Curcumin is the main active component in turmeric, which possesses many pharmacologic effects, including anti-in-flammatory, antioxidant, anti-tumor, anti-atherosclerosis, liver and kidney protection and so on. However, due to its poor bioavail-ability, its clinical application is limited. Therefore, the methods for improving the bioavailability of curcumin were reviewed by refer-ring to a large number of literatures. The bioavailability of curcumin can be improved by different administration routes and various dos-age forms. The review provides theoretical basis and research ideas for the development of new drugs.

Objective To evaluate the long-term therapeutic efficacy of subtotal colectomy,ascending colon-rectum anastomosis, pelvic floor hernia repair, functional rectal suspension, and uterine suspension surgery for slow transit constipation with pelvic floor hernia and rectal mucosal prolapse.Methods From June 2007 to May 2008, 35 patients with intractable constipation caused by slow colonic transit combined with pelvic floor hernia and rectal mucosal prolapse underwent subtotal colectomy and ascending colon-rectum anastomosis, pelvic floor hernia repair, functional rectal suspension, and uterine suspension surgery. Postoperative defecation, complications, quality of life, and degree of satisfaction were followed-up. Results The average follow-up period was two years. At one month after the operation, the average defecation frequency was five times (2 -8 times) a day, with a semi-liquid stool consistency; After two years the frequency was twice ( 1 -3 times) a day, with solid stool consistency. Of the 35 patients, 19 were satisfied with the surgical efficacy, and 16 were very satisfied. All the patients' quality of life improved significantly. Conclusions For patients suffering from slow transit constipation with pelvic floor hernia and rectal mucosal prolapse subtotal colectomy, ascending colon-rectum anastomosis, pelvic floor hernia repair,functional rectal suspension, and uterine suspension surgery has satisfactory results.

Objective To observe the curative effect in patients with systemic lupus erythematosus(SLE) complicated by moderate or severe thrombocytopenia with a blood platelet count(BPC) of under 50 × 109/L and analyze its related factors. Methods We retrospectively analyzed the clinical data on 109 SLE patients with mod-erate or severe thrombocytopenia. Results Of the 109 patients,82(75.2%)had complete response(CR),15 (13.8%)had partial response(PR),and 12(11.0%)had no response(NR),respectively. As compared with the CR+PR group,the NR group had a higher incidence rate of decreased bone marrow megakaryocyte(P < 0.05). However,there were no significant differences between the two groups in SLEDAI scores,rates of positive PAIg and ACA,and levels of C3 and C4(P>0.05 for all comparisons). The total effectiveness rate did not differ signifi-cantly between MP pulse therapy and high-dose corticosteroid therapy. Conclusions A decrease in bone marrow megakaryocytes can be an adverse factorfor affecting the efficacy in patients with SLE complicated by moderate or severe thrombocytopenia.

Objective To study appliction value of quantitative dynamic contrast enhanced MRI(T1-DCE MRI)in preoperative grading of brain glioma.Methods 80 patients who were pathologically confirmed with a tumor grade (WHO grade Ⅰ 20 cases, grade Ⅱ 20 cases,grade Ⅲ 20 cases and grade Ⅳ 20 cases).All patients were examined with MR enhancements and T1-DCE MRI. The original perfusions imaging datas were analyzed using the GE Omni Kinetic software,which produced the transfer constant (Ktrans )map,the rate constant (Kep )map and fractional volume (Ve )map.Choose ROI and get values of Ktrans ,Kep and Ve .Pearson correlation was carried out to analyze the correlation between values of Ktrans ,Kep ,Ve of different grades of gliomas and pathology classifications.The Ktrans ,Kep and Ve values of the different grade gliomas were statistically analyzed using an ANOVA .Receiver operator characteristics (ROC)curve was used to analyze sensitivity and specificity of permeability parameters.Results The Ktrans ,Kep and Ve values of each levels has a strong correlation with pathological grading (r=0.95 1,0.804,0.766).There was obviously statistically significant difference between different grade groups(P < 0.01 )by Ktrans .Kep values have statistically difference between different grades except grade Ⅱ and Ⅲ.Ve values were different between different grades except grade I andⅡand grade Ⅲ and IV.Accord-ing to ROC curve,Ktrans seemed to be a better parameter for evaluating the tumor grade with the highest sensitivity and specificity. With the cutoff thresholds of Ktrans of 0.1 60,0.420 and 0.935,different grades of glioma can be differentiated with sensitivities of 90%,95%,95% and specificities of 95%,95%,85% respectively.Conclusion Quantitative analysis of microcirculation perfusion status of different grade gliomas by Ktrans values obtained from T1-DCE MRI can assessment the degree of the destruction of the blood brain barrier and evaluate the grade of gliomas more accurately before operation.

Objective Objective To explore the reasons of lung hypervolemia after liver transplantation and the corresponding treatment strategies.Method 291 patients received liver transplantation,in which 35 cases underwent pulmonary edema at early stage (pulmonary hypervolemia group),and the rest without pulmonary hypervolemia served as control group.Average central venous pressure (CVP) was recorded pre-,intra-and post-operatively.Total intake,total discharge and fluid balance were also recorded intraoperatively and 3 days post-operatively.Result In pulmonary hypervolemia group,CVP was (12.33 ± 5.08),(14.33 ± 3.03) and (16.50 ± 4.57) mmHg pre-,intra-and post-operatively,significantly higher than that in control group (P＜0.05 for all).Total intake,total discharge and fluid balance in pulmonary hypervolemia group were significantly higher than those in control group intraoperatively and 3 days post-operatively (P＜0.05 for all).After diuretic therapy and hemodialysis,30 cases in pulmonary hypervolemia group recurred,and 5 cases died of infection.Conclusion Pulmonary hypervolemia at early stage after liver transplantation is related to fluid balance.The reasonable control of total intake,total discharge and fluid balance is necessary.

From the aspects of strengths,weaknesses,opportunities and threats,this paper analyzed external factors of the reorganizations and group building reform of public hospitals in Shanghai.Points made are as follows:Characteristics of individual hospitals should he respected instead of a generalized pattern for all;the role of the government to play in this regard should he guidance of an orderly competition,Strengthen Supervision,and promotion of the reform in property rights,These efforts will create a desirable environment for hospital groups;mid- and long-term goals for the reform should consolidate the independent legal entity status of such groups.

Objective:To investigate the expression of human epidermal growth factor receptor 2 (HER2) in pancreatic ductal adenocarcinoma(PDAC) and its relationship with the prognosis of patients with PDAC.Methods:From January 2001 to December 2012, 109 paraffin embedded PDAC tissue samples and 27 normal pancreatic tissue samples were collected from the Department of Pathology, Huadong Hospital Affiliated to Fudan University. The expression of HER2 protein in pancreatic tissue was detected by immunohistochemical Envision two-step method. HER2 expression was evaluated according to Hercept test, and its relationship with clinicopathological features and survival time was analyzed.Results:The expression of HER2 protein was negative (-) in 29.4% of PDAC tissues, weakly positive (+ ) in 35.8%, positive (+ + ) in 25.7% and strongly positive (+ + + ) in 9.2%, respectively, and the overexpression rate (+ + , + + + ) was 34.9%; the negative (-) and weakly positive (+ ) expression of HER2 protein in normal pancreatic tissues accounted for 88.9% and 11.1% respectively. There was no expression with positive (+ + ) or strongly positive (+ + + ), therefore, the overexpression rate was 0. The overexpression rate of HER2 protein in PDAC and normal pancreatic tissues was significantly different ( P=0.000). The expression of HER2 protein was significantly correlated with age, and the expression of HER2 protein in patients with PDAC over 65 years old was significantly higher than that in patients with PDAC under 65 years old ( P=0.043), but not with gender, tumor location, tumor grade, T stage, N stage and nerve invasion (all P>0.05). Univariate Cox proportional hazards analysis showed that HER2 expression was associated with postoperative survival time of patients with PDAC ( P=0.032). Multivariate Cox proportional hazards analysis showed that HER2 expression was an independent prognostic factor for survival of patients with PDAC ( P=0.040). The median survival period of patients with HER2 expression + + + was significantly longer than that of patients with HER2 expression -~+ + (128.4 months vs 21.5 months), and the difference was statistically significant ( P=0.038). Conclusions:The overexpression of HER2 in PDAC tissue was related to the age of patients. The survival time of patients with HER2 strongly positive PDAC was significantly longer. HER2 can be considered as an index to evaluate the biological behavior and prognosis of PDAC.

AIM: To assess the degree of oxidative damage during acute myocardial infarction and reperfusion, and to clarify the protective effect of Tongxinluo in mini-swine model. METHODS: Thirty mini-swines were randomized into 5 study groups: sham group, model group, low dose (0.05 g·kg~(-1)·d~(-1)), medium dose (0.2 g·kg~(-1)·d~(-1)) and high dose (0.5 g·kg~(-1)·d~(-1)) of Tongxinluo groups (pretreated with Tongxinluo for 3 d). Animals except in sham group were subjected to 3 h of coronary occlusion followed by 1 h of reperfusion. Concentrations of total antioxidative capability (T-AOC), total superoxide dismutase (T-SOD), reduced glutathione (GSH) and malondialdehyde (MDA) in blood sample and the myocardium were measured. RESULTS: (1) T-AOC, T-SOD and GSH in serum significantly decreased (all P<0.05), while MDA significantly increased (P<0.01) at 3 h after AMI in comparison with those at baseline. Compared to those at 3 h after AMI, the contents of T-AOC, T-SOD and GSH at 1 h after reperfusion significantly decreased (all P<0.01), accompanied by increase of MDA (P<0.01). (2) Compared to those in normal area, levels of T-AOC, T-SOD and GSH in reperfusion myocardium decreased significantly (all P<0.01) and MDA increased significantly (P<0.01). T-AOC, T-SOD and GSH in no-reflow myocardium further decreased (all P<0.01) and MDA increased (P<0.01) as compared to those in reperfusion myocardium. (3) Compared to model group, medium dose of Tongxinluo increased the contents of T-AOC and T-SOD and reduced MDA production in serum at 3 h after AMI (all P<0.05), while medium dose of Tongxinluo increased T-SOD level at 1 h after reperfusion (P<0.05). High dose of Tongxinluo increased the levels of T-AOC and T-SOD and decreased MDA content in serum at 3 h after AMI and 1 h after reperfusion (all P<0.05). (4) The medium dose of Tongxinluo increased T-AOC content (P<0.05) and reduced MDA (P<0.05) in reperfusion myocardium, while high dose of Tongxinluo increased T-AOC, T-SOD and GSH (all P<0.05), reduced MDA (P<0.01) in reperfusion myocardium, and also increased T-AOC, T-SOD (all P<0.05), reduced MDA (P<0.01) in no-reflow area as compared to those in model group. CONCLUSION: Impairment of antioxidant defense system in vivo and imbalance of redox homeostasis in myocardium region might play an important role in the pathogenesis of no-reflow after myocardial acute infarction following reperfusion. Tongxinluo protects myocardium from reperfusion injury by improving antioxidant defense and attenuating oxidative damage.

Objective: To evaluate the changes of left and right ventricular function in patients after percutaneous pulmonary valve implantation (PPVI). Methods: A total of 8 patients with successful PPVI in our hospital from 2014-05-27 to 2015-03-25 were studied. The patients received pre-operative evaluation including clinical symptoms, plasma BNP levels, ECG, chest X-ray, echocardiography, CT and MRI examinations. Post-operative follow-up study was conducted at 6 months after PPVI to compare the ventricular functional changes. Results: The average age in 8 patients was 14-42 (25.4±8.1) years including 7 with tetralogy of Fallot correction and 1 with pulmonary stenosis plasty for 24 years. Echocardiography found that 3 patients with mid to large pulmonary regurgitation and 5 with large regurgitation. Compared with pre-operation, at 6 months after PPIV, all patients had decreased right ventricular end-diastolic diameter (RVEDD) as (44.0±4.8) mm vs (33.6±7.1) mm, right ventricular end-diastolic volume index (RVEDVI) (150.1±25.7) ml/m2 vs (111.4±39.1) ml/m2, RVESVI (107.8±21.5) ml/m2 vs (80.7±22.2) ml/m2 and right ventricular cardiac output (RV-CO) (6.8±1.3) L/min vs (4.9±0.8) L/min, but right ventricular ejection fraction (RVEF) was similar (40.5±6.2) % vs (39.5±9.9) %, P>0.05; while
increased LVEDD (42.9±4.4) mm vs (46.1±3.0) mm, P<0.05, but LVEDVI (61.8±15.0) ml/m2 vs (72.4±17.6) ml/m2, LVESVI (47.8±12.4) ml/m2 vs (41.0±10.4) ml/m2, LVEF (50.9±5.5) % vs (52.8±6.7) % and LV-CO (3.7±1.0) L/min vs (4.2±1.0) L/min were similar, allP>0.05. Conclusion: PPVI may decrease right ventricular preload, improve its reverse remodeling and maintain systolic function at normal level in relevant patients; while the impacts on left ventricular function and geometry should be further studied.

Objective Dilated cardiomyopathy (DCM) is generally considered to be accompanied by both left and right ventricular dysfunction,but most studies only analyze the left ventricular function. In this study, we evaluated the effect of arotinolol on right ventricular function in patients with DCM. Methods Right ventricular ejection fraction (RVEF) and right ventricular diameter (RVD) were measured by two-dimensional echocardiography (2-DE) in 33 DCM patients; RVEF measured by first-pass radionuclide angiography (FPRA) was compared with that by 2-DE. Results The treatment with arotinolol for one year resulted in a reduction in the right ventricular diameter (baseline, 23.0 ± 8.3 mm vs after one-year treatment, 20.7 ± 5.4 mm; P=0.004 ) and an associated increase in ejection fraction (baseline, 36.9 ± 10.3% vs after one-year treatment, 45.8 ± 9.6%; P ＜ 0.001 ); there is a high correlation between the 2-DE method and radionuclide ventriculographic method. The correlation coefficient is 0.933 (P＜0.001). Conclusion Arotinolol therapy could not only improve left ventricular function, but also improve right ventricular function in DCM patients.