OBJECTIVE:To study the factors influencing the stability of Chlorogenic acid in Marsdenia tenacissima extract.METHODS:The contents of Chlorogenic acid in Marsdenia tenacissima extract in different solvents,different lighting and different time under the heat were determined by HPLC.RESULTS:The Chlorogenic acid in Marsdenia tenacissima extract in organic solvents was more stable,in addition,lighting and heating temperature were important factors affecting the stability of the Chlorogenic acid.CONCLUSION:The stability of the Chlorogenic acid in Marsdenia tenacissima extract changes in different conditions;and the study results serve as a reference for the preparation,storage,analysis and production of Marsdenia tenacissima extract.

Objective To investigate the clinical manifestation, diagnosis, therapies and medical economics of cesarean scar pregnancy (CSP). Methods From Jan. 2005 to Dec. 2008, 96 patients with CSP treated in Obstetrics and Gynecology Hospital of Fudan University were studied retrospectively. Those cases were divided into 3 groups. Thirty-three patients were treated with methotrexate (MTX) 50 mg/m2 intravenously guttae in group A. Among that 18 cases were treated with MTX, after 5 - 10 days they underwent dilation and curettage of uterus; 15 cases were given by dilation and curettage first if the level of serum human chorionic gonadotrophin-β(β-hCG) descent less than 30% in every 48 hours for 3 times after curettage, then MTX (50 mg/m2) intravenously guttae. Sixty patients were treated with MTX 100 mg bilateral uterine artery injection and embolization in group B. After 2 days, they underwent curettage.Group C: 3 patients were treated with laparotomy lesion excision. The following clinical parameters were compared, including blood loss( M), lesion diameter (-x±s), blood β-hCG level (M)before treatment, the number of cases with myometrial thickness anterior to the CSP ≤3 mm, the resistant index (RI) ≤0. 5,expense(-x ± s), hospital days(-x ±s) in those 3 groups. The correlation of blood loss with lesion diameter and blood β-hCG level was studied. Results ( 1 ) Clinical manifestation: bleeding loss were 20 ml in MTX +curettage of group A, 10 ml in curettage + MTX of group A, 12 ml in group B and 200 ml in group C. The volume of bleeding loss in group C was significantly higher than those in group A or group B ( P ＜ 0. 01 ).The lesion diameter were ( 23 ± 15 ) mm in curettage + MTX of group A and ( 30 ± 14 ) mm of group B ,which were higher than ( 16 ± 8 ) mm of MTX + curettage of group A (P ＜ 0. 01 ). The lesion diameter of (52 ± 7 )mm in group C were significantly bigger than those in the other groups ( P ＜ 0. 01 ). The level of blood β-hCG levels were 21 592 U/L in MTX + curettage of group A, 979 U/L in curettage + MTX of group A,which reach statistical difference ( P ＜0. 05). The level of blood β-hCG levels were 11 312 U/L in group B and 101 U/L in group C. Among 28 cases with Rl≤0. 5,there was 8 cases in group A (24% ,8/33),18 cases in group B ( 30%, 18/60) and 2 cases in group C (2/3). Among 23 cases with myometrial thickness anterior to the CSP ≤ 3 mm, there was 21 cases in group B (35%, 21/60 ), which were significantly higher than 2 in group A (6%, 2/33 ) and none in group C ( P ＜ 0. 05 ). The expense were ( 5578 ± 3679) yuan in MTX + curettage of group A and (5346 ± 2765 ) yuan in curettage + MTX of group,which did not reach statistical difference (P＞0. 05). The expense were (7860 ±2104) yuan in group B,which were significantly higher than those in group A and (5004 ± 421 ) yuan in group C (P ＜ 0. 05 ). The hospital days were ( 15 ±8) days and ( 19 ± 14) days of group A, ( 16 ± 10) days in group B and ( 17 ±8)days in group C, there was no significant difference among those treatments ( P ＞ 0. 05 ). (2) Correlatin:there was positive correlation between bleeding loss and lesion diameter( r = 0. 31, P ＜ 0. 05 ) or blood β-hCG level ( r = 0. 35, P ＜ 0. 05). Conclusions MTX intravenously guttae, MTX uterine artery injection and embolization, and laparotomy lesion excision were all properly used in treatment of CSP. MTX uterine artery injection and embolization was recommended for those with big lesion, high β-hCG level, less myometrial thickness anterior to the CSP or plentiful blood supply of the lesion but the expense might be high.

Silk fibroin (SF) and hydroxyapatite (HA) composite powders were synthesized from CaO, H3PO4 and SF solution on the principle of neutralization. SF/HA porous materials were prepared through adding silk short fibers and NaCI particles as reinforcing material and pore-forming agent respectively by isostatic compaction. The structure and mechanical properties of the SF/HA porous materials were investigated. Results indicated that short silk fibers in it could markedly enhance flexural strength and flexural breaking energy. The average pore diameter and porosity could be regulated from 64 μm to183 pm and from 55% to 75% respectively by adding pore-forming agent.

On the basis of Poincare scatter plot and first order difference scatter plot, a novel heart rate variability (HRV) analysis method based on scatter plots of RR intervals and first order difference of RR intervals (namely, RdR) was proposed. The abscissa of the RdR scatter plot, the x-axis, is RR intervals and the ordinate, y-axis, is the difference between successive RR intervals. The RdR scatter plot includes the information of RR intervals and the difference between successive RR intervals, which captures more HRV information. By RdR scatter plot analysis of some records of MIT-BIH arrhythmias database, we found that the scatter plot of uncoupled premature ventricular contraction (PVC), coupled ventricular bigeminy and ventricular trigeminy PVC had specific graphic characteristics. The RdR scatter plot method has higher detecting performance than the Poincare scatter plot method, and simpler and more intuitive than the first order difference method.
Arrhythmias, Cardiac ; Databases, Factual ; Heart Rate ; Humans ; Ventricular Premature Complexes

Objective To observe the change in IL-1β,IL-13mRNA expression in drowning rat lungs and serum,so as to investigate the significance of IL-1β and IL-13 mechanism in the development of drowning.Methods SD rats were randomly divided into control group,drowning group.Then using TaqMan probe method to determine the expression of IL-1β and IL-13 mRNA in Right lower lobe of lung tissue and the serum of right ventricle,which were extracted respectively from each group of rats.Results (1) The lung tissue morphological changes:Typical appearance signs and anatomy of drowning group meet ante-mortem drowning feature.(2) The expression of IL-1β,IL-13 in lung tissue:compared with the control group,the expression of IL-1β and IL-13 were slightly decreased,which has no statistical significance.(3) The expression of IL-1β and IL-13 in serum:compared with the control group,the expression of IL-1β and IL-13 were significant increased,both of which has statistical significance.Conclusion (1)The expression of IL-1β and IL-13 were decreased in lung tissue may be due to drowned rats present compensatory anti-inflammatory response syndrome which causes immune incompetent performance.(2) The expression of IL-1β and IL-13 were significant increased in serum may be relate to drown stress and drowning associated acute lung injury after traumatic stress.

Objective To evaluate the effect of nurse-led follow-up on medication adherence and quality of life for breast cancer patients receiving adjuvant hormonal therapy.Methods A randomized controlled trial was conducted with 157 patients in the intervention group and 154 in the control group.A self-design web-database medication monitoring platform was designed for managing patients such as texting,reminding and mailing.Participants were randomized to follow-up care as usual(yearly outpatient clinic visits) or nurse-led telephone follow-up(monthly consultation with structured intervention).Telephone follow-up was performed by four trained breast care nurses (BCN) and consisted of a semi-structured interview including managing the side-effects of endocrine therapy,compliance with hormonal therapy and an open discussion of these issues.Patients' medication adherence and quality of life were evaluated by Morisky Medication Adherence Questionnaire(MAQ) and FACT-B at baseline and 3,6 18 and 24 months,respectively.Results The Nurse-led telephone follow-up did not significantly improve the quality of life(P＞0.05).MAQ score in the intervention group was significantly greater than that in the control group(P＜0.05) at 3,6,18 and 24 months.Conclusion Nurse-led follow-up using computer-based monitoring system can improve patients' medication adherence,but there is no obvious increase in quality of life.

Objective To understand the changes of schistosomiasis endemic situation in Sichuan Province,the upstream of Yangtze River basin,and the impact on schistosomiasis transmission in Three Gorges Reservoir area after the construction of Three Gorges Reservoir. Methods The annual reports of the schistosomiasis endemic situation in Sichuan Province from 2000-2012,the data of the schistosomiasis surveillance sites in Sichuan Province from 2001-2012,the data of the schistosomiasis sampling survey in Sichuan Province in 2001,and the relevant reference of Three Gorges Reservoir were collected. The schisto-somiasis prevalence in human and cattle,and Oncomelania hupensis snail status were investigated. The snail survey was imple-mented in Qianjin Village,Jianyang City,Sichuan Province,the nearest village to Three Gorges Reservoir Area. Results The schistosomiasis endemic situation presented a continuous declining state in Sichuan Province from 2000-2012,and reached the criteria of schistosomiasis transmission controlled in 2008. From 2012,65.07%of endemic counties reached the criteria of schis-tosomiasis transmission interrupted. From 2006,no schistosome infected snails were found. In Qianjin Village,1714 m2 environ-ments were surveyed and no snails were found. Conclusions The schistosomiasis endemic area and snail area are significantly reduced in Sichuan Province,the upstream of Yangtze River basin,after the construction of Three Gorges Reservoir. Therefore, the possibility of schistosomiasis endemic diffusing to Three Gorges Reservoir area is minimum.

Purpose To discuss the clinical pathological features, diagnosis and differential diagnosis, treatment and prognosis of pri-mary breast diffuse large B-cell lymphoma ( DLBCL) . Methods 7 cases of primary breast DLBCL were collected, their clinical path-ological characteristics and immunophenotypes were also observed, and the treatment and prognostic factors were discussed. Results All of the 7 patients were women, aged 28~75 years, with the median 51 years. 5 cases involved left breast, 2 cases were located in the right breast. Painless mammary mass and ipsilateral axillary lymphadenopathy were the commonest clinical manifestations. On mi-croscopic observation, tumor cells were large to medium-sized which characterized as diffuse infiltration between the lobules of mamma-ry gland, around the duct, interstitial and fat tissue, some were single file cord pattern. 1 case was ALK-1 positive DLBCL, 6 cases were DLBCL of the non special type. The immunophenotype showed 5 cases were of non-GCB, 2 cases were of GCB type. Ki-67 index were from 60% to 95%. According to Ann Arbor staging, 2 cases were stage I EA, 5 cases were stage II EA. IPI score:4 cases with 0 score, 3 cases with 1 score. Of 7 patients, one case was modified radical mastectomy, 4 cases were lumpectomy, 2 cases were diag-nosed by core needle biopsy. 2 patients died without chemotherapy, 5 patients were chemotherapy or radiotherapy for 4 to 6 cycles ( CHOP/R-CHOP) , 4 patients received complete response, one died. Patients were followed up from 1 to 114 months, the median fol-low-up time was 18 months. The 1 year OS rate was 57. 1%, 5 years OS rate was 14. 3%. Conclusion The diagnosis of primary breast DLBCL is confirmed by pathological biopsy and immunohistochemical markers. The immunophenotype was mainly non-GCB type. Comprehensive treatment including chemotherapy and radiotherapy is appropriate. The prognosis should be comprehensively eval-uated by multiple factors.

Infectious disease hospitals are obliged to cope with public health emergencies such as outbreak of infectious diseases.Such hospitals are required to make early detection,early containment,proper management,reasonable preplans,timely training,targeted drills,reasonable deployment of hospital resources,appropriate protection for hospital staff.General hospitals should also cope with prevention and control of infectious diseases to some extent,and work with infectious disease hospitals hand in hand to better cope with such outbreaks.

This study was aimed to establish an HPLC method to simultaneous determine 6 kinds of monoester and diester aconitum alkaloids. The content of alkaloids in aconite roots, black and white prepared lateral root of aconite and the compatibility of aconite roots with rhubarb were determined. This study provided reference for the interpreta-tion of the attenuation of processing and compatibility of medicines from chemical component aspect. The HPLC analysis was performed on a Phenomenex Gemini C18 (4.6 mm í 250 mm, 5 μm) with 40 mmol·L-1 ammonium ac-etate (adjusted to pH 9.8 with ammonia water) and acetonitrile as mobile phase, with a gradient elution at the flow rate of 1.0 mL·min-1 and a detection wavelength of 235 nm. The results showed that 6 alkaloids in aconite roots achieved favorable separation and a good linearity relationship (r > 0.999) over the studied concentration range. The extraction recoveries were ranged from 96.9% to 102.4% for the 6 alkaloids. The content of diester alkaloids de-creased markedly in processed products and the compatibility of aconite roots with rhubarb compared with the raw a-conite roots. It was concluded that this method was stable, reliable, simple and practical. It can be used for the si-multaneous determination of 6 kinds of monoester and diester aconitum alkaloids in aconite roots. This processing and compatibility can significantly reduce the content of alkaloids in aconite roots in order to reduce its toxicity.