Objective To improve the diagnostic rate of mammary ductal disease by galactography and mammoscopy.Methods 100 cases of the galactographic and mommoscopy materials were retrospectively analyzed.Results Tumorous diseases including intraductal papilloma,intraductal papillary carcinoma and ductal carcinoma,they accounted for 14%,intraductal papilloma and intraductal papillary carcinoma were the most in this group(12%).Non-tumorous diseases including mammary ductal ectasia with chronicmastitis,plasma cell mastitis,mammary cyst,lobular hyperplasia and cystic hyperplasia,they accounted for 71%,mammary ductal ectasia was the most in this group(42%).Conclusion The galactography and mammoscopy are very valuable in the diagnosis and differentiating diagnosis of mammary ductal diseases.

Aim To study the effect of genistein on contractility of isolated papillary muscles in guinea pig and its mechanisms.Methods Isolated guinea pig papillary muscles were suspended in organ baths containing KH solution,and the effect of genistein on contractility of myocardium was observed after an equilibration period.Results Genistein and isoprenaline hydrochloride showed positive inotropic effects on contractility of myocardium in a dose-dependent manner(1～100 ?mol?L~(-1)) Propranolol(1 ?mol?L~(-1)) and verapamil hydrochloride(0.5 ?mol?L~(-1)) attenuated the positive inotropic effect of isoprenaline hydrochloride(2 ?mol?L~(-1)),but did not change the effect of genistein(100 ?mol?L~(-1)).Furthermore,the enhancement of the contractility induced by elevation of extracellular Ca~(2+) concentration in papillary muscles did not show any change after pretreatment with genistein(1,10 ?mol?L~(-1)).Finally,the positive inotropic effect of genistein was attenuated partially by tamoxifen(1 ?mol?L~(-1)),however,was not influenced by sodium orthovanadate(1 ?mol?L~(-1)).Conclusions Genistein has the positive inotropic effect on guinea pig papillary muscles,which is not related to the activation of Ca~(2+) channel on cell membrane,? adrenoceptor and tyrosine kinase pathway,but this effect may involve in uptake and utilization of sarcoplasmic reticulum Ca~(2+).

Objective To study the mechanism of Liangruntongluo Recipe in improving gastrointestinal function on DM rats induced by STZ. Methods Forty male Wistar rats were divided into four groups randomly: group A as model control group,group B as Liangruntongluo group,group C as Cisapride group,and group D as normal control group. There are 10 rats in each group. After the establishment of DM animal model with Wistar rats,the animals were raised for 6 weeks without any hypoglycemic agents. And then medicines were intragastric administrationed for another 6 weeks. In the 12th week motile and cholecystokinin in blood and tissue were tested. Result By the time of the twelfth week,the rats with DM presented the disorder of gastrointestinal hormone. Liangruntongluo Recipe affected the excretion and releasing of hormone in blood,stomach,and duodenum. With a wide target range,effect of Liangruntongluo Recipe is superior to Cisapride. Conclusions Chinese herbal medicine Liangruntongluo recipe has the superiority in improving the obstacle of the gastrointestinal function of diabetes mellitus.

Objective To identify if there was increased DNA damage in cardiomyocytes of rats with diabetic cardiomyopathy and also to evaluate the change in gene expression of DNA repair enzymes 8-oxoguanine DNA glycosylase 1(OGG1) and AP endonuclease 1(APE1).Methods Total DNA,RNA and proteins of hearts were isolated in diabetes rat hearts.DNA damage was examined with quantitative polymerase chain reaction(Q-PCR) assay.mRNA and protein expressions of OGG1 and APE1 were detected with real time-polymerase chain reaction(RT-qPCR) and Western blot analysis.The levels of 8-hydroxy-2′-deoxy-guanosine(8-OHdG) in DNA were studied with ELISA.ResultsThe damage of mtDNA was increased in rat hearts(P<0.05) and there was not significant damage in nDNA.The amount of 8-OHdG in DNA was significantly increased(P<0.05),mRNA and protein expressions of OGG1 and APE1 were increased in diabetic rat hearts(P<0.01).Conclusions The damage of mtDNA increased in diabetic rat hearts.Although the expression of OGG1 and APE1 increased in diabetic rat hearts,which fails to repair the damage of the mtDNA.The increased mtDNA damage may contributes to myocardium damage.

Objective To investigate the clinical value of MRI in the diagnosis of oblique vaginal septum syndrome(OVSS),and to improve the diagnostic level for this disease.Methods Clinical and imaging data of 8 patients (7 adolescent females and 1 female in fertility period)with vaginal septum syndrome were analyzed retrospectively.All participants were evaluated by ultrasound examination before MRI scanning,and 1 of them underwent enhanced MRI scan.Results Among the 8 patients with OVSS,the main findings of MRI includes uterine deformity (4 double uterus,3 mediastinal uterus,1 double angle uterus with uterine septum),oblique vaginal septum (7 right oblique septum and 1 left oblique septum).All subjects presented with ipsilateral renal agenesis,and 4 patients with endometriosis,1 patient with ureteral distortion and ectopic opening and 1 patient with double inferior vena cava.6 patients suffered with hemorrhage in the posterior chamber of oblique septum and 2 patients with empyema.Hemorrhage in the contralateral vagina were observed in 3 cases,while no significant abnormality was found in other 5 cases.Conclusion MRI scan has an important clinical value on the diagnosis of OVSS and can provide crucial information for the optimal individual treatment.

The German ( Kooperation für Transoarenz und Qualit?t im Gesundheitswesen, KTQ) certification system was officially launched in Germany in December 2001. Over ten years′ development proves that the KTQ certification system as a high standard medical management system. The authors introduced its background, the update of certification content and procedures, and explained its characteristics and advantages.These insights provide valuable references for establishing a professional and efficient quality certification system, suitable for China′s social and economic development level.

Objective:To investigate the effect of Asarinin on the survival time of transplanted heart after allogeneic heterotopic heart transplantation and to further verify the anti-immune rejection effect of Asarinin in spleen and peripheral blood.Methods:Using 64 Wistar rats as donors, 64 SD rats as recipients to establish the allogeneic heterotopic heart transplantation model in rats.After successful transplantation, 64 rats were use simple randomization divided into control group, cyclosporine A(CsA) group, Asarinin group and half CsA + half Asarinin group with 16 rats in each group.CsA group was given 5 mg/kg by gavage; Asarinin group was given 25 mg/kg; half dose group was given CsA 2.5 mg/kg+ Asarinin 12.5 mg/kg and the control group was given the same volume of normal saline by gavage.After administration for 1 week, half of them were used to observe the survival time.The other half of the rats were fully anesthetized with chloral hydrate, spleen and peripheral blood were taken.Half of the spleen was taken to observe the slices under the microscope.The other half of spleen was used RT-PCR to detect the relative expression of IFN-γ and IL-4.The expression of co-stimulatory molecules CD80, CD86 and CD40 in peripheral blood were detected by flow cytometry.Results:Survival time of transplanted heart was control group (8.4±0.9), CsA group (30.5±8.3), Asarinin group (16.5±4.3) and half-dose group (26.1±5.2) days.Compared with control group, survival time of heart transplantation became prolonged in all groups and the difference was statistically significant ( P<0.05). HE staining of splenic tissue showed that, as compared with control group, the injury of each group was alleviated.The relative expression of IFN-γ in spleen was control group (1.055±0.083), CsA group (0.396±0.038), Asarinin group (0.833±0.094) and half-dose group (0.862±0.104). The last three groups were lower than control group and the difference was statistically significant ( P<0.05). The relative expression of IL-4 in spleen was control group (1.429±0.234), CsA group (3.808±0.729), Asarinin group (2.209±0.306) and half-dose group (2.323±0.321). The last three groups all spiked as compared with control group and the difference was statistically significant ( P<0.05). The expressions of CD80, CD86 and CD40 in peripheral blood were control group (98.21±0.54), (85.78±0.89) and (96.36±0.66), CsA group (89.26±0.36), (56.86±2.32) and (88.11±1.61), Asarinin group (94.19±0.47), (79.01±1.12) and (87.86±1.67) and half-dose group (94.87±0.74), (80.81±0.98) and (89.71±0.97) respectively.The last three groups were lower than control group and the difference was statistically significant ( P<0.05). Conclusions:Asarinin can prolong the survival time of transplanted heart after allogeneic heterotopic heart transplantation in rats, inhibit the immune injury of spleen after allogeneic heterotopic heart transplantation in rats, decrease IFN-γ in spleen, increase IL-4 in spleen and inhibit the expression of peripheral blood costimulatory molecules CD80, CD86 and CD40.

Objective To establish new classification criteria for early rheumatoid arthritis (E-RA) based on large samples of early inflammatory arthritis patients and to evaluate the value of this criteria in China.Methods Patients who had arthritic complaints with disease duration less than one year were enrolled.They were divided into RA group and non-RA group according to the clinical diagnosis by experienced rheumatologists.The clinical and laboratory parameters were analyzed and those with high sensitivity or specificity were selected as the new classification criteria.Statistical analysis was carried out by using t test,x2 test and Logistic regression.Results ① A total of 803 patients with early inflammatory arthritis were included in this study.Five hundreds and fourteen patients were diagnosed as early RA and 251 were diagnosed as other rheumatic diseases,and the diagnosis of 38 patients remained unestablished by the end of follow-up.② New E-RA classification criteria were established based on the parameters with high sensitivity and/or specificity.The sensitivity of the new E-RA criteria was 84.4％,which was higher than 1987 ACR criteria (58.0％),while the corresponding specificities were similar,which were 87.4％ and 93.6％ respectively.③ Compared with the complex scoring system of 2010 ACR/EULAR criteria,the E-RA criteria was more simple and practical.The diagnostic sensitivity and specificity of E-RA criteria were higher than those of 2010 ACR/EULAR criteria reported in the literatures.④ New classification criteria based on scoring system using Logistic regression analysis was established.The sensitivity of this criteria was 86.4％,which was higher than 1987 ACR criteria (58.0％).Conclusion The diagnostic value of the E-RA criteria developed in this study for early RA is better than 1987 ACR criteria,and is more simple than 2010 ACR/EULAR criteria.It may be used as a new classification criteria for early RA diagnosis.

Objective:To explore the clinical application and long-term safety of hydroxychloroquine sulfate (HCQ) in the treatment of rheumatic diseases.Methods:A multi-center cross-sectional study was conducted between August 2017 and August 2018 in a random sample of eleven medical institutions of rheumatology and immunology in China. Patients who took HCQ for more than 3 months were enrolled into this study. The cumulative dose and long-term side effects of HCQ were recorded. The changes of laboratory indexes before and after treatment with HCQ were analyzed. Categorical variables were presented with counts and proportions, and evaluated by Chi-square test. Continuous parametric data were presented as Mean±standard deviation, and evaluated by Student's t test or Mann-Whitney U test. P-values less than 0.05 were considered statistically significant. Results:A total of 886 patients with rheumatic diseases were enrolled into this study, including 505 cases with systemic lupus erythematosus (57.0%), 210 cases with rheumatoid arthritis (23.7%), 80 cases with Sj?gren's syndrome (9.0%), 57 cases with undifferentiated connective tissue disease (6.4%), 12 cases of systemic vasculitis (1.4%), 10 cases of mixed connective tissue disease (1.1%), 7 cases of myositis (0.8%) and 5 cases with systemic sclerosis (0.6%). The most common long-term side effects of HCQ was skin or mucous lesions (12.4%) and vision problems (8.0%). Other adverse reactions included problems of digestive system (3.0%), nervous system (2.1%), musculoskeletal system (1.1%) and cardiovascular system (0.9%). 140 cases (15.8%) had stopped taking HCQ during the treatment. More than half of them decided to stop taking medicine by themselves. Fifty-four patients (6.1%) stopped using HCQ due to side effects while 24 of them took it again, and another 12 patients (1.4%) stopped the drug due to remission of illness. Patients were divided into three groups according to the cumulative dose of HCQ: less than 500 g, 500-1 000 g and more than 1 000 g respectively. There was significant difference in the incidence of long-term side effects among the three groups ( χ2=6.382, P=0.041). The last group (more than 1 000 g) suffered the highest incidence of long-term adverse reactions (37.1%). No severe adverse drug reactions were observed in this study. Conclusion:Hydroxychloroquine is widely used in the treatment of rheumatic diseases. The incidence of long-term side effects is 20.4%, is 6.1% lead to drug withdrawal, which are especially related to the cumulative doses. It should be adjusted properly according to the clinical application.