Objective To evaluate the feasibility and safety of transjugular liver biopsy (TJLB) by using LABS 100 liver access and biopsy set (Cook Inc, bloomington, IN, USA). Methods During the period from June 2014 to Sep. 2014, a total of twelve patients received TJLB at authors’ hospital. The clinical data were retrospectively analyzed, and the indications, number of puncturing times, technical success rate, complications, sufficient amount of specimen, etc. were summarized. Results Technical success of TJLB was achieved in all patients, and no procedure- related complications occurred. The mean number of puncturing was 2.8 times, and sufficient amount of specimen for histological examination was obtained in all cases. Conclusion This preliminary result indicates that transjugular liver biopsy with the use of LABS 100 liver access and biopsy set is clinically safe and feasible.

A novel method was developed for the direct analysis of testosterone, androstenedione, methyltestosterone and methenolone in serum samples by fully automated online turbulent flow solid phase extraction coupled with high performance liquid chromatography-tandem mass spectrometry. An aliquot of 50 μL serum sample was preconcentrated directly on a Turboflow SPE column after centrifugation. Turboflow SPE C18-P could be used to remove serum matrix effectively. The optimum loading flow rate and elution time were 4. 0 mL/min and 1. 0 min, respectively. The linearity ranges were from 1. 0 μg/L to 100. 0 μg/L for four target compounds. The method limits of detection ( LODs) were in the range of 0. 2-0. 3 μg/L. The relative standard deviations (RSDs) ranged from 2. 9% to 14. 1% (n=5). The time for one sample analysis including extraction, separation and determination was 32 min. The proposed method has been successfully applied for the analysis of serum samples.

Objective To improve a HPLOUV method for the determination of Tramadol hydrochlo-ride in human plasma. Method Alkalinized samples of plasma were extracted with dichloromethane. Tramadol and internai standard were analyzed on Elite C18 column (200mm?5.0mm, 5?m) with a acetoni-trile-phsphate buffer (pH6.5) (74:26, v/v) mobile phase and detedted at 220nm. Results The Calibra-tion plots in human plasma were linear (r=0.9984, n =5) from 10 to 800 ng/ml. The limit of detection was 10 ng/ml. For 20, 100, 400 ng/ml check samples, intra-run precisions (RSD) were 3.81% -5.44% and inter-run preceisions (RSD) were 3.95% -4.41% , respectively. The average recoveries were 89% , 96% and 92% for the low, middle and high check samples, respectively. Conclusion The improved ana-lytical method for Tramadol hydrochloride was found to be sensitive, simple and rapid, suitable for applica-tion in forensic toxicological analysis and routine determination of numerous samples.

Objective To investigate the resistance rate of Pseudomonas aeruginosa to several commonly used antibiotics,as well as the prevalence status of three species of integrons in multi-drug resistant Pseudomonas aeruginosa from 2005 to 2006 in our hospital,and to identify the genetic structure of class Ⅰ integron in in our hospital.Methods Drug resistance slip method was applied to detecting the resistant rates of 100 isolates of Pseudomonas aeruginosa to ciprofloxacin,cefotaxime,gentamicin and imipenem.Boiling method was adopted to abstract DNA template of 100 isolates of Pseudomonas aeruginosa,and PCR assay adopted to identify the prevalence rate of three species of integrons and class Ⅰ integron structure.Results The resistant rates of 100 isolates of Pseudomonas aeruginosa to ciprofloxacin,cefotaxime,gentamicin,cefoxitin,tobramycin and imipenem were 32%,45%,82%,37%,39% and 43% respectively.The prevalence rates of three species of integrons was as follows:class Ⅰ 53%,Ⅱ 21% and Ⅲ 5%.Sequence analysis displayed there existed box gene dfrA17 and aadA2 in variable region of class Ⅰ integron.Conclusion The resistant rates of Pseudomonas aeruginosa to four drugs are elevated,especially to gentamycin.Multi-drug resistance may be partly due to prevalence of class Ⅰ integron.

Objective To detect the expression of tumor‐associated macrophages(TAM) in esophageal squamous cell carci‐noma ,and to study the clinical pathological characteristics of T AM in the esophageal squamous cell carcinoma .Methods Patients with esophageal squamous cell carcinoma who accepted operation were chosen as study subjects ,and tissue samples of esophagus were collected ,including 90 squamous cell carcinoma tissues ,20 paracancerous atypical hyperplasia and 20 normal mucosa tissues , and the expression of CD206 ,MCP‐1 were detected by immunohistochemisty .Results The positive expression of CD206 was sig‐nificantly increased in tissues of esophageal squamous cell carcinoma (P<0 .01) ,and it was positively correlated with clinical stage , invasion depth and lymph node metastasis in esophageal squamous cell carcinoma (P<0 .05) .The expression of MCP‐1 was signifi‐cantly increased in esophageal squamous carcinoma tissues (P<0 .05) ,and its positive expression was closely correlated with depth of invasion and lymph node metastasis in esophageal squamous cell carcinoma (P< 0 .05) .There was a positive relation between ATM infiltration quantity and the expression of MCP‐1(r=0 .617 ,P<0 .05) .Conclusion The positive expression of TAM was up‐regulated in esophageal squamous cell carcinoma tissues ,and its number was positively correlated with clinical stage ,invasion depth and lymph node metastasis .

6 cases(2 males to 4 females) who have received mandibula reconstruction with free vascularized fibular flaps in our hospital were studied retrospectively.The average length of the fibula grafts was 8.0 cm(range from 7.0 to 14 cm). 3 cases received primary insertion of osteointegrated dental implants into the free fibula flap. The mean follow-up of six cases of patients was 3 months to 1 year. The success rate was 100%. All patients spoke clearly. 4 patients could eat normally, the other two could eat soft food. 5/6 of patients with the recovery of facial appearance was satisfied. All patients were able to walk normally. No ankle unstability was reported. Vascularized free fibula flap is confirmed to be one of the optimal methods for mandible reconstruction by our study.

Objective To study the clinical features and angiographic findings of moyamoya disease (MMD) as well as their relationship. Methods A total of 22 MMD patients received routine digital substraction angiography (DSA). The clinical manifestations and angiographic findings were analyzed. Results Clinical manifestations varied and each patient often had multiple symptoms, including cerebral infarction in 9 patients with an average age of 23.6 (13-39 years) and cerebral hemorrhage in 7 patients with an average age of 31.2 (28-46 years). Angiographic examination found that all the diseased sides showed MMD blood vessels. The patients who received encephalo-myo-arterio-synangiosis (EMAS) had better prognosis than those without receiving the treatment. Conclusion Cerebral infarction is frequent in children and adolescents with MMD, whereas cerebral hemorrhage is common in adults. DSA is a golden criterion for diagnosing MMD. Surgical treatment, EMAS blood supply reconstruction in particular, should be prescribed.

BACKGROUND: Diabetes causes abnormal insulin like growth factor-1 (IGF-1) gene expression, which contributes to initiation and development of peripheral neuropathy.OBJECTIVE: To investigate the efficacy of a single dose of methylcabalamin on prevention of experimental diabetic neuropathy and the possible molecular mechanism of its involvement in IGF-1 gene expression.DESIGN: Completely randomized and controlled experiment.SETTING: Endocrinology Department of the First Affiliated Hospital of Nanjing Medical University.MATERIALS: The study was carried out in an Animal Center of Nanjing Medical University. Totally 80 male Sprague Dawley rats (sanitary degree)were randomly selected.METHODS: ① Totally 64 rats were chosen to be induced diabetic. They were injected intravenously with alloxan dissolved in saline solutions, at the dose of 240 mg/kg. ② Of 16 rats were chosen as normal control group who were injected intravenously with equivalent volume of saline solution. ③ Of 64 established diabetic rats were treated with daily subcutaneous injection of pork regular insulin in combination of protamine zinc insulin (2:1) then further divided into 2 groups as insulin-treatment diabetic control groups based on different blood glucose levels: group 1 with relatively better control of diabetes, group 2 with relatively worse control of diabetes, with 32 rats in each group. Totally 16 rats of each group were treated with methylcobalamin injection intramuscularly with 500 μg/kg body weight, thus correspondingly divided into insulin +methylcobalamin group 1 and insulin+methylcobalamin group 2. The remaining 16 rats of each group as respective insulin-treatment diabetic control groups were treated with equivalent volume of saline. ④ Initiate weight and end weight were measured at beginning of the experiment and after diabetic model was established. Glucose oxidase was used to detect glucose level. 1-deoxy-1-malin was used to detect fructose level. ⑤ Parameters were measured as follows: Sensory/motor nerve conduction velocity (SNCV, MNCV) and evoked potential amplitude (EPA) of sciatic nerves detected by evoked electromyogram; IGF-I mRNA by reverse-transcriptase polymerase chain reaction (RT-PCR); IGF-1 peptide by enzyme-linked immunosorbent assay (ELISA). ⑥ One-way analysis of variance was used to analyze the Significance of differences among groups.MAIN OUTCOME MEASURES: ① Tissue IGF-1 mRNA/ IGF-1 peptide, electrophysiological data of individual groups at different points of the experiment. ② Comparison between individual groups in glucose metabolic parameters and body weights at different points of the experiment.RESULTS: Three rats died for diabetic infection or other acute complications and only 77 rats were included in the final statistical analysis.① Body weight and glucose metabolic parameter changes: After diabetic model, glucose, fructose level and body weight change between methylcobalamin+insulin treated groups and insulin treated groups were not significant. ② IGF-1 mRNA/peptide changes: Tissue IGF-1 mRNA increased significantly in methylcobalamin + insulin treated groups than that in insulin treated groups, respectively (P ＜ 0.05-0.01). Two weeks after diabetic model was established, the sciatic tissue IGF-1 mRNA contents were obviously higher in methylcobalamin + insulin treated group 1 than that in insulin treated group 1 (P ＜ 0.05), but not significantly different from that in NC group; Similarly, tissue IGF-1 mRNA contents were obviously higher in methylcobalamin + insulin treated group 2 than that in insulin treated group 2 (P ＜ 0.05), but lower than that in NC group (P ＜ 0.01); Month 2, tissue IGF-1 contents in methylcobalamin+ insulin treated groups were lower signiiicantly than NC groups, but higher than insulin treated groups (P ＜ 0.05-0.01). By month 3, IGF-1 mRNA level in methylcobalamin+ insulin treated group 2 was not significantly different from that in insulin treated group 2. The IGF-1 peptide levels in nerve tissue changed approximately parallel to IGF-1 mRNA level over time course. ③ Nerve electrophysiological data changes: Month 2 and 3, SNCV, MNCV and EPA were significantly higher in methylcobal-amin+ insulin treated group 1 than in insulin treated group 1 (P ＜ 0.05);Month 2, SNCV and EPA were higher in methylcobalamin+ insulin treated group 2 than in insulin treated group 2 (P ＜ 0.05); Month 3, SNCV, MNCV and EPA were significantly lower in methylcobalamin + insulin treated group 2 than in control group (P ＜ 0.05-0.01), whereas no difference was observed between methylcobalamin + insulin treated group 2 and insulin treated group 2.CONCLUSION: ① Methylcobal has not effect on blood glucose. ②Methylcobal could prevent occurrence of experimental neuropathy through its effect on nerve IGF-1 gene expression of diabetic rats. ③ A better efficacy could be achieved by Methylcobal with a good control of blood glucose level in prevention of diabetic peripheral neuropathy.

Dendrobii Officinalis Caulis is considered as one kind of rare and precious Chinese medicinal herb with the efficacy of nourishing yin fluid, enhancing physique, benefiting and tonifying spleen and stomach, protecting liver and cholagogue, strengthening gluten, lowering lipid and blood sugar, inhibiting tumor, brightening eyes, nourishing skin, and prolonging life. This article used SWOT method to analyze the strength, weakness, opportunity, and threat of Dendrobii Officinalis Caulis respectively so as to analyze its marketing prospects in Hunan Province comprehensively. On the basis of the analysis, the early stage and late stage strategies of development of Dendrobii Officinalis Caulis in Hunan Province was carried out, which played a role in its medicinal value, economic value, and social value.