AIM:To determine notoginsenoside R_1 and ginsenoside Rg_1, Rb_1 in Zidan Huoxue Tablet by HPLC linear gradient elution (total saponins of Radix et Rhizoma Notoginseng). METHODS: Using HPLC method with Hypersil ODS2 C_ 18 column. A mobile phase consisted of acetonitrile-water 0-20 min (20∶80), 20-21 min(40-20∶60-80), 21-30 min(20∶80) gradient elution. The column temperature was at room temperature. The detection wavelength was at 203 nm. RESULTS: The linear ranges of R1, Rg1, Rb1 were 0.52-2.6 ?g (r= 0.999 9 ), 2.106 -10.53 ?g (r= 0.999 6 ) and 2.946-14.73 ?g (r= 0.999 6 ), respectively. The average recoveryies were 99.3% (RSD=1.1%), 100.0%(RSD=0.5%) and 99.7%(RSD=0.9%), respectively. CONCLUSION: The method is selective and reproducible for determination of notoginsenoside R_1 and ginsenoside Rg_1, Rb_1 in Zidan Huoxue Tablet.

Clinical data of 61 cases of imported malaria were analyzed retrospectively.Patients with malaria were divided into three groups,asymptomatic tertian (vivax) malaria,symptomatic tertian malaria and pernicious (falciparum) malaria.Only mild hepatic damage occurred in some patients with asymptomatic tertian malaria,compared with other groups Symptomatic tertian malaria and pernicious malaria were misdiagnosed in 6 of 20 and three of six,respectively before hospitalization,and 16 of 20 and four of six patients complicated with thrombocytopenia,respectively,and both of them had increased serum level of C-reactive protein (CRP).Platelet count negatively correlated with their serum level of CRP significantly in patients with symptomatic tertian malaria (r =-0.555,P ＜ 0.05).Routine anti-malaria therapy was used in imported malaria,blackwater fever occurred in two patients and acute renal failure occurred in one with falciparum malaria.It is suggested plasmodium exam ination in peripheral blood should be performed in all persons returned from countries prevalent with malaria,thrombocytopenia is an indicator of acute malaria,and more severe complications usually tend to occur in falciparum malaria.

The authors report one case of primary hepatic neuroendocrine carcinoma associated with multiple liver metastases. A patient was a 41-year-old female. In 2010, B-ultrasound examination revealed that there were multiple space-occupying lesions in the liver, and hepatic hemangiomas was considered to be the diagnosis. Then, the patient was followed up regularly. In Aug. 2013, B-ultrasound examination indicated that the hepatic lesions were significantly enlarged. Multi-detector CT scanning and MRI examination were performed, and still the diagnosis of multiple hepatic hemangiomas was suggested. On CT and MRI the lesion presented as a well-circumscribed hypervascular tumor with “fast-in and slow-out” enhancement pattern. On MRI, the lesion was characterized by multiple nodules. Needle biopsy was carried out, and the pathological and immunohistochemical diagnosis was metastatic neuroendocrine tumor. Systemic examination did not find the primary lesion. Therefore, primary hepatic neuroendocrine carcinoma associated with intra- hepatic metastases was diagnosed. The patient was treated with transcatheter arterial chemoembolization. The drugs used were 100 mg Oxaliplatin+one bottle of gelatin sponge particles(300-500μm)+10 ml iodized oil, and micro-pump infusion of 100 mg oxaliplatin(99 mg/h) through catheter was also employed. Clinically, primary hepatic neuroendocrine carcinoma is extremely rare. In combination with the medical literatures, the authors attempt to make a preliminary discussion on the clinical characteristics, differential diagnosis, treatment and prognosis of primary hepatic neuroendocrine carcinoma.

Objective To analyze the characteristic and the clinical application of high -frequency stimulation ABR for the patients with unilateral sudden deafness .Methods 40 patients aged 17~45 with unilateral sudden deaf-ness(40 health ears ,subject group)and 20 normal volunteers (40 ears ,control group)were selected to receive high and low frequency stimulation ABRs and pure tone audiometry .Results There were no statistical differences be-tween subject group and control group in pure tone audiometry .The wave Ⅰlatency of high -frequency ABR was longer in the subject group than that in the control group(P<0 .001) .The abnormal rate of Ⅰ - Ⅴ interval between high and low frequency stimulation ABRs was 62 .5% (25/40) in the subject group ,and 5% (2/40) in the control group .There were statistical differences between the two groups (χ2 =29 .574 ,P<0 .001) .Conclusion The waveⅠlatency of high-frequency ABR was longer and the abnormal rate of Ⅰ - Ⅴ interval markedly increased in the health ear of patients with unilateral sudden deafness .This may suggest that the contralateral ear may have an ab-normal blood supply of the inner ear when single side sudden deafness happened .High frequency stimulation ABR can be used to detect the potential changes of contralateral ear before the hearing loss occurred .

Objective To evalute the effects of subcutaneous transfection of human beta-nerve growth factor (Ad-hNGFβ) gene on the function of sensory nerve in a rat model of diabetic neuropathic pain (DNP).Methods Healthy male Sprague-Dawley rats,weighing 180-220 g,were used in this study.Ten rats were randomly collected as normal control without DNP (group C).DNP model was established by intraperitoneal injection of streptozocin (STZ) 75 mg/kg.Seventy-five rats with DNP were randomly divided into 3 groups (n =25 each):DNP group; Ad-hNGF group and Ad-LacZ group.Groups Ad-NGF and Ad-LacZ received subcutaneous transfection of 1.12 × 1011 PFU Ad-hNGFβ 10 ul and 1.12 × 1011 PFU Ad-LacZ 10 ul respectively after pain thresholds were measured on 21 days after STZ injection.The mechanical and thermal pain thresholds were measured before STZ injection (baseline) and at 21,35 and 49 days after STZ injection.The conduction velocity and latency of the sensory nerve and the expression of substance P (SP) in dorsal root ganglion (by immmuno-histpchemistry) were determined after measurement of pain threshold on 49 days after STZ injection.Results Compared with group C,the mechanical and thermal pain thresholds were significantly increased at each time point after STZ injection in groups DNP,Ad-NGF and Ad-Lacz,the conduction velocity of the sensory nerve was significantly decreased,the latency of the sensory nerve was prolonged,and the expression of SP in dorsal root ganglion was down-regulated in groups DNP and Ad-LacZ,the conduction velocity of the sensory nerve was significantly decreased (P ＜ 0.05),and no significant change was found in the latency of the sensory nerve and expression of SP in dorsal root ganglion in group Ad-NGF (P ＞ 0.05).Compared with group DNP,the thermal pain threshold was significantly increased at 49 days after STZ injection,the conduction velocity of the sensory nerve was decreased,the latency of the sensory nerve was shortened,and the expression of SP in dorsal root ganglion was down-regulated (P ＜ 0.05 or 0.01),while no significant change was found in the mechanical pain threshold in group Ad-NGF,and no significant change was found in the parameters mentioned above in group Ad-LacZ (P ＞ 0.05).Conclusion Subcutaneous transfection of Ad-hNGFβ can improve the function of sensory nerve in a rat model of DNP through up-regulat-ing of the SP expression in dorsal root ganglion.

Objective: To compare the effect of scalp acupuncture and scalp acupuncture plus acupuncture exercise therapy (AET) on walking ability in children with spastic cerebral palsy (CP). Methods: A total of 60 spastic CP children with gross motor function classification system (GMFCS) grades Ⅰ-Ⅲ were divided into a control group and an observation group by the random number table method, with 30 cases in each group. Both groups were treated with the same conventional rehabilitation and scalp acupuncture therapy for CP. The control group received conventional rehabilitation first and then scalp acupuncture. The observation group received AET, which was to receive the conventional rehabilitation and scalp acupuncture simultaneously. Before and after treatment, the clinical efficacy was evaluated by the modified Ashworth scale (MAS) score, scores of dimensions D and E of the gross motor function measure (GMFM) scale, walking speed, and walking distance. Results: During treatment, there were 2 dropouts in the observation group. After 3 courses of treatment, the MAS scores in both the control group and observation group decreased compared with the same group before treatment (P<0.05), and the scores of dimensions D and E of the GMFM, walking speed, and walking distance were increased (P<0.05); the between-group comparison showed that the MAS score in the observation group was lower than that in the control group (P<0.05), and the scores of dimensions D and E of the GMFM, walking speed, and walking distance in the observation group were higher or longer than those in the control group (P<0.05). Conclusion: W ith the same treatments, scalp acupuncture combined with AET is superior to the conventional scalp acupuncture method in reducing lower-limb muscle tone, improving standing balance ability, and walking stability in children with spastic CP.

Objective To investigate the characteristics and the clinical significance of relevant parame-ters of blood in psoriasis vulgaris(PV). Methods A retrospective analysis among 38 PV patients and 40 normal controls was done. The comparing parameters contained NLR,CRP,total cholesterol,triglyceride,serum uric acid.Pearson correlation analysis was used to detect the correlations.Results NLR,total cholesterol,triglyceride, serum uric acid in psoriasis vulgaris patients were significantly higher than in the normal controls(P < 0.05). There was a statistically significant correlation between NLR and PASI in the PV patients,but no correlation of CRP with NLR and PASI(P > 0.05). In the patients with PASI ≥ 7,the serum uric acid level was significantly higher than in those with PASI < 7. Conclusions NLR is indicateive of the severity and state of inflammation. The severer PV,the higher the level of serum uric acid.

OBJECTIVETo analyze the extent of postoperative hip abductor insufficiency in primary total hip arthroplasty (THA) patients undergoing anterolateral minimally invasive (ALMI) approach, and to investigate whether the clinical outcomes are more favorable in femoral neck fracture (FNF) patients than in non-femoral neck fracture (nFNF) patients.

METHODSA total of 48 patients were enrolled in this study. Each patient underwent a clinical examination preoperatively and 6, 12, 24 and 48 weeks postoperatively. The abductor torque, Trendelenburg's sign, gait velocity, Harris hip score, Oxford hip score, Westren Ontario and McMaster Universities (WOMAC) score and visual analog scale pain score were recorded. Statistical evaluation was performed with SPSS software version 18.0. The significance level was set at P<0.05.

RESULTSThe abductor torque of the operated hip and the recovery ratio showed a gradual improving tendency from 6 weeks postoperatively until the last follow-up. Gait velocity, Harris hip score, Oxford hip score and WOMAC score improved significantly after the operation until 24 weeks postoperatively. In the FNF group, the abductor torque of the operated side and the recovery ratio were significantly higher than in nFNF group at 6 weeks postoperatively, however, as time passed, this trend tended to disappear.

CONCLUSIONThis study demonstrates that patients can obtain good abductor strength and function in the early postoperative period and the hip abductor function of patients who suffer from hip osteoarthritis, rheumatoid arthritis, avascular necrosis of the femoral head could be significantly improved following ALMI THA.

Aged ; Arthroplasty, Replacement, Hip ; Femoral Neck Fractures ; physiopathology ; surgery ; Hip ; Humans ; Middle Aged ; Minimally Invasive Surgical Procedures ; Muscle Strength ; Muscle, Skeletal ; physiology ; Prospective Studies ; Recovery of Function ; Torque