The innovation of Chinese materia medica (CMM) is the central driver of CMM modernization. The application of modern theories and techniques in life sciences to innovating CMM research remains to be an urgent issue to be solved. Currently, the international R&D for drug is stepping into a new trend, in which these transformations are going through a signal target to multiple drug combination and active constituents selection by pharmacodynamics to optimize the design with pharmacokinetics. In the face of changes, the pace of CMM R&D is slow. Based on the R&D content of system biology and Huangqin Decoction extract (PHY906), the "preceded pharmacokinetics" concept is introduced. Taking pharmacokinetics as the tool to rapidly screen the potential constituents with the aims at CMM R&D. Furthermore, why the "preceded pharmacokinetics" is needed and how to start the innovation model are preliminarily discussed in this paper.

M2 type of pyruvate kinase (PKM2) is one of the most important regulatory molecules in glycolysis,which at high level is a major feature of tumor cells.Besides,PKM2 also regulates gene transcription and cell cycle,promoting the formation,invasion and migration of tumors.Meanwhile,PKM2 can beregulated by many transcription factors,oncogene proteins,miRNA and intermediate metabolites.Extensive studies indicated that PKM2 plays an important role in the developmental tumor.In view of the significance of PKM2 in tumor cells,it holds promise for diagnosis and treatment benefits.

Objective To evaluate the efficacy and safety,particularly eye safety of hydroxychloro-quine(HCQ)treatment in primary Sj(o)gren's syndrome(pSS)patients.Methods Forty pSS patients were en-rolled and treated with HCQ 400 mg/day for 12 months.This is a prospective open-label study.Clinical mani-festations,clinical efficacy,biochemical and immunoserological parameters as well as ophthalmological exami-nations were investigated every three months to assess the safety and tolerability.Results There were signifi-cant decrease in the erythrocyte sedimentation rate(ESR),immunoglobulin G(IgG),immunoglobulin M (IgM)and rheumatoid factor(RF)level after 6 months treatment with HCQ(P＜0.01 or P＜0.05).No changewas detected in serum antinuclear antibody(ANA),anti-SSA/SSB antibodies after treated for 12 months.Somepatients had partial improvement in symptoms such as dry mouth,dry eyes and arthralgia.During the treat-ment,no significant effect on serum alanine aminotransferase (ALT),blood urea (BUN),serum creatinine (Cr),whole blood count(WBC)or hemoglobin(Hb)could be discovered.Central semus retinopathv(CSR)was found in one patient after 6 months treatment with HCQ.However,its association with HCQ could not be confirmed since it was not compatible with the usual HCQ retinopathy.Conclusion HCQ can improve svmp-toms of some pSS patients and can significantly decrease ESR,IgG,IgM and RF level.The safety profile of HCQ is generally good.However,ophthalmological examination before and after a 6-month interval may be necessary in long term HCQ treatment.

OBJECTIVE: To present our experience of manipulation under general anesthesia for treating postoperative hip joint stiffness in children.METHODS: 193 children (226 hips) with postoperative joint stiffness were retrospectively studied at the Department of Pediatric Orthopaedics, Shengjing Hospital, China Medical University from January 1978 to December 2005, comprising 53 males and 140 females, aged 1-14 years old. 226 hips with postoperative stiffness from open reduction of developmental dysplasia of the hip (DDH) (155 cases with 188 hips) and capsulotomy for hip sepsis or tuberculosis (38 cases with 38 hips) were retrospectively reviewed. All patients laid on the surgical table supinately under general anesthesia. The assistant fixed the pelvic with palms. The operator manipulated the hip joint with 3 steps: flexed hip joint slowly and gently to 110°-120° or more; then abducted and externally rotated hip joint; adducted and internally rotated the hip. Then 3-step passive manipulation was repeated for once at least. As soon as the patient waked from general anesthesia, Continuous passive motion was applied for the affected hip with the range of motion increasing daily for 1-2 weeks. They were followed averagely 15 months (6-24 months) to evaluate the promoted range of motion in flextion-extension and adduction-abdduction.RESULTS: 186 hips (82.3%) succeeded in manipulation in addition to 34 failure hips (15%) and 6 hips (2.7%) with femoral neck fracture. The successful rate, promoted range of motion in group of ≤6-year-old and group of ≤12-month-duration from primary surgery were significantly higher, femoral neck fracture rate was less than those in group of >6 years of age and group of >12-month-duration from primary surgery.CONCLUSION: Passive manipulation under general anesthesia is a safe, uninvasive and effective method in treating postoperative hip stiffness in children. Younger age (≤6 years) and less duration from the primary surgery (≤12 months) would yield better result.

This study was aimed to screen out an optimal pharmaceutical formulation of Wuji Gastric Floating Sus-tained-release Tablets. With multicomponents of release for index, the extra-floating ability of the tablets was stud-ied with the orthogonal test of four excipients, which were HPMC (K100M), PEG 6000, sodium bicarbonate and se-tanol. The results showed that the combined optimal pharmaceutical formulation was 35% HPMC, 5% PEG 6000, 10% sodium bicarbonate, 15% setanol, 10% MCC and 25% main drug. It was concluded that Wuji Gastric Floating Sustained-release Tablets had the characteristics of slow-release and long floating duration which comply with re-quirements of formulation design. This preparation technique is with good maneuverability.

Purpose To investigate the clinicopathlogical characteristics, diagnosis and differential diagnosis of ovarian small cell car-cinoma hypercalcemic type ( OSCCHT) associated with acute renal dysfunction. Methods A case of OSCCHT associated with acute renal dysfunction was reported. The clinical and pathologic data, treatment and pathological examinations were analyzed and the related literatures were reviewed. Results A 29-year-olds women was presented to hospital with inappetence and significant weight loss for 2 months. The laboratory examination showed abnormal renal function, and pelvic cavity mass, possibly coming from adnexa of the uterus was seen by radiography. Serum levels showed significantly increased serum calcium with acute renal dysfunction. An emergency opera-tion was performed just after renal function partially recovered by 2 times hemodialysis. During surgery, right ovary tumor with a size of 12 cm × 10 cm × 10 cm was inspected. Microscopically, the tumor cells were arranged in a diffuse solid pattern, mutiple nodules were separated by fibrous tissue. some small folliculars and pseudoglandular cavities with acidophilia secretion within nodules could been ob-served. Tumor cells were medium to large with eosinophilic cytoplasm, round or oval vesicular nucleus, increased karyoplasmic ratio and pathologic mitosis. Immunohistochemistry revealed that the tumor cells expressed EMA, CKpan, C-erbB-2 ( +) , CA125 ( focal+) and Ki-67 proliferation index was about 60%, while ER, PR, Syn, CgA, PTH, Inhibin, CD99, AFP, PLAP, CD30 and CD20 were not expressed. Conclusion Ovarian small cell carcinoma hypercalcemic type with acute renal dysfunction is a very rare with a rapidly progressive and highly malignant tumor. The final diagnosis mainly lies on clinical information ( hypercalcaemia) , morphology and immunohistochemistry, combined with electron microscopy and molecular biological detection when necessary.

OBJECTIVETo study the clinicopathological characteristics of papillary cystadenoma of the epididymis.

METHODSUsing routine pathology and immunohistochemistry, we observed the surgically obtained samples from 2 cases of papillary cystadenoma of the epididymis, analyzed their pathological features and clinical presentations, and reviewed the related literature.

RESULTSThe 2 patients were both adult males. The tumors typically manifested as painless swelling in the epididymis, with occasionally dull pain and tenesmus in 1 of the cases. Pathologically, the lesions exhibited three morphological features, i. e., dilated ducts and small cysts surrounded by fibrous connective tissue, adenoid papillary hyperplasia into the cysts embraced by fibrovascular stroma, and acidophil substance present in the cysts. Immunohistochemistry showed that the tumors were strongly positive for CK8/18, CK7, and EMA, but negative for CK20, CEA, MC, Calretenin, P53, P63, SMA, VHL, and CD10, with the positive rate of Ki-67 <1%. Follow-up visits revealed good prognosis in both cases.

CONCLUSIONPapillary cystadenoma of the epididymis is a rare benign tumor in the male urogenital system, which may be accompanied by the VHL syndrome. Surgery is the first choice for its treatment.

Adult ; Cystadenoma, Papillary ; chemistry ; pathology ; Epididymis ; Genital Neoplasms, Male ; chemistry ; pathology ; Humans ; Immunohistochemistry ; Male ; von Hippel-Lindau Disease

Objective To investigate effects of dendritic cells (DC) vaccine on immune function in postoperative gastric cancer patients Methods DCs were extracted and pulsed with self tumor antigens in vitro Fifty patients with gastric cancer were divided into 2 groups randomly Four times of DC vaccinations were administered at 7 days intervals to the postoperative patients in treatment group after they underwent chemotherapy The control group were treated with chemotherapy only The level of IL 12 、 IFN ? and IL 4 in peripheral blood were analysed Results In DCs group, the levels of IL 12 were 37?4、 68?6、 96?12 and 59?9 pg/ml, the levels of IFN ? were 61?12、 134?19、 145?20 and 111?15 pg/ml, and levels of IL 4 were 55?7、 49?6、 46?5 and 50?8 pg/ml before and 2, 4 and 8 weeks after vaccination, respectively In control group, the levels of IL 12 were 39?7、 45?9、 44?10 and 44?6 pg/ml, the levels of IFN ? were 63?10、 61?13、 62?11、 61?7 pg/ml, and levels of IL 4 were 52?11、 55?9、 53?10、 55?8 pg/ml before and 2, 4 and 8 weeks after vaccination, respectively The levels of IL 12 and IFN ? increased significantly in DCs group No severe side effects were found during treatment Conclusion DC vaccine improves immune function of posroprative patients with gastric cancer

Adenocarcinoma ; metabolism ; pathology ; surgery ; ultrastructure ; Aged ; Carcinoembryonic Antigen ; metabolism ; Carcinoma, Neuroendocrine ; metabolism ; pathology ; surgery ; ultrastructure ; Cardia ; Humans ; Ki-67 Antigen ; metabolism ; Male ; Microscopy, Electron, Transmission ; Stomach Neoplasms ; metabolism ; pathology ; surgery ; ultrastructure ; Synaptophysin ; metabolism

Adult ; Diagnosis, Differential ; Humans ; MART-1 Antigen ; metabolism ; Magnetic Resonance Imaging ; Male ; Medulloblastoma ; metabolism ; pathology ; Melanocytes ; pathology ; Melanoma ; diagnosis ; metabolism ; pathology ; surgery ; Melanoma-Specific Antigens ; metabolism ; Meningeal Neoplasms ; diagnosis ; metabolism ; pathology ; surgery ; Neoplasms, Multiple Primary ; diagnosis ; metabolism ; pathology ; surgery ; Neurilemmoma ; metabolism ; pathology ; Nevus of Ota ; diagnosis ; metabolism ; pathology ; surgery ; S100 Proteins ; metabolism ; Skin Neoplasms ; diagnosis ; metabolism ; pathology ; surgery ; Vimentin ; metabolism