Objective For purpose of meeting the requirement of forensic toxicological investigation, a RPHPLC method was established for simultaneous determining lidocaine and bupivacaine in human spinal cord pretreated with formaldehyde. Method Analytical column was YWG-C18 (4.6mm?150mm) and a per column. Mobile phase was CH3OH:0.015M NaH2PO4 =75:25 (v/v) pH = 7.2. The wavelength of detection was 210 nm. The pretreatment method of sample, detection condition, linear range, precision and recorery of the method were systematically investigated by using blank spinal cord spiked with standard lidocaine and bupivacaine. Results The linear range was 0.5 ~ 10.0?g.g-1 (lidocaine: r=0.9999; bupivacaine: r = 0.9998). The detection limit of lidocaine was 15ng and of bupivacaine 20ng (S/N≥3). The intra and inter day precision of assay of lidocaine and bupivacaine were less than 4.3% (n=5). Both lidocaine and bupivacaine have been detected in a forensic toxicological analysis case by using this method and the result was correct. Conclusion Lidocaine and bupivacaine can determined in human spinal cord pretreat-edwith formaldehyde by HPLC. The method is simple, useful and accurate. It can be applied in the forensic toxicological analysis investigation and other medical studies.

Objective To investigate the effects of Tongmai Tang on the production of nitric oxide(NO) and the balance of fibrinolysis system in human umbilical vein endothelial cells(HUVEC) injured by oxidized low density lipoprotein(oxLDL). Methods The herbage-contained serum of Tongmai Tang and oxLDL were prepared, then the human HUVEC-304 cells were divided into 4 groups: ⑴control group; ⑵bovine serum control group; ⑶oxLDL group: 100mg/L oxLDL, and ⑷Tongmai Tang group: 5% herbage-contained serum of Tongmai Tang and 100mg/L oxLDL. After 24h incubation, the morphology of the endothelial cells was observed under the inversion microscope, while the concentrations of NO, t-PA and PAI-1 in the culture medium were measured. Results ⑴The endothelial cells in oxLDL group were seriously injured, while those in Tongmai Tang group got better; ⑵the concentrations of NO and t-PA in the oxLDL group were significantly lower than those in the control group(P

Objective To study the diagnosis and management of extra-adrenal pheochromocytoma.Methods A retrospective clinical study was done on 33 patients of extra-adrenal pheochromocytoma treated at our department.Results Extra-adrenal pheochromocytoma accounted for 16.2％ (33/204) of all pheochromocytoma patients admitted between Jan 2005 and Dec 2012.There were 13 males and 20 females.The mean age at diagnosis was 45 years,with a range from 17 to 81 years.14 patients were hospitalized for abdominal discomfort,8 patients suffered from typical hypertension symptoms including headache and dizziness and blurred vision,one of bladder pheochromocytoma was found paroxysmal hypertension and 10 patients had no obvious clinical symptoms.All the patients underwent CT scan,and 8 extra-adrenal pheochromocytoma were discovered.11 patients were given circulation expansion therapy.Most of the tumors were located at bladder(3 case),renal hilus (7 case) and para-aorta(23 case).There were two patients with multiple tumors.In 26 cases,blood pressure fluctuated when touching tumor during operation.All the patients were treated with surgical operation.Except for 1 biopsy,32 patients underwent total resection of tumor including a case combined resection with left kidney and a case with the spleen.There were no perioperative mortality.Postoperative follow up showed very good prognosis,with no death.Conclusions Compared with imaging examination,clinical manifestations and laboratory tests were less evaluable for the diagnosis of extra-adrenal pheochromocytoma.Proper preoperative preparation and precise operation is essential for the prognosis.

Objective To establish a sensitive,specific,simple and high-throughput method for detection of the epidermal growth factor receptor (EGFR) mutation in the plasma samples of patients with non-small cell lung cancer (NSCLS) by the use of mutant-enriched liquid chip (MEL) assay.Methods The specific probes for the EGFR exon19 E746-750 deletion,exon 21 L858R mutation and wild-type sequence were designed and coupled to the microspheres coding with different fluorescent dye.The probe coupling efficiency was verified by crossing hybridization test with biotin-labeled reverse sequence.A blood-based MEL approach which integrates a sensitive mutant-enriched PCR and quantitative high throughput liquid chip assay for assessment of EGFR mutations was developed.The sensitivity and specificity of MEL was further evaluated using the mixture with different copy numbers of mutant and wild-type plasmids as template.The mutations of exon 19 and 21 of EGFR gene in plasma samples from 201 patients with stage ⅢB or Ⅳ NSCLC who enrolled in the First Affiliated Hospital of Guangzhou Medical College from September 2008 to April 2010 were analyzed by both the MEL and the mutant-enriched PCR assay.The result comparison was made between direct sequencing and MEL in 50 cases whose EGFR gene type had been tested by MEL and mutantenriched PCR.The correlation of EGFR gene mutation and the response to the Geftinib treatment was analyzed in 16 patients with lung adenocarcinoma as well.Results The probes were successfully coupled to the microspheres encoding with different fluorescent dye,and could be specifically recognized by the corresponding target sequence.The MEL was capable of detecting as few as 10 copies of EGFR mutants (sensitivity was 0.1％).Among the enrolled 201 cases of advanced NSCLC,the detection rate of the EGFR exon19 E746-750 del and exon 21 L858R was 55.7％ (112/201) by MEL assay.Conpared with mutantenriched PCR[58.2％ (117/201)],the coincidence rate was 97.5％ (196/201).There was no statistically significant difference between the results of mutant-enriched PCR and MEL (x2 =3.20,P ＞ 0.05).The mutations detection rate was 22.0％ (11/50) by directing sequencing,which was significantly lower than by MEL[50.0％ (25/50),x2 =12.07,P ＜ 0.05].Among the 16 patients treated with Gefitinib,9 cases who had EGFR mutation showed a higher response rate(P =0.041)and prolonged progression-free survival (x2 =6.76,P =0.009) after the treatment compared to those 7 who without EGFR mutation.Conclusions A new method of MEL with accuracy,specificity,fast and high-throughput is established for the detection of EGFR 19 E746-750 deletion and exon 21 L858R mutations in plasma from advanced NSCLC patients.It has the ability to provide the most direct and valuable guidance for clinicians to make decision on EGFR tyrosine kinase inhibitors therapy in the advanced NSCLC paticnts.

Drug therapy is one of the efficient methods for prostate cancer treatment. However, drug resistance greatly hindered the treatment of prostate cancer patients. Herein, the mechanisms of drug resistance in prostate cancer have been exhaustively reviewed, and that can provide an alternative strategy and new targets for anti-prostate cancer therapy.
Drug Resistance, Neoplasm ; Humans ; Male ; Prostatic Neoplasms ; drug therapy

Objective To evaluate the safety and feasibility of injection test which is used to locate esophageal balloon catheter.Methods A prospective study was conducted. The patients undergoing invasive mechanical ventilation (MV) admitted to general intensive care unit (ICU) of Beijing Tiantan Hospital Affiliated to Capital Medical University from May 2015 and March 2017 were enrolled. The commercially available esophageal balloon catheter was modified to perform injection test. The catheter was withdrawn step by step and the injection test was repeated until the presence disturbance wave presented, which indicated that the balloon had just entered the esophagus. The position where disturbance wave appears was named 0 cm. End-expiratory occlusions were performed at the positions of+15,+10,+5, 0, -5, -10 and -15 cm, respectively, and the changes of esophageal pressure (Pes) and airway pressures (Paw) were measured in the spontaneous breathing and passive ventilation, and the ratio between the changes (ΔPes/ΔPaw) was calculated.Results A total of 20 patients were enrolled, of which 15 patients finished both the spontaneous and the passive ventilation parts, and 2 patients finished only the spontaneous part and 3 patients finished only passive part. ① Disturbance waves could be induced by injection test in all patients. The average depth of disturbance wave in spontaneous breathing was deeper than that in passive ventilation (cm: 42.4±3.8 vs. 41.8±3.3), but there was no significant difference between the two ventilation settings (P = 0.132). No adverse events occurred during the study period. ② Pes increased with the stepwise withdraw of esophageal catheter, reached the maximal value at+5 cm, and then decreased when the catheter was further withdrawn, no matter in the spontaneous or the passive ventilation. In spontaneous breathing, the ΔPes/ΔPaw was within the ideal range (0.8-1.2) at the positions of 0, -5 and -10 cm. The ΔPes/ΔPaw was closest to unity at the positions of 0 cm (0.98±0.15). The ΔPes/ΔPaw at -15 cm (0.66±0.26) was significantly lower than that at 0 cm (P < 0.05). For passive ventilation, the ΔPes/ΔPaw was within the ideal range at the positions of -5 cm and -10 cm, and the ΔPes/ΔPaw was closest to unity at the positions of-10 cm (0.94±0.12). The ΔPes/ΔPaw at 0 cm and -5 cm was significantly higher than that at -10 cm (1.43±0.31 and 1.12±0.14, respectively); while the ΔPes/ΔPaw at -15 cm (0.68±0.23) was significantly lower than that at -10 cm (allP < 0.01).Conclusions Ideal position of the esophageal balloon catheter could be determined quickly and easily by using injection test. The method is safe and clinically feasible.Clinical Trial Registration Clinical Trials, NCT02446938.

Objective To investigate the effects of posterior fossa operation analgesia with tramadol compound dexmedetomi‐dine ,and the feasibility of reducing the dosage of tramadol .Methods Forty cases undergoing posterior fossa operation were ran‐domly divided into dexmedetomidine group (group A) and control group (group B) .Patients in group A with tramadol compound dexmedetomidine intravenous infusion analgesia ,reducing the dosage of tramadol .Group B with tramadol intravenous infusion anal‐gesia .To observe two groups of patients with preoperative ,postoperative 1 ,6 ,12 ,24 ,48 hVAS score ,Ramsay score ,heart rate , blood pressure ,respiratory rate ,SpO2 ,the postoperative complications such as nausea and vomiting ,and carries on statistics analy‐sis ,the two groups of patients with postoperative analgesic and sedative effect evaluation .Results VAS score :postoperative at each time point ,there was no significant difference between groups (P>0 .05) .Ramsay score :after operation and postoperative at each time point ,the experimental group were significantly higher than those in the control group (P<0 .05);the incidence of nausea and vomiting ,restlessness complications ,the experimental group was significantly lower than that of the control group (P<0 .05) .Con‐clusion Posterior fossa operation patients with tramadol and dexmedetomidine postoperative to analgesia could reduce the dosage of tramadol ,reduce nausea and vomiting ,restlessness and other complications ,and the analgesic effect is ideal .It was favorable to ob‐serve the postoperative condition .

Objective To investigate the basis of ultrasound microbubble technology enhanced thermal ablation effect.Methods All 48 rabbits bearing hepatic tumors were averagely randomly divided into four groups:only laser group,sham,destruction + laser group,and blank group.The filling defect area changes of before and after treatment were observed and the differences between groups were compared.Results Pathology confirmed ablation of tumor tissue could produce coagulation necrosis for experiment group.The conventional ultrasound showed there was no significant variation in the maximum diameter and area in the pre and post treatment of experiment group and control group(P ＞0.05).There was no change for the control group.Ultrasound imaging showed an area of filling defect were:laser treatment alone group (0.83 ± 0.06) cm2,microbubbles false break combined with laser therapy group (0.65 ± 0.05) cm2,microbubbles break combined with laser therapy group (2.40 ± 0.16)cm2,blank control group (0.01 ± 0.01) cm2.The filling defect area of the treatment group,which was combined with ultrasound microbubble break technology and laser ablation was increased,there was significant variation in the each group (P ＜0.05).Conclusions Microbubble burst combined laser ablation could expand the single needle laser ablation area of rabbit VX2 liver tumor and increase the therapeutic effect.

Aim To investigate the relationship be-tween the cardioprotection of apigenin ( Api ) from an-oxia/reoxygenation ( A/R) injury and Bcl-2 pathway. Methods H9 c2 cardiomyocytes were cultured and di-vided into normal control group, A/R group, Api pre-treatment group ( Api ) , Api + Bcl-2 inhibitor group ( Api + ABT-737 ) . Expression of Bcl-2 was deter-mined by Western blot,and cell viability was measured by MTT method. LDH, SOD, GSH-Px, MDA activity were determined by chromometry. ROS generation, mi-tochondrial membrane potential and apoptosis were de-termined by flow cytometry. Results 25h after apige-nin precondition,the expression of Bcl-2 was upregulat-ed in cardiomyocytes ( P <0. 01 ) . In the group pre-treated with 40 μmol · L-1 apigenin before A/R, the activity of LDH in culture medium decreased; the ac-tivity of intracellular SOD, GSH-Px increased; the content of MDA and ROS generation decreased; cell viability increased; mitochondrial membrane potential could be more stable and cell apoptosis decreased ( P<0. 01 ) . However, all these protective effects were attenuated significantly in the group pretreated with apigenin and Bcl-2 inhibitor ABT-737 . Conclusion The effect of apigenin against A/R injury in cardiomyo-cytes involves Bcl-2 pathway, and at least partly de-pends on its effect on upregulating the expression of Bcl-2 .

Objective To investigate the expression and significance of calcyclin binding protein (CacyBP)in the brain of rat model of traumatic brain injury(TBI).Methods Sixty 60 male SD rats were divided randomly into normal control group (n=10) and TBI group (n=50).The TBI model was created by using lateral head rotation device and subdivided into 6 h,24 h,72 h,7 d and 14 d group (10 rats per group).The expression and distribution of CacyBP in the rat brain was investigated immunohistochemically.The presence of the brown stained particles was considered aspositiveand lack of the stained particles agnegative. Results CacyBP was mainly distributed in the hippocampus,dentate gyrus and cortical neuron cytoplasm.Compared with the high level expression of CacyBP in the normal control group,the expression of CacyBP was decreased to the lowest in the rat brain at 6 h post TBI (P<0.01),became stronger gradually at 24 hours and recovered to normal at day 14,with no statistical difference compared with normal control group (P>0.05). Conclusion The lowest level expression of CacyBP after TBI indicates that CacyBP may play an important role in development of brain injury under effect of difierent mechanisms.