Objective To observe the clinical efficacy of Simotang oral liquid combined with compound glutamine enteric capsules in the treatment of diarrhea-predominant irritable bowel syndrome (IBS-D) belonging to liver depression and spleen deficiency pattern, and to explore its possible mechanism. Methods Sixty patients were randomly divided into two groups. The treatment goup (30 cases) took Simotang oral liquid and compound glutamine enteric capsules, the control group took Cerekinon and Medilac-S. The treatment course was 4 weeks. Clinical symptoms, 5-hydroxytryptamine (5-HT) and substance P (SP) of both groups were evaluated respectively before and after treatment. Recurrence rate and adverse reactions were recorded. Results The total effective rate after treating 1, 2, 4 weeks between the two groups had no significant difference (P>0.05). Four weeks later, in the treatment group, total score of the symptoms, abdominal distension and defecation urgency were apparently lower than that of control group (P<0.05). The levels of 5-HT and SP of the two groups significantly decreased after treatment (P<0.05). The recurrence rate at 4 weeks after drug withdrawal of treatment group and control group was 10.7%(3/28) and 32.1%(9/28) respectively. The difference between the two groups wasn’t significant (P>0.05). Obvious side effects were not found in the two groups. Conclusion Simotang oral liquid combined with compound glutamine enteric capsules has evident therapeutic effect on IBS-D of liver depression and spleen deficiency pattern, especially good at releasing abdominal distension and defecation urgency. The mechanism may be related with decreasing the levels of 5-HT and SP.

Ischemic stroke is closely associated with carotid atherosclerosis.Detecting carotid plaque components (including fibrous Cap,lipid core,hemorrhage,and calcification) using high-resolution 3.0T magnetic resonance imaging contributes to evaluate the risk of ischemic stroke and guide treatment.This article reviews the research status of magnetic resonance imaging of carotid atherosclerotic plaque components.

Objective To compare the value of biphasicmulti-detector row helical computed tomogrpahy(MDCT),digital subtraction angiography(DSA)and lipiodol computed tomography(CT)in hypervascular hepatocellular carcinoma(HCC).Methods 80 cases with liver cancer were underwent MDCT、DSA、iodized oil CT scan,then compared detection rates of three methods.Results In detecting hepatic nodules(＞2cm),these three imaging techniques had the same sensitivity;for 1～2cm hepatic nodules,the detecting rate had no significant difference;The MDCT scan＜1cm detected 47 nodules(94.0%),iodized oil CT detected 27 nodules(54.0%),both statistically significant difference in detection rate(χ~2=3.11,P＜0.01),DSA is only detected 16 nodules(32.0%)compared with enhanced dual-phase MDCT scan and iodized oil CT detection rate the differences were statistically significant(χ~2=9.09,9.03,all P＜0.01).Conclusion MDCT is able to better show feeding arteries of hepatocellular carcinoma,The imaging examination of liver cancer before treatment can be used as a comprehensive evaluation.

Objective To investigate the clinical characteristics, treatment, and factors of recurrence of abdominal wall endometrioms ( AWE). Methods 19 cases of AWE diagnosed at Shaoxing People' s Hospital from January 2005 to April 2009 were reviewed retrospectively. Results All patients had a history of cesarean section. Eleven patients (57.9%) had the typical complaint of an enlarging mass and pain during menstruation. All patients received surgical excision and postoperative adjuvant therapy of gonadotropin releasing hormone agonist (GnRHa) or Mifepristone treatment for 6 months. The diagnosis was confirmed by histological examination in all patients. At follow- up, ranging from 1 month to 3 years, there was 1 case of recurrence of endometrioms during a follow -up of 2 years. Conclusion AWE could be diagnosed easily by its typical clinical manifestations preoperatively. Sonography or MRI may be helpful in identifying the exact anatomical location of the lesion and in excluding other surgical conditions, however it lacks specificness. Surgical excision is the only effective treatment, and complete and wide local excision is the key point to prevent recurrence. Combination surgical excision with postoperative adjuvant therapy might reduce the recurrence, although its effectiveness need being testified in the future.

Objective To discuss the clinical value of transposition of the pedicled anterolateral femoral periosteal flap. Methods The blood supply of anterolateral femoral periosteum were dissected on 38 adult cadaveric lower limber specimens injected with red dye. The origins, distributions and anastomosis of periosteal breanches were observed and measured. Based on these anatomic investigations, the transposition of pedicled anterolateral femoral periosteal flap was designed to repair the bone nonunion and lesion of femur. Results Twenty-two cases were treated in the satisfactory results, and followed-up from 1 to 5 years. The size of the periosteal flap ranged from 8cm?4cm to 10cm?5cm. Conclusions The periosteal flap could be operated so conveniently and safely as to be spread easily, treatment of lesion and incision of periosteal flap can be finished in the same operative approach. The periosteal flap have been proved to be powerfully clinical value.

A high performance liquid chromatography-electrospray ionization mass spectrometry- charged aerosol detection ( HPLC-MS-CAD) method was established for the simultaneous quantitative analysis of four Lignans in Magnoliae Flos extract. The components were separated on a YMC-Pack ODS-A column (250 mm× 4. 6 mm, 5 μm) by gradient elution with methanol and water as the mobile phase at aflow rate of 1. 0 mL/min. Then the elution solution was routed into MS equipment at a flow rate of 0. 3 mL/min and CAD detector at a flow rate of 0. 7 mL/min by a split ratio of 3:7 for the further detection. The column temperature was 25 ℃ and the detection wavelength was 278 nm. A method was developed for the quantitative analysis of muti-components by single maker ( QAMS) to determine pinoresinol dimethylether, magnoli, 1irioresinol B dimethylethe and epi-magnoli A . Magnoli was selected as internal standard and the relative correction factors ( RCF) of the four Lignans were calculated. The contents of the four Lignans in Magnoliae Flos extract were determined by both external standard method and QAMS. The QAMS method was evaluated by comparison of its assay result and that of external standard method. Under the selected chromatographic condition, the limits of detection of pinoresinol dimethylether, magnoli, lirioresinol B dimethylethe and epi-magnoli A were 0. 34, 0. 55, 0. 50 and 0. 58 mg/L, respectively, while the linear range were within 6. 8-270 mg/L, 11-546 mg/L, 2. 0-101 mg/L and 2. 3-116 mg/L. The recoveries ( n=9 ) were 98. 2%-99. 5%, and the correlation coefficient were 0 . 9995-0 . 9998 . No significant differences were found between the quantitative results of external standard method and QAMS method. The developed method is accurate, feasible, and can be used for quality evaluation of Magnoliae Flos .

OBJECTIVE To learn the molecular epidemiologic character of 21 genotypes of human papillomavirus(HPV).METHODS Totally 500 samples from women genital tract secretion were monitored by flow-through hybridization and gene chip,then studying the molecular epidemiologic character of HPV included HPV6,11,16,18,31,33,35,39,42,43,44,45,51,52,53,56,58,59,66,68,and CP8304.RESULTS The total positive rate of 21 genotypes of HPV was 53% in women cervicitis patients,high-risk HPV genotypes were 60% in all positive samples.Among 21 genotypes of HPV,the positive rate of HPV11 was the first(12.4%),but HPV16 positive rate was the first among high-risk genotypes(11.2%).Among the positive rates in different stage of years,the 21-30 years old group was the highest,the 31-40 years old group was the second,total of two groups was 76.6%.CONCLUSIONS The molecular epidemiologic results can be used in development of HPV vaccine,and in prevention and cure of HPV infection.

Objective To establish the normal data of the fetal thorax,and to evaluate its values in the diagnosis of fetal thorax malformation.Methods Totally 398 normal singleton fetuses at 16 to 36 gestational weeks(GW) were enrolled,2D-US and 3D-US VOCAL technique were used to measure the 2D data and 3D volumes on the transverse section at the level of the four-chamber view,and the correlation among all measurements with GW was analyzed.Thirty fetuses collected randomly were examined to analyze the reliability.Nine fetuses with congenital thoracic dysplasia (CTD) and 10 fetuses with congenital diaphragmatic hernia (CDH) were assessed and compared with the normal fetuses.Results ① In healthy controls,the fetal thoracic 2D measurements and 3D volumes increased along with the growth of the GW.The regression equations were listed as follows:thoracic transverse diameter (cm) =-0.002 GW2 + 0.301 GW-1.510;thoracic anteroposterior diameter (cm) =0.003GW2 + 0.046GW + 0.666;thoracic area (cm2) =0.071GW2-1.466 GW + 14.728;thoracic circumference (cm) =0.01GW2 + 0.313GW + 3.341;thoracic volume (cm3) =0.285 GW2-7.797GW + 66.592;lung volume (cm3) =0.178 GW2-5.317GW + 45.539;the ratio of lung volume to thoracic volume =0.005GW + 0.396.② The reliabilities of the data obtained by the same/two different operators were good.③ CTD group was obviously lower than the healthy controls in all thoracic measurements (all P ＜0.01).There was no statistical difference in the 2D data between the CDH group and healthy controls (P ＞0.05),while the 3D volumes and the ratio of lung volume to thoracic volume were obviously lower than those in the healthy controls (P ＜0.01).Conclusions 2D-US can evaluate the fetal thoracic development and malformation preliminarily,but 3D-US VOCAL technology plays an important role in distinguishing different types of thoracic malformations.

Objective To evaluate the effects of dexmedetomidine on the development of perioperative cardiovascular events in elderly patients.Methods Forty-eight patients of both sexes,aged 65-85 yr,with body mass index of 19.5-25.3 kg/m2,of American Society Anesthesiologists physical status Ⅱ or Ⅲ,scheduled for elective abdomninal or lower limb surgery under general anesthesia,were divided into 2 groups (n =24 each) using a random number table:general anesthesia group (group G) and dexmedetomidine plus general anesthesia group (group D).In group D,dexmedetomidine was intravenously infused in a loading dose of 0.25 μg/kg over 10 min and then continuously infused at 0.2 μg · kg-1 · h-1 until 30 min before the end of surgery.The equal volume of normal saline was intravenously infused instead in group G.At 1 day before surgery and 1 and 2 days after surgery,dynamic electrocardiogram was used to monitor heart rate variability including standard deviation of normal-to-normal intervals,standard deviation of the average 5-min normal-to-normal intervals,and root of the mean of the sum of the squares of differences between adjacent normal-to-normal intervals.The development of intraoperative cardiovascular events and requirement for vasoactive drugs were recorded,and the development of cardiovascular events within 2 days after surgery was also recorded.Results Compared with group G,standard deviation of normal-to-normal intervals and standard deviation of the average 5-min normal-to-normal intervals at 1 and 2 days after surgery and root of the mean of the sum of the squares of differences between adjacent normal-to-normal intervals at 2 days after surgery were significantly increased,the total incidence of intraoperative cardiovascular events and requirement for vasoactive drugs were decreased,and the total incidence of cardiovascular events within 2 days after surgery was decreased in group D (P ＜0.05).Conclusion Dexmedetomidine can reduce the development of perioperative cardiovascular events in elderly patients.

Objective To examine loss of heterozygosity(LOH) and microsatellite instability(MSI) of locus D8S277 on chromosome 8 and their influence on the expression of PINX1 in the gastric carcinoma,which may provide an experimental basis for the mechanism of PINX1 gene and tumor development.Methods DNA was extracted from formalin-fixed paraffin-embedded tissues.Polymerase chain reaction-single strand conformation polymorphism(PCR-SSCP) and ordinary silver staining were used to study LOH and MSI of locus D8S277.Envision immunohistochemistry and Leica-Qwin computer imaging techniques were used to assess the expression of PINX1.Results The frequency of LOH was significantly higher in the cases with lymph node metastasis than in those without metastasis(21.15% vs 0,P