OBJECTIVE:To establish the quality standard of New Tongzhi surunjiang capsule. METHODS:Qualitative identification of Folium Sennae,Crocus sativus and Colchicum autumnale was conducted by TLC method. The content of gallic acid in the formulation was determined by HPLC. RESULTS:The TLC spots of Folium Sennae,Crocus sativus and Colchicum autumnale were clear and well-isolated. The linear range of gallic acid was 0.155 7～1.401 3 ?g(r=0.999 8) with a mean recovery rate of 101%(RSD=1.64%,n=9).CONCLUSION:The established standard is suitable for the quality control of New Tongzhi surunjiang capsule.

Objective To evaluate the feasibility, advantages and pitfalls of trans-gastric, trans-colonic and trans-umbilical peritoneoscopy, and to compare pure natural orifice transluminal endoscopic surgery (NOTES) with hybrid NOTES. Methods Two female pigs of 30kg were used in the study, one for pure NOTES, the other for hybrid NOTES. Each pig received trans-gastric, trans-colonic and trans-umbilical peritoneoscopy, respectively, followed by postmortem examination for organic lesions and closure of incisions.The two approaches were compared in terms of intra-operative situation and manipulation. Results The vital signs of the pigs were stable during the procedures, with no peri-incision organic lesions. There were blind areas in trans-gastric as well as in trans-colonic peritoneoscopy. It was easier to close the colonic incision than the gastric one. The situation in trans-umbilical peritoneoscopy was similar to laparoscopic surgery. Hybrid NOTES seemed superior to pure NOTES with regard to safe access, stable pneumo-peritoneum and adequate visualization. Conclusion Three routes for NOTES appear to be reasonable and feasible. Hybrid NOTES is more effective and safer than pure NOTES with current instruments.

Objective To analyze the correlation between postoperative systemic inflammatory response syndrome (SIRS) and calculi composition following flexible ureteroscopy (f-URS) lithotripsy.Methods The clinical data of 1 130 patients with kidney stones treated with f-URS lithotripsy in the department of urology surgery of our hospital from November 2013 to August 2016 were collected to analyze the correlation between postoperative SIRS occurrence and calculi composition.Results The compositions of urinary stones were mainly calcium oxalate monohydrate(67.7 ％),carbonate apatite (14.7 ％),anhydrous uric acid (6.4 ％),six magnesium ammonium phosphate (6.2 ％) and calcium oxalate dihydrate (3.2 ％).Only six magnesium ammonium phosphate was related to the development of SIRS(P＜0.01).Conclusion Six magnesium ammonium phosphate has a correlation with the development of SIRS following f-URS lithotripsy,and the results of stone compositions analysis can help to prevent the occurrence of SIRS after f-URS lithotripsy.

Aim: To observe the effects of sarsasapogenin ( SAR) on osteoblasts and osteoclasts cultured in vitro. Methods: Colonal murine calvarial osteoblast-like cell line MC3T3-E1 cells were cultured in vitro. MTT,p-nitropheneye phosphate and tinctorial method of alizarin Bordeaux were used to investigate the effects of SAR on the proliferation, ALP expression, and mineralization tuberculation of MC3T3-E1 cells. Mature osteoclasts were i-solated from the long bone of one-day rat. Meanwhile, marrow cells of mouse bone were cultured with induction of 1,25( OH)_2VitD_3. During the culturing of osteoclasts or marrow cells, SAR of different concentrations was added into the medium. The number of osteoclasts was recognized as tartrate resistant acid phosphatase( TRAP) ( +) multinucleate cells and the resorption lacuna on bone slice were examined with toluidine blue staining. Results: Comparing with the control group, SAR (0.01, 0. 1, 1μg/mL) significanthy increased the proliferation of MC3T3-E1 cells (P <0. 05, P <0. 01). There was no significant difference in the expression of ALP in early pro-liferating MC3T3-E1 cells exposed to SAR of 0.01,0. 1, 1μg/mL, but in the differentiation phase MC3T3-E1 cells, SAR improved ALP activity very significantly if compared with the control group, of which SAR of 1 μg/mL had the most promotion effect(P <0. 01). In addition, compared to the control group, there were, to various ex-tents, increased in the number of mineral nodes in MC3T3-E1 cells after 15day incubation with SAR of different conentrations. Furthermore, no obvious effects of 0.01-1μg/mL SAR on mature osteoclast were observed. But typical osteoclasts were formed when marrow cells were cultured with the induction of 1,25(OH)_2D_3 in medium for 7 days while little or no osteoclasts were induced from marrow cells in the presence of SAR. Conclusion: The results suggest that SAR can effectively promote the proliferation, differentiation and mineralization of osteoblasts cultured in vitro. Besides, SAR can inhibit the generation of osteoclasts from marrow cells.

This paper discusses the issues related to research capacity building in a military teaching hospital.We analyzed the opportunities,challenges and proposed development of military hospitals in order to strengthen the collaboration,,to adjust disciplinary structure,to consolidate research platform,to promote international exchanges,and to train the talented researchers and eventually to improve the hospital's overall research capacity.

Objective To investigate the efficacy and toxicity of sorafenib in the treatment of advanced renal cell carcinoma. Methods From May 2007 to JUN 2009, 33 patients with advanced renal cell carcinoma were given oral sorafenib 400-600 mg twice daily. There were 23 males and 10 females in the study group. The pathological diagnosis of the primary tumors was clear cell carcinoma in 29 patients, papillary renal cell carcinoma in 2 patients, chromophobe renal cell carcinoma in 1 patient and chromophobe renal cell carcinoma mixed with clear renal cell carcinoma in 1 patient. Fifteen patients had multiple organ metastases and 18 patients had single organ metastasis. The median follow-up time was 29 weeks. Results Four (12%) patients achieved partial remission, 2 (6%) patients achieved progression disease, the remaining 27 (82%) patients achieved stable disease. Complete remission was not observed in the group. Two of the partial remission patients benefited on bone metastases. Common toxicities were skin reaction (85%), diarrhea (46%), erythra (42%), alopecia (36%), oral ulcer (18%) and hypertension (9%). Conclusions Sorafenib could be effective in controlling tumor growth. The overall effectiveness was 12%, the disease control proportion was 94% in this group and its toxicity was relatively minor and well tolerated.

Objective To investigate the clinical value of argon plasma coagulation (APC)trans-choledochoscopy in biliary tract complications following liver transplantation. Methods All 27 patients underwent T-tube-choledochoscopy or percutaneous transhepatic cholangioscope (PTCS).APC was used to burn the hyperplasia of bile duct stenosis and then expended the stenosis with bougienage. The bile duct foreign bodies were burnt by APC and then eliminated. The granulation tissues of bile duct were burnt by APC after biopsied. The sutures of anastomoses were burnt by APC and then eliminated. Results In general, the therapeutic achievement ratio of stenosis of bile duct in 25 cases of 28 locations was 78. 6% (22/28). The clearance ratio of bile duct foreign bodies was 85. 7% (6/7). The elimination ratio of granulation tissues was 100% (5/5), the same as the elimination ratio of sutures of anastomoses. There were no treatment-related complications about APC. The recurrence ratio of bile duct stenosis was respectively 4.5% (1/22) and 13. 6% (3/22)after follow-up for 3 and 6 months respectively. All the recurrent stenosis was non-anastomotic. The recurrence ratio of bile duct foreign bodies was respectively 16. 7% (1/6) and 33.3% (2/6) after follow-up for 3 and 6 months respectively. Conclusion APC trans-choledochoscopy in treatment of biliary anastomotic stenosis, mural foreign bodies, mural biliary cast, granulation tissues of bile duct and sutures of anastomoses following liver transplantion has a high success ratio and a sure long-term efficacy without treatment-related complications.

Objective To explore the technological and therapeutic value of endoscope for removal of hepatobiliary necrosis after liver transplantation.Methods Data of 36 patients with suspected hepatobiliary diseases,who underwent choledochoscopy or duodenoscopy to remove necrosis after liver transplantation,were reviewed.Liver function before and after the treatment were compared.Results Hepatobiliary necrosis located in common bile duct (n =6),intrahepatic bile duct (hilar bile duct included) (n =24) and intraand extra-hepatic duct (n =6).The total success rate was 72.2％ (26/36).Full clearance of bile duct necrosis was accomplished in 16 patients,partial clearance in 15 patients and the necrosis could not be removed in 5 others.The serum bilirubin and transaminase decreased significantly,compared with those before endoscopic treatment (P ＜ 0.05).No serious complications or death related to endoscopy occurred during the treatment.After 6-84 month follow-up,in 17 survivals,3 patients underwent a second liver transplantation with good prognosis.All the survivals had a life of good quality with no placed drainage tube except for one with drainage tube for four years with unstable serum bilirubin.Nineteen patients died from biliary tract related complications or other diseases during the long-term follow-up,among which eleven patients survived beyond four years.Conclusion Endoscopy for hepatobiliary necrosis removal,a minimally invasive method,is effective and safe.

Objective To explore the role of p16 gene methylation in fibroblasts in the occurrence and development of keloid.Methods Skin tissue specimens were resected from the lesions of patients with keloid and normal skin of healthy human controls.Fibroblasts were isolated from these tissue specimens and subjected a primary culture.An immunohistochemical analysis was performed to measure the expression of p16 protein in tissue specimens,real-time fluorescence-based quantitative PCR to determine the mRNA expression level (expressed as 2-△△Ct) of p 16 and DNA methyltransferases (DNMTs) in fibmblasts,and bisulfite sequencing PCR (BSP) to estimate the methylation status of p16 gene in the tissue specimens and primary fibroblasts.Results The keloid fibroblasts (KFbs) showed significandy lower mRNA expression of p16 gene (0.64 ± 0.18 vs.1.92 ± 0.23,t =10.54,P＜ 0.05),but significantly higher mRNA expressions of 3 DNMTs (DNMT1:2.58 ± 0.23 vs.1.13 ± 0.21,t =11.22,P ＜ 0.05; DNMT3A:4.87 ± 0.46 vs.2.38 ± 0.32,t =10.81,P＜ 0.05; DNMT3B:1.57 ± 0.12 vs.0.57 ± 0.16,t =12.45,P＜ 0.05) compared with the normal fibmblasts (NFbs).The DNA methylation rate in the p16 gene promoter region was significantly increased in keloid tissue (1.81％ ± 0.46％) and KFbs (3.15％ ± 0.94％) compared with normal skin tissue (0.90％ ± 0.35％,F =14.23,P＜ 0.01) and NFbs (0.17％ ± 0.29％,F=37.62,P＜ 0.01).Conclusions The methylation and low expression of p16 gene in KFbs may be associated with the uncontrolled growth of keloid,and DNMTs may play a role in the pathogenesis of keloid.

AIM: To study the role of post-hemorrhagic shock mesenteric lymph (PHSML) drainage on the balance of angiotensin-converting enzyme ( ACE) and ACE2 in the kidney.METHODS:A hemorrhagic shock model was established and then fluid resuscitation was performed to the animals in shock and shock+drainage groups, and the PHMSL was drained in shock+drainage group after fluid resuscitation.After 6 h of resuscitation, the mRNA expression of ACE, ACE2, angiotensin II (Ang II) type 1 receptor (AT1R) and Mas-related G-protein-coupled receptor (MasR), and the levels of Ang II and Ang (1-7) in the renal tissues were observed.RESULTS:Hemorrhagic shock increased the levels of ACE mRNA, AT1R mRNA and Ang II, and decreased the levels of ACE2 mRNA, MasR mRNA and Ang(1-7) in the kid-ney.PHSML drainage abolished the effect of hemorrhagic shock on ACE2 and AT1R mRNA expression.Meanwhile, PHSML drainage reduced the hemorrhagic shock-induced increases in the ratios of ACE/ACE2, Ang II/Ang(1-7) and AT1R/MasR.CONCLUSION:The PHSML drainage restores the balance of ACE/ACE2, which is beneficial to alleviate acute kidney injury following hemorrhagic shock in the mice.