A total of 173 patients with Cushing's syndrome, including 35 patients with clinical data before and after operation, were retrospectively analyzed in this study. The results showed that patients with Cushing's syndrome had high prevalence of metabolic disorder and cardiovascular risk factors. Remission of diease and normalization of circulating cortisol level were not always followed by complete disappearance of metabolic disorder and cardiovascular risk factors.

A novel chitosan derivant, N-octyl-N-arginine chitosan (OACS) with a mimetic structure of cell-penetrating peptides was synthesized by introducing hydrophilic arginine groups and hydrophobic octyl groups to the amino-group on chitosan's side chain. Structure of the obtained polymer was characterized by FT-IR and 1H NMR. The substitution degree of octyl and arginine groups was calculated through element analysis and spectrophotometric method, separately. The critical micelle concentration of OACS was 0.12 - 0.27 mgmL(-1) tested by fluorescence spectrometry. The solubility test showed OACS could easily dissolve in pH 1 - 12 solutions and self-assemble to form a micelle solution with light blue opalescence. The OACS micelles have a mean size of 158.4 - 224.6 nm, polydisperse index of 0.038 - 0.309 and a zeta potential of +19.16 - +30.80 mV determined by malvern zetasizer. AFM images confirmed free OACS micelle has a regular sphere form with a uniform particle size. MTT test confirmed that OACS was safe in 50 - 1 000 micromol-L(-1). The result of HepG2 cell experiment showed that the cell internalization of OACS micelles enhanced with increased substitution degree of arginine by 40 folds compared to chitosan. Thus, OACS micelles were a promising nano vehicle with permeation enhancement and drug carrier capability.

Objective To observe the apoptosis or oncosis of pancreatic acinar cells of different severity of acute pancreatitis (AP) and the release level of enzymes in vitro, and to investigate the relationship between them. Methods Two-step enzymatic digestion method was used to separate pancreatic acinar cells into 4 groups. 0. 1 μg/ml of the caerulein was added in the AP group. Caerulein and LPS (bacterial lipopolysaccharide, 10 mg/L) were added in LPS group. Caerulein and OCT (octreotide, 100 ng/ml) were added in OCT group. Medium was added in the control group. AO (acridine orange) and EB (ethidium bromide) double staining method was used to detect the incidence of apoptosis or oncosis of acinar cell. The release of intracellular enzyme was detected by measuring the concentrations of amylase and LDH in cell culture media by colorimetry method. Results The apoptosis index was 2.2 + 0.4, 6.4 ± 0.6, 4.6 + 0.4, 11.2 +1.2 in the control group, AP group, LPS group, OCT group; while the oncosis index was 3.0 +0.4, 17.2 ±1.6, 23.0 ± 2.2, 12.8 ± 1.4 in the control group, AP group, LPS group, OCT group; the release of LDH was (2180 ±240), (8060 ±930), (9460 +920), (6860 ±740) U/dl, the level of amylase was (1750 ± 190),(3820 ±460), (4420 ±480), (2260 ±260)U/L. All the values in the experiment groups were significantly higher than that in control group ( P ＜ 0.05 ). The oncosis index, LDH, amylase in LPS group was significantly higher than that in AP group ( P ＜ 0.05 ), but the apoptosis index in LPS group was significantly lower than that in AP group ( P ＜ 0.05 ). The apoptosis index in OCT group was significantly higher than that in AP group ( P ＜ 0. 05 ), but the oncosis index, LDH, amylase was significantly lower than that in AP group ( P ＜ 0. 05 ).Conclusions Induction of apoptosis and reduction of oncosis in AP pancreatic acinar cells can reduce the release of enzyme in acinar cells.

Hepatectomy is the treatment of choice for huge ( ＞ 10 cm) hepatocellular carcinoma.However,the resection is more difficult and risky due to a huge space occupied by the tumor and vascular invasion.Precise hepatectomy is a new concept of liver surgery in the 21st century.The goal of which is the least invasive,most parenchymal preserving and optimal recovery.A male patient with a huge hepatocellular carcinoma (diameter =22.5 cm) received precise hepatectomy in the Department of Hepatobiliary Surgery of Fuzhou General Hospital of Nanjing Military Area.By using the digital medical technology and procedure of liver surgery planning system,the tumor and the whole structure of the liver were three dimensionally reconstructed,and the planning of resection was made.During surgery,the right liver artery and the right.porta hepatis were ligated and the right hemihepatic vessels were occluded.We accomplished right hepatectomy by accurate resection according the precisely planned preoperation,with less bleeding or no bleeding surgical field and rapid recovery.

A new HPLC-UV technique for the separation and analysis of 10 monosaccharides achieved within 13.5 min using 1-phenyl-3-methyl-5-pyrazolone (PMP) as the labelling molecule of the reductive monosaccharides has been established by combining common high performance liquid chromatography-UV and C18 column. The established technique was applied to the quantification of the monosaccharide components in extract of Silybum marianum. The results showed that the tested 10 monosaccharides as PMP derivatives were baseline separated under the HPLC conditions proposed. It was confirmed that Silybum marianum extract was composed of mannose, rhamnose, glucuronic acid, galacturonic acid, glucose, xylose, galactose and arabinose with the molar ratio of 0.66:0.84:0.58:1.0:1.6:0.69:2.7:4.8. Quantitative recoveries of the compositional monosaccharides separated from the extract were in the range of 92.4%-104.0%, and the RSD values fell within 0.68%-3.81%. The results demonstrated that the proposed HPLC method was simple, rapid, convenient, and precise, and it was applicable to the analysis of the compositional monosaccharides of Silybum marianum extract.

Objective:To observe the effect and safety of the inhalation of Lanqin oral solutions combined with interferon in the treatment of children herpes angina. Methods:The children with herpes angina were randomly divided into two groups. On the basis of support treatment, the control group (57 cases) was intravenously treated with ribavirin, and the observation group (58 cases) was treated with the combined inhalation of interferon and Lanqin oral solutions. The time of transference cure, total efficiency and adverse drug reactions in the two groups were observed and compared. Results:The time of transference cure of the observation group was sig-nificantly shorter than that of the control group (P<0. 05) with higher total efficiency (P<0. 05). The adverse drug reactions were few and mild in the two groups. Conclusion:The inhalation of Lanqin oral solutions combined with interferon in the treatment of chil-dren with herpes angina is effective with short transference cure time, convenience of use and promising security, which is worthy of clinical application.

Objective:To determine the spectrum drift characteristics of CI4+CD25+Tregs TCR β chain CDR3 in patients with different phases of acute hepatitis B (AHB) and chronic hepatitis B (CHB) patients before and after the entecavir treatment.Methods:Anticoagulation venous blood was collected from 4 normal control subjects,3 AHB patients with acute phase and convalescent phase,and 4 CHB patients before and after the entecavir treatment;and peripheral blood mononuclear cells were isolated;CD4+ CD25+ Tregs were separated by using the magnetic beads,and total RNAs were extracted from CD4+ CD25+ Tregs and used for reverse transcription.The TRBV CDR3 was amplified by polymerase chain reaction (PCR) with forward primers specific for 24 TRBV families and one fluorescence-labeled common reverse primer specific for the BC region.The PCR products were sent out for Genescan,and results were analyzed for the TRBV family CDR3 spectrum characteristics by using the Peak Scanner Software vl.0.Data were analyzed with the comparative t-test to perform the statistical analysis.Results:The CDR3 spectral types of the TRBV family showed drift characteristics in 3 cases of AHB patients with acute and convalescent phases;single/oligo peak spectral type family was observed in most of patients with acute phase;multiple peak spectral type was seen in patients with convalescent phase;and the common spectrum shift of TRBV4,10,14,16,19 families seen in patients with acute phase was changed to multiple peak spectral type.The clonal expansion of TRBV family in the CD4+CD25+Tregs in PBMC from AHB patients with convalescent phase was significantly lower than AHB patients with acute phase (t =9.456,P =0.011).The clonal expansion of Tregs TRBV13.2,15,16,18,20 family seen in C HB patients before treatment may interfere the virus removal through down-regulating the body's immune response;and with the decline of viral load in serum after the antiviral treatment,the clonal expansion of Tregs TRBV1,5.2,6,12,14,24 family may help body induce immune tolerance and result in the HBV persistence.The clonal expansion of TRBV family in the CI4+CD25+Tregs in PBMC from of CHB patients after antiviral treatment was increased (t =-0.666,P =0.553).Conclusion:TRBV4,10,14,16,19 family of spectrum shift seen in AHB patients with acute phase was changed to multiple peak spectral type in patients with convalescent phase,suggesting this transition may be associated with HBsAg and HBeAg turning to negative.The clonal expansion of Tregs TRBV13.2,15,16,18,20 family seen in CHB patients before treatment may interfere the virus removal through down-regulating the body's immune response;and with the decline of viral load in serum after the antiviral treatment,the clonal expansion of Tregs TRBV1,5.2,6,12,14,24 family may help body induce immune tolerance and result in the HBV persistence.

Objective Peritoneal dialysis can be done at home , however , its clinical follow-up quality is lower compared with hemodialysis due to the lack of detailed follow-up system and professional management team for post-discharge nursing care .The article aimed to explore the effect of a nurse-led integrated specialized disease management model in the follow-up of peritoneal dialysis patients . Methods Nurse-led integrated specialized disease management model was provided for 270 patients with peritoneal dialysis (PD) from January 2012 to May 2013.Self-designed questionnaire on diasease knowledge and self-care assement questionnaire were used for patients to evaluate their self-care ability and understanding of disease knowledge .Regular follow-up continued . Results The patients′understanding of disease knowledge was on the rise at 1st day before discharge, 1st month and 3rd months after discharge. After the application of nurse-led integrated specialized disease management model , the patients′regular clinical follow-up rate was in-creased from 78.3% to 88.6%.The patients′self-care ability improved gradually at 1st day before discharge , 1st month and 3rd months after discharge , which was of significant differences . Conclusion The nurse-led nurse-led integrated specialized disease management model can improve peritoneal dialysis patients′self-care ability and reduce their medical expense , which is of clinical sig-nificance .

BACKGROUND: The affected liver can be completely removed by liver transplantation,long-term efficacy is superior to liver resection,the 5-year survival rate reaches 70% H1.In addition,liver transplantation can avoid a serious risk for incomplete liver function caused by hepatic resection in the case of liver dysfunction.OBJECTIVE: To retrospectively analyze the treatment effects and importance of orthotoplc liver transplantation for primary hepatic cancer patients.METHODS: A total of 75 patients with primary hepatic cancer treated by orthotopic liver transplantation in Department of Hepatobiliary Surgery,Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA from March 1980 to December 2008 were involved in the analysis for the postoperative survival rates and recurrence of tumors.RESULTS AND CONCLUSION: For all the patients,the total postoperative survival rate in the 1st,2nd and 3rd year was 86.6%,66.7% and 53.3% respectively,the disease free survival rate was 65.2%,53.9%,34.1%.Their mean survival time is 25 months.For the patients in line with Milan standard,the postoperative survival rate in the 1st,2nd and 3rd year was 88.4%,72.5% and57.9% respectively,the disease free survival rate was 77.6%,62.3%,51.8%.Their mean survival time is 39 months.Tumor recurrence occurred within one year in all six patients who were beyond Milan standard.Two patients died in one year after operation,the survival rate at postoperative one year was 66.7% and the remanent four patients all died in the 2nd year after operation.Orthotopic liver transplantation was one of the effective treatments for pdmary hepatic cancer patients.The patients which were measured up to Milan standard would have the best curative effects.

Objective To compare the efficacies of hepatectomy and liver transplantation for patients with hepatocellular carcinoma (HCC) fulfilling the Milan criteria.Methods From July 2002 to February 2009,121 patients with HCC combined with hepatic cirrhosis fulfilling the Milan criteria were admitted to the Fuzhou General Hospital.Eighty-nine patients who received hepatectomy were in the hepatectomy group,and 32 patients who received liver transplantation were in the liver transplantation group.There were no significant difference in the age,gender,etiology of liver disease,the size of the largest tumor,number of tumors,microscopic venous invasion,microsatellite lesion and tumor differentiation between the 2 groups.The clinical data of the patients in the 2 groups were retrospectively analyzed.The overall survival and disease-free survival were evaluated by Kaplan-Meier method,and differences in survival rates between the 2 groups were determined by Log-rank test.COX proportional hazard was used for univariate and multivariate analysis to evaluate the risk factors for prognosis.Results The median period of follow-up was 37 months.The 1-,3-,5-year survival rates were 86％,63％ and 44％ in the hepatectomy group,and 87％,70％ and 62％ in the liver transplantation group.There was no significant difference in the overall survival rate between the 2 groups (x2 =1.092,P ＞ 0.05).The 1-,3-,5-year disease-free survival rates were 68％,44％ and 26％ in the hepatectomy group,and 80％,65％ and 52％ in the liver transplantation group.There was a significant difference in the disease-free survival rate between the 2 groups (x2 =4.712,P ＜ 0.05).The result of univariate analysis revealed that microscopic venous invasion and microsatellite lesion were significantly correlated with the survival (Wald =9.625,7.340,P ＜ 0.05),and the result of multivariate analysis indicated that microscopic venous invasion was the independent risk factor influencing the survival (Wald =5.008,P ＜ 0.05).Conclusions As for patients with HCC fulfilling the Milan criteria,the overall survival rate of patients who received hepatectomy is not different from those who received liver transplantation,but the disease-free survival rate of patients who received liver transplantation is higher than those who received hepatectomy.Microscopic venous invasion is an independent risk factor influencing the survival.