OBJECTIVE To investigate the forms of carbamazepine and its metabolites in the gastric juice,blood and urine samples from a poisoned patient and its metabolic pathways. METHODS The gastric juice,blood and urine samples were obtained from a patient who was rushed to the Hospital of Prevention and Treatment for Occupational Diseases to be treated for an overdose of carbamazepine for about six hours. The samples were analyzed by gas chromatography-mass spectrometry. The metabolites were identified from their mass spectra by comparison with spectra in NIST 98 libraries. The metabolic pathways were inferred by fragmentation regularities of mass spectra and the published data. RESULTS The results showed that only M1 was found in the gastric juice sample. Four metabo?lites,such as iminostilbene(M1),9-methyl-acridine(M2),9-propyl-acridan(M4)and M3,were found in the blood sample and thirteen metabolites,including M1,M2,M4,acridine(M5),acridone(M6), 9,10-dihydro Acridine (M7), 1a,10b-dihydro-6H-dibenz[b,f]oxireno[d]azepine-6-carboxamide (M8),9-acridinemethanol (M9),10,11-dihydrodiol-carbamazepine (M10),2-methyl-acridone (M12),4-methyl-acridone(M13),undetermined M3 and M11,were found in the urine from the poi?soned patient. The forms of carbamazepine metabolites in the gastric juice ,blood and urine were different. Little carbamazepine was found in the urine after metabolism. CONCLUSION Based on the analysis by gas chromatography-mass spectrometry and identification of NIST 98 libraries,the metabolites could be identified accurately,which can help analyze the metabolic mechanism and pathways of carbam?azepine.

Objective To investigate the clinical features of cryptogenic multifocal ulcerous stenosing enteritis(CMUSE),and to improve the diagnosis of this rare disease.Methods From 2010 to 2015,clinical data of 10 patients with CMUSE were retrospectively analyzed,including clinical features,laboratory examination,imaging examination,appearance under endoscopy,pathologic characteristics,location of lesions,treatment and prognosis.Results Among the 10 patients with CMUSE (male six,female four),the mean age was (35.1±14.8) years.The predominant clinical manifestation was melena (eight cases),abdominal pain (eight cases) and anemia (nine cases).The results of laboratory examination showed normal in erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP).Among seven patients,hypersensitive C reactive protein (hsCRP) of two patients increased.Imaging examination showed intestinal stricture and appearance under endoscopic examination was intestinal ulcers and stenosis.Pathologic finding was superficial ulcers at mucosal and submucosal layers.Lesions mostly involved small intestine,and one case involving ileocecal valves and rectum.Among the 10 patients,seven patients received combination of surgical resection and prednisone treatment,and three patients were only administrated with medications.After treatment,seven patients remainedremission and three patients relapsed after remission.Immunosuppressors and enteral nutrition was effective in two of them and glucocorticoid resistance happened in one patient.Conclusions The diagnosis of CMUSE should he considered in patients with unexplained recurrent bowel obstruction,melena,anemia and concomitant intestinal ulcer and stricture.Endoscopy plays an important role in the diagnosis.Glueocorticoid is effective but easy to relapse.Immunomodulators and enteral nutrition may be considered as second-line therapy.

OBJECTIVETo investigate the application of intense pulsed light (IPL) depilation in the auricular reconstruction with totally expanded skin and its suitable parameter.

METHODSFrom February 2009 to September 2013, one tissue expander(100 or 150 milliliters) were implanted under the skin of mastoid in 126 patients who suffered from microtia. During the skin expanding, the hair on the expanded skin was depilated by JPL technique. The parameter, operation, interval, the depilation result and the complication were recorded. The autologous rib cartilage frameworks were implanted in the second phase of auricular reconstruction.

RESULTSThe energy of IPL was 20 - 35 J/cm2 (mean 25. 3 J/cm2), the width of pulse was 26 - 30 ms ( mean 27. 9 ms), the interval between two operations was 4 weeks. Ninety-six patients were cured(76. 2%, 96/126). The total depilation efficient is 96. 8% (122/126). A fine banding blisters was found in one patient whose depilation areas was marked by black pen. Skin erythema was found in five patients and skin pigmentation was found in 7 patients. There were no skin necrosis and expander exposure in all patients. During 6 - 12 months of follow-up period, ninety-two patients were cured (73.0%, 92/126) and the total depilation efficient is 92. 9% (117/126).

CONCLUSIONSIPL depilation during the skin expanding is feasible and safe with careful procedure. The hairless expanded skin is enough to cover the framework, as well as the post-auricular area. The appearance of reconstructed ear is better without hair.

Congenital Microtia ; surgery ; Costal Cartilage ; transplantation ; Ear, External ; Erythema ; etiology ; Hair Removal ; methods ; Humans ; Mastoid ; Phototherapy ; adverse effects ; methods ; Reconstructive Surgical Procedures ; Skin Pigmentation ; Surgical Flaps ; Tissue Expansion ; Tissue Expansion Devices

AIM:To establish the quality standard for Xuesaitong Granule(total saponins of Radix et Rhizoma Notoginseng). METHODS:The contents of notoginsenoside R1,ginsenoside Rg1 and Rb1 were determined on the Shim-Pack C 18 (250 mm?4.6 mm,5 ?m) column,with CH3CN—H2O gradual elution and monitored at 203 nm. RESULTS:The average recovery of notoginsenoside R1 was 100.0% (RSD=1.00%,n=6),the minimum detection quantity cannot be lower than 5% labelled weight. The average recovery of ginsenoside Rg1 was 99.8 % (RSD=0.47%,n=6),the minimum detection quantity cannot be lower than 20% labelled weight. The average recovery of ginsenoside Rb1 was 99.8% (RSD=0.79%,n=6),the minimum detection quantity cannot be lower than 30% labelled weight. CONCLUSION:The method is simple,reliable,accurate and can be applied to the quality control of Xuesaitong Granules.

Objective To develop a gut-brain interaction animal model of IBS which combines multiple factors including behavior, visceral sensation and motility. Methods Setting up a multifactor interactional animal model (chronic acute combining stress model, CACS) based on a chronic unpredictable mild stress model of depression (CUMS) while combined with wrap restraint stress (WRS) , changes of some indexes were recorded including motility (granules of defecating, time of defecating), visceral sensitivity ( spontaneous contraction of abdominal striated muscles ) and behavior/mind ( sucrose consumption, body weight). G protein subunits were measured by Western blot in both hippocampus and prefrontal cortex simultaneously. Results ( 1 ) Compared with the state before stress given, defecating granules increased, defecating time of glassie from rectum shorten, number of abdominal contraction increased, and sucrose consumption decreased in CACS, however, neither significant change was found on defecating behavior in CUMS nor on sucrose consumption in WRS; (2) Compared with the control group, some G protein submits expression decreased in both CACS and CUMS( P < 0. 05 ) , while no significant changes of any G protein subunits were found in WRS. Conclusion The CACS animal model was a new, brain-gut interaction model, which can mimic part of human symptoms of IBS very well.

AIM: To study toxicology of Sanqi Shuishu Capsule (SQSS) (Panax Notoginseng, Semen Ziziphi Spinosae; Fructus Schisandrae, etc). in order to establish a theoretical basic for clinical use. METHODS: With the aid of the acute toxicity tests, the inheritance toxicity tests, feeding the rat on trial research for 30 d, we observed the toxicology of SQ SS Capsule. RESULTS: SQ SS Capsule had not action of mutation, micronucleolus proliferation of rat's marrow polychrouiatic erythrocytes increase, and rat's sperm malformation. CONCLUSION: Poisonous effect has not been observed in SQ SS Capsule.

Background and purpose:MicroRNA(miRNA) is a class of small non-coding RNA playing an important regulatory role in many tumors. This study investigated which miRNA might negatively regulate the expression of Aurora-B in osteosarcoma cells, and to lay the foundation for the further investigation of the effort and regulation of Aurora-B in osteosarcoma malignant phenotype.Methods:Bioinformatics prediction software (http://www.targetscan.org) and luciferase assays were used to investigate which miRNA might target to modulate the Aurora-B. Real-time fluorescent quantitative polymerase chain reaction (RTFQ-PCR) and Western blot assay were used to further verify which miRNA could negative regulate the expression ofAurora-B gene.Results:Bioinformatics prediction showed let-7 family have the possibility to modulate the expression of Aurora-B; Luciferase assays showed thatAurora-B might be the target gene of let-7a/b/c/d/e/f/g/i; RTFQ-PCR and Western blot analysis testiifed that both the expression levels of Aurora-B mRNA and Aurora-B protein were signiifcantly decreased in Let-7a/g/i up-regulated U2-OS and HOS cells, compared to the cells in the negative control group; but in Let-7b/c/d/e/f up-regulated U2-OS and HOS cells, the expression levels of Aurora-B mRNA and Aurora-B protein have no signiifcant difference, compared to the cells in the negative control group.Conclusion:Let-7a/g/i may downregulate the expression of Aurora-B in human osteosarcoma cells.

Objective To analyze the risk factors of incision infection and spinal canal hematoma after lumbar spinal posterior surgery.Methods Data of 33 patients with incision infection and 25 patients with spinal canal hematoma after posterior surgery for lumbar spinal disease from January 2010 to December 2014 were retrospectively analyzed.For the patients with incision infection,20 of them were males and 13 were females,with an average age of 58.85±8.76 years (range 38-79 years).Of these patients,5 were diagnosed with lumbar disc herniation,9 with lumbar spondylolisthesis,15 with lumbar spinal stenosis and 4 with lumbar vertebral fracture.For patients with spinal canal hematoma,17 of them were males and 8 were females,with a mean age of 60.96±11.37 (range,38-77).The diagnoses of them were lumbar disc herniation in 18 patients,spondylolisthesis in 3 patients and spinal stenosis in 4 patients.From the same period database,patients who underwent lumbar posterior lumbar surgery with no postoperative complications were selected by 3:1 ratio as the control group according to age,gender and diagnosis.Results For patients with incision infection,it was found that diabetes mellitus,preoperative RBC,hemoglobin,total protein,albumin,serum calcium,operation time,number of segment fusion,intraoperative blood loss,postoperative WBC,RBC,hemoglobin and platelet were significantly different from those with non-infection group.Moreover,multivariate logistic analysis showed that diabetes mellitus (OR=3.716,P=0.032),preoperative serum calcium (OR＜ 0.001,P=0.001),intraoperative blood loss (OR=1.002,P=0.014),postoperative hemoglobin (OR=0.923,P=0.018) and postoperative platelet (OR=1.007,P=0.017) were independent risk factors for postoperative incision infection.For patients with spinal canal hematoma,it was found that patients' preoperative total protein,albumin,serum calcium,platelet,operation time,intraoperative blood loss and postoperative total protein were significantly different from non-hematoma group.Multivariate logistic analysis showed that preoperative serum calcium (OR＜ 0.001,P=0.001),preoperative total protein (OR=1.298,P=0.043),intraoperative blood loss (OR=1.003,P=0.021) and postoperative total protein (OR=1.080,P=0.028) were independent risk factors for postoperative spinal canal hematoma.Conclusion The preoperative diabetes mellitus,serum calcium,intraoperative blood loss,postoperative hemoglobin and platelet were important risk factors for lumbar incision infection.And preoperative serum calcium,total protein,intraoperative blood loss and postoperative total protein were the risk factors for spinal canal hematoma.

Objective To analyze the risk factors and characteristics of bone metastases in patients with prostate cancer. Methods Patients who were diagnosed as prostate cancer by biopsy and histopathologic analysis between June 2006 and June 2016 were included in this study. The clinical data of the patients were reviewed, and the demographic data, laboratory examination results and Gleason score were recorded. The correlations between clinical factors and bone metastasis were analyzed, and the risk factors of bone metastasis were identified. Results A total of 585 patients were recruited in this study, including 228 with bone metastasis and 357 without bone metastasis. Of the patients with bone metastasis, the incidence of pelvic metastasis was the highest, accounting for 81.58%, followed by spin (63.16%) and rib (58.33%), and the incidence of clavicle metastasis was the lowest (14.47%). Logistic regression analysis showed that age <71.5 years, alkaline phosphotase >85.5U/L, prostate-specific antigen >79.88μg/L and Gleason score >7.5 were the risk factors of bone metastasis in prostate cancer. ROC curve analysis showed that the sensitivity of diagnosing bone metastasis was 56.1%, 66.7%, 68.4% and 56.1%, and the specificity was 56.6%, 81.8%, 70.0% and 65.3%, respectively for above 4 factors. Conclusions The most common site of bone metastasis in patients with prostate cancer is pelvis. Patients' age, concentrations of plasma ALP and PSA, and Gleason score are the risk factors for bone metastasis in patients with prostate cancer.

Objective In order to evaluate that whether Pluronic P85 coated poly(butylcyanoacrylate) nanoparti-cles was able to deliver antiepileptic drug phenytoin into the brain va bypassing mesial temporal lobe epilepsy (MTLE)-induced Pgp in a rat model of MTLE. Methods The rat model of MTLE, induced by li-pilocarpine, was divided in-to two groups (6 for nanoparticle drug group and 7 for PHT drug group). Immunohistochemistry assay was performed to detect Pgp expression at the hippocampus. Nanoparticles were prepared by interfacial polymerization method. Dialysate samples of brain were collected at 30, 60, 120, 180, 240 and 300 min after drug administration by microdialysis tech-nology. Samples were analyzed by high performance liquid chromatography (HPLC). Results The area under the curve (AUC) ratio of brain/plasma in Nanoparticle drug group was 0.370.10 which was significantly higher compared with 0.190.06 in conventional PHT drug group (P<0.05). The Pgp immunopositive area, as assessed by analysis of labeled surface area, was higher in the DG, CA3 and CA1 sector in the hippocampus of MTLE rats when compared to the normal rats. Conclusions Pluronic P85 coated PBCA nanoparticles can significantly deliver PHT into brain via bypassing MTLE-induced Pgp in a rat model of MTLE.