed epithelial and stromal tumor. By immunohistochemistry, all seven SFTs showed diffuse and strong nuclear reactivity to antibody against STAT6. Conclusions Extra-pleural SFTs show a significant heterogeneity of morphology and biological behavior which could cause differential confusion.Careful attention to its characteristic histomorphology with the use of STAT6 immunohistochemistry can help distinguish this tumor from its many mimickers.

Objective: To detect the clinicopathological features, immunophenotype, diagnosis, and differential diagnosis of composite pheochromocytoma(CP). Methods: Five cases of CP were collected at Zhejiang Provincial People′s Hospital from January 2011 to January 2019. The clinical, radiological, histologic, immunohistochemical and outcome data were analyzed; the diagnosis and differential diagnosis were discussed. Results: The patients′ age range was 52-68 years (mean 59 years, median 54 years), There were 4 males and 1 female, and the male to female ratio was 4∶1. Tumor size was 3-4 cm (mean 3.6 cm, median 3.5 cm). The most common clinical manifestation was adrenal mass. Histologically, the classical feature was two distinct morphologic components, one with tumor cells arranged in irregular nests, and with fine granular and basophilic oramphophilic cytoplasm; the other was composed of scattered ganglion cells in the background of Schwann cells organized in interwoven bundles. The components of pheochromocytoma expressed PHOX2B(5/5), synaptophysin (5/5), CgA (5/5), the sustentacular cells expressed S-100 protein; the components of ganglioneuroma expressed S-100 protein (5/5), NF (5/5), the ganglion cells were weakly positive for PHOX2B, synaptophysin and CgA. All the cases were surgically resected and all patients were free of recurrence at follow-up. Conclusions CP is rare adrenal tumor, and it has typical histologic features but no specific clinical manifestations. Attention should be paid to its characteristic histomorphology with the use of PHOX2B, CgA, synaptophysin and S-100 protein immunohistochemistry that is helpful for its diagnosis.

Objective: To analyze the clinicopathological features, immunohistochemical (IHC) phentotype,diagnosis and differential diagnosis of infantile/congenital fibrosarcoma (IFS/CFS) with unusual histological features. Methods: Five IFS/CFS at Children′s Hospital of Fudan University from March 2014 to July 2018 were analyzed for their diagnosis and differential diagnosis. Results: Two cases were males, three cases were females. The clinical manifestation of IFS/CFS was a rapidly-growing and painless mass. There were no specific radiologic features. Histologically, the tumor cells are arranged in intersecting or sheet-like patterns. There were focal hemangioma-like areas in four cases. There were also focal areas of primitive asteroid, short-spindled, and oval tumor cells in three cases. IHC study showed the tumor cells diffusely expressed TLE1(2/5), Vimentin(5/5), and WT1(3/5), in a cytoplastic pattern; they focally expressed CD34(3/5), CD31(3/5), and α-SMA(2/5). Fluorescence in situ hybridization (FISH) detected break-apart positivity of ETV6 gene. Conclusions Hemangioma-like pattern, myxoid area, and TLE1 expression is very rare in IFS/CFS. Detection of ETV6 gene break-apart by FISH is very helpful in the diagnosis and differential diagnosis of IFS/CFS.

Objective To investigate the feasibility of manual reduction with inverse shift for pronation-extorsion trimalleolar fracture by applying the finite element method combined with clinical experience. Methods Based on CT images and anatomical features of bone, ligaments and other tissues as well as material parameters, a normal ankle model with completed muscles and bones for a Chinese young male was established. According to the related characteristics of the pronation-extorsion trimalleolar fractures, fracture was simulated in the proper position to make osteotomy model. The finite element model of pronation-extorsion trimalleolar fractures was thus established and then applied with mechanical loading to simulate manual reduction with inverse shift. Results The established finite element model of pronation-extorsion trimalleolar fractures was effectively restored by the displacement loading. Conclusions The finite element analysis on pronation-extorsion trimalleolar fractures by inverse shift maneuver could further prove the feasibility, effectiveness and scientificity of manual reduction with inverse shift based on clinical experience.