The activities of interleukin 6 (IL 6) and tumor necrosis factor alpha (TNF?) produced by peripheral blood mononuclear cells (PBMCs) in vitro and their relevant levels in sera were measured in 49 patients with psoriasis vulgaris (PV) and in 20 normal controls using bioassay. The relationship between them was also analysed. The results showed that in PV patients the activites of IL 6 and TNF? produced by PBMCs and their serum levels were higher than those in healthy controls. There was a positive linear correlation between the activites in vitro and relevant levels in sera, and a positive linear correlation between serum levels of IL 6 and TNF?. These results indicate that there is dysfunction of cellular immune of PBMCs in PV patients. The increase of serum levels of IL 6 and TNF? may be related to the increased activity of PBMCs, and there may be a synergic action between IL 6 and TNF? in the pathogenesis of psoriasis.

Objective To evaluate the effects of age factors on the pharmacokinetics of ropivacaine during combined lumbar plexus-sciatic nerve block in patients.Methods Twenty patients of both sexes,aged ≥ 18 yr,weighing 50-75 kg,of American Society of Anesthesiology physical status Ⅰ or Ⅱ,scheduled for elective lower extremity surgery,were divided into 2 groups (n=10 each) according to age:young and middle-aged group (18-59 yr) and elderly group (≥ 60 yr).Combined lumbar plexus-sciatic never block was performed using an ultrasonic instrument and a nerve stimulator.Lumbar plexus block was performed with 0.5％ ropivacaine 30 ml.Sciatic never block was performed with 2％ lidocaine 10 ml plus 0.75％ ropivacaine 10 ml.Before administration and at 5,10,15,20,30,45,60,120,180 and 360 min after administration,blood samples were collected from the radial artery for determination of the blood concentration of ropivacaine by high-performance liquid chromatography.The area under the concentrationtime curve,maximum concentration (Cmax),time to C terminal elimination half-life and clearance were calculated.Results Compared with young and middle-aged group,the blood concentration of ropivacaine was significantly decreased at 5-45 min after administration,the Cmax was significantly decreased,terminal elimination half-life was significantly prolonged (P＜0.05),and no significant change was found in area under the concentration-time curve,the time to C and clearance in elderly group (P＞ 0.05).Conclusion Age factors can affect the pharmacokinetics of ropivacaine during combined lumbar plexus-sciatic nerve block,and both absorption and metabolism of ropivacaine are slower in elderly patients than in young and middle-aged patients.

ObjectiveTo assess the efficacy of adjuvant therapy with fenofibrate for primary biliary cirrhosis (PBC). MethodsCNKI, Wanfang Data, China Biology Medicine, PubMed, Embase, and Cochrane library were searched for the pertinent literature of randomized controlled trials (RCTs) of adjuvant therapy with fenofibrate for PBC published up to December 31, 2014. Data extraction and quality assessment were carried out, and the data were statistically analyzed by Stata10.1 software. Respectively, for heterogeneity test. The fixed effect model is chosen for homogeneity, and the random effect model is chosen for heterogeneity. ResultsSix RCTs met the inclusion criteria. Treatment with fenofibrate was associated with significantly reduced levels of gamma-glutamyl transpeptidase, alanine aminotransferase, and alkaline phosphatase in PBC patients (SMD=-1.595, -0.447, and -2.125, respectively, all P＜0.05). There were no significant changes in the levels of aspartate aminotransferase and total bilirubin after adjuvant therapy with fenofibrate (both P＞0.05). Also, fenofibrate led to no significant improvement in immunoglobulin M (P＞0.05). ConclusionFenofibrate, which improves the indicators of liver function but leads to no changes in immunological indicators, appears to be an effective adjuvant therapy in PBC patients. There is a critical need for more large-scale, multi-center, high-quality RCTs to determine its effect on liver disease-related morbidity and mortality.

Objective To observe CT features of primary yolk sac tumor (YST).Methods Clinical data and CT findings of 31 patients with primary YST proved by pathology were analyzed retrospectively.Plain CT was performed in 31 patients,while contrast enhanced CT scanning was performed in 23 patients.Results The lesions in 19 patients located in the gonads,including ovaries (n=11) and testes (n=8).Other lesions in 12 patients located out of gonads,including sacrococcygeal region (n =7),anterior mediastinum (n =3) and vagina (n=2).The tumors were oval shaped in 20 patients,while irregular shaped in other 11 patients.Well-defined boundary was found in 20 patients,whereas ill-defined boundary was found in 11 patients.Fat and calcification were found in 2 patients with teratomas.Moderate to marked enhancement of the solid part of tumors were observed in 23 patients,loofahs enhancement were observed in 17 patients,the blood vessels were found in 18 patients,while delayed enhancement of coated edge was found in 21 patients.The rupture of tumor capsule was found in 4 patients.Conclusion CT manifestations of YST have certain characteristics,which can provide imaging diagnostic evidences.

Lung cancer is considered as the leading cause of cancer-related mortality worldwide. Non-small cell lung cancer (NSCLC) accounts for about 85% of primary lung cancer. Owing to the improved utilization of medical technological level and the popularization of health examinations, the detection rate of early-stage NSCLC is gradually increasing. The main treatment modalities for early-stage NSCLC are surgical resection and adjuvant chemotherapy. Platinum-based chemotherapy is recommended as the standard postoperative adjuvant treatment for patients with completely resected stageⅡ-ⅢA NSCLC. However, adjuvant therapy remains a controversial option in stageⅠB NSCLC. This review focuses on postoperative adjuvant therapy such as adjuvant chemotherapy, targeted therapy, and immunotherapy for completely resected stageⅠB NSCLC. Moreover, the biomarkers and prognostic factors of high-risk patients are discussed.

Objective To explore the imaging features of MRI in the patients with gouty arthritis of knee and the diagnostic value.Methods The MR imaging and clinical date of 31 knees in 22 patients with gouty arthri-tis of the knee confirmed by pathology were retrospectively analyzed. Results All of the 31 knees showed synovial thickness,21 knees showed hydrarthrosis.29 knees had the gouty tophus which located at the patella bursa,patel-lar fat pad,joint cavity,intercondylar fossa,femoral condyle or surrounding,patella or before,and tibial platform or before.Tophi showed hypointensity on T1WI,showed isointensity,slight hyperintensity,and hypo-/slight hyper-intensity on T2WI.Conclusion MRI is very effective image examination method of diagnosis the gout arthritis of the knee,MRI can clearly show synovial thickeness,hydrarthrosis and soft tissue swelling,sensitively observe the bone erosion and the gouty tophi.

Objective:To evaluate the relationship between mitochondrial calcium uniporter protein (MCU)-mediated mitochondrial dynamics and intestinal ischemia-reperfusion (I/R) injury in mice.Methods:Twenty-four wild-type adult male C57BL/6J mice, aged 6-8 weeks, weighing 18-20 g, were divided into 4 groups ( n=6 each) using a random number table method: sham operation group (S group), intestinal I/R group (IIR group), sham operation+ MCU inhibitor Ru360 group (S+ Ru360 group) and intestinal I/R + Ru360 group (IIR+ Ru360 group). The mouse model of intestinal I/R injury was prepared by clamping the root of the superior mesenteric artery for 45 min followed by 2 h of reperfusion in anesthetized animals. Small intestinal tissues were obtained at the end of reperfusion for examination of the intestinal mucosal injury which was scored according to Chiu and for determination of the content of malondialdehyde (MDA) (TBA method), activity of superoxide dismutase (SOD) (WST-8 method), content of lactic dehydrogenase (LDH) (colorimetric method), and expression of MCU, dynamin-related protein 1 (Drp1), recombinant human mitochondrial fission 1 protein (Fis1), mitofusin-1 (Mfn1) and Mfn2 (by Western blot). Results:Compared with S and S+ Ru360 groups, the Chiu′s score and contents of MDA and LDH were significantly increased, the activity of SOD was decreased, the expression of MCU, Drp1 and Fis1 was up-regulated, and the expression of Mfn1 and Mfn2 was down-regulated in IIR and IIR+ Ru360 groups ( P<0.05). Compared with IIR group, the Chiu′s score and contents of MDA and LDH were significantly decreased, the activity of SOD was increased, the expression of MCU, Drp1 and Fis1 was down-regulated, and the expression of Mfn1 and Mfn2 was up-regulated in IIR+ Ru360 group ( P<0.05). Conclusions:The mechanism underlying intestinal I/R injury may be related to MCU-induced promotion of mitochondrial fission, reduction of mitochondrial fusion and mediation of imbalance in mitochondrial dynamics in mice.

Objective To investigate the characteristics of multimodal MRI of breast cancer with different molecular subtypes and the correlation between each molecular type and MRI findings. Methods Multimodality MRI date of 87 patients with breast cancer confirmed by pathology were retrospectively analyzed. According to the expression of estrogen receptors(ER),progesterone receptors(PR)and human epidermal growth factor receptor-2 (HER-2),the tumors were classified into triple-negative breast cancer,HER-2 overexpression,Luminal A and Lu-minal B subtypes. The MRI features of breast cancers of different molecular subtypes were compared. Results Among the 87 cases of breast cancer,luminal type A accounted for 29.9%(26/87),luminal type B accounted for 36.8%(32/87),HER-2 type accounted for 19.5%(17/87),and triple-negative type accounted for 13.8%(12/87). The average ADC value is 0.97 × 10-3 mm2/s;those whose irregular or edge burr like mass were more often Lu-minal type MRI,triple-negative breast cancer showed the edge smooth,clear boundary,annular enhancement, more easily showed enhanced mode of TIC type Ⅲ. The mean ADC values of type Luminal and HER-2 over-expres-sion were lower than the mean ADC values of the triple-negative type. Conclusion The different molecular sub-types of breast cancer MRI morphologic and hemodynamic characteristics and the value of ADC has certain charac-teristics. The MRI features of breast cancer can be predicted to analyze the molecular typing,providing a reference for clinical treatment.

OBJECTIVE： To optimize and improve the quality standard for Citrus reticulata formula granules. METHODS： Totally 13 batches of C. Reticulata formula granules from 4 different manufacturers were used as trial samples， and qualitative identification of hesperidin and nobiletin in the samples were carried out by TLC according to the method of 2015 edition of Chinese Pharmacopoeia （part Ⅳ）. The quantitative analysis of naringin， hesperidin， hesperetin， nobiletin and tangeretin in C. reticulatae formula granules were conducted by UPLC[The determination was performed on Waters Acquity UPLC BEH C18 column with mobile phase consisted of acetonitrile-0.2％ phosphoric acid aqueous solution （gradient elution）. The detection wavelength was set at 283 nm， and sample size was 3 μL]. RESULTS： The results of TLC showed that in the chromatograms of samples， same color spots were shown in the corresponding positions of the chromatogram of reference substance. The results of UPLC showed， that the linear range of naringin， hesperidin， hesperetin， nobiletin and tangeretin were 0.64-6.44， 15.78-157.80， 0.17-1.66， 2.08-20.85 and 2.04-20.43 μg/mL， respectively （all r≥0.999 2）； the limits of detection were 0.03， 0.33， 0.10， 0.20 and 0.06       μg/mL； the limits of quantitation were 0.07， 1.34， 0.20， 0.60 and 0.22 μg/mL. The average recoveries were 99.4％， 99.6％， 99.7％， 99.7％ and 99.7％ （n＝9）； RSDs of precision （n＝6）， stability （n＝7） and reproducibility （n＝6） tests were all≤2.03％； naringin was detected in only 3 batches of samples from one manufacturer （the content ranged from 0.067 3 to 0.069.6    mg/g）， while the other 4 components were detected in 13 batches of samples （the contents of them ranged 0.646 5-1.728 0，   0.102 6-0.290 5， 0.023 1-0.689 8， 0.018 2-0.270 7 mg/g）. CONCLUSIONS： In this study， the quality standard of C. reticulata formula granules was improved by qualitative and quantitative methods， and the contents of hesperidin， hesperetin， nobiletin and tangeretin were not less than 0.60， 0.10， 0.02 and 0.01 mg/g， respectively.