Objective To study the diagnosis and treatment of restless legs syndrome(RLS)in the elderly.Methods The diagnosis of RLS was based on criteria proposed by the International Restless Legs Syndrome Study Group.Ten elderly patients with RLS were enrolled in the research. The clinical presentation and treatment results were analyzed retrospectively.Results All 10 patients were complained of compelling urge to move their limbs.The sensory symptoms were involved in the 4 patients' legs,involved both arms and legs in another 5 patients.It occurred unilaterally in the left of I patient.All patients complained of syndromes aggravated in the night, other three patients also had distinct syndromes in the daytime.Three patients had family history of RLS.The unpleasant sensations were partially or totally relieved by movement.Neurophysiological tests in 5 patients were normal.The iron deficiency occurred only in 1 patient with low serum ferritin and iron levels,Rebound and augmentation were observed in 1 patient in the course of three years treatment with Sinemet.All patients administered a dopamine receptor agonist(pergolide)and showed positive results.Oral administration of iron improved RLS symptoms in a patient with iron deficiency. Conclusions The diagnosis of RLS is usually based on the patient's clinical presentation,which has characteristic feature in the elderly.Rebound and augmentation are serious side-effects in the course of long-term treating with L-DOPA.Therapy of RLS with dopamine receptor agonists is firstly chosen.

BACKGROUND: Cardiac function of patients with hypertension is impaired to various extents. How does the impairment level of cardiac function of patients with hypertension differ at various stages?OBJECTIVE: To observe cardiac function of patients with hypertension at various stages and compare the indexes with those of healthy people.DESIGN: Case-control and comparative observation.SETTING: Department of Special Treatment, General Hospital of Shenyang Military Area Command of the Chinese PLA.PARTICIPANTS: Totally 100 patients with hypertension were selected from the Internal Medicine Department of General Hospital of Shenyang Military Area Command of the Chinese PLA between October 2002 and May 2003. Among them, 30 cases of hypertension were at stage Ⅰ , 40 at stage Ⅱ and 30 at stage Ⅲ. At the same time period another 30 healthy people were selected as the control group. All the subjects signed the informed consent.METHODS: Cardiac function of the included subjects were detected with XJS-Ⅰ cardiac function testing equipment. Patients were tested at supine position and electrode was put on the basis of four-probe method.Breath was held at the end of expiration; meanwhile, lead electrocardiograph Ⅰ, cardiophonogram, cardiac admittance differential coefficient method and beating of carotid artery were recorded. Various indexes were processed with the computer. Detected indexes were heart rate, ejection prophase, ejection time of left ventricle, ejection prophase/ejection time of left ventricle, delay time of electro-machine, isovolumetric contraction time, isovolumetric contraction time/ejection time of left ventricle, time of pulse wave transmission, stroke volume, cardiac output, cardiac index,stress index of myocardial contraction, total peripheral resistance, and vascular compliance.MAIN OUTCOME MEASURES: Comparison of cardiac function between hypertensive patients at various stages and healthy people.RESULTS: All the 100 patients with primary hypertension and 30healthy people entered the final analysis. [1] Ejection prophase, isovolumetric contraction time, peripheral resistance, ejection prophase/ejection time of left ventricle and isovolumetric contraction time/ejection time of left ventricle: Those of hypertensive patients were obviously longer or stronger than those of the healthy subjects (P ＜ 0.01); those of patients with hypertension at stages Ⅱ and Ⅲ were obviously longer or stronger than those of patients with hypertension at stage Ⅰ (P ＜ 0.01). [2] Stroke volume, cardiac output, stress index of myocardial contraction, vascular compliance, time of pulse wave transmission and cardiac index: Those of hypertensive patients were obviously shorter or weaker than those of the healthy subjects (P ＜ 0.01); those of patients with hypertension at stages Ⅱ and Ⅲ were obviously shorter or weaker than those of patients with hypertension at stage Ⅰ (P ＜ 0.01). Among the indexes mentioned above, vascular total peripheral resistance of hypertensive patients at stage Ⅲ was obviously stronger than that of hypertensive patients at stage Ⅱ (P ＜ 0.05),but vascular compliance of the latter ones was obviously than that of the former ones (P ＜ 0.05).CONCLUSION: Cardiac function of patients with hypertension is decreased as compared with that of healthy people, and tends to further decrease with the development of hypertensive condition.

OBJECTIVE： To establish a HPLC assay for the determination of hydroxycamptothecinum and camptothecinum.METHODS： The concentrations of hydroxycamptothecinum and camptothecinum were assayed on a C18 column with a mobile phase consisting of methanol－ water(45∶ 55) at a flow rate of 1.0 ml/min,and detected at 266nm.RESULTS： The mean recovery of hydroxycamptothecinum was 100.2％ ,the 2,4,8 hours precision RSD were less than 1.8％ ;The mean recovery of camptothecinum was 99.7％ ,the 2,4,8 hours precision RSD were less than 2.0％ .CONCLUSION： The HPLC method for determination of hydroxycamptothecinum and camptothecinum was rapid,sensitive and accurate.

Objective To explore the clinical value of methylene blue in sentinel lymph node biopsy ( SLNB) in breast conservative therapy of breast cancer. Methods 55 patients performed sentinel lymph node biopsy( SLNB)in were analyzed,with breast conservative therapy of breast cancer in clinical stage Ⅰ-Ⅱ. The mapping procedures and SLNB were performed using subareolar injection of Methylene blue dye,followed by the axillary lymph node dissection(ALND). All of the SLN and ALN were evaluated pathologically after the operations. Results Among 55 cases ,52 cases were checked out sentinel lymph node and the positive rate was 95% (52/55). The axillary status was 100% accurately predicted by SLNs;Sensitivity in this group was 93% (52/55) ;False negative rate was 5% (1/20);False positive rate was 0. Conclusion Methylene blue dye is a reliable method for sentinel lymph node biopsy. SLNB is a simple and safe technic, which helps to reveal the state of the axillary lymph nodes.

ObjectiveTo investigate the effect of Puerarin on expression of inductible nitric oxide synthase (iNOS) in RAW264.7 macrophage cells induced by lipopolysaccharide （LPS）. MethodsThe protein and mRNA levels of lipopolysaccharide (LPS)-induced iNOS was determined in RAW264.7 macrophage cells using Western blotting and RT-PCR respectively. ResultsPuerarin inhibited expression of iNOS concentration dependently (P<0.01). ConclusionPuerarin may reduce iNOS level, result in prevention of inflammation.

The drug-loading system of DMF (dextran - magnetic layered double hydroxide - fluorouracil) was synthesized by "co-precipitation intercalated assembly - dextran composite in situ - solvent conversion" technology. The crystal-phase characteristic and slow-release performance of DMF were investigated through X-ray diffraction (XRD), infrared spectrum (IR), transmission electron microscopy (TEM), thermogravimetry (TG) and in vitro release experiment. The targeted transshipment and slow-release effect of DMF system were evaluated by in vivo animal experiment. It was showed that the XRD of DMF matched with R-sixtetragonum type layered double hydroxide and Fd-3m cubic type ferrite. IR test demonstrated that the DMF system was a supra-molecular complex consisted of Dextran (DET), magnetic layered double hydroxide (MLDH) and fluorouracil (FU) components. The two-level supra-molecular MLDH-FU presented six-edge lozenge TEM morphology, with layered characteristics. DET on the surface of DMF was capable of protecting the layered structure of MLDH-FU, improving particle dispersion properties, and strengthening the slow-release performance of the drug delivery system. The drug release model of DMF at pH 7.35 of PBS in vitro fit to the zero-order kinetics equation C = 1.1716 x 10(-5) + 4.4626 x 10(-7) t. The drug delivery system DMF could transport drugs principally to in vivo target organs with a local effect, targeted specificity, and excellent circulation transshipment performance. The pharmacokinetic process of DMF presented multi-peak phenomenon with peak attenuation and cyclic growth. The peaks appeared at 0.25, 1, 3, 5 and 9 d separately after dosing intervention. The first peak process of DMF accorded with a pharmacokinetic equation of C(FU) = 14.34 e(-0.530t) + 36.04 e(-0.321t) + 24.18 e(-0.96t), and presented the characteristic of slow absorption and fast elimination. As for subsequent peak processes, half-life increased, bioavailability increased, and plasma clearance decreased. The highest peak value of DMF was 1/37 of original value of FU, and the relative bioavailability was 419% to original FU.

Objective To study the relationship between serum pregnancy-associated plasma protein-A(PAPP-A)and plaque stability of coronary lesion.Methods Levels of serum PAPP-A were measured among 230 patients seemed as coronary heart disease(CHD)including 50 cases with acute myocardial infraction(AMI),110 cases with unstable angina pectoris(UAP),40 cases with stable angina pectoris(SAP)and 30 cases without CHD as control by enzyme-linked immunoassay(ELISA).Anginographic morphology of the coronary lesion was assessed in patients with CHD.Then,the serum PAPP-A levels were compared among different types of CHD and plaque.Results Serum PAPP-A levels were significantly higher in the AMI group(26.13±4.65)mIU/L and UAP group(20.37±5.78)mIU/L than in the SAP group(12.82±3.94)mIU/L and without CHD group(10.70±2.86)mIU/L(P<0.01,UAP group vs AMI group,P<0.05).Serum PAPP-A levels were significantly higher in the type Ⅱ lesions(24.52±4.82)mIU/L than in the other type lesions group(16.82±5.37)mIU/L and in the control group(10.70±2.86)mIU/L(P<0.01).Conclusion Serum PAPP-A level was closely associated with plaque stability of coronary lesion.

ObjectiveTo investigate the effects of Shenmai Injection(SI) on chronic systolic heart failure patients.Methods120 chronic heart failure patients were randomly divided into routine treatment and the routine treatment and SI group. The changes of angiotension Ⅱ(Ang Ⅱ), aldosterone(Ald), endothelin-1 (ET-1), interleukin-6 (IL-6), tumour necrosis factor-α (TNF-α), plasm rennin activity (PRA), cardionatrin(ANP), brain natriuretic peptide (BNP), cardiac function were observed.ResultsAfter treatment, LVEF,stage of NYHA increased in two groups,LVDs, LVDd and the level of Ang Ⅱ,Ald, ET-1, IL-6, TNF-α,PRA, ANP and BNP decreased in both groups(P<0.05). LVEF, stage of NYHA in the routine treatment and SI group incresed more significantly than those in routine treatment group(P<0.05). LVEDs, LVEDd and the level of Ang Ⅱ,Ald, ET-1, IL-6, TNF-α,PRA, ANP and BNP in the routine treatment and SI group were decreased more significantly than those in routine treatment group (P<0.05).ConclusionSI can improve not only the disturbed endocrine function and cytokines, but also left ventricular function.

Alleles ; Gene Frequency ; Genotype

Objective To investigate inhibitory effect and mechanism of extract from taraxacum mogonon (ETM) on human poorly differentiated gastric cancer MKN45 cells and their model nude mice tumors. Methods Human poorly differentiated gastric cancer MKN45 cells cultured in vitro were divided into the control group and the experimental group. The experimental group was treated with different concentrations of ETM, while the control group was treated with phosphate buffered saline (PBS). The tumor cell growth was examined by methyl thiazolyl tetrazolium(MTT).Cell apoptosis was detected by flow cytometry (FCM). The expression of Survivin mRNA was detected by reverse transcription polymerase chain reaction (RT-PCR), and the protein expression of Survivin was detected by Western blot. The nude mouse model with poorly differentiated gastric cancer was established with MKN45 cells. Successful models of nude mice were divided into the experimental group and the control group according to random number table. ETM 0.4 ml (100 mg/ml) was injected into abdominal cavity of the nude mice in the experimental group, while only equal dose of 0.9 % NaCl solution was injected in the control group, every 3 days for once, 42 days in total. The weight and volume changes of transplantable tumors were observed. The protein expression of Survivin in transplantable tumors was examined by immunohistochemistry(IHC) method. Results ETM could inhibit the cell proliferation and promote apoptosis of MKN45 cells in a dose-dependent and time-dependent way when its concentration reached 0.2 μmol/L (P< 0.05). The expression of Survivin mRNA and Survivin protein was down regulated in a dose-dependent way in the experimental group. Survivin mRNA expression in the experimental group with 0.1,0.2,0.4,0.8, 1.6 μmol/L of ETM and in the control group was 0.18±0.04, 0.14± 0.03, 0.11±0.01, 0.08±0.04, 0.06±0.02 and 0.19±0.03 respectively (F = 132.35, P< 0.05); Survivin protein expression in the experimental group in 0.1, 0.2, 0.4, 0.8, 1.6 μmol/L of ETM, and in the control group was 0.86±0.03, 0.60±0.05, 0.43±0.01, 0.22±0.01, 0.14±0.03 and 0.92±0.06 respectively (F= 76.57, P< 0.05). The difference of experimental group was statistically significant when concentration of ETM reached 0.2 μmol/L or above compared with the control group (P< 0.05). Nude mouse experiment showed that the tumor inhibition rate was (60.3±3.2) % in the experimental group. The volume and weight of transplantable tumor in the experimental group was(326± 27)mm3and(0.31±0.13)g,which was obviously lower than that in the control group[(843±14) mm3and (0.78±0.25) g]. The difference was statistically significant (t= 3.94,P =0.043;t= 3.27,P = 0.037). IHC experiment results showed that positive cell count of Survivin protein in the experimental group was obviously less than that in the control group(28±11 vs.152±20;t =4.32,P =0.029). Conclusions ETM has an obvious inhibitory effect on human poorly differentiated gastric cancer MKN45 cell and its nude mouse tomor model. The mechanism may be related with down-regulation of Survivin expression caused by ETM.