AIM:To improve the standard of quality control of Yiqi Zhixue Granule(Radix Codonopsis,Radix Astragali,Rhizoma Atractylodis macrocephalae,etc.) METHODS: In the prescription,both Radix codonopsis and Radix Astragali were identified by HPLC.Folium mahoniae was distinguished by TLC.Rhizoma Bletillae was authenticated by microscope.Morever,RP-HPLC method was adopted to determine the astragaloside content in the productions,using a column of C_(18),the column temperature was at 35(?C),acetonitrile-water(32∶68) as a mobile phase,he flow rate was 1.0 mL/min,and ELSD as detection in which the tube temperature was set at 102(?C) and the air flow was at 2.8 mL/min,the impactor was chosen off. RESULTS: The established identification methods were simple and proper,reflecting a good specificity,while the determination method was accurate and reliable,which showed the recovery of 97.95%,RSD=2.21%(n=9),the intermediate precision of RSD=2.67%(n=3),the robustness of RSD=3.67%(n=3) between columns,and the LOQ of 0.539 2 ?g,RSD=2.92%(n=5). CONCLUSION: The improved standard of quality control of Yiqi Zhixue Granule is not only practical but capable of effectively controlling the quality of the medicine as well.

Objective To detect the mutation of STK11 in a family with Peutz-Jeghers syndrome.Methods Genomic DNA was extracted from peripheral blood and harmatoma polypus of all the patients,and 9 exons and noncoding regions of STK11 were amplified by PCR.Cycle sequencing was used to analysis the DNA sequence,and western blot was used to detected the mutational STK11 protein in the harmatoma polypus.Results The 21th codon CAG in exon 5 of STK11 gene transformed to TAG in all the patients,which translated into a truncated STK11 protein.Conclusion This novel mutation is the pathogeny of PJS in this family,which could be an indicator for the diagnosis of PJS in this family.And it may lead to a higher risk of cancer in patients.

BACKGROUND:Studies have found abnormalities in the biological activity and cytokine levels of bone marrow mesenchymal stem cels from psoriasis patients, while the biological activity of skin-derived mesenchymal stem cels from psoriasis lesions is rarely reported.
OBJECTIVE:To explore the influences of skin-derived mesenchymal stem cels from psoriasis lesions on T cel proliferation
METHODS:After isolation and culture, skin-derived mesenchymal stem cels from psoriasis lesions and normal controls were separately co-cultured with peripheral blood T cels. T cel proliferation was detected using MTT assay,andlevels of epidermal growth factor and transforming growth factor β1 in cel supernatant determined using ELISA method.
RESULTS AND CONCLUSION:Skin-derived mesenchymal stem cels frombothpsoriasis lesions and normal controls significantly inhibited T cel proliferation (P< 0.05). Furthermore, skin-derived mesenchymal stem cels from psoriasis lesions exhibited a weaker inhibitory effect on T cel proliferation than normal skin-derived mesenchymal stem cels (P< 0.05). Skin-derived mesenchymal stem cels from psoriasis lesions significantly increased epidermal growth factor but reduced transforming growth factor β1 compared with the normal skin-derived mesenchymal stem cels (P< 0.05). In conclusion, maybe the imbalances of growth factor levels due to skin injury elicit a decrease in the inhibitory effect of skin-derived mesenchymal stem cels from psoriasis lesions on T lymphocytes.

Objective To investigate the value of modified T staging system in the diagnosis and treatment of hilar cholangiocarcinoma (HCCA).Methods The clinical data of 95 patients with HCCA who were admitted to the Memorial Sun Yat-Sen Hospital from December 1995 to January 2010 were retrospectively analyzed.Based on the results of imaging examination,preoperative staging was determined according the modified T staging system.The prognosis of the patients in difference T stages were compared.The data were analyzed by using the chi-square test and Fisher exact test.The survival curve was drawn by Kaplan-Meier method and the survival rate was compared by using the Log-rank test.Results The diagnostic rates of ultrasound + magnetic resonance cholangiopancreatography (MRCP),ultrasound + computed tomography (CT) or spiral CT were 93％ (37/40) and 66％ (23/35),respectively.The diagnostic rates of ultrasound + CT or spiral CT and endoscopic retrograde cholangiopancreatography (ERCP),ultrasound + CT or spiral CT and MRCP were 14/15 and 15/15,respectively.Of the 95 patients,44 received operation (including 28 cases of radical resection and 16 cases of palliative resection),16 received exploratory laparotomy,and 35 received simple internal or external drainage.For patients in T1,T2 and T3 stages,the resection rates were 71％ (30/42),50％ (12/24) and 7％ (2/29),respectively,with significant differences (x2 =30.182,P ＜0.05).The negative rates of the resection margins of patients in T1 and T2 stages were 77％ (23/30) and 5/12,respectively,2 patients in T3 stage were found with tumor residuals at the resection margin.There was a significant difference in the radical resection rate among patients in different T stages (x2 =8.204,P ＜ 0.05).Of the 44 patients who received surgical treatment,30 (68％) received concomitant partial hepatectomy.The ratios of patients in T1 and T2 stages who received concomitant partial hepatectomy were 70％ (21/30) and 9/12,respectively,with no significant difference (x2 =0.101,P ＞ 0.05).Fourteen (32％) patients received tumor resection.The incidences of complications and perioperative mortalities were 53％ (16/30) and 10％ (3/30) for patients who received concomitant partial hepatectomy,and 5/14 and 1/14 for patients who received tumor resection,with no significant differences between the 2 groups (x2 =1.188,0.094,P ＞ 0.05).The median survival time of patients who received concomitant partial hepatectomy was 29 months,which was significantly longer than 19 months of patients who received tumor resection (x2 =11.317,P ＜0.05).Eighty-six patients were followed up,and the median time of follow up was 15.6 months (range,3-70 months).The 1-year cumulative survival rates of patients in T1,T2 and T3 stages were 73.8％,58.0％ and 9.2％,respectively,and the 3-year cumulative survival rates of patients in T1,T2 and T3 stages were 33.5％,12.1％ and 0,respectively.The median survival time of patients in T1,T2 and T3 stages were 24,16 and 7 months,respectively.The prognosis of patients was getting poor as the increase of the T stages (x2 =37.07,P ＜ 0.05).Conclusions The modified T-staging system is beneficial to preoperative evaluation of patients with HCCA.Concomitant partial hepatectomy could improve the radical resection rate and prolong the median survival time of HCCA patients.

ObjectiveTo review our experience in the diagnosis and surgical treatment of solid pseudopapillary neoplasm (SPN) of the pancreas which can be used as a reference for other doctors to avoid misdiagnosis and to provide a better treatment.MethodThe clinical,laboratory,radiological,pathological and operative data of 24 patients with SPN of the pancreas operated between February 2001 to December 2009 were collected and retrospectively analyzed.Results23 of 24 patients were female and the mean age was 31 years.The most common clinical presentations were vague abdominal pain and abdominal mass.In most cases,abdominal imaging showed a solid or a solid-cystic mass in the tail or head of pancreas.All patients received surgery.20 of 22 patients who received curative resection were alive with no evidence of tumour recurrence.One patient who had a R1 resection died 42 months after surgery.The remaining patient was alive after a second operation.ConclnsionsSPN of the pancreas is a tumour with low malignancy.A correct diagnosis of SPN of the pancreas is made on its clinical,radiological and histopathological characteristics.Radical surgical resection is the treatment of choice.For patients with an advanced disease,palliative resection is beneficial.

Animals ; Carcinogens ; toxicity ; Female ; Lung Neoplasms ; chemically induced ; pathology ; Mice ; Mice, Inbred BALB C ; Mice, Inbred C57BL ; Mice, Inbred Strains ; Sensitivity and Specificity ; Urethane ; toxicity

Objective To examine the levels of serum adipunectin (ADPN)in patients with end-stage renal disease (ESRD), and identify the relationship between serum ADPN and tumor necrosis factor (TNF)-α, high sensitivity C-reactive protein(hs-CRP) and renal function. Methods Sixty ESRD patients and twenty normal healthy persons were involved in this study. The patients were divided into three groups: patients with chronic renal failure (CRF, 18 cases), patients with hemodialysis (HD,22 cases) and patients with peritoneal dialysis (PD,20 cases). The levels of serum ADPN, TNF-α and hs-CRP were detected by means of ELISA. Differences in continuous variables be-tween the three groups were evaluated. Results The levels of serum ADPN, TNF-α and hs-CRP in CRF, HD and PD patients were signifi-cantly higher than those in control group ( P<0.01 ). Serum ADPN levels in ESRD patients were positive related to serum TNF-α( r≥0.478, P<0.01 ), and negative related to GFR ( r≥-0.582, P<0.01 ). Conclusion The level of serum ADPN was markedly in-creased in patients with ESRD, and correlated with serum TNF-α level and.renal function.

Objective To explore the therapeutic effect of patients with intractable by microsurgical operation.Methods All patients assisted by a 3-dimensional precise localization system of epileptic foei for epilepsy diagnosis and the epileptogenic focus and comprehensive surgical measures were taken for the treat- ment of isolated epileptic foci and their network.The outcomes of 50 patients in the following up 1～2 years were defined.A retrospective review was conducted.Results In this group,Excellent 53 cases (31.90%);good 83 cases(50.93%);moderate 10 cases(6.13%)and poor 18 cases(11.04%).The ef- fective rate was 80%.Conclusion The microsurgical management is an effective approach for treatment of refractory epilepsy.

Background Argon laser peripheral iridoplasty (ALPI) is proved to be effective in lowering intraocular pressure (IOP) of patients with mild acute primary angle closure (APAC).It is unclear whether this laser treatment is equally efficient in managing patients with severe APAC.This study aimed to evaluate the IOP-lowering efficacy of ALPI and laser peripheral iridotomy (LPI) on patients with refractory APAC,who have previously responded poorly to intensive medical therapy.Methods Thirty-six patients (8 men and 28 women) were identified as medically refractory APAC,who still had ocular pain,red eye,hazy cornea,closed anterior chamber (AC) angle,and IOP of not less than 21 mmHg after two days or more of anti-glaucoma medication.All enrolled patients underwent ophthalmologic examinations including measurement of visual acuity (VA),best corrected VA (BCVA),IOP,biomicroscopy,and gonioscopy followed by ALPI immediately in the APAC eye and LPI in both eyes.Results All patients were affected unilaterally,with average age of (54.6±11.7) (range,37.0-75.0) years old.The mean IOP value of the affected eyes dropped from (31.6±7.7) (range,21.0-39.0) mmHg at enrollment to (18.4±8.7) (range,10.0-27.0) mmHg 2 hours after ALPI.At follow-up day 7,the mean IOP value maintained at (14.8±4.2) (range,9.0-21.0)mmHg,which was significantly different (P=0.000) compared with baseline.The average decrease of IOP in the APAC eyes was (16.8±7.4) (range,12.0-21.0) mmHg.At follow-up three years later,the mean IOP of the APAC eyes stabilized at (16.3±3.2) (range,9.0-20.0) mmHg with at least 180° of AC angle opened.Conclusion ALPI and LPI lower the IOP of medically refractory cases of APAC though they have responded poorly to anti-glaucoma medication.

Karoshi remains one of the most troublesome issues in forensic identification. It is rather a social medicine than a clinical disease. Japanese scholars pioneered examining the relation between sud- den cardiac death (SCD) and chronic fatigue from long time and/or high-tension work. In the current case, a 55-year-old man, whose job was loading and carrying heavy cement bags, was found dead after 11 days of continuous hard work. His family members sued the cement factory for his death and claimed for compensation. The problem was the difficulty of identifying the causative relation without the precedent or the relevant regulations. However, the forensic problems were finally acknowledged after autopsy and calculation of labor intensity. The lawsuit was won as the first case pertaining to Karoshi in the Chinese court.
Autopsy ; Death, Sudden, Cardiac/etiology* ; Fatigue/mortality* ; Forensic Pathology ; Humans ; Male ; Middle Aged ; Risk Factors ; Workload/legislation & jurisprudence*