Objective:To study the feasibility and efficacy of the modified posterolateral laparoscopic approach for resection of massive splenomegaly.Methods:The data of 48 patients who underwent laparoscopic splenectomy for massive splenomegaly at the Affiliated Hospital of Jiangnan University (Wuxi 4th People's Hospital) from January 2016 to July 2019 were retrospectively analyzed. There were 29 males and 19 females, with an average age of 55.8 years. These 48 patients were divided into two groups according to the operative approach, the study group ( n=26) using the modified posterolateral approach which treated the splenic pedicle as the last step; and the control group ( n=22) which used the posterior tunnel of splenic pedicle established by anterior approach to treat the splenic pedicle first. The operation time, gastrointestinal function, recovery time, intraoperative blood loss, rates of conversion to laparotomy and postoperative complications were compared between two groups. The follow-up data were also analyzed. Results:There were no significant differences in operation gastrointestinal function recovery and hospitalization time between the two groups (all P>0.05). The intraoperative blood loss, numbers of patients with convention to open surgery and intraoperative blood transfusion, were (50.2±15.1) ml vs (160.1±40.3) ml, 2 patients (7.7%) vs 7 patients (31.8%), and 1 patients (3.8%) vs 5 patients (22.7%), in study group and control group respectively. The differences between groups were significant (all P<0.05). The complications of the study group and control group were 9 patients (34.6%) vs 13 patients (59.1%), which were significantly in the two groups ( P<0.05). On follow-up which ranged from 1 to 15 months, the numbers of patients with thrombocytosis and portal vein thrombosis in the study group and the control group were 20 patients (76.9%) vs 17 patients (77.3%), and 7 patients (26.9%) vs 6 patients (27.3%), respectively. Conclusion:The modified posterolateral laparoscopic approach for resection of massive splenomegaly was safe and feasible. It should be promoted to treat massive splenomegaly.

Leaves of Chrysanthemum morifolium were potential medicinal resource. The present study aims to estimate the main bioactive components: total flavonoids (TF), galuteolin (GA), quercitrin (QU), chlorogenic acid (CA) and 3 ,5-O-caffeoylquinic acid ( CQ), which were considered to be the main effective components, in leaves of C. morfolium cultivars in China. The TF content was estimated hy UV-VIS spectrophotometry, while GA, QU, CA, and CQ were quantitatively determined by HPLC. The highest TF content (7. 13% w/w) was found in cultivar Wan Cong (Shexian county). Cultivar Da Bo ( Bozhou county) had the highest GA content (33. 45 mg - g-1); Cultivar Hong Xin (Sheyang county) contained the highest QU content (29.25 mg · g(-1)); Cultivar Chang Ban (Sheyang county) had the highest CA content (13.14 mg ·(-1)). The maximum CQ content (7.35 mg · g(-1)) was observed in culti- r Da Yang ( Tongxiang county). Different cultivars of C. morfolium had significant difference in components, but the leaf and capitulum of C. morifolium. were found to possess similar chemical compositions. The high content of bioactive components in several cultivars suggested the potential utilization of C. morifolium leaves.
China ; Chromatography, High Pressure Liquid ; Chrysanthemum ; chemistry ; growth & development ; Drugs, Chinese Herbal ; analysis ; Plant Leaves ; chemistry

Objective To evaluate the effectiveness and safety of varicella attenuated live vaccine ( VarV) produced by A Co. Ltd. Methods We selected 3 provinces in China and enrolled 15 002 children aged 3-<11 in this random, multicenter study. Participants were randomly divided into two groups: the ex-perimental group and the control group. Every varicella case was collected and recorded to calculate the vac-cine efficacy. Vaccine safety was assessed by means of spontaneous report and regular follow-up visits. Re-sults During the observation period, the incidence of varicella was 0. 147% in the experimental group and 1. 155% in the control group (P<0. 001). The vaccine efficacy was 87. 27%. The adverse reaction rate af-ter vaccination was lower than the rates reported in other literatures. Conclusion The VarV produced by A Co. , Ltd. in China was effective and safe in preventing varicella.

Background Congenital heart disease (CHD) is a diverse group of diseases determined by genetic and environmental factors.Considerable research has been done on genes associated with the development of the heart.Recently,focus is on the role of transcription factor NFATc1 in the development of proper valve and septa.As part of a larger study,high density single nucleotide polymorphism (SNP) scanning was used to explore the relationship between NFATc1 gene polymorphism and susceptibility to ventricular septal defect (VSD) in the Chinese Han population.Methods One hundred and ninety-two pediatric patients with congenital VSD and 192 matching healthy control subjects were studied.The haplotype reconstructions were calculated by PHASE2.0 software.Haploview software was used to perform linkage disequilibrium assessment and define haplotype blocks.The algorithm used for defining the blocks was the confidence interval method.Results The NFATc1 gene region can be divided into 11 haplotype blocks.Strong linkage disequilibrium existed within blocks 6,8,9,and 11.Three SNPs (rs7240256,rs11665469,and rs754505) within the NFATc1 gene had significant correlation with VSD by single marker association analysis.In addition,two haplotypes correlated with VSD.Conclusions NFATc1 is associated with the occurrence of VSD and it may be a predisposing gene to CHD in Han Chinese.This finding has set a direction for further genetic and functional studies.

Objective To evaluate the efficacy and drug-related toxicities of pemetrexed disodium in the treatment of advanced pulmonary adenocarcinoma.Methods A total of 41 patients who had received pemetrexed disodium and cisplatin therapy were retrospectively reviewed.The patients were given respectively pemetrexed disodium (500 mg/m2,1st day) and cisplatin (200 mg/m2,1-4 day) until disease progressed.The clinical outcomes and adverse reactions were observed.Results The CR rate was 7.3 ％ (3/41),PR rate was 22.0 ％ (9/41),SD rate was 31.7 ％ (13/41),PD rate was 39.0 ％ (16/41),the DRR was 29.3 ％ (12/41),DCR rate was 61.0 ％ (25/41),the median PFS was 5 months.The age,sex,smoking history,staging and timing of treatment had not the statistics difference on ORR and DCR.The sex,smoking history,staging and timing of treatment had not the statistical difference on PFS (P ＞ 0.05).The main toxicities were fatigue,nausea,vomiting and myelosuppression.Conclusion The pemetrexed disodium and cisplatin are feasible and welltolerated for advanced pulmonary adenocarcinoma patients.

Objective To investigate the effects of quetiapine on serum levels of brain-derived neurotrophic factors ( BDNF) and the correlation between BDNF and psychiatric symptoms and cognitive function in patients with first-episode schizophrenia. Methods Eighty patients with first-episode schizophrenia ( treatment group) were treated with quetiapine orally for 4 weeks,at initial dose of 100 mg·d-1 and average dose of (580±120) mg·d-1 . The psychiatric symptoms were evaluated by using the positive and negative syndrome scale ( PANSS) . The cognitive function was assessed by using Wisconsin cards sort test ( WCST) . The serum BDNF level was detected with enzyme-linked immunosorbent assay ( ELISA) . Results The serum level of BDNF was markedly lower in schizophrenic patients before[(13. 72±8. 79) ng·mL-1,P<0. 01] and after treatment[(18. 02±9.06) ng·mL-1,P<0.05]in comparison with normal controls(23. 67±10. 13) ng·mL-1]. After treatment,the PANSS total scores and subscale scores decreased,WCST number of categories and the number of correct answers increased,and the number of wrong answers reduced. There was a positive correlation between the serum BDNF and negative symptoms ( SANS) ( r= 0. 54, P=0. 032),and the number of correct answers. Conclusion The quetiapine significantly increases serum level of BDNF in schizophrenia patients,which correlates positively with improvements in symptoms and cognitive function.

Objective To study the effects of bone marrow mesenchymal stem cells (BMSCs) transplantation on the ischemia-reperfusion injury of the intestine in rats.Methods BMSCs were isolated from femur of male Wistar rats and cultured,and the phenotypes of third generation cultured cells were identified.B16-F10-Luc-G5 cells were injected into the intestinal submucosa and traced by Luciferin.Intestinal ischemia-reperfusion injury models were established in male Wistar rats,which were divided into the experimental group (1 ml BMSCs suspension which contained 5 × 106 cells was injected into the intestinal submucosa) and the control group (1 ml normal saline was inject into the intestinal submucosa).Then,serum and intestinal tissue samples were collected at 0,2,6,24,72 and 120 h after operation.Diamine oxidase,D-lactate and TNF-α were tested by ELISA,intestinal tissue samples were observed under the Light microscopy and transmission electron microscopy,and tight junction protein-1 (ZO-1) was detected by using Western blotting and immunohistochemistry.Results BMSCs were isolated and cultured successfully and they colonized in the intestine.The pathological changes of the intestine in experimental group were milder than in control group. Intestinal mucosal barrier was more intact in experimental group than in control group.In the experimental group and control group,DAO was (11.36 ± 1.89) and (14.27 ± 2.09)IU/ml (P＜0.05) at 6th h after injection,and that was (5.04 ± 1.04) and (7.35 ± 1.46) IU/ml (P＜0.05) at 24h after injection,respectively.In the experimental group and control group,D-lactate was (1.57 ± 0.25) and ( 1.93 ± 0.19) mmol/L (P＜0.05) at 6th h after injection,and that was ( 1.09 ± 0.13) and ( 1.41 ± 0.07) mmol/L (P＜0.01 ) at 24th h after injection,respectively.In the experimental group and control group,TNF-α was (266.09 ± 8.84) and (286.81 ± 11.54) ng/L (P＜0.01 ) at 6th h after injection,and that was (190.39 ± 4.24) and (218.49 ± 15.51 )ng/L (P＜0.01 ) at 24th h after injection,respectively.The expression of ZO-1 protein was higher in experimental group than in control group. ConclusionInjection of BMSCs into could protect the intestine from ischemia-reperfusion injury in rats.

Objective To clarify the effectiveness of QS Nd ∶ YAG laser on melasma in Chinese patients.Methods A group (n=45) of patients previously diagnosed as facial melasma were treated with QS Nd ∶ YAG laser at approximately 1 week intervals.Eleven to twenty treatments were per formed for each patient.The treatment efficacy of QS Nd ∶ YAG laser was evaluated by patients and doctors,respectively,at various time point such as before treatment,5 weeks and 10 weeks after treatment and end of the treatment.The skin melanin index and the transepidermal water loss were e valuated by the skin multifunction tester at different time point,respectively.Results Compared with untreated,the melanin index of melasma areas decreased significantly after the laser treatment for 5 weeks,10 weeks and the end of treatment.But there was no significant difference in the melanin index of normal skin areas with or without laser treatment.Compared with untreated,the transpidermal water loss of melasma areas increased significantly after the laser treatment for 5 weeks,10 weeks and end of treatment.The patients' skin became smooth,delicate,pores shrink and more flexible.In 45 melasma patients treated by QS Nd ∶ YAG laser,8 cases basically cured (17.78 ％),25 cases were markedly effective (55.56 ％),12 cases improved (24.44 ％) and only 1 case was uneffective (2.22 ％).Theoverall effective rate was 73.33 ％.Conclnsions QSNd∶ YAG laser is a useful treatment modality for Chinese women who have melasma with precise efficacy,less side effects and high safety.

Objective To explore the sensitivity of using NT,combined with serum biochemical markers (Free-βhCG,PAPP-A) for Down's Syndrome screening in early stage of pregnancy.Methods Collect pregnant women aged 17-45 years old voluntary antenatal screening in our hospital from March 2009to October 2010,a total of 11882 cases.Serum Free-βhCG and PAPP-A were measured NT value was determined by ultrasound at 11-13w+64 of gestation.Calculating combined screening (NT,Free-βhCG,PAPP-A),and serum integrated screening (Free-beta hCG,PAPP-A) risk,respectively,using the risk calculation software for the same person.Results Early pregnancy screening was performed in 11 882patients,18 had a fetus with Down's syndrome,a rate of 0.15％.The detection rates of Down's syndrome in combined screening and serum integrated screening were 83.3％ and 72.2％ respectively.The specificities were 98.4％ and 97.3％ and detection efficiency were 7.18％,3.90％ respectively.Areas under the curve (AUCs) of fhst-trimester combined screening and serum integrated screening were 0.975 (95％ CI:0.943,1.007),0.901 (95％ CI:0.789,1.013) respectively.Conclusion In early stage of pregnancy,combined screening for Down's syndrome has higher sensitivity and specificity than serological screening,has higher detection rate in the same false-positive rate case,which can effectively reduce the pregnant women to receive invasive puncture.

Objective To establish the reference interval for CA 72-4 in indirect method.Methods All results for CA72-4 that were stored in our laboratory information system of Zhongshan hospital between Jan.2010 and Dec.2012 were included in this study.Outliers were identified and omitted using Stem-and-Leaf&Box Plots in SPSS statistical software.The treated data was divided into several groups according to gender and age.Nonparametric rank sum test was used to observe the difference between male and female participants and Spearman correlation analysis was used to examine the correlation between CA 72-4 and age.Nonparametric reference intervals for CA 72-4 were estimated statistically in two gender sub-groups.Results After 139 cases excluded, there were 1 548 cases of male (Median 1.7, 0.4 to 18.9) and 773 cases of female ( Median 1.8, 0.2 to 18.9 ).There was a significant difference in serum CA 72-4 between male and female participants.No significant difference was found in serum CA 72-4 among age sub-groups.Indirect reference values for CA 72-4 of male and female were respectively 0 to 8.9 U/ml and 0 to 11.6 U/ml.Conclusion Indirect method to establish biological reference interval is a relatively simple and less expensive method under the high rapid development of the hospital information network .It can be used in the periodical review and establishing the reference intervals where the direct method can not be used.