OBJECTIVE:To conduct supplementary study for quality standard for Compound vaccariae tablets. METHODS:TLC was used for the qualitative identification of Vaccariae;HPLC was used to determine the contents of vaccarin and anthranilic acid. The column was YMC-Pack Pro C18 with mobile phase of methanol- 0.3% phosphpric acid(gradient elution)at the flow rate of 1.0 ml/min,the detection wavelength was 280 nm,column temperature was 35 ℃ and volume size was 10 μl. RESULTS:The chromatographic spots were clear and well-separated without interference from negative control. The linear range was 0.055 7-2.228 7μg(r=0.999 9)for vaccarin and 2.011 4-40.227 9 μg(r=0.999 9)for anthranilic acid;RSDs of precision,stability and reproduc-ibility tests were no more than 1.01%;average recoveries were respectively 99.69%(RSD=1.11%,n=6) and 99.84%(RSD=1.18%,n=6). CONCLUSIONS:The method is simple,rapid and accurate with good reproducibility,and can be used for quality control of Compound vaccariae tablets.

As a component of traditional Chinese medical therapies, the therapeutic effects of acupuncture for some nervous system diseases have been proven by a large number of clinical and experimental studies. But, the electrophysiological techniques of the commonly used EEG and evoked potentials are still not sufficient to reveal the functional mechanism of acupuncture therapy. The recording technique of microelectrode array (MEA), a kind of electrophysiological technique originated from the overseas biological electrical signal monitoring technique, can be used to record multiple electrical signals of the nervous cells in vivo or in vitro, and maintain the accuracy and stability of the recorded information at the same time, which greatly enriches the means of electrophysiological study. This technique has been already applied in the basic study and clinical treatment abroad, but it is very seldom used in the study of acupuncture field. In order to guide the application of MEA in the research field of acupuncture science, a general survey about the application of MEA technique in vivo was done, and the present situation and prospects of the application of the technique in acupuncture science was briefly analyzed.

According 1o the genome sequences of α.β,e,ι toxins of Clostridium perfringens in GenBank,four pairs of primers targeting α,β,ε,ι toxin genes were designed.After the multiplex PCR reaction condition was optimized,the multiplex PCR for identification and toxintyping of C.perfringens strains was developed.The specificity test showed that the expected fragments of C.perfringens reference strains including A.B,C,D,E five toxin types were amplified successfully from genomic DNA of C.perfringens,respectively.However,a band could not be amplified from Clostidrium novyi and Clostridium septicum as negative control groups.The sensitivity test showed that the limit detection of multiplex PCR was 9.0,17.8,12.2,13.8,18.5 pg DNA of A,B,C,D,E five toxin types C.perfringens,respectively.Repetitive testing showed that the established method had a good repeatability.Nine type A strains of and 1 type C strains of C.Perfringens from 21 clinical samples of dead goat were detected by the multiplex PCR developed in this study.This study establishes the multiple PCR method which not only can detect C.perfringens rapidly but also can identify five toxin types of C.perfringens.

Objective To analyze the species classification and chracteristics of drug resistance and virulence in CTX-M producing Escherichia coli isolated from urine culture.Methods Escherichia coli cultured by urine were collected from our hospital during 2014,the ring disk diffusion test was implemented to determine the bacterial susceptibility,the EBLs determination test was used to analyze the bacterial EBLs producing situation;the enterobactoer duplicated gene spacer consensus sequency PCR(ERIC-PCR) was adopted to perform the genetic relation analysis;PCR was used to amplify the CTX-M encoding genes and multiple virulence genes iutA,ompT,fyuA,fdeC,fimH,traT,cvaC,pap,kpsMT,pAI,usp,aer,hlyA,cnf and chuA;the multiple PCR was used to analyze the species calssification of CTX-M-producing Escherichia coli;these strains of bacteria were classified as the CTX-M-producing group and non-CTX-M-producing group according to the results of CTX-M coding gene detection,the differences in the antibacterial drug resistance and virulence genes between the two gorups were performed the contrastive analysis.Results One hundred and sixty-two strains of E.coli by urine culture had no genetic correlation,among 126 EBLs positive strains,91 strains produced CT-M,in which 57 strains of CT-M producing Escherichia coli belonged to type D,and 116 strains belong to Type B2.The statistical analysis found that the drug resistance rate in the CTX-M-producing group was significantly higher than that in the non-CT-M producing group (except for imipenem),the prevalence of virulence genes including iutA,chuA and traT in the CT-M producing bacteria group was significantly higher than that in the non-CTX-M-producing group(P=0.001,0.006,0.000)Conclusion CTX-M-producing E.coli is main pathogenic bacterium of urinary infection in our hospital,its majority belong to type D with increased drug resistance,moreover has close correlation with virulence genes iutA,chuA and traA and is a pertential threat in clinical treatment of urinary infection.

Objective To evaluate the value of ADC and FA of diffusion tensor imaging (DTI) in differentiating clear cell renal cell carcinoma (ccRCC) and transitional cell carcinoma (TCC) of kidney pelvis.Methods Thirty-eight histopathology proven ccRCC and TCC patients (29 cases of ccRCC and 9 cases of TCC) were retrospectively enrolled.All the patients were performed abdominal MR fat saturation T1WI,fat saturation T2WI,LAVA and DTI (b=0,600 s/mm2).MR images were reviewed and analyzed by two radiologists in a double-blind manner with the value of ADC and FA measured using the Functool on AW 4.4 workstation.The data of two observers were analyzed with intra-class correlation coefficients (ICC) to assess inter-observer consistency.The differences of ADC values and FA values between ccRCC and TCC were compared by independent t-test.The ROC curves were used to analyze and compare the diagnostic value of DTI in differentiating ccRCC and TCC.Results The inter-observer agreements were good (ICC＞0.75).The ADC value of ccRCC was statistically higher than that of TCC ([2.03 ± 0.49] × 10-3 mm2/s vs [1.57 ± 0.43] × 10-3 mm2/s,P =0.015).But the FA value of ccRCC was statistically lower than that of TCC ([0.24±0.10] vs [0.42±0.22],P=0.002).The area under the ROC curve of ADC was 0.761 (P＜0.05),and the sensitivity and specificity were 79.3％ and 77.8％.The ADC threshold for differentiating ccRCC from TCC was 1.59× 10-3 mm2/s.The area under the ROC of FA was 0.762 (P＜ 0.05),and the sensitivity and specificity were 66.7 ％ and 93.1％.The FA threshold for differentiating ccRCC from TCC was 0.326.Conclusion MR DTI can effectively discriminate ccRCC and TCC.FA values has good diagnostic specificity in differentiating between ccRCC and TCC.

Objective To analyze the susceptibilities of Escherichia coli isolates collected from blood and the prevalence of ESBLs encoding genes.Methods A total of 121 Escherichia coli isolates collected from blood during 2012 were analyzed for antimicrobial susceptibilities by software of WHONET 5.6,the production of ESBLs was confirmed by confirmatory pheno-typic testing,PCR and DNA sequence were further implemented to analyze the ESBLs-encoding genes.Results 121 E.coli isolates displayed high resistance towards broad spectrum penicillin and 2nd or 3rd generation cephalosporins,levofloxacin and cotrimoxazole,with the resistance rates being more than 40%,susceptibilities to imipenem,piperacillin/tazobactam,ami-kacin were observed,with the resistance rates to be less than 12%,86(88.7%)out of 121 isolates were found to produce ESBLs.Among them,59.5% (72),38.8% (47)and 4.1% (5)were confirmed to carry blaCTX-M,blaTEM and blaSHV genes.Additionally,2(1.7%)isolates carried all the genes detected,30(24.8%)isolates carried both of blaCTX and bla-TEM,1(0.8%)isolate carried both of blaSHV andblaTEM.Conclusion Most of the E.coli isolates from the blood culture in Nanjing Gulou Hospital produce ESBLs,and displayed resistance towards most of the penicillins,cephalosporins and sin-gle amide antimicrobial agents should be chosen according to susceptibility results.

ObjectiveTo investigate the effects of dopamine D1 receptor (D1R) tool drugs and combined acupuncture and medicine on striatal expressions of D1R and dopamine transporters (DAT) in middle cerebral artery occlusion (MCAO)-reperfusion rats.MethodForty-seven male SD rats were randomly grouped, used to make a model and given corresponding interventions. The materials were taken and fixed six hrs later. Striatal D1R and DAT expressions were detectedby an immunohistochemical method in different groups.ResultThe neurological deficit score was significantly higher in the model group than in the blank group. Electroacupuncture treatment decreased the score significantly (P<0.05). D1R expression was significantly down-regulated in the antagonist, electroacupuncture and electroacupuncture plus antagonist groups compared with the model group (P<0.05). There was no statistically significant difference in D1R expression between the model group and the antagonist or electroacupuncture plus antagonist group (P>0.05). DAT expression was significantly down-regulated in the other groups compared with the model group (P<0.05). There was no statistically significant difference in D1R expression between all groups except the model group (P>0.05).ConclusionCerebral ischemia-reperfusion can result in high D1R and DAT expressions in rat striatum on the ischemic side. Electroacupuncture, D1R antagonists and a combination of the two can significantly down-regulate D1R expression and have a protective effect on the brain. The effects of electroacupuncture and D1R antagonists can not be added to each other. D1R signaling pathway may be one of ways by which electroacupuncture produces a protective effecton the brain.

Objective To investigate CT and MRI features of hepatoblastoma in adults.Methods CT and MRI findings of 8 cases of adult hepatoblastoma were retrospectively analyzed.Results (1) 75.0％ of the tumors was located in the right lobe of the liver and 25.0％ in the left lobe of the liver.(2) The maximum diameter of the tumor was averaged at (8.2±5.5)cm,and the maximum diameter of ＞ 5 cm was 62.5％.(3) Most tumors have a complete or incomplete false envelope,and the boundary is clear.(4) 75.0％ tumors were of necrocystic degeneration with calcification or bleeding in 25.0％ cases.(5) CT flat scan showing uniform low density or low density,MRI scanning T1WI was low signal,T2WI,T2WI fat suppression and DWI were high in parenchyma.(6) To strengthen substantial part in mild and moderate arterial uneven improved or ring slightly improved,portal venous phase continued mild reinforcement,delay slow exit accounted for 75.0％,reinforced psuedocapsule was mild.(7) The adjacent organs are under pressure deformation.(8) All patients underwent tumor resection and were followed up for 3 to 24 months.Conclusions CT and MRI characteristics of hepatblastoma in adult are specific and help improve the diagnostic accuracy of the disease.

BACKGROUNDTo evaluate the diagnostic significance of FDG PET in preoperative mediastinal lymph node staging for NSCLC.

METHODSWhole-body FDG PET imaging was performed in 70 patients with NSCLC. All patients received thoracic CT examination 2 weeks before PET scan or 1 week after PET scan, and then were given thoracotomy with hilar and mediastinal lymph nodes dissection. After intravenous administration of 18F-FDG (150μCi/kg), PET scan was performed in 3-7 bed positions with 2D acquisition and OSEM reconstruction. For quantitative evaluation, a region of interest (ROI) was placed over the mediastinal lymph node which had abnormal uptake of radiation activity, then the standardized uptake value (SUV) were calculated. If SUV≥2.5 or uptake activity was higher than the blood pool of mediastinal on the basis of visual inspection, it was considered to be positive.

RESULTSThe sensitivity, specificity and accuracy of PET were 100%, 93% and 94%, respectively. The positive lymph nodes diagnosed by PET correctly corresponded to pathological results. PET changed the clinical staging of 12 patients. The sensitivity, specificity and accuracy of CT were 70%, 77% and 76%, respectively.

CONCLUSIONSPET is an effective modality for accurate mediastinal lymph node staging in patients with NSCLC. It is valuable for determining clinical treatment.

Objective:To investigate the computed tomography (CT) features of primary liver leiomyosarcoma (PHLMS).Methods:The retrospective and descriptive study was conducted. The clinical and imaging data of 10 patients with PHLMS who were admitted to 4 medical centers including 3 cases in Wenzhou Central Hospital, 3 cases in the Second Affiliated Hospital of Wenzhou Medical University, 2 cases in Wenzhou People's Hospital and 2 cases in Yueqing People's Hospital from January 2011 to December 2020 were collected. There were 5 males and 5 females, aged from 41 to 83 years, with a median age of 55 years. All 10 patients underwent abdominal CT examination. Observation indicators: (1) CT features; (2) treatment and pathological examination; (3) follow-up and survival. Follow-up using postoperative outpatient or inpatient examination to detect patient survival was conducted. Patients underwent imaging examination to detect tumor recurrence. Follow-up was up to December 2020. Measurement data with skewed distribution were represented as M (range). Count data were described as absolute numbers. Results:(1) CT features: results of CT examination showed that each of the 10 patients had only one single tumor, including 3 cases with tumor on the left lobe of liver and 7 cases with tumor on the right lobe of liver. The tumor diameter of the 10 patients was 8.0 cm(range, 4.5-13.5 cm). Results of plain CT scan of 10 patients showed that 7 cases had tumor in expansive growth as round or oval, with clear boundaries and the tumor parenchyma showing low-density signals and patchy lower density area can be seen in the center, and 3 cases had tumor in infiltrative growth as patchy, with unclear boundaries and the tumor parenchyma showing iso-density signals. The CT scan value of 10 patients was 40 HU(range, 23-47 HU). Results of enhanced CT scan at arterial phase of the 7 cases with tumor in expansive growth showed that 3 cases undergoing tumor parenchyma with uneven mild enhancement signals, 3 cases undergoing tumor parenchyma with uneven moderate enhancement signals and 1 case undergoing tumor parenchyma with uneven significant enhancement signal. The CT scan value of 7 cases was 68 HU(range, 62-88 HU). Results of enhanced CT scan at arterial phase of the 3 cases with tumor in infiltrative growth showed that the peripheral region had high signal than the central region. The CT scan value of 3 cases was 73 HU(range, 67-90 HU). Results of enhanced CT scan at portal vein phase in the 7 cases with tumor in expansive growth showed that the tumor parenchyma showing continuous and progressive mild and moderate enhancement with uneven density, and the CT scan value was 63 HU(range, 55-78 HU). Of the 7 cases, 3 cases showed the enhancement range of tumor parenchyma with the trend of fusion and filling, and 4 cases showed small patchy or nodular enhancement and grid like enhancement in the center and periphery of the tumor. Results of enhanced CT scan at portal vein phase in the 3 cases with tumor in infiltrative growth showed that the enhancement withdrew, the density was uneven, and the CT scan value was 58 HU(range, 50-62 HU). Results of enhanced CT scan at delayed phase in 10 patients showed that the enhancement in the tumor withdrew slowly, and the CT scan value was 53 HU(range, 50-60 HU). Of the 10 patients, 4 cases showed decreased density of enhanced nodules around the tumor and 6 cases showed partially fused and filled to the center of tumor with no enhancement in the necrotic part. (2) Treatment and pathological examination: all 10 patients underwent completed tumor resection successfully, and no metastasis was found in liver or the hilar region. Results of postoperative pathological examination showed that each of the 10 patients had only one single visible tumor with tumor diameter of 8.0 cm(range, 4.5?13.5 cm). Of the 10 patients, 7 cases had tumor with complete or incomplete pseudocapsule with clear boundary and 3 cases had tumor without pseudocapsule and the boundary was unclear. All 10 patients had tumor with hard parenchyma and the section was mostly gray and fish like. Among them, patchy or punctate necrosis was seen in 7 cases, small patchy or punctate hemorrhage was seen in 3 cases, and small patchy calcification was seen in 2 cases. Microscopically, the tumor tissue was crisscross, the tumor cells were in spindle shaped, the nuclei were in round, oval, blunt at both ends or in thin rod like, with obvious heteromorphism, large and deeply staining, and obviously division. Immunohistochemical staining showed positive staining of smooth muscle actin, desmin and vimentin. (3) Follow-up and survival: all 10 patients were followed up postoperatively for 6 to 130 months, with a median follow-up time of 55 months. The overall survival time of 10 patients were 10 to 120 months, with a median overall survival time of 46 months. Of the 10 patients, 2 cases died of tumor recurrence and distant metastasis 10 and 11 months after operation, respectively and 8 cases survived >12 months.Conclusions:Results of plain CT scan of PHLMS show clear or unclear cysts and solid masses with uneven density. Results of enhancement CT scan of PHLMS show persistent uneven enhancement in tumor parenchyma and the surrounding area.