Objective To explore the clinical manifestation,imaging features and treatment of primary lacri-mal gland epithelial tumor.Methods The clinical data of 25 cases with primary lacrimal gland epithelial tumors were retrospectively studied.Results All of 25 primary lacrimal gland epithelial tumor cases received surgical treatment. Fourteen primary orbital tumors cases were male and 11 cases were female.The mean age was 44 years old (ranged 23 to 65).The mean hospital stay was 12d(ranged 7 to 20).Among 25 primary lacrimal gland epithelial tumor cases, 11 cases were benign tumors which included 4 inflammatory pseudotumor,11 pleomorphic adenoma.Fourteen cases were malignant tumors which included 4 malignant pleomorphic adenoma,6 adenoid cystic carcinoma and 4 adenocar-cinoma.After opeation,visual acuity improved in 9 cases,unchanged 10 cases,decreased 6 cases.The patients were followed up for 16 -48 months(mean 27 months).There were 4 malignant tumors recurrence after operation and received radical operation.While 2 patients were lost and 2 patients died of tumor metastasis,the other 21 patients survived with tumor -free.Conclusion Primary lacrimal gland epithelial tumors have different clinical and imaging appearances.Combination of ultrasound,CT and MRI is important to ascertain the character,range and degree of primary lacrimal gland epithelial tumors.Surgical excision is the main and effective treatment for primary lacrimal gland epithelial tumors,while gamma knife treatment is safe and effective for malignant,unresectable,recurrences tumors.

Objective To investigate the therapeutic effect of Yishen Tianjing Zhuyun Prescription(a Chinese herbal recipe consisting of Xianqi Yizhen Capsules and Xianzi Yizhen Capsules, having the actions of strengthening kidney-essence and promoting gestation) together with active lymphocyte immunotherapy for habitual abortion (HA)patients. Methods A total of 139 HA outpatients with negative blocking antibodies(BA)were randomly divided into treatment group(70 cases) and control group(69 cases). The control group was treated only with active lymphocyte immunotherapy, while the treatment group was treated with Yishen Tianjing Zhuyun Prescription and active lymphocyte immunotherapy . Results (1) After treatment, the BA-positive rate was 82.86% in the treatment group and was 60.87% in control group, and there existed significant difference between the two groups (P < 0.05 ). (2) The total anti-abortion effective rate was 87.14% in the treatment group and was 66.67% in control group, the difference being significant between the two groups(P<0.05 ). Conclusion Yishen Tianjing Zhuyun Prescription combined with active lymphocyte immunotherapy is more effective than active lymphocyte immunotherapy alone for the treatment of HA patients with negative BA.

Objective To establish two-dimensional electrophoresis profiles with high resolution and reproducibility from human gastric carcinoma and paired normal gastric mucosa tissues and to analyse the differential expression proteins between the two types of the tissues. Methods The total proteins of gastric carcinoma and paired normal gastric mucosa tissues were seperated by immobilized pH gradient-based two-dimensional gel electrophoresis (2-DE).After silver staining, the differential expression proteins were analyzed by using Imaging Master 2D analysis software. Results ⑴Average protein spots were 1049?67, 1097?73 in gastric carcinoma and paired normal gastric mucosa respectively,the matched spots were 835?48, 953?56 in both the two types of tissues respectively, and the average matching rate was 79.6%, 86.7% respectively. ⑵A total of 769?45 protein spots were matched between the electrophoretic maps of 5 gastric carcinoma and paired normal gastric mucosa tissues. The 81 differential protein spots were identified between the two types of the tissues. 17 protein spots were expressed only in the gastric carcinoma and 24 protein spots were expressed only in the normal gastric mucosa. The expression levels of 26 protein spots in the gastric carcinoma were higher than those in the normal gastric mucosa, and the expression levels of 14 protein spots in the gastric carcinoma were lower than those in the normal gastric mucosa. Conclusion In this study, the well-resolved,reproducible 2-DE patterns of gastric carcinoma and paired normal gastric mucosa tissues were established and some differential proteins between the two types of tissues were found. These data will be helpful to further screen specific biomarkers of gastric carcinoma.

OBJECTIVETo investigate the effectiveness of polycystic ovary syndrome (PCOS) of damp-phlegm constitution treated with embedding therapy on back-shu points and front-mu points and needle-pricking therapy on Sifeng (EX-UE 10).

METHODSEighty-five patients were randomly divided into 2 groups of observation group (42 cases) and control group (43 cases). Embedding therapy on back-shu points and front-mu points and needle-pricking therapy on Sifeng (EX-UE 10) were applied to the observation group. Points such as Zhongwan (CV 12), Guanyuan (CV 4), Tianshu (ST 25), Zhangmen (LR 13), Jingmen (GB 25), Qimen (LR 14), Ganshu (BL 18), Weishu (BL 21), Pishu (BL 20), Shenshu (BL 23), Dachangshu (BL 25) and Xiaochangshu (BL 27), etc. were adopted for embedding therapy. At the same time, needle-pricking therapy on Sifeng (EX-UE 10) was also applied once a week. 0. 5 g metformin hydrochloride tablet was given to the control group, once a day for the first week, and twice a day from the second week. Estimation on therapeutic effect was made for both groups after 3 months treatment. Change of symptoms and signs scores, fasting insulin (FINS), 2 hour insulin after meal (2hINS) and insulin resistance index (HOMA-IR) of both groups before and after treatment were observed, and therapeutic effect estimated.

RESULTSThe total effective rate of the observation group is 97. 6% (41/42), and that of the control group was 95. 4% (41/43). There was no significant difference between the two groups (P>0. 05). Scores of symptoms and signs after treatment were significantly improved in both groups (all P<0. 01), and the observation group was better than the control group (7.01+/-4.23 vs 8. 47+/-2. 82,P<0. 05). Compare with those before the treatment, FINS, 2hINS and HOMA-IR after the treatment were all decreased in both groups (all P<0. 05). The comparison between the two groups showed that differences of FIN had no statistic significance (P>0. 05) after the treatment, while both differences of 2hINS and HOMA-IR had statistic significance [ 2hlNS: (443. 531+/- 93. 90) pmol/L vs (621.29+/-93. 87) pmol/L ; HOMA-IR: 4. 88+/-0. 30 vs 5.06+/-0. 32, both P<0. 05]. The improvement of 2hINS and HOMA-IR in the observation group was better than that of the control group.

CONCLUSIONTreatment of PCOS of damp-phlegm constitution with embedding therapy on back-shu points and front-mu points and needle-pricking therapy on Sifeng (EX-UE 10) have positive effect, which can effectively reduce the insulin resistance, meanwhile, reduce the side-effects of western medication.

Anthracyclines ; administration & dosage ; adverse effects ; Antineoplastic Agents ; administration & dosage ; adverse effects ; Biomarkers ; blood ; Cardiomyopathies ; chemically induced ; diagnosis ; prevention & control ; Cardiotonic Agents ; therapeutic use ; Child ; Child, Preschool ; Echocardiography ; Heart ; drug effects ; Heart Diseases ; chemically induced ; diagnosis ; prevention & control ; Humans ; Risk Factors ; Survival Analysis ; Troponin I ; analysis

Objective To estimate the application for the rapid identification of common clinical bacteria by MALDI-TOF MS. MethodsFour hundred and twenty-six bacteria, including Salmonella spp strains collected from Zhejiang center for disease control and prevention were collected from blood, sputum,secretion and urine in 2nd Affiliated Hospital of Zhejiang University during December 2008 to August 2009. The isolates included 76 gram positive coccus and 350 gram negative bacilli. Species identification was performed with the Vitek system, and serotypes of Salmonella and Shigella were determined by serum agglutination test. 16s rDNA gene of 91 bacteria were amplified by PCR. The RCP products were sequenced. Then the results were compared with the reported sequences from GenBank. All strains were identified by MALDI-TOF MS. Results of three identification methods were compared with each other. Results Among 426 tested isolates, identification results from Vitek system and MALDI-TOF MS for gram positive coccus and 323 out of 350 gram negative bacilli (exception for Salmonella and Shigella spp.),were identical. For 23 Salmonella and Shigella spp. , only 2 Salmonella enterica subsp, enterica serovar Typhimurium were identified the same results by the three methods. Besides, results from Vitek system and serum agglutination test for 1 Salmonella enterica subsp, enterica serovar Typhi, 3 Salmonella enterica subsp.enterica serovar Paratyphi A, 1 Salmonella enterica subsp, enterica serovar Paratyphi B, 1 Salmonella enterica subsp, enterica serovar Enteritidis, and 1 Salmonella enterica subsp, enterica serovar Bovis-morbificans were consistent with that from 16S rDNA gene sequence. Four isolates which were confirmed as S. flexneri by Vitek system and serum agglutination test were identified as Escherichia coli by both 16S rDNA gene sequence and MALDI-TOF MS. ConclusionMALDI-TOF MS could be used for rapid and accurate identification of common clinical bacteria with good repeatabihty, excepting for the Salmonella and Shigella spp.

Objective To investigate the relationship between polycystic ovary syndrome (PCOS) susceptibility single nucleotide polymorphisms (SNP) and metabolic phenotypes in glucose and lipid metabolism and explore the pathophysiological mechanism of the susceptibility genes.Methods Three of PCOS susceptibility locus 2p16.3 (rs13405728 of LHCGR gene),2p21 (rs13429458,rs12478601 of THADA gene) and 9q33.3 (rs2479106,rs10818854 of DENNDIA gene) were selected and the metabolic phenotypes were compared between different genotypes of SNP in PCOS patients (using dominant model).Results Low-density lipoprotein cholesterol was significantly increased in CC genotype group than in TC + TT groups at rs12478601 of THADA gene [(2.5 ± 0.8),(2.4 ± 0.8) mmol/L; P =0.01].Serum insulin level of 2 hours after 75 g glucose intake was significantly higher in GG + AG groups than that of AA group at rs2479106 of DENND1A gene[(71 ±65),(64 ±50) mU/L;P =0.05],and the prevalence of type Ⅱ diabetes in first-degree relatives of patients were also increased [9.9％ (66/666),6.9％ (52/751) ; P ＜ 0.05].No association was found between metabolic phenotypes and genotypes of rs13429458,rs10818854,and rs13405728.Conclusions Genetic factors probably have effect on the metabolic characteristics of PCOS.THADA gene is related to lipid metabolism,while DENND1A gene may be involved in insulin metabolism in patients with PCOS.

Objective To explore the clinical manifestation,imaging features,histopathological classifications and treatment of primary orbital tumors.Methods Twenty-six cases with primary orbital tumors were retrospectively studied.Results All of 26 primary orbital tumor cases received surgical treatment.Sixteen primary orbital tumors cases were male and 10 cases were female.The mean age was 46 years (ranged from 15 to 72).The mean hospital stay was 13 d (ranged from 9 to 21).Among 26 primary orbital tumors cases,21 cases were benign tumors which included 11 cases of cavernous hemangioma,5 cases of inflammatory pseudotumor,3 cases of dermoid cyst,2 cases of venous angioma.Five cases were malignant tumors which included 4 cases of adenoid cystic carcinoma and 1 case of rhabdomyosarcoma.After operation,visual acuity improved in 9 cases,unchanged in 11 cases,decreased in 6 cases.The patients were followed up for 18-48 months (mean,25 months).There were 4 cases of malignant tumors recurrence after operation and received radical operation.While 2 patients were lost,the other 24 patients survived with tumor-free.Conclusions Surgical excision is the main and effective treatment for primary orbital tumors.To be very familiar with the imaging characteristics and local anatomy is the key for operation.Individualized treatment plan should be chosen based on clinical manifestation,imaging features and histopathological classifications.

Objective To analyse a novel splice mutation in EXT1 gene of hereditary multiple osteochondroma, and study its pathogenic mechanism.Methods In April of 2013, the proband was hospitalized from the outpatient department with multiple joint deformity for more than 20 years, peripheral blood of the proband and his parents were collected and genomic DNA was extracted .Coding regions and adjacent intron sequences of EXT1/EXT2 genes in genomic DNA of the family members were amplified and sequenced.Bioinformatics was used to analyze the mutation from sequencing .cDNA from peripheral blood of the proband ,the mother and normal control was made respectively as a template for amplifying coding regions of EXT1 gene, and the product was T-A cloned and sequenced.The abnormal transcripts of each group were counted and analyzed using chi square test to study the pathogenic mechanism of the mutation .Results Sequencing results of family members revealed that there was a heterozygous deletion mutation ( c.1284 +2del) in the 5′splice site of intron 4 in EXT1 gene of the proband and his mother .Bioinformatics predicted that exon 4 of EXT1 gene was skipping or spliced aberrantly due to the mutation .T-A clone and sequencing results as well as the statistical analysis suggested that there was a significantly higher proportion of transcripts with skipping exon 4 in the proband and his mother compared with the normal control (P=0.000, P<0.01).Conclusions c.1284+2del in EXT1 gene is reported for the first time internationally , which results in a considerable number of abnormal transcripts with skipping exon 4 in EXT1 gene, thereby influences the normal transcription and translation of EXT1 gene.

With more and more international medical students studying medicine in China,international medical education becomes an important part of Chinese medical education.By integration of basic and clinical pharmacology,the teaching mode of theory,experiment,problem based learning and seminar was applied to the international medical students according to their characteristics and specificity.75％,80％ and 70％ of the total international medical students respectively passed the two consecutive final exams and one pharmacology group exam.Through the teaching of pharmacology for international medical students major in MBBS,this author aims to explore the teaching mode of pharmacology for the international medical students.