Objective To study the clinical characteristics and imaging features of alien hand syndrome (AHS). Methods We retrospectively analyzed the clinical data of 3 typical cases in our hospital,in comparison with case reports and reviews of domestic and foreign during the past decade. Result All 3 patients showed corpus callosum lesions from CT or MRI detections. The symptoms of the patients included alien hand sign , abnormal involuntary movements, intermanual conflict of upper limbs, and so on. And the patients accompanied with emotional and cognitive changes. Two of them were improved in different degrees after treatment. Conclusion AHS was a complex disease. The diagnosis of this syndrome was based on the advanced neuroimaging. There was still no well established treatment for AHS.

Objective To evaluate the efficacy of laparoscopic and open operation combined with endoscopic nasobiliary drainage(ENBD) in the management of choledocholith. Methods 44 cases treated by laparoscopic common bile duct exploration (LCBDE) and 34 ones by open common bile duct exploration(OCBDE) combined with ENBD and primary suture of common bile duct were retrospectively analyzed from January 1997 to July 2001. Results All cases were operated on successfully. The clearance rate of stones was 100%(78/78). No postoperative complications such as bile leakage, hemobilia, cholangitis, etc occurred. Postoperative hospital stay was (6 2?1 3)days in group LCBDE and (7 4?2 1)days in group OCBDE. 57 cases had been followed up for (1～4 5)years with an average of 2 6 years, and ultrasoundgraphy showed no bile duct stricture and recurrent stones. Conclusions LCBDE or OCBDE combined with ENBD and primary suture of common bile duct is safe and reliable.

Objective To study on the method of applying laparoseopy for the treatment of choledo cholithiasis after biliary tract operation, and to evaluate its therapeutic efficacy. Methods Thirty-seven cases of common bile duct stones after operation from October 1999 to December 2003, received laparoscopic common bile duct exploration (LCBDE) were retrospectively analyzed. Results Satisfactory results were accepted in 35 cases and the rest two cases converted to laparotomy. Thirty cases had got primary healing by the help of employing endoscopic nasobiliary drainage (ENBD) , 7 cases received T-tube drainage. There was neither residual stones left nor serious after-effect including biliary fistula and hemobilia happened. Mean operative time was ( 168 ?30. 2) min. Mean postoperative stay in hospital was (11.5?1.3) d. Recurrences of calculi and bile duct stricture never happened within 6-48 m follow-up study. Conclusion The laparoscopic procedure is technically feasible and safe alternative, however, the technique in lyses of adhesions, dissection and suture of choledochus are quite difficult, therefore it is recommended to be performed in experienced hands expected to minimize the occurrence of complications, and firmly mastered the indications of conversion to laparotomy as far as possible.

Objective To investigate alterations in epigenetic regulation in B cells in subacute cutaneous lupus erythematosus (SCLE).Methods Peripheral blood mononuclear cells (PBMC) were isolated from the peripheral venous blood of SCLE patients and healthy donors with density gradient centrifugation.B cells were isolated with CD19 micro beads and protocols provided by the manufacturer.Total RNAs were isolated with RNA kits.The expressions of silence information regulator 1 (Sirt1) mRNA were investigated with quantitative real time polymerase chain reaction (PCR).Results The levels of Sirt1 mRNA were significantly increased in SCLE B cells relative to healthy controls (P ＜ 0.01).Conclusions Histone modifications appear abnormal in B cells in SCLE.

Objective: To clone and express the preferentially expressed antigen of melanoma (PRAME) gene in E.coli. Methods: The cDNA encoding human PRAME gene was extracted from human AML cell line HL-60 and amplified by RT-PCR, then the PRAME gene was inserted into plasmid PGEM-T-easy. After sequenced, it was cloned into the prokaryotic expression vector pGEX-4T-2 to construct a clone with high level expression and the recombinant plasmid was cloned in E.coli. Results:The protein product reached the highest level at 5 h after IPTG induction. Conclusion: Since PRAME is only expressed at low levels in a few normal tissues and encodes an antigen recognized by autologous cytotoxic T lymphocytes, while expressed at high levels in patients with leukemia, it might be a new targeting candidate for tumor immunotherapy.

Reference materials containing mixed degradation products of amoxicillin and ampicillin were developed after optimization of preparation processes. The target impurities were obtained by controlled stress testing, and each major component was identified with HPLC-MS and compared with single traceable reference standard each. The developed reference materials were applied to system suitability test for verifying HPLC system performed in accordance with set forth in China Pharmacopeia and identification of major impurities in samples based on retention and spectra information, which have advantages over the methods put forth in foreign pharmacopoeias. The development and application of the reference materials offer an effective way for rapid identification of impurities in chromatograms, and provide references for analyzing source of impurities and evaluation of drug quality.
Amoxicillin ; chemistry ; Ampicillin ; chemistry ; China ; Chromatography, High Pressure Liquid ; Drug Contamination ; Mass Spectrometry ; Reference Standards

OBJECTIVE:To optimize the inclusion process of the volatile oil of Pogostemon cablin and Acorus tatarinowii in Xiaoyu anshen capsule.METHODS:The inclusion process was carried out by saturated water solution method.And the inclusion process was optimized by orthogonal experiment with the inclusion ratio and yield of the volatile oil as indexes taking the ratio of volatile oil to ?-CD,the temperature and the time of inclusion as factors.The physical phase of the inclusion complex was detected by differential scanning calorimetry(DSC).RESULTS:The optimum inclusion process was established as follows:the ratio of oil to ?-CD=1∶8;the ratio of water to ?-CD=10∶1;the inclusion time was 1h and the inclusion temperature was 50 ℃.The inclusion rate was as high as 90%.The DSC revealed that a new physical phase has been formed for the inclusion complex.CONCLUSION:The intermolecular inclusion complex with good stability and high yield of volatile oil could be obtained from the optimized inclusion process.

Objective To search for the distinctive diagnostic features of Crohn's disease and intestinal tuberculosis in clinical manifestations with methods widely used clinically.Methods A retrospective study enrolled 33 Crohn's disease and 34 intestinal tuberculosis inpatients in West China Hospital of Sichuan University from 1996 to 2007.The clinical characteristics and key points of differential diagnosis were analyzed.All the pathological sections were studied again.Results The total duration of symptoms in patients with a diagnosis of Crohn's disease was longer than that in patients with intestinal tuberculosis ( P < 0.05 ).The incidence of eolectomy is significantly higher in Crohn' s disease than in intestinal tuberculosis because of intestinal obstruction or undefined diagnosis ( P < 0.05 ).Hematochezia,extra-intestinal manifestation and ileus occurred significantly more in Crohn's disease than in intestinal tuberculosis( P < 0.05 ).Night sweating and hypoalbuminemia occurred significantly more in intestinal tuberculosis than in Crohn's disease( P <0.05 ).The positive rate of serum antibodies to mycobacterium and increased erythrocyte sedimentation rate is higher in intestinal tuberculosis than in Crohn's disease(P < 0.05).Cobblestone sign and fissure-shape ulcers were only found in Crohn's disease,while circular ulcer occurred significantly more in intestinal tuberculosis( P <0.05).The involvement of stomach,jejunum or ileum was significantly more in Crohn's disease than in intestinal tuberculosis( P < 0.05 ).Granulomas were more common in intestinal tuberculosis than in Crohn's disease( P < 0.05 ) and the site of granulomas was valuable for differential diagnosis.In all the Crohn's disease specimens,lymphoid aggregates in the lamina propria or submucosa were significantly more in surgically reseeted specimens than in endoscopic biopsies (P <0.05).Conclusions There are definitely some different features between the two diseases.It is essential to review the whole clinical data of the patient.The frequency of granulomas and the distribution of chronic inflammation are identified as histological parameters that can be used to differentiate tuberculosis and Crolm's disease.

Objective To study on the effectiveness and reliability of endoscopic varicose vein ligation (EVL) combined with hand-assisted laparoscopic splenectomy (HLS) in portal hypertensive patients. Methods Retrospectively 15 cases of EVL combined with HLS were reviewed from June 2001 to October 2004. These patients with severe esophageal varicose and hypersplenism were adapted to perform endoscopic varicose vein ligation, then 1 -2 weeks after the varicose became milder or disappeared, hand-assisted laparoscopic splenectomy was conducted. Results The number of preoperative ligation was 2. 2 times in average. Esophageal varicose was completely disappeared in 11 and mild in 4. There were no postoperative complications, conversion and death in Hand-assisted laparoscopic splenectomy. The average postoperative count of platelets were (38-67) ? 106/L preoperatively raised to (89-310) ? 106/L postoperatively. In the follow up period (average 17. 6 months) , no varicose vein bleeding happened. Conclusions EVL combined with HLS is not only minimal invasive, but also a secure and effective measure for portal hypertension.

Objective To investigate the relation between the expression of Caspase recruitment domain-containing membrane-associated guanylate kinase protein 1 (CARMA1),clinicopathological features of gastrointestinal mucosa-associated lymphoid tissue (MALT) lymphoma,diffuse large B cell lymphoma (DLBCL),and Helicobacter pylori (H.pylori) infection.Methods From January 1999 to March 2011,34 patients with DLBCL and 20 patients with MALT lymphoma were selected,and at same period 21 cases with reactive hyperplasia of gastrointestinal lymphoid tissue were enrolled in as control.The expression of CARMA1,Ki-67 and cytotoxin-associated gene A (CagA) at protein level were examined by immunohistochemistry.The relative expression quantity of CARMA1 mRNA was detected by real-time polymerase chain reaction (PCR).The condition of H.pylori infection in 25 gastric lymphoma and 10 controls was detected by methylene boric acid and blue staining or semi-nested PCR.Chi-square test was used for counting data analysis,t test for measurement data.Multivariate COX regression analysis was implemented for survival analysis.Survival curve was drawn by Kaplan-Meier method and analyzed by Log-rank test.Results The relative expression quantity of CARMA1 mRNA of 28 patients with DLBLC (3.073±1.846) was higher than that of 14 patients with MALT lymphoma,and the difference was statistically significant (F 0.975,P＜ 0.05).The positive rate of CARMA1 expression at protein level of gastrointestinal lymphoma group (75.9 ％,41/54) was higher than that of control group (47.6％,10/21),and the difference was statistically significant (x2 =5.568,P＜0.05),and the positive rate of CARMA1 expression of MALT lymphoma group (11/20) was lower than that of DLBCL group (88.2％,30/34),and the difference was statistically significant (x2 =5.900,P＜0.05).Among 42 patients with gastrointestinal lymphoma who received surgery,the relative expression quantity of CARMA1 mRNA in cases with high proliferation (2.885±1.837) was higher than that in cases with low proliferation.The expression of CARMA1 mRNA in the cases at advanced stage of the disease (4.416± 1.010) was higher than that in cases at early stage,and the difference was statistically significant (F=3.317 and 2.972,both P＜0.05).Among 54 patients with gastrointestinal lymphoma,the positive rate of CARMA1 expression at protein level of patients with high proliferation (88.6％,31/35) was higher that that of patients with low proliferation (10/19),and the difference was statistically significant (x22 ＝ 6.847,P＜0.05).There were no significant differences in relative expression quantity of CARMA1 mRNA and the positive rate of CARMA1 expression at protein level between 11 gastric lymphoma patients without H.pylori infection and 14 gastric lymphoma patients with H.pylori infection (both P＞0.05).The positive rate of CARMA1 expression at protein level of CagA positive and CagA negative H.pylori infected gastric lymphoma patients was 11/11 and 2/3.The expression of CARMA1 at protein level was correlated with the prognosis of gastrointestinal lymphoma (RR＝4.160,P＜0.05).In the 29 cases of patients with gastrointestinal MALT lymphoma and 18 cases of patients with DLBCL who were followed up,the survival situation of gastrointestinal lymphoma patients with CARMA1 positive expression rate over 50％ was worse than that of patients with the rate less than 50％,and the difference was statistically significant (x2=5.383 and 4.028,both P＜0.05).Conclusions CARMA1 might be involved in the pathogenesis and progression of MALT and DLBCL; and it might be a related factor of poor prognosis.There was no correlation between the expression of CARMA1 and H.pylori infection in these two lymphomas.