OBJECTIVE To validate the anticancer effect of Angong Niuhuang pill (AGNH) and pinpoint associated molecular mechanisms using human cancer cells.METHODS Human MGC-803 gastric carcinoma and human BEL-7402 hepatocarcinoma cells were incubated with AGNH 9,30,90,300 and 900 mg·L-1 for 24,48and 72 h,respectively.Cell viability was detected with 3-(4,5-dimethylthiazol-2-yl) -5-( 3-carboxymethoxyphe-nyl)-2-(4-sulfophenyl)-2H-tetrazolium (MTS) assay and colony formation assay.Apoptosis was measured with flow cytometry and Hoechst 33258/PI staining.Change in mitochondrial membrane potential (△qψ) was detected by spectrofluorophotometer.RESULTS AGNH inhibited MGC-803 cell proliferation ( for 48 h,r =0.996,P =0.002; for72 h,r=0.756,P=0.024 ) and BEL-7402 cells (for 48 h,r =0.732,P=0.030; for72 h,r=0.702,P =0.037) in a concentration-dependent manner,as showed by MTS assay.AGNH inhibited colony formation on MGC-803 cells (r =0.914,P =0.011 ) and BEL-7402 cells (r =0.871,P =0.024) in a concentration-dependent manner for 24 h.Hoechst 33258/PI staining and flow cytometry assay showed that AGNH 900 mg·L-1 for 24 h induced apoptosis of MGC-803 and BEL-7402 cells,and the apoptosis rate was 27.2％ and 19.7％,respectively.Compared with normal control group,AGNH 900 mg·L-1 for 3 min decreased the mitochondrial membrane potential of MGC-803 and BEL-7402 cells to 15.9％ and 15.0％ of control group.CONCLUSION AGNH inhibits proliferation of human cancer cells.Apoptosis and depolarization of mitochondrial transmembrane potential are probablly its mechanism.

【Objective】To explore the therapeutic effect of TCM syndrome differentiation and treatment for immunoglobulin A(IgA) nephropathy.【Methods】The selected 123 patients with IgA nephropathy were divided into two groups(in the proportion of 3∶1) by number randomization.Group A(n=86) was given Tripterygium Glycosides tablets and differential treatment according to syndrome patterns,and Group B(n=37) was given routine western medicine including anti-inflammation drugs,drugs for controlling blood pressure and glucocorticoid hormone.The two groups received a 3-month treatment course and received one more course according to individual cases.The total therapeutic effect,effect for TCM syndrome patterns,and toxic and side effects were observed.The changes of TCM syndrome scoring were compared before and after treatment.【Results】In group A,symptoms were completely relieved in 29,markedly relieved in 30,relieved in 15 and un-relieved in 12 patients,the total effective rate being 86.05%,while respectively in 4,5,10 and 18 of patients in group B,the total effective rate being 51.35%.The total effect was better in group A than that in group B(P0.05).The improvement on TCM syndrome scoring in group A was superior to that in group B(P

Objective To observe the clinical effects of pulsed radiofrequency combined with acupuncture and traction on nerve-roottype cervical spondylopathy. Methods 62 patients with nerve-root type cervical spondylopathy were divided into treatment group (n=31),whom were treated with pulsed radiofrequency combined with acupuncture and traction, and the control group (n=31) only with acupunctureand traction. Results The incidence of effect was significantly higher in the treatment group than in the control group (P<0.01). ConclusionCombining with pulsed radiofrequency is more effective on nerve-root type cervical spondylopathy than acupuncture and traction only.

Objective To analyse the therapeutic effect and safety of radiofrequency thermocoagulation on refractory neuralgia after craniotomy.MethodsFourteen patients with refractory neuralgia after craniotomy were treated by radiofrequency thermocoagulation. The pain degree (Numeric Rating Scales, NRS) and the complication were observed.ResultsNRS decreased significantly after treatment(P<0.01). No serious complication was observed after radiofrequency thermocoagulation except numbness. No patients recurred after one year follow-up.ConclusionRadiofrequency thermocoagulation is effective on refractory neuralgia after craniotomy.

Objective To explore the effect of preoperative local blocking with compound lidocaine hydrochloride (CLH) on postoperative pain of patients undergoing craniotomy.Methods40 patients suffered from superatentorial occupying lesion and scheduled for craniotomy were randomly divided into the CLH group and control group with 20 cases in each group. In the CLH group, local blocking with CLH was performed just before craniotomy, while in control group local blocking with 0.5% procaine was performed preoperatively and all patients of two groups used patient-controlled intravenous analgesia (PCIA) with fentanyl postoperatively. Postoperative pain was assessed for 48 hours according to visual analogue scale (VAS), and the comparison of analgesia-related postoperative complications of the two groups was demonstrated.ResultsThere was no significant difference in VAS postoperatively and incidence rate of complications between two groups ( P>0.05).ConclusionCompound lidocaine hydrochloride local infiltration may provide a safe and effective analgesia for postoperative pain in patients after craniotomy.

Objective To investigate the effect of radiofrequency on trigeminal neuralgia as the chief complaint of intracranial benign tumor. Methods 18 patients with intracranial benign tumor mainly presenting with trigeminal neuralgia were treated with radiofrequency thermocoagulation guided by CT scanning. The numeric rating scales (NRS) of pain and the complication were observed. Results The scores of NRS decreased significantly after treatment (P<0.01). The common complications included facial numbness and masticatory movement obstacle. One patient recurred 13 months and another patient recurred 24 months after operation. Both were treated with radiofrequency once again, and the pain ceased. Conclusion Radiofrequency is effective on secondary trigeminal neuralgia after intracranial benign tumor.

Purpose To study the expression of TMPRSS2, ERG and ETV1 in prostatic cancer and their clinical pathologic signifi-cance. Methods Tissue microarray and immunohistochemistry (MaxVision) were used to detect TMPRSS2, ERG and ETV1 expres-sion in 70 prostatic cancer tissues, 10 prostatic intraepithelial neoplasia tissues and 18 benign prostate tissues. Results There was no statistical significance on positive rate of the expression of TMPRSS2 among prostatic cancer tissues, prostatic intraepithelial neoplasia tissues and benign prostate tissues (P>0. 05). The positive rate (81. 4%) of ERG in prostatic cancer tissues was significantly higher than that in prostatic intraepithelial neoplasia tissues ( 30. 0%) and benign prostate tissues ( 0. 0 ) ( P <0. 05 ) . The positive rate (68. 6%) of ETV1 in prostatic cancer tissues was significantly higher than that in prostatic intraepithelial neoplasia tissues (50. 0%) and benign prostate tissues (22. 2%) (P<0. 05). There was no correlation among the positive rates of TMPRSS2, ERG and ETV1 in prostatic cancer tissues and age (P>0. 05). The expression of TMPRSS2, ERG and ETV1 was positively correlated to Gleason score and clinical stage (P<0. 05). TMPRSS2 had positive correlation with ERG (rs =0. 465, P<0. 01). TMPRSS2 had positive correla-tion with ETV1 (rs =0. 590, P<0. 01). ERG had no positive correlation with ETV1 (rs =0. 151, P>0. 05). Conclusion ERG and ETV1 are expected to become therapeutic targets for prostate cancer. Detecting TMPRSS2, ERG and ETV1 at the same time is helpful to diagnosis and differential diagnosis of prostatic cancer, which might be new molecule markers of prostate cancer.

Objective:To investigate the diagnostic value of different detection methods for Mycobacterium tuberculosis in bronchoalveolar lavage fluid (BALF) from patients with pulmonary tuberculosis.Methods:BALF from l00 patients in Changsha Central Hospital from January 2013 to December 2015 was collected.Among 100 patients,65 cases were clinically diagnosed as tuberculosis,and 35 cases served as control.BALF smear method,polymerase chain reaction (PCR) and membrane reverse dot blot (RDB) were used for synchronous detection of Mycobacterium tuberculosis.Results:The positive rates by BALF smear method,PCR and RDB were 43.08％,73.84％ and 92.31％,respectively (P＜0.05).Sensitivity,specificity,accuracy,and negative predictive value for BALF smear were 43.08％,88.57％,59.00％,and 45.59％,respectively;for PCR were 73.85％,100％,83.00％,and 67.31％,respectively;for RDB were 92.31％,100.00％,95.00％,and 87.50％,respectively.Conclusion:The technique of membrane RDB can not only accurately diagnose Mycobacterium tuberculosis,but also can rapidly and easily identify the resistance of Mycobacterium tuberculosis to streptomycin (SM),rifampicin (RFP) and isoniazid (INH) genotypes.It possesses high clinical value.

Objective:To evaluate the effect of esketamine on postoperative delirium (POD) in elderly patients undergoing general anesthesia.Methods:Two hundred and twenty-four elderly patients, aged ≥ 65 yr, with American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅲ, undergoing elective surgery under general anesthesia, were divided into 2 groups ( n=112 each) using a random number table method: esketamine group (S group) and control group (C group). Esketamine 0.5 mg/kg was intravenously injected before anesthesia induction in S group, while the equal volume of normal saline was given instead in C group.The Fuzzy Consciousness Assessment Scale (3D-CAM) was used to assess the occurrence of POD within 7 days after surgery.The consumption of propofol, remifentanil and sufentanil and use of vasoactive drugs were recorded during operation.The rescue analgesia within 48 h after operation and occurrence of postoperative complications were recorded. Results:Compared with C group, the incidence of POD was significantly decreased, the intraoperative consumption of remifentanil was reduced, and the utilization rate of vasoactive drugs, rate of rescue analgesia and incidence of postoperative vertigo, nausea and vomiting within 48 h after surgery were decreased in S group ( P<0.05). Conclusions:Esketamine can reduce the development of POD in elderly patients.

Objective:To evaluate the effective dose, efficacy and safety of remimazolam for induction of general anesthesia in super-elderly patients.Methods:Trial Ⅰ American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅲ patients of either sex, aged ≥80 yr, with body mass index of 18-25 kg/m 2, undergoing elective surgery with general anesthesia in the Zhejiang Provincial People′s Hospital from January to March 2022, were selected. Remimazolam 0.12 mg/kg or propofol 0.8 mg/kg was intravenously injected in the first patient, and the dose of remimazolam or propofol in the next patient was determined by using the modified Dixon′s up-and-down method. The difference between the two successive doses was 0.01 mg/kg for remimazolam and 0.05 mg/kg for propofol. A positive response was defined as achieving an anesthesia depth (BIS value ≤ 65) within 5 min of administration. If the response was positive, the next patient received a lower dose, or conversely if negative, a higher dose was given in the next patient. The 50% effective dose (ED 50) and 90% effective dose (ED 90) of remifentanil and propofol and their 95% confidence intervals ( CIs) were calculated by Probit method. Trial Ⅱ One hundred and forty-six American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅲ elderly patients of either sex, aged ≥80 yr, with a body mass index of 18-25 mg/kg, scheduled for elective surgery with general anesthesia from April to October 2023 in Zhejiang Provincial People′s Hospital, were selected and divided into 2 groups ( n=73 each) by using a random number table method: remimazolam group (R group) and propofol group (P group). R group was induced with intravenous remimazolam ED 90 and P group was induced with intravenous propofol ED 90, and the injection time was both 30 s. If the BIS value was still greater than 65 at 5 min after administration, remimazolam 0.05 mg/kg was intravenously added each time in R group and propofol 0.5 mg/kg was intravenously added each time in P group until the patient′s BIS value ≤65. The success of anesthesia induction, time for successful induction of anesthesia and rescue sedation were recorded. The occurrence of intraoperative injection pain, hypertension, hypotension, bradycardia, hypoxemia, intraoperative awareness and postoperative delirium, nausea and vomiting was also recorded. Results:Trial Ⅰ The ED 50 (95% CI) of remimazolam was 0.148 (0.139-0.157) mg/kg, and the ED 90 (95% CI) was 0.160 (0.153-0.202) mg/kg; the ED 50 (95% CI) of propofol was 0.824 (0.726-0.983) mg/kg, and the ED 90 (95% CI) was 0.916 (0.860-2.472) mg/kg. Trial Ⅱ Compared with group P, the time for successful induction of anesthesia was significantly prolonged, the incidence of intraoperative injection pain and hypotension was decreased ( P<0.05), and no significant change was found in the success rate of anesthesia induction, rate of rescue sedation, intraoperative hypertension, bradycardia, hypoxemia, postoperative delirium, and nausea and vomiting in group R ( P>0.05). Conclusions:The ED 50 and ED 90 of remimazolam for induction of general anesthesia are 0.148 and 0.160 mg/kg, respectively, in super-elderly patients. Compared to propofol, remimazolam has a slightly longer onset time, but it is safer when used for induction of general anesthesia in super-elderly patients.