Objective To discuss the uhrasonography and hemodynamic characteristics of carotid atherosclerosis in elderly patients with coronary heart disease (CHD).Methods The 548 people were divided into CHD group (n = 373) and control group (n = 175) by the coronary angiography.And the patients in CHD group were sorted into myocardial infarction (MI) group (n= 160) and non-MI group (n= 213).All patients were above 60 years of age, and underwent carotid artery ultrasound examination.The data of carotid sonography and hemodynamics were classified and analyzed using SPSS 10.0 software.Results The carotid intima-media thickness (IMT), plaque thickness and score were much more in CHD group than in control group [(0.96±0.24) mm vs.(0.78±0.11) mm, (1.90±0.36) mm vs.(1.66±0.13)mm, (2.2±0.7) vs.(1.9±0.4), t= 14.81, 27.89 and 27.83, all P=0.00].A total of 161 (43.2%) patients had atherosclerotie plaques in CHD group, and there were 7 (4.0%) people with plaques in healthy control group(χ~2 =337.18, P =0.00).And there were 81.3% of patients with plaques in MI group, it was more than non-MI group, in which there were 12.9% of patients with plaques (χ~2 =60.88, P=0.00).The carotid peak systolic velocity (PSV) and resistance index (RI) were both higher in CHD group than in control group [(77.0±11.9) cm/s vs.(65.2±3.1) cm/s and 0.77±0.06 vs.0.67±0.08, (t= 12.26 and 50.43, P=0.00)].Conclusions Carotid ultrasonography could evaluate not only CHD, but also CHD severity in the elderly.

Objective To explore and summarize the heart-shape anastomosis for hirschsprung′s disease .Methods Before the operation,the colon was cleaned thoroughly ,31 cases of this group (8 month-6 years old)underwent colonic pull-through and the dilated segment of colon was pulled out and resected.Normal colon and lower segment of rectum′s stomosis were stomosed as heart-shape (higher anterior and lower posterior).After replacing the colon and stomosis ,close the abdomen layer by layer.Results All 31 cases anus sphincter muscle were retained at most degree,so that retained their function of normal defecation .All 31 cases were healed and discharged, without one case with early complications as stomosis fistila,et al.No stomosis stenosis or other late period complication were found in 24 cases with long period follow-up.Conclusions Heart-shape stomosis is a good method for hirschsprung′s disease,especially fitful to the common type and short-segment type and long-segment type with diseased part in sigmoid colon .This method is easy,convenient,no special equipment was needed,easy to be publicized.

AIM:To establish a method for determining saikosaponin A,paeoniflorin,hesperidin and ferulic acid in Chaihu Shugan Powder(Pericarpium Citri Reticulatae,Radix Bupleuri,Rhizoma Chuanxiong,Fructus Aurantii,Radix Paeoniae alba,etc.).METHODS:The chromatographic saparation was performed on a Hypersil C18 column(250 mm?4.6 mm,5 ?m).The mobile phase was acetonitril-water(43:57) for saikosaponin A,and the mobile phase for rest components was acetonitrile -0.5% acetic acid(40:60).All of flow rates were 0.8 mL/min and column temperature maintained at 30 ℃.The detection wavelength was set at 200-400 nm.RESULTS:The four constituents were separated within 15 min.The linear ranges of saikosaponin A,paeoniflorin,hesperidin and ferulic acid were 38.5-166.7 ?g/mL(r=0.999 6),15.9～254.5 ?g/mL(r=0.999 9),22.1-353 ?g/mL(r =0.999 3),6.30-201.5 ?g/mL(r=0.999 9),respectively.The average recoveries were 97.57%,97.40%,98.86%,96.37%,respectively.The RSD were 2.1%,1.1%,0.70%,1.3%,respectively.CONCLUSION:The method is rapid,simple and accurate,and can be used for quality control of Chaihu Shugan Powder.

Objective To observe the effect of astragalus polysaccharides ( APS) on glucose homeostasis regulation and focus on glycogen synthase kinase 3 beta (GSK3 beta) activity and subcellular localization (nuclear translocation).Methods HepG2 human hepatoma cells were cultured in vitro and treated with high glucose of different concentrations (30, 40 mM) to induce hepatocyte endoplasmic reticulum stress model, then acquire optimum operating concentration.The HepG2 cells were treated with APS of different concentrations (50, 100, 200, 400 μg/mL) to select the most effective concentration.The HepG2 cells were divided into seven groups with different treatment: negative control group (C), positive control group (Tm), 30 mM high glucose-induced group (G30), 45 mM high glucose-induced group (G45), negative control+APS group (CA), positive control+APS group ( TA) and high glucose-induced+APS group ( GA).Effect of APS at different concentrations on proliferation activity of HepG2 cells were detected by MTT assay, transcription and shear levels of XBPlmRNA in HepG2 cells by quantitative real-time PCR, and phosphorylation levels of GSK3βin cytoplasm and nucleus by immunoblotting techniques.Results The optimum operating glucose concentration was 30 mM.The most effective APS concentration was 200μg/mL.The transcription and shear levels of XBPlmRNA in HepG2 cells of GA group were lower than those of G30 group ( P<0.05), respectively, but there were no significant differences between TA and Tm group.The phosphorylation levels of GSK3βin cytoplasm and nucleus of GA group were higher than those of G group(P<0.05), respectively, but there were no significant differences between TA and Tm group. Conclusion APS could improve hepatic steatosis, and its mechanism might be that APS inhibits the activity and nuclear localization of GSK3β, then alleviate endoplasmic reticulum stress.

AIM:To establish a method for determining saikosaponin A,paeoniflorin,hesperidin and ferulic acid in Chaihu Shugan Powder(Pericarpium Citri Reticulatae,Radix Bupleuri,Rhizoma Chuanxiong,Fructus Aurantii,Radix Paeoniae alba,etc.).METHODS:The chromatographic saparation was performed on a Hypersil C_(18) column(250 mm×4.6 mm,5 μm).The mobile phase was acetonitril-water(43:57)for saikosaponin A,and the mobile phase for rest components was acetonitrile-0.5% acetic acid(40:60).All of flow rates were 0.8 mL/min and column temperature maintained at 30℃.The detection wavelength was set at 200-400 nm.RESULTS:The four constituents were separated within 15 min.The linear ranges of saikosaponin A,paeoniflorin,hesperidin and ferulic acid were 38.5-166.7 μg/mL(r = 0.999 6),15.9～254.5 μg/mL(r = 0.999 9),22.1-353 μg/mL(r =0.999 3),6.30-201.5 μg/mL(r =0.999 9),respectively.The average recoveries were 97.57%,97.40%,98.86%,96.37%,respectively.The RSD were 2.1%,1.1%,0.70%,1.3%,respectively.CONCLUSION:The method is rapid,simple and accurate,and can be used for quality control of Chaihu Shugan Powder.

ObjectiveTo investigate the mechanism and the protective effect of heat shock protein 27 (HSP27) on rat cardiomyocytes when ischemic preconditioning performed.MethodsCultured rat cardiomyocytes were divided into four groups: control group, ischemic group,ischemic preconditioning group and cyclohexamide group. Cell viabilities were analyzed by MTT. The apoptosis was evaluated with DNA ladder and flow cytometry Annexin V Flous staining. Western Blot was used to determine the expression of HSP27 and caspase-3 in cardiomyocytes.ResultsIschemic preconditioning could improve cell viability. The apoptosis ratio in ischemic preconditioning group was significantly less than that in ischemic group. These were accompanied by an increase in the expression of HSP27 and a decrease in caspase-3. The expression of the increased HSP27 and the protective effect induced by ischemic preconditioning were completely abolished by the presence of cycloheximide, a translation inhibitor.ConclusionThe expression of HSP27 induced by ischemic preconditioning plays an important role in protecting cardiomyocytes, and the mechanism is possibly related to the inhibition of cell apoptosis.

Objective To analyze the MRI data of misdiagnosed and missed diagnosed of breast lesions and their histopathological features.Methods Data from 241 breast lesions within 121 patients were recruited in this study.The data included MRI images,uhrasounds and X-ray images were retrospectively interpreted by two radiologist and each lesion was assessed according to the BI-RADS classification.The pathologic features of miss or error diagnosed lesions on MRI were analyzed.Results In 241 breast lesions (malignance 120,bcnign 121),4 lcsions were miss diagnosed on MRI.Thcy were 2 intraductal papillomatosis and 2 fibroadenoma.All was benign.Twenty three lesions were misdiagnosed on MRI.Sixteen were overestimation,including 3 chronic inflammations,3 sclerosing adenosis,2 fibroadenoma,4 fibrocystic changes with or without atypical ductal hyperplasia (ADH),2 intraductal papilloma,1 infiltration of pectoralis major muscle and 1 axillary lymphnode metastasis.Meanwhile,there were 7 lesions were underestimation.These lesions included 2 invasive ductal carcinomas,1 mucinous adenocarcinoma,2 DCIS and 1 blunt duct adenosis with ADH and focal cancerous,1 inflammatory breast cancer underwent chemotherapy.The sensitivity and specificity and accuracy of breast MRI were 95.83 ％ (115/120),72.73 ％ (88/121),84.23 ％ (203/241),respectively.MRI findings had no difference with respect to mammogram or ultrasound was 75.10 ％ (181/241).Conclusion MRI misdiagnosis and missed often occurs in smaller breast lesions,morphologic and hemodynamic malignant manifestation atypical,especially intraductal lesions.MRI diagnosis should be combined with physical examination,X-ray mammogram and ultrasound to improve diagnostic accuracy and reduce missed diagnosis.

Purpose To investigate the value of systemic abdominal ultrasonography in the diagnosis of acute abdominal diseases. Materials and Methods A total of 234 patients with acute abdominal diseases were enrolled consecutively in the study and randomly divided into the study group who received systemic abdominal ultrasonography and the control group who received traditional selective abdominal ultrasonography. The diagnose accordance rate and diagnose duration of two groups were compared with the results of pathology or clinical follow-up which served as the golden standard. Results The diagnose accordance rate in the study group (95.04%, 115/121) was significantly higher than that of the control group (86.73%, 98/113) (χ2=4.946, P<0.05);the ultrasound examination duration in the study group was statistically longer than that of the control group [(16.41±1.31) min vs (10.11±4.35) min, t=14.771, P<0.05], and the diagnose duration in the study group was significantly shorter than that of the control group [(2.00±1.30) h vs (2.65±1.72) h, t=3.301, P<0.05]. Conclusion Systemic abdominal ultrasonography can improve the diagnosis coincidence rate and shorten the duration in the diagnosis of acute abdominal diseases.

Objective To evaluate the effects on the mineral bone disorder using different calcium concentration citrate-based dialysate in maintenance hemodialysis (MHD) patients.To compare the concentrations of intact parathyroid hormone(PTH) with biointact PTH(1-84) in these patients.Methods Citrate dialysate with different calcium concentration (DCa 1.75,DCa 1.5,DCa 1.25 mmol/L)were used in turn in 15 stable MHD patients each week.Serum tCa and iCa were measured by automatic biochemistry analyzer.The concentrations of iPTH and bio-iPTH were compared.Results (1) The patients treated with DCa 1.75 citrate dialysate had increased serum iCa and tCa after dialysis,and PTH did not change significantly as compared to those findings before the dialysis.With the DCa 1.5 citrate dialysate,serum iCa and tCa were kept stable and PTH level was increased.With DCa 1.25 citrate dialysate,serum iCa and tCa decreased significantly and PTH decreased.(2)iPTH and bioPTH had excellent correlations.Variation of bio-iPTH was more correlated with the changes of calcium than iPTH.Conclusions Serum levels of iPTH,tCa and iCa can be kept stable in MHD patients treated with DCa 1.75 ～ 1.5 citrate dialysate.Bio-iPTH is a more sensitive marker for mineral bone disease than iPTH.

Objective To investigate changes ane clinical significance of renal pathomorphology ane transforming growth factor-β1(TGF-β1 ),connective tissue growth factor(CTGF)of rats with eifferent stages of eiabetes mellitus(DM). Methods Thirty-six SD rats were raneomly eivieee into control ane DM group. Rats in DM group were given streptozotocin(STZ)at a eose of 65 mg/ kg boey weight ane rats in control group were given same amount citric acie/ soeium citrate buffer solution. Rats were killee at 4th,12th ane 24th weeks after DM moeels establishment. The renal hyeroxyproline concentration(HPC)was measuree. Masson′s trichrome was performee to observe perivascular collagen area(PVCA). Glomerular collagen eeposition score(GCDS),tubular interstitial eisease score(TIDS)in kieney interstitial tissue were measuree. Immunohistochemical staining were usee to measure the expression of type Ⅰ ane Ⅲ collagen,TGF-β1 ,CTGF. Renal path morphology change were observee with light microscope ane transmission electron microscope. Results (1)HPC levels of rats in DM group at 4th,12th,24th weeks were(216. 50 ± 10. 05)μg/ g,(267. 67 ± 11. 29)μg/ g,(340. 67 ± 39. 22)μg/ g,higher than that of control group((123. 00 ± 6. 00)μg/ g,(158. 50 ± 8. 89)μg/ g,(201. 00 ± 7. 69)μg/ g). The PVCA score in DM group were higher than that of control group( 4 weeks:(0. 45 ± 0. 07)vs (0. 96 ± 0. 11);12 weeks:(0. 60 ± 0. 06)vs(1. 65 ± 0. 18);24 weeks:(0. 72 ± 0. 07)vs(2. 63 ± 0. 0. 40);P< 0. 05). Meanwhile the scores of GCDS ane TILS in DM group)at 4th,12th,24th weeks increasee comparee with control group(4 weeks:((0. 34 ± 0. 03)vs(0. 14 ± 0. 01))× 103 / μm2 );12 weeks:((0. 49 ± 0. 03)vs (0. 26 ± 0. 04))× 103 / μm2;24 weeks:((0. 62 ± 0. 06)vs(0. 33 ± 0. 03))× 103 / μm2 )). The expression of CollagenⅠane Collagen Ⅲ in DM group were higher than that of control at 4,12,24 weeks after DM moeel establishment(Collagen Ⅰ:4 weeks:((4. 56 ± 0. 75)vs(1. 34 ± 0. 34))× 103 / μm2;12 weeks:((6. 07 ± 0. 74)vs(2. 17 ± 0. 12))× 103 / μm2;24 weeks:((7. 22 ± 0. 19)vs(3. 00 ± 0. 33))× 103 / μm2;CollagenⅢ:4 weeks:((3. 44 ± 1. 41)vs(1. 58 ± 0. 24))× 103 / μm2;12 weeks:((5. 60 ± 1. 34)vs(2. 95 ± 0. 41)) × 103 / μm2;24 weeks:((6. 22 ± 0. 18)vs(3. 27 ± 0. 27))× 103 / μm2 )),ane the eifferences between the groups all significant(P < 0. 05). Diffuse thickening of glomerular capillary basement membrane ane interstitial collagen hyperplasia in eiabetic rats were observee by electron microscope.(2)TGF-β1 expression in DM group were(2. 16 ± 0. 50)× 103 / μm2 ,(5. 31 ± 0. 25)× 103 / μm2 ,(6. 44 ± 0. 74)× 103 / μm2 respectively at 4th, 12th,24th weeks after DM moeel establishment,higher than that of control group((1. 18 ± 0. 15)× 103 / μm2 , (2. 99 ± 0. 25)× 103 / μm2 ,(3. 28 ± 0. 66)× 103 / μm2 )ane the eifferences were significant(P < 0. 05). The same trene was also seen in terms of CTGF expression((6. 02 ± 1. 39)vs(2. 32 ± 0. 87))× 103 / μm2 ,((6. 51 ± 0. 51)vs(3. 96 ± 0. 92))× 103 / μm2 ,((7. 89 ± 1. 46)vs(4. 58 ± 1. 02))× 103 / μm2;P < 0. 05) Conclusion Early eiabetic rats show renal fibrosis ane it may be relatee with overexpression of CTGF ane TGF-β1.