Objective:To optimize the processing technology of processed Morinda Officinalis by taking monotropein content as the index. Methods:The amount of licorice,stir frying time and cooking pot temperature were used as the investigation factors in orthogonal experiments design,and an HPLC method was used to determine the content with he following chromatographic conditions:Kromalsil C18 chromatographic column(200 mm × 4. 6 mm,5μm),mobile phase of methanol-0. 4% phosphoric acid solution(90 ∶10),the column tem-perature at 30℃,the flow rate at 1 ml·min-1 ,the detection wavelength at 233 nm and the sample size of 5μl. Results:The monotropein content of each processed Morinda Officinalis sample after different processing was:0. 535 6, 0. 582 4, 0. 523 4, 0. 589 1, 0. 578 6, 0. 587 8,0. 575 2,0. 609 1 and 0. 558 7 mg·g-1,which showed that the processing technology could affect,the monotropein content. Conclusion:The best processing technology of preparation Morinda Officinalis based on Monotropein content is: Liquorice of 6%,stir time of 10min and boiling pot temperature at 100 ℃.

Objective: To analyze the clinical effect of pelvic floor rehabilitation therapy combined with traditional Chinese medicine prescription in the treatment of female pressure urinary incontinence, and its influence on quality of life. Methods: A retrospective study of 190 females with stress urinary incontinence was conducted.The patients were divided into control group and observation group according to the treatment method.Patients in the control group were treated with pelvic floor rehabilitation.The observation group was treated with traditional Chinese medicine prescription based on the treatment of the control group.The therapeutic effect of the two groups was analyzed. Results: The total effective rate of the observation group was 96.84%, which was significantly higher than 86.32% of the control group (χ²=3.168, P<0.05). After treatment, the maximal urethral pressure, maximum urethral closure pressure of the observation group were (55.16±8.96)cmH₂O, (45.65±12.41)cmH₂O, respectively, which of the control group were (40.58±5.64)cmH₂O, (31.69±8.87)cmH₂O, respectively, the differences between the two groups were statistically significant (t=6.456, 5.124, all P<0.05). After treatment, the scores of restrictive behaviors, social psychology, formed the social awkwardness of the observation group were (73.54±12.54)points, (75.23±14.11)points, (76.21±15.12)points, respectively, which of the control group were (67.13±7.84)points, (68.16±8.14)points and (65.28±8.13)points, respectively, the differences between the two groups were statistically significant(t=5.124, 4.058, 6.218, all P<0.05). Conclusion The clinical curative effect of pelvic floor rehabilitation combined with traditional Chinese medicine in the treatment of female stress urinary incontinence is better than pure pelvic floor rehabilitation, it can improve women's quality of life, the bladder urine storage and urinary continence ability, it is worthy of popularizing in clinical application.

OBJECTIVETo investigate neuroendocrine differentiation and Wilms' tumor protein-1 (WT-1) expression in breast mucinous carcinoma and their clinicopathological significance.

METHODSThe clinicopathological data of 65 patients with breast mucinous carcinoma, including 31 cases of mixed mucinous carcinoma, 23 cases of hypocellular pure mucinous carcinoma and 11 cases of hypercellular pure mucinous carcinoma, admitted in Taizhou Hospital from January 2010 to June 2015 were retrospectively reviewed. The expression of neuroendocrine markers and WT-1 was detected by immunohistochemistry staining in all cases.

RESULTSThe mixed mucinous carcinomas and hypercelluar pure mucinous carcinomas had higher incidence of axillary lymph node metastasis and human epidermal recepter 2 (HER-2) positive than hypocellular pure mucinous carcinoma (all (P<0.01). However, the difference was not significant between mixed mucinous carcinomas and hypercellular pure mucinous carcinomas (all P>0.05). The expression of neuroendocrine marker was stronger in hypercellular mucinous carcinoma than that in mixed mucinous carcinoma and hypocellular mucinous carcinoma (all (P<0.05), but the difference was not statistically significant between mixed mucinous carcinoma and hypocellular pure mucinous carcinoma (P>0.05). The expression of WT-1 was weaker in mixed mucinous carcinoma than that in hypercellular and hypocellular pure mucinous carcinoma(all (P<0.05), but the difference was not statistically significant between hypercellular and hypocellular pure mucinous carcinoma (P>0.05). The mucinous carcinomas with lymph node metastasis had lower expression of neuroendocrine markers than those without lymph node metastasis ((P<0.01). The expression of WT-1 in breast mucinous carcinoma with lymph node metastasis trended lower than that in those without lymph node metastasis, but the difference was not statistically significant (P>0.05).

CONCLUSIONHypercellular pure mucinous breast carcinoma has higher rates of lymph node metastasis and HER-2 amplification than hypocellular pure mucinous carcinoma, the sub-classification of breast pure mucinous carcinoma should be considered. Neuroendocrine differentiation and WT-1 expression may be helpful in distinguishing the subtypes of breast mucinous carcinoma. Breast mucinous carcinoma with neuroendocrine differentiation trends to have less lymph node metastasis.

Adenocarcinoma, Mucinous ; classification ; diagnosis ; pathology ; Axilla ; Breast Neoplasms ; classification ; diagnosis ; pathology ; Female ; Humans ; Immunohistochemistry ; Incidence ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Neuroendocrine Tumors ; diagnosis ; pathology ; Receptor, ErbB-2 ; metabolism ; Retrospective Studies ; WT1 Proteins ; metabolism

OBJECTIVETo retrospectively study curative effects of three repair methods for rotator cuff tears under arthroscopy, and to explore relationships between different repair methods and cuff lesions.

METHODSFrom January 2009 to Jaunary 2014, a total of 353 patients with rotator cuff tears treated with surgical repair under arthroscopy were included in this study. All the patients were divided into three groups according to time of visitiny hospital and it was divided into three periods. The patients on the first period were treated with single row rivet fixation(115 cases), including 51 males and 64 females, with an average age of (57.46±9.08) years old. The patients on the second period were treated with double row rivet fixation(163 cases), including 76 males and 87 females, with an average age of (56.93±9.92) years old. The patients in the third period were treated with suture bridge fixation(75 cases), including 32 males and 43 females, with an average age of (55.90±9.15) years old. There were 29 patients with huge rotator cuff injuries, who were treated with single-row suture. The shoulders were protected by a brace for 6 weeks after operations were permit ted to perform passive movement within 6 weeks, and then perform active shoulder exercise 6 to 10 weeks after operation. Constant-Murley score, UCLA score and VAS score were recorded preoperatively and postoperatively.

RESULTSAll the patients were followed up, and the duration ranged from 12 to 62 months, with a mean of 30 months. There was no infection or nerve injury. UCLA score was improved from preoperative 10.71±2.45 to postoperative 32.07±3.16; Constant-Murley score was improved from preoperative 43.33±11.55 to postoperative 78.15±12.64; VAS score was improved from preoperative 5.81±1.27 to postoperative 0.52±0.71. There were no statistical differences among three groups in UCLA score, Constant-Murley score and VAS score. Total 337 cases were satisfied with treatment results and 16 cases were not satisfied with the results. Among the 16 cases, 3 cases had huge rotator cuff surgery, and 13 cases had no joint stiffness before operation. The main complaints that resulted in dissatisfaction were weakness of the postoperative muscles and failure to restore the labour capacity(11 cases).

CONCLUSIONSRotator cuff repair under arthroscopy has a reliable clinical effect for the patients with rotator cuff tears. Stable and reliable clinical results can be obtained regardless different repair methods or different rotator cuff tears. The following factors such as no stiffness before operation, too early active exercise and preoperative rotator cuff atrophy may be the risk factors for postoperative dissatisfaction of patients.

ObjectiveTo investigate the expression of CXCR4 and CD133mRNA in primary lesion of primary gastric adenocarcinoma and the relation with clinicopathological features,and to explore the correlation of CXCR4 and CD133.MethodsThe primary lesion of primary gastric adenocarcinoma and normal tissues adjacent to gastric cancer were obtained from 50 patients.The diction of CXCR4 and CD133 protein expression was detected by the immunohistochemical staining,and the relative gray scale values of CXCR4 and CD133mRNA by semi-quantitative RT-PCR (Fisher' s exact probability method).Their relationship with clinicopathological features was also investigated ( Spearman relation analysis).ResultsThe positive rates of CXCR4 and CD133 protein in gastric cancers were 76.0％ and 66.0％ respectively,which were significantly higher than that in normal tissues adjacent to gastric cancer ( 16.0％ and 10％ ; P =0.000,P =0.000).The increment of relative gray scale values of CXCR4mRNA was associated with the larger tumor diameter,the later TNM stage and the occurrence of lymphatic metastasis( P ＜ 0.05 ).And the larger diameter of tumor,the later TNM stage were associated with the higher relative gray scale values of CD133mRNA (P ＜0.05).The levels of the relative gray scale values of CXCR4 mRNA and CD133mRNA were positively related(r =0.453,P ＜ 0.01 ).ConclusionsThe higher expression of CXCR4 and CD133mRNA correlateswith tumour diameter,TNM stage and lymphatic vessel invasion. The relative gray scale values of CD133mRNA increase with the increment of the relative gray scale values of CXCR4.

A 33 years old male patient who suffered from a flame burn of 88% total body surface area was admitted to our hospital on November 28th, 2016. During his hospitalization, we repeatedly performed central vein catheterization in internal jugular veins, subclavian veins, or femoral veins for fluid transfusion. We incidentally found bilateral internal jugular vein thrombosis by performing a point-of-care ultrasound examination before catheterizing sometime. We treated the patient by avoiding catheterization in the affected internal jugular veins, anticoagulating with low molecular weight heparin, closing the wounds with skin autografting, and guiding the patient to practice functional exercise. The thrombus disappeared in the end. The patient was cured and discharged 3 months post burn.

ObjectiveTo investigate the predictive value of heart rate turbulence(HRT) in patients with diabetes mellitus (DM) after acute myocardial infarction (AMI).MethodsNinety-two AMI patients combined with DM (DM group) and 120 AMI patients without DM (non-DM group) were selected.Turbulence onset (TO) and turbulence slope (TS) were two indexes of HRT.HRT was considered positive when TO was ≥0 and TS was ≤2.5 ms/R-R.The differences in clinical data between HRT-positive and HRT-negative patients were compared.And the related risk factors after AMI were analyzed.ResultsAge,left ventricular ejection fraction (LVEF) level,renal insufficiency,LVEF＜40％,standard deviation of sinus cardiac cycle (R-R interval)(SDNN),heart rate variability (HRV) positiveand HRT indexes (TO,TS) between HRT-positive and HRT-negative patients in DM group had significant differences (P ＜ 0.05 ).Age,LVEF level,SDNN and HRT indexes(TO,TS) between HRT-positive and HRT-negative patients in non-DM group had significant differences(P ＜ 0.05).Multivariate Cox regression analysis showed that renal insufficiency (OR=4.8,95％ CI:1.8 - 10.7,P=0.008) and HRT positive (OR=3.7,95％ CI:1.5 - 8.6,P=0.070) in DM group had statistical significance.And HRT positive in non-DM group had statisticalsignificance(OR=23.0,95％ CI:5.2 ～ 86.0,P ＜ 0.01 ).ConclusionsHRT,an index of dynamic electrocardiogram,can predict the risk in patients with DM or without DM after AMI.

OBJECTIVETo study the clinical effects of Müller method for reconstruction of posterolateral corner (PLS) of knee joint.

METHODSFrom June 2005 to June 2007, 13 patients with PLS injured were treated with Müller method. Four patients complicated with injuries in anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL), 7 patients complicated with injuries in PCL, 4 patient also had injuries in ACL, 1 patient complicated with ACL injury, and 1 patient complicated with avulsions fractures of the tibial ACL insertion. Among the patients, 5 patients had chronic injuries with a duration of 2 to 7 months. After the cruciate ligament was reconstructed, the popliteus tendon was reconstructed with iliotibial band and lateral collateral ligament (LCL) reconstructed with biceps femoris tendon. All the ligaments were fixed with interface screws. The patients were encouraged to do strength and motion exercise on bed immediately after operation and permit toe-touch weight-bearing till two months after operation. The brace was used till six months after operation.

RESULTSThe average follow-up period was 13 months (ranged from 6 to 27 months). There was no restriction of range of motion. External rotation range were good compared to the normal side. One year after operation, one-grade varus instability at 30 degrees flexion was found only in 2 patients. The postoperative Lysholm scores were from 77 to 94 (average 86).

CONCLUSIONThe method is easier to perform, easier to get the materiar for reconstruction and promised satisfactory clinical results.

Adult ; Female ; Humans ; Knee Joint ; physiopathology ; surgery ; Male ; Middle Aged ; Range of Motion, Articular ; Reconstructive Surgical Procedures ; methods

OBJECTIVETo study therapeutic effects of lateral ankle ligaments reconstruction for the treatment of chronic lateral instability of the ankle joint.

METHODSFrom July 2005 to January 2008, among 13 patients with chronic lateral instability of the ankle joint, 10 patients were male and 3 patients were female, ranging in age from 24 to 45 years,with an average of 33 years. Anterior talo-fibular ligament (ATFL) and calcanea-fibular ligament (CFL) were anatomy reconstructed with a split peroneus brevis tendon graft for all patients. The ankle scoring system was used to evaluate ankle joint function before and after operation, which including stability, pain, locomotor activity and X-ray films.

RESULTSAll the patients were followed up ranged from 6 to 32 months, averaged 16.4 months. The postoperative scores of the ankles increased in respect to stability, pain and locomotor activity. The total average score increased from preoperative (43.54+/-7.04) to postoperative (73.38+/-4.17). There was significant difference between preoperative scores and postoperative scores (P<0.01). All the patients were satisfied with the results.

CONCLUSIONAnatomy reconstruct of the ATFL and CFL with a split peroneus brevis tendon graft (Sammarco method) is a practical method for lateral ankle instability and promise good results especially for patients complained of instability.

Adult ; Ankle Joint ; anatomy & histology ; pathology ; surgery ; Female ; Humans ; Joint Instability ; pathology ; surgery ; Lateral Ligament, Ankle ; anatomy & histology ; pathology ; surgery ; Male ; Middle Aged ; Models, Biological ; Reconstructive Surgical Procedures ; methods ; Young Adult

OBJECTIVETo investigate the associations between epidermal growth factor receptor (EGFR) gene mutations and serum tumor markers in advanced lung adenocarcinomas.

METHODSWe investigated the association between EGFR gene mutations and clinical features, including serum tumor marker levels, in 97 advanced lung adenocarcinomas patients who did not undergo the treatment of EGFR tyrosine kinase inhibitors. EGFR gene mutation was detected by real-time PCR at exons 18, 19, 20, and 21. Serum tumor marker concentrations were analyzed by chemiluminescence assay kit at the same time.

RESULTSEGFR gene mutations were detected in 42 (43%) advanced lung adenocarcinoma patients. Gender (P=0.003), smoking status (P=0.001), and abnormal serum status of carcinoembryonic antigen (CEA, P=0.028) were significantly associated with EGFR gene mutation incidence. Multivariate analysis showed the abnormal CEA level in serum was independently associated with the incidence of EGFR gene mutation (P=0.046) with an odds ratio of 2.613 (95% CI: 1.018-6.710). However, receiver operating characteristic (ROC) curve analysis revealed CEA was not an ideal predictive marker for EGFR gene mutation status in advanced lung adenocarcinoma (the area under the ROC curve was 0.608, P=0.069).

CONCLUSIONSEGFR gene mutation status is significantly associated with serum CEA status in advanced lung adenocarcinmoas. However, serum CEA is not an ideal predictor for EGFR mutation.

Adenocarcinoma ; blood ; genetics ; Biomarkers, Tumor ; blood ; Female ; Humans ; Lung Neoplasms ; blood ; genetics ; Male ; Middle Aged ; Mutation ; ROC Curve ; Real-Time Polymerase Chain Reaction ; Receptor, Epidermal Growth Factor ; genetics ; Retrospective Studies