Objective:To establish the quality standard for Naoxin Luotong pills. Methods:Astragali radix, bombyx batryticatus and scorpio were identified under a microscope. Peach kernel, astragali radix, paeoniae radix alba, rheum, paeonia suffruticosa and salvia miltiorrhiza were identified by TLC. The content of total ferulic acid was determined by HPLC with a Sapphire C18 column (250 mm × 4. 6 mm,5 μm). The mobile phase was acetonitrile-0. 1% phosphoric acid(12 ∶88)and the detection wavelength was 316 nm. The column temperature was 35℃ and the flow rate was 1. 0 ml·min-1 . Results:The microscopic characteristics of astragali radix, bombyx batryticatus and scorpio were obvious to be observed easily. The TLC spots of peach kernel, astragali radix, paeoniae radix al-ba, rheum, paeonia suffruticosa and salvia miltiorrhiza were clear and specific. Ferulic acid had a good linear relationship within the range of 5. 1-81. 6μg·ml-1(r=0. 999 9), and the average recovery was 103. 30% with RSD of 1. 96% (n= 9). Conclusion:The standard can be used for the quality control of Naoxin Luotong pills.

In the process of MPH graduates education in medical universities , there are three problems such as lack of initiative subjective of postgraduate, uneven level of tutors and monitoring defi-ciency of education. The main reasons are the low quality of MPH graduates, lack of quality consciousness for graduates education and graduates’ value tending to be utilitarian. Facing the problems, we suggest establishing guarantee mechanism for MPH graduate education quality, strengthening the tutors’ construc-tion and framing an eliminating system.

Objective To assess the development,progression and change of nonmotor symptoms in patients with Parkinson' s disease and its impact on patients' quality of life.Methods Eighty-seven consecutive patients with idiopathic Parkinson' s disease were studied.Parkinsonian status was assessed at baseline and 3 years follow-up using Unified Parkinson' s Disease Rating Scale (UPDRS) part Ⅲ & Ⅳ,Nonmotor Symptoms Questionnaire (NMSQuset),Parkinson-related quality of life (PDQ) scales.Paired ttest,Chi-square test,Spearman rank order correlation and hierarchical regression of the major statistical procedures were employed.Results At 3 years follow-up,compared to baseline,the UPDRS Ⅲ score (22.21 ±11.31 vs 30.49± 11.68),UPDRS Ⅳ score(1.00±1.54 vs 2.94±3.12),NMS score (7.98±3.96 vs 12.35 ± 5.12) and PDQ score (28.11 ± 22.88 vs 36.65 ± 26.95) were significantly higher ( t =- 5.54,- 5.75,- 6.46,- 5.29,all P =0.000,respectively).The aggravation of motor and nonmotor symptoms caused the decline of quality of life.The prevalence of constipation,problem of remembenng thing,nocturia ranked tops,and depression,and anxiety were still in the middle,compared with baseline.The prevalence of pains,sweating,dribbling,sense of incomplete emptying etc were significantly increased during the follow-up,△R2 were 21.6％ and 23.4％ respectively,resulting in the deterioration of quality of life.Conclusions PD nonmotor symptoms appear from the early stage.The motor and nonmotor symptoms aggravate over time.

Objective To study the CT performances and literature review of myoepithelioma (ME)of the parotid gland,to improve the recognition and diagnostic accuracy of this disease.Methods The CT findings of 1 2 cases with ME of the parotid gland confirmed by surgery and pathology were analyzed retrospectively,the characteristics of the age of onset,gender,size,location,density,boundary and enhancement were analyzed.And then,the related literatures were reviewed.Results Among the 1 2 patients,5 were male and 7 were female,age ranged from 11 to 68 years old,with a median age of 45.2 years.2 patients had the symptom of tenderness and fever, and the other 10 patients were asymptomatic and painless preauricular mass,2 of which were gradually enlarged.All the tumors were single in this study,2 had visible capsule infiltration or unclear boundaries,and other 10 had intact or smooth edges.CT showed that the masses all located in the parotid gland(1 in the deep lobe and 11 in the superficial lobe).The diameter of the tumor was 10 mm to 50 mm,with an average of 29.1 mm.The density was uniform in 2 cases and irregular cystic degeneration and necrosis in the other 10 cases.Mild enhancement was found in the arteriovenous phase after enhanced scanning,in which 8 cases had marginal enhancement or nodular enhancement in the arterial phase,and gradual filling into the center in the venous phase.Conclusion The CT performances of ME of the parotid gland have define characteristics.The possibility of myoepithelioma of the parotid gland should be taken into account when it has continuous centripetal reinforcement after enhancement,combing with the single cystic solid mass with clear boundary in superficial lobe of the parotid gland.Malignant myoepithelioma (MM)should be considered when the tumor envelope is incomplete or the boundary with the surrounding structure is not clear.

Objective To observe the effects of excessive fluoride on osteocalcin and glucose metabolism in mice.Methods Thirty-two male C57 mice (body mass:18-24 g) were selected as study subjects which were randomized into four groups (8 mice in each group) according to their body mass by random number table method:0 mg/L group (control group),50 mg/L fluorine group,100 mg/L fluorine group and 150 mg/L fluorine group.Sodium fluoride in distilled water was freely taken by these animals to replicate fluorosis animal model.After 12 weeks,total osteocalcin,uncarboxylated osteocalcin,insulin and glucagon were measured by enzyme-linked immunosorbent assay,fasting blood glucose and glycated hemoglobin were measured by chemiluminescence.Results After 12 weeks of intervention with sodium fluoride,serum total osteocalcin,uncarboxylated osteocalcin,fasting blood glucose,glycated hemoglobin,insulin,and glucagon were significantly different between different groups (F =17.23,22.29,4.43,45.57,4.45,55.21,P ＜ 0.05).Total osteocalcin,uncarboxylated osteocalcin,fasting blood glucose,glycated hemoglobin,and insulin in the 100,150 mg/L fluorine groups were higher than those of control group [(30.02 ± 5.35),(35.22 ± 4.98) vs (20.23 ± 3.22) μg/L;(8.72 ± 1.34),(11.01 ± 1.02) vs (5.80 ± 1.60) μg/L;(7.53 ± 2.29),(8.53 ± 2.81) vs (4.99 ± 1.60) mmol/L;(6.74 ± 0.68),(7.12 ± 0.25) vs (4.95 ± 0.28) mmol/L;(2.65 ± 0.25),(2.74 ± 0.47) vs (2.13 ± 0.28) mU/L,P＜ 0.05].The serum glucagon levels in the 50,100,150 mg/L fluorine groups were lower than that in the control group [(20.90 ± 3.00),(23.68 ± 2.58),(21.63 ± 2.42) vs (38.61 ± 3.73) ng/L,P ＜ 0.05].Conclusion Excessive fluoride can lead to elevated osteocalcin level and abnormal glucose metabolism in mice.

Objective Compared with chest CT,endoscopic ultrasonography (EUS) can more accurately determine the upper and lower margins of esophageal cancer,and marking the upper and lower margins of the esophageal cancer with titanium clip contributes to the delineation of target area of esophageal cancer during radiotherapy.To compare the effects of esophageal X-ray,chest computed tomography (CT)scan and EUS-assisted placement of marker clip in the determination of the length of gross target volume (GTV),aiming to provide reference for the determination of GTV during esophageal cancer radiotherapy.Methods Thirty patients who were initially diagnosed with thoracic esophageal cancer by histological and cytological examinations and scheduled to receive radiotherapy were recruited in this investigation.All patients received esophageal X-ray,CT scan,and EUS-assisted placement of marker clip.The length of GTV was quantitatively measured and statistically compared among three different methods.Results The length of GTV was (6.1 ± 1.4) cm,(6.8± 1.9) cm and (6.3± 1.9) cm determined by esophageal X-ray,CT scan and EUS-assisted placement of marker clip,respectively.Compared with CT scan,the length of GTV determined by EUS-assisted placement of marker clip did not significantly differ (P=0.11).The length of GTV determined by esophageal X-ray was significantly shorter than that by CT scan (P =0.03).Among all patients,the length of GTV determined by EUS-assisted placement of marker clip was longer compared with that by chest CT scan in 22.2％ of patients.The length of GTV determined by EUS-assisted placement of marker clip was the same as that by chest CT scan in 11.1％ of patients.The length of GTV determined by EUS-assisted placement of marker clip was shorter compared with that by chest CT scan in 66.7％ of patients.Conclusions EUS-assisted placement of marker clip differs from esophageal X-ray and CT scan in determining the length of GTV,which acts as one of the effective methods in the determination of the length of GTV during esophageal cancer radiotherapy.

Spinal cord injury (SCI) is a disabling and destructive central nervous system injury that has not yet been successfully treated at this stage. Three-dimensional (3D) bioprinting has become a promising method to produce more biologically complex microstructures, which fabricate living neural constructs with anatomically accurate complex geometries and spatial distributions of neural stem cells, and this is critical in the treatment of SCI. With the development of 3D printing technology and the deepening of research, neural tissue engineering research using different printing methods, bio-inks, and cells to repair SCI has achieved certain results. Although satisfactory results have not yet been achieved, they have provided novel ideas for the clinical treatment of SCI. Considering the potential impact of 3D bioprinting technology on neural studies, this review focuses on 3D bioprinting methods widely used in SCI neural tissue engineering, and the latest technological applications of bioprinting of nerve tissues for the repair of SCI are discussed. In addition to introducing the recent progress, this work also describes the existing limitations and highlights emerging possibilities and future prospects in this field.

Objective To investigate the changes of CT cerebral perfusion (CTP) and the application value of nuclear magnetic resonance proton spin labeling (3D-ASL) and to conduct a comparative study. Methods Multi-slice spiral CT(MDCT) was used to study the changes of CTP in 22 patients with HAPC. Comparison of CT whole-brain perfusion technique and nuclear magnetic resonance proton spin labeling technique (3D-ASL) in hemodynamic changes of the brain in plateau polycythemia. Results With the aggravation of HAPC, CBF of cerebral cortex and white matter showed a downward trend. Except the white matter of frontal lobe and temporal lobe, the difference of HAPC among different diseases was statistically significant (P < 0.05). Along with the aggravation of, each part of the brain cortex and white matter CBV increase, white matter, and each part CBV difference had statistical significance between different condition (P < 0.05). With the aggravation of the disease, the MTT of cortex and white matter in all parts of the brain increased significantly, and the difference of MTT between different parts of the disease was statistically significant (P < 0.05). HAPC patients along with the aggravation of different level, rCBF is reduced, in addition to the parietal cortex, temporal and occipital white matter, white matter rCBF differences between different parts of different condition have statistical significance (P < 0.05). ROC curve was used to evaluate the diagnostic value of CTP and ASL. The two curves were close to each other, and CTP was slightly better than ASL. Conclusion With the progression of HAPC, cerebral blood flow decreased, blood volume increased, and average blood flow time prolonged in patients with different degrees of HAPC. CTP and ASL had similar effects, and the former had slightly better value.

Objective To externally validate the accuracy of combined use of neutrophil-lymphocyte ratio (NLR),V20,and Dmean in predicting the incidence of grade Ⅲ or higher radiation-induced lung injury (RILI) in lung cancer patients.Methods A total of 166 lung cancer patients,who participated in the model establishment were selected into the internal validation group,and 85 lung cancer patients who received intensity-modulated radiotherapy in our department between June 2016 and June 2018 were assigned into the external validation group.The incidence rate of grade 3 or higher RILI was statistically compared between the internal and external validation groups.Multivariate logistic analysis was performed for NLR,V20 and Dmean The discrimination degree of the predictive model was evaluated by using ROC curve in combination with NLR,V20 and Dmean The calibration degree of the predictive model was assessed by Hosmer-Lemeshow test.Results The incidence rate of grade 3 or higher RILI in the internal and external validation groups was 23.8％ and 22.9％.Multivariate logistic analysis demonstrated that NLR,V20 and Dmean significantly differed in the internal validation group (P=0.032,0.006 and 0.005).However,only V20 significantly differed in the external validation group (P=0.038).The discrimination and calibration degree of RILI was almost consistent between the internal and external validation groups (both P＞0.05).The area under the curve (AUC) predicted by NLR,V20,Dmean and the combination of three indexes were 0.611,0.646,0.682 and 0.775 in the internal validation group,and 0.544,0.702,0.658 and 0.754 in the external validation group,respectively.The calibration degree in the internal validation group was P=2.797and 0.834,P=2.452 and 0.653 in the external validation group.Conclusion Combined application of NLR,V20 and Dmean can accurately predict the incidence of grade Ⅲ or higher RILI in lung can cancer patients,which has been validated by external dataset.

Chronic myeloid leukemia (CML) is a slowly progressing hematopoietic cell disorder. Sphingosine kinase 1 (SPHK1) plays established roles in tumor initiation, progression, and chemotherapy resistance in a wide range of cancers, including leukemia.However, small-molecule inhibitors targeting SPHK1 in CML still need to be developed. This study revealed the role of SPHK1 in CML and investigated the potential anti-leukemic activity of hirsuteine (HST), an indole alkaloid obtained from the oriental plant Uncaria rhynchophylla, in CML cells. These results suggest that SPHK1 is highly expressed in CML cells and that overexpression of SPHK1 represents poor clinical outcomes in CML patients. HST exposure led to G2/M phase arrest, cellular apoptosis, and downregulation of Cyclin B1 and CDC2 and cleavage of Caspase 3 and PARP in CML cells. HST shifted sphingolipid rheostat from sphingosine 1-phosphate (S1P) towards the ceramide coupled with a marked inhibition of SPHK1. Mechanistically, HST significantly blocked SPHK1/S1P/S1PR1 and BCR-ABL/PI3K/Akt pathways. In addition, HST can be docked with residues of SPHK1 and shifts the SPHK1 melting curve, indicating the potential protein-ligand interactions between SPHK1 and HST in both CML cells. SPHK1 overexpression impaired apoptosis and proliferation of CML cells induced by HST alone. These results suggest that HST, which may serve as a novel and specific SPHK1 inhibitor, exerts anti-leukemic activity by inhibiting the SPHK1/S1P/ S1PR1 and BCR-ABL/PI3K/Akt pathways in CML cells, thus conferring HST as a promising anti-leukemic drug for CML therapy in the future.