A probe into the management of outpatient medical records written by rural doctors:Such a record is indispensible for technical appraisal of medical accidents; yet writing of such a record might involve illegal medical practice or go beyond the scope of practice.It is recommended to normalize the behavior of rural doctors in their writing of outpatient medical records,stipulating that the Basic Regulations on Medical Records do not apply to rural doctors at present.It is also recommended that separate regulations for rural doctors be formulated,along with a promotional period before these regulations are in practice.An alternative would be clarifying that Article 28 of the Regulations of Medical Malpractice Settlement do not apply to rural doctors.

Peripheral T-cell lymphoma (PTCL) is a relatively common subtype of non-Hodgkin lymphoma in China. PTCL is clinically highly aggressive, and it progresses rapidly. The current treatment methods are ineffective and the overall prognosis is poor. The 62nd American Society of Hematology Annual Meeting reported on the progress of PTCL molecular targeted therapy and immunotherapy, including programmed death receptor 1/programmed death receptor ligand 1 antibodies, JAK inhibitors, brentuximab vedotin, etc. These novel drugs bring a better prospect for patients.

To compare the chemical change of Paeoniae Radix Alba (PRA) after vinegar-baking processing, as well as the effect of vinegar types exerted on the processing, 1H NMR-based metabolomic approach combined with multivariate statistical analysis was used to investigate the different metabolites between the raw and two vinegar-baked PRA. More than thirty metabolites were identified in the 1H NMR spectrum of PRA, and the multivariate statistical analysis showed that raw and two vinegar-baked PRA could be separated obviously. After vinegar-baking, the contents of isoleucine, lactate, alanine, arginine, albiflorin, and 5-hydroxymethyl furfural (5-HMF) elevated, while those of sucrose, paeoniflorin and its analogues (calculated by benzoate) decreased. The chemical compositions of two vinegar-baked PRA were also different. Shanxi vinegar- baked PRA showed higher levels of leucine, isoleucine, valine, and albiflorin, while rice vinegar-baked PRA contained more sucrose and paeoniflorin's analogues (calculated by benzoate). And the chemical changes in Shanxi vinegar-baked PRA were greater than those of rice vinegar-baked PRA. The results revealed the chemical differences between raw and vinegar-baked PRA, as well as the influence of vinegar type on processing, in a holistic manner, the results obtained suggested that the correlations between the chemical change and the drug action after processing, as well as the vinegar type used in processing, should be further studied.
Acetic Acid ; Benzoates ; Bridged-Ring Compounds ; Cooking ; Drugs, Chinese Herbal ; Furaldehyde ; analogs & derivatives ; Glucosides ; Metabolome ; Metabolomics ; Monoterpenes ; Paeonia ; chemistry ; Plant Roots ; chemistry

Cerebellar Neoplasms ; pathology ; Hemangioblastoma ; pathology ; Humans

Objective To investigate the relationship between carotid intima-media thickness (IMT) and coronary atherosclerosis plaque through coronary CT angiography (CTA) in asymptomatic individuals.Methods Two hundred and fifty cases with CTA screened were selected in asymptomatic individuals,and according to the inspection result they were divided into no plaque group (detection of no coronary atherosclerosis plaque,180 cases) and plaque group (detection of coronary atherosclerosis plaque,70 cases).All cases were checked carotid IMT with B-ultrasonic.Results ANOVAs analysis showed that age and body mass index (BMI) had significant correlation with coronary atherosclerosis plaque (P ＜ 0.05).x2 test was used to show the smoking and family history of coronary heart disease had significant correlation with coronary atherosclerosis plaque (P ＜ 0.05).Univariate Logistic regression analysis showed that carotid IMT,systolic pressure,diastolic pressure,low density lipoprotein cholesterol,fasting serum glucose and creatinine had significant correlation with coronary atherosclerosis plaque (P ＜ 0.05).Multifactor Logistic regression analysis showed that carotid IMT had correlation with coronary atherosclerosis plaque (P ＜ 0.05).Conclusion There is significant relationship between carotid IMT and coronary atherosclerosis plaque in asymptomatic individuals.

Objective To compare the Dectin-1 signal transduction pathway and its function on dendritic cells between a female patient with recurrent vulvovaginal candidiasis (RVVC) and a healthy woman,and to explore the possible mechanism for VVC recurrence in this patient.Methods Venous blood samples were collected from a female patient with RVVC and a healthy woman.Then,monocytes were isolated from the blood samples,and were induced to differentiate into dendritic cells (DCs) in vitro.The obtained DCs were divided into three groups to be cultured alone,cocultured with Candida albicans or the combination of Candida albicans and anti-Dectin-1 antibodies for different durations.Flow cytometry was performed to determine the expression levels of CD83,CD86 and CD80 on DCs to evaluate the maturity of DCs,Western blot analysis to measure the protein expressions of Dectin-1,Syk and CARD9 in DCs,and enzyme-linked immunosorbent assay (ELISA) to determine the levels of interleukin (IL)-23,tumor necrosis factor α (TNF-α) and IL-12 in the culture supernatant of DCs.Results After co-culture with Candida albicans for 24 hours,the expressions of CD83,CD86 and CD80 were significantly inhibited on the patient-derived DCs compared with the controlderived DCs.Western blot analysis showed no significant differences in the expression of Dectin-1 between the controland patient-derived DCs,but a decrease in the expressions of phosphorylated-Syk and CARD9 in the patient-derived DCs compared with the control-derived DCs after 2-hour coculture with Candida albicans.After co-culture with Candida albicans for 6 hours,the levels of IL-23,TNF-α and IL-12 were lower in the culture supernatant of patient-derived DCs than in that of control-derived DCs.Furthermore,the anti-Dectin antibody showed no inhibitory effects on the activation of the Syk-dependent signal transduction pathway in or the secretion of the above cytokines by the patient-derived DCs.Conclusion The Dectin-1 signal transduction pathway was abnormal in DCs from the patient with RVVC,which may decelerate the maturation of DCs,inhibit the secretion of IL-23,TNF-o and IL-12 by them,and finally result in a defect in natural mucosal immunity against Candida infection in the host.

Adolescent ; Adult ; Diverticulum ; diagnostic imaging ; Female ; Humans ; Jugular Veins ; diagnostic imaging ; Male ; Middle Aged ; Tomography, X-Ray Computed ; Young Adult

Objective: To evaluate pharmacokinetic and pharmacodynamic of repaglinide tablets in Chinese subjects.Methods: Twenty healthy male volunteers were enrolled in the study. A single dose (4 mg) of repaglinide tablets was givenorally. Plasma concentrations of repaglinide were determined by HPLC method. Blood glucose and serum insulin leve1s weremeasured by biochemistry and radioimmunoassay methods respectively. Results: Plasma concentration-time curve conformedto one-compartment open model. The pharmacokinetic parameters were as follows: tmax (0. 75?0.43 ) h,cmax (54.44?24.97)ng/ml, t1/2 (0. 80?0. 31) h, MRT (1. 55?0. 41) h, C1/F (61. 43?20. 10) L/h and AUC (73. 34?29.95) h? ng/ml. Thelevel of serum insulin was raised and the level of blood glucose decreased after administration of repaglinide. The highest levelof serum insulin was (l26. 24?95.93) mU/L at 0.75h and blood glucose level reached its lowerest vaIue (2. 34I0.44) mmol/L 1 h after oral administration. Conclusion: Repaglinide is characterised by fast-acting and short effects on in-sulin secretion. It decreases serum glucose level by stimulating insulin secretion from the pancreatic ?-cells. It is a novel oralprandial glucose regulator for the treatment of type 2 diabetes mellitus.

Objective To investigate the influence of knee joint instability induced by the rupture of anterior cruciate ligament (ACL) on the meniscus and cartilage. Methods Forty-eight consecutive patients with rupture of ACL from 1998 to 2002 were retrospectively studied upon the relationship of distribution, severity and incidence of meniscal tears and cartilage injuries with different period of time post injury. Results The incidence of meniscal injury was increased from six cases (55%, 6/11) in acute period, 13 (68%, 13/19) in subchronic period to 17 (94%, 17/18) in chronic period with a significant difference (P

Purpose To discuss the clinicopathological features of primary thymic extranodal marginal zone lymphoma of mucosa associated lymphoid tissue (MALT) lymphoma and lymphoepithelial sialadenitis (LESA)-like thymic hyperplasia,their relationship and differential diagnosis.Methods Three cases of thymic MALT lymphoma and one LESA-like thymic hyperplasia were evaluated by HE staining,immunohistochemistry and immunoglobulin (Ig) gene rearrangement technology.Results The symptoms of Sjsgren syndrome were found in the two patients with thymic MALT lymphoma.Microscopically,the normal architecture of thymus was effaced by dense lymphoid infiltration composed predominantly of centrocyte-like and monocytoid B cells with prominent lymphoepithelial lesions.Immunohistochemically,the tumor cells were positive CD20,PAX-5,and BCL-2.The plasma cells showed lambda light chain restriction in one case with prominent plasmacytoid differentiation.In LESA-like thymic hyperplasia,the normal lobular architecture of thymus was generally reserved and abundant lymphoid tissue containing lymphoid follicles was seen with prominent lymphoepithelial lesions in expanding islands of thymic epithelial cells and epithelium lining the cysts,but a monocytoid B-cell population was absent.Immunohistochemically,a mixed B-cell and T-cell population was identified.A monoclonal rearrangement of the Ig gene was detected in all three thymic MALT lymphomas but not in the case of LESA-like hyperplasia.Conclusion Primary thymic MALT lymphoma and LESA-like thymic hyperplasia are both rare lymphoid proliferative lesions and the two lesions have overlapping histological and immunohistochemical features.A combination of genetic rearrangement and analysis of the differential points is helpful to distinguish between them.