OBJECTIVE:To investigate the healing-promoting effect of total tanshinone on sore and ulcer of model rats. METH-ODS:Staphylococcus aureus levitation liquid was made to reproduce model rats with sore and ulcer,sc. 50 rats were randomly di-vided into normal group(equal volume of CMC-Na solution),model group(equal volume of CMC-Na solution),ampicillin group (positive drug 20 mg/kg)and total tanshinone high and low dose groups(200 and 100 mg/kg),ig,once a day for continuous 12 d. The general conditions were observed. The content of lysozyme(LZM)and immunoglobulins G(IgG)in serum were tested af-ter 12 d;the content of LZM and IgG in purulent secretion of model rats were respectively tested after dosing of 4 d,8 d and 12 d. The integral of wound deterioration were evaluated. RESULTS:Compared with normal control group,the index was worse in model group. Compared with model group,the appetite and activity amount of total tanshinone in high dose group (200 and 100 mg/kg)were increased,with no secretion on the wound and a clean escharosis;content of LZM and IgG in serum of rats in in to-tal tanshinone high and low dose group were increased after 12 d;also,the content of LZM and IgG in purulent secretion of rats in total tanshinone high and low dose groups were increased after dosing of 4 d,8 d,and 12 d;the integral of wound deterioration in total tanshinone high dose group were decreased after dosing of 8 d and 12 d,with significant difference (P<0.01 or P<0.05). CONCLUSIONS:Total tanshinone can promote the wound healing on sore and ulcer of model rats by a mechanism that is related to the content of LZM and IgG in serum and purulent secretion.

Objective To explore the optimal storage methods to maintain serum clozapine (CZP) and N-desmethylclozapine (N-CZP) concentration in a long-term stablility. Methods Ten fresh clinical blood samples were collected, and each sample's serum was separated at volume of 0.5 ml into five pieces of 10 ml conic glass cen-trifuge tubes with cocks; then CZP and N-CZP were beth assayed with HPLC in samples collected on sampling day, stored at 4 ℃ and -20 ℃ for 12 weeks and 24 weeks,respectively. Results There was no significant difference in CZP among samples stored at 4 ℃ for 12 weeks[(525.1±124.3) μg/L] ,at -20 ℃ for 12 weeks[ (535.5± 126.7) and 24 weeks[ (532.5±126.7) μg/L] ,as well as collected on sampling day[(542.7±135.0) μg/L] (P>0.05); There was also no significant difference in N-CZP among samples stored at -20 ℃ for 12 weeks [(226.2±50. 7) μg/L] and 24 weeks[ (224.9±44.8) μg/L] and collected on sampling day[(236.9± 66.6) μL] (P>0.05). Conclusion CZP and N-CZP concentration would be maintained stable within 24 weeks under the refrigerated storage temperature of -20 ℃ at a fixed volume.

Objective To explore the dynamic changes of serum S100B and glial fibrillary acidic protein (GFAP) levels and their clinical significance in patients with delayed encephalopathy after acute carbon monoxide poisoning (DEACMP).Methods By means of enzyme-linked immunno-sorbent assay (ELISA),the serum S100B and GFAP levels from 33 DEACMP patients were assayed,and the condition changes were analyzed with three types of scale:the activity of daily living scale ( ADL),information-memory-concentration test (IMCT) and Hasegawa' s dementia scale(HDS).The comparison with 32 patients of acute carbon monoxide poisoning without DEACMP was also conducted.Results (1) The serum S100B( (0.60 ±0.21)ng/ml) and GFAP( (226.58 ±90.05 )ng/ml) in DEACMP group at acute stage were significantly higher than those in acute-CO-poisoning group ( (0.50 ± 0.20) ng/ml,( 183.04 ± 73.01 ) ng/ml) and those in DEACMP group at convalescent stage ( (0.51 ±0.16) ng/ml,(183.25 ±81.76)ng/ml) (all P values ＜0.05).(2)In DEACMP group,the serum S100B and GFAP at acute and convalescent stages were significantly correlated (at acute stage:r=0.466,P=0.006; at convalescent stage:r=0.365,P=0.037 ).(3)The S100B and GFAP in ineffective DEACMP patients at acute stage were significantly higher than those in the other groups ( all P values ＜ 0.05 ).(4) In DEACMP group,the ADL,HDS and IMCT scores( (45.21 ± 9.69),(8.26 ± 6.31 ),(9.91 ± 7.52) ) at acute stage were significantly different from those at convalescent stages( (33.67 ± 13.62),( 15.91 ± 10.83),( 19.06 ± 10.37 ) ) ( all P values ＜0.01 ).Conclusion There is secondary brain insult (SBI) in DEACMP; glial activation may play an important role.The S100B and GFAP levels may be associated with the prognosis of DEACMP.

Objective To discuss the treatment experience of adrenocorticotropic hormone independent macronodular adrenal hyperplasia (AIMAH).Methods The clinical data of 24 cases of AIMAH from August 1972 to December 2016 were retrospectively analyzed.The cases included 10 males and 14 females with a mean age of 43 (range 26 to 59) years.16 patients presented with typical Cushing syndrome (CS) and 8 patients had weight gain, hypertension or diabetes mellitus without any sign of CS.The circadian rhythm of serum cortisol was abnormal.Low and high dose dexamethasone suppression tests failed to suppress cortisol secretion.The preoperative CT scan showed bilateral enlargement of the adrenal glands with multiple macmnodules.14 patients underwent open surgery, including 5 cases of unilateral adrenalectomy, 6 cases of adrenalectomy combined with contralateral subtotal adrenalectomy and 3 cases of bilateral adrenalectomy simuhaneously.6 patients underwent conventional laparoscopic adrenalectomy,including 2 cases of unilateral adrenalectomy, 2 cases of adrenalectomy combined with contralateral subtotal adrenalectomy and 2 cases of bilateral adrenalectomy.4 patients underwent robot-assisted laparoscopic bilateral adrenalectomy.Results The postoperative pathological examination showed that all patients had bilateral adrenal macronodular or adenomatoid hyperplasia.During the mean follow-up of 68 months (range 3 to 192 months), the clinical symptoms of CS disappeared after surgery in all cases.7 patients who received unilateral adrenalectomy had urinary free cortisol and serum cortisol within normal ranges and no further enlargement of the contralateral gland was noticed.Among the 3 patients who received bilateral adrenalectomy simultaneously, 1 case died of adrenal crisis on the seventh day post-operation.The remaining 2 cases presented with adrenal insufficiency but returned to normal after glucocorticoid replacement therapy.Nelson's syndrome was not observed in other patients.Conclusions The use of bilateral adrenalectomy to treat AIMAH may involve risk.Unilateral adrenalectomy is recommended for an alternative treatment for AIMAH.Controlateral adrenalectomy with lifelong corticosteroid replacement or contralateral subtotal adrenalectomy may be performed if the symptoms have not improved or recurred after unilateral adrenalectomy.

Objective To evaluate the feasibility and advantages of robot-assisted laparoscopic radical prostatectomy (RALRP) in treating high-risk prostate cancer.Methods From Mar.2010 to Dec.2014,69 men with high-risk prostate cancer (clinical stage ≥ T3a,serum PSA ≥ 20 μg/L or biopsy Gleason score ≥8) underwent surgical treatment at our center.RALRP was performed in 44 cases,with a mean age of (66.7 ± 8.6) yrs (range:50 ～ 82) and a mean baseline PSA of (23.1 ± 11.2) μg/L (range:3.6-48.8).Transperitoneal approach was adopted in all cases.Twenty-five patients were treated with ORP.The mean age was (64.3 ± 5.9) yrs (range:52-75) and baseline PSA was (21.7 ± 10.2) μg/L (range:5.7-41.3).Baseline clinical features,including age,initial PSA,biopsy Gleason score and clinical staging,were comparable between two cohorts.Surgical outcomes after RALRP were analyzed and compared between groups.Results All RALRP procedures were successfully performed with da Vinci robotic system and there was no open conversion.Mean operation duration were similarly (158 ± 47)min for RALRP group and (152± 42)min for ORP group,respectively.The mean estimated blood loss and postoperative length of hospital stay in RALRP group were (328 ± 254) ml and (8.4 ± 3.1) days,both of which were significant lower than those in ORP group,(674 ± 302) ml and (14.4 ± 3.7) days.Two cases of urine leak and two of lymphatic leak occurred after RALRP,and a statistically insignificantly higher complication rate was observed for the ORP group,in which four of urine leak and three of lymphatic leak happened.The positive surgical margin rates of two groups were 20.5％ and 24％,respectively.After the mean follow-up of 25 (RALRP) and 27 months (ORP),continence rate was significantly higher in the RARLP group (93.2％ vs.72.0％).PSA failure was observed in seven RALRP cases (15.9％) and four ORP cases (16.0％).Conclusion Compared with traditional ORP,RALRP shows significant advantages,including less blood loss,fewer complications,shorter length of stay,better postoperative continence and equivalent oncologic outcome when dealing with high-risk prostate cancer cases.Robot-assisted surgery is a safe and efficacious surgical modality in this setting.

ObjectiveTo study the synergistic effect of p38MAPK and ERK1/2 in bone marrow mesenchymal stem cells (BMSCs), and to explore their influence on osteogenic differentiation in BMSCs cultures. MethodsMouse BMSCs were cultured in phenol red-free α-MEM containing osteogenic supplements (OS) for inducing osteogenic differentiation. The temporal sequence of osteogenic differentiation in BMSCs cultures was assayed by measuring alkaline phosphatase activity (ALP) and calcium deposition gene expression. The activation of p38MAPK and ERK1/2 was detected by western blotting using phospho-specific MAP kinase antibody. BMSCs were treated with the inhibitor of p38MAPK pathway(SB203580) or ERK1/2 pathway (PD98059), and osteogenic differentiation was measured. BMSCs were treated with SB203580 or sodium arsenite(ARS), a strong activator of p38MAPK, and the phosphorylation of ERK 1/2 was measured. BMSCs were treated with PP2A inhibitor, Okadaic acid(OA), the phosphorylation of ERK1/2 and osteogenic differentiation were measured. lmmunoprecipitation was used to test the binding interaction between PP2A and ERK1/2, and the effect of SB203580 on the interaction. ResultsTreatment of BMSCs with osteogenic supplements resulted in activation of p38MAPK and ERK1/2 that coincided with osteogenic differentiation. Inhibition of p38MAPK activation by SB203580, blocked the osteogenic differentiation, whereas inhibition of ERK1/2 activation by PD98059, enhanced the osteogenic differentiation in a dose-dependent manner.SB203580 treatment resulted in increased ERK1/2 phosphorylation. By contrast, ARS treatment resulted in decreased ERK1/2 phosphorylation. Inhibition of PP2A by OA resulted in increased ERK1/2 phosphorylation. OS-induced osteogenic differentiation was also attenuated by PP2A inhibition. Immunoprecipitation confirmed the association of PP2A with ERK1/2 in BMSCs cultures, which was decreased by SB203580 treatment. ConclusionThe present study demonstrates a synergistic effect between p38MAPK and ERK1/2 signaling pathways via PP2A in BMSCs cultures, which may regulate the osteogenic differentiation of BMSCs.

Objective:To explore the clinicopathological characteristics and prognostic factors of bladder squamous cell carcinoma (SqCC)and bladder adenocarcinoma.Methods:A retrospective analysis of the clinical data of 107 patients with nonurothelial carcinoma of the bladder admitted to the First Affiliated Hospital of Zhengzhou University from October 2011 to January 2019 was performed. Among the 107 patients, 78 were males and 29 were females(ratio 2.69∶1), and the median age of onset was 62.0 years. According to histological types, patients were divided into SqCC group, urachal adenocarcinoma group and non-urachal adenocarcinoma group. There were 55 cases in the SqCC group, including 40 males and 15 females. Their mean age was 69.0(58.0, 75.0) years. 14 cases had the history of smoking. The clinic manifestation included hematuria in 35 cases, bladder irritation in 13 cases, dysuria in 2 cases and pain in 5 cases .Tumors located at the anterior and posterior walls in 18 cases, at the lateral wall in 27 cases, at the triangular area in 8 cases and at the apical wall in 2 cases. The average diameter of tumor was 4.5(3.0, 6.0) cm. 37 cases suffered with single tumor and 18 cases suffered with multiple tumors. The surgical method was radical cystectomy in 38 cases, partial cystectomy in 4 cases, TURBT in 9 cases, interventional surgery in 2 cases, and no operation in 2 cases. There were 20 cases in the urachal adenocarcinoma group, including 14 males and 6 females; age 53.5(43.5, 57.8) years; 6 cases with a history of smoking. The clinic manifestation included hematuria in 16 cases, bladder irritation in 1 case, pain in 2 cases and asymptomatic in 1 case. Tumors located at anterior and posterior walls in 4 cases and at apical wall in 16. The average diameter of tumor was 3.0(2.0, 4.8) cm. Single tumor was present in 18 cases, multiple tumors were present in 2 cases. The surgical method was partial cystectomy in 16 cases, radical cystectomy in 1 case, TURBT in 1 case and no operation in 2 cases. There were 32 cases in the non-urachal adenocarcinoma group, including 24 males and 8 females. Their mean age was 55.0(46.3, 70.8) years.11 cases had a history of smoking. The clinic manifestation included hematuria in 16 cases, bladder irritation in 3 cases, dysuria in one case and pain in 7 cases. Tumor located at anterior and posterior walls in 17 cases, at lateral wall in 7 cases, at triangular area in 5 cases and at apical wall in 3 cases. The average diameter of tumor was 3.6(2.0, 4.5) cm. 23 cases suffered with single tumor, 9 cases suffered with multiple tumors.The surgical method was radical cystectomy in 11 cases, partial cystectomy in 9 cases, TURBT in 9 cases , and no operation in 3 cases. The preoperative data of the three groups of tissue types were compared, the differences of age of onset, tumor diameter, tumor location, reason for treatment, operation method ( P<0.05)among the 3 groups were statistically significant. The clinicopathological characteristics and prognosis of the 3 groups of tissue types were compared, and the Cox proportional regression risk model was used to analyze the clinical factors affecting the prognosis. Results:91 patients were followed up, the overall follow-up rate was 85.1%, the median follow-up time was 26(7, 48) months. The 3-year and 5-year overall survival rates were 54.1% and 42.2%, respectively. In the SqCC group, 11 cases received chemotherapy; 3 cases received postoperative radiotherapy; 12 cases received postoperative perfusion.10 cases had recurrence; 17 cases had lymph node metastasis; 19 cases had distant metastasis; 5 cases were pT x in pT stage, 36 cases were pT 1-pT 2, 14 cases were pT 3-pT 4. 19 cases had unknown tumor differentiation, 4 cases had well differentiated, 24 cases had moderately differentiated and 8 cases had poorly differentiated. In the urachal adenocarcinoma group, 7 cases received chemotherapy, 3 cases had recurrence, 2 cases had lymph node metastasis, 2 cases had distant metastasis; 1 case was pT x in pT stage, 16 cases were pT 1-pT 2, 3 cases were pT 3-pT 4. 9 cases had unknown tumor differentiation, 3 cases had well differentiated, and 5 cases had moderately differentiated, 3 cases had poorly differentiated. In the urachal adenocarcinoma group, 3 cases received chemotherapy, 1 case received postradiotherapy, 11 cases received postoperative perfusion; 10 cases had recurrence. 5 cases had lymph node metastasis, 4 cases had distant metastasis, 6 cases were pT x, 21 cases were pT 1-pT 2 and 5 cases were pT 3-pT 4. 14 cases had unknown tumor differentiation, 8 cases had moderately differentiated and 10 cases had poorly differentiated.The postoperative general data of the three groups of tissue types were compared. There was statistically significant difference between whether there was postoperative perfusion and whether there was distant metastasis (all P<0.05). The univariate analysis results showed gender, age, surgical method, lymph node metastasis, distant metastasis, pT staging, tumor differentiation and histological type were risk factors that affect the prognosis(all P<0.05). Cox multivariate analysis showed that women ( HR=2.604, P=0.032) and distant metastases ( HR=2.571, P=0.026) were independent risk factors affecting the prognosis of patients. Conclusions:SqCC and adenocarcinoma are clinically rare and have poor prognosis. They often present with hematuria. Surgical treatment is the first choice. Radical cystectomy is the first choice for SqCC and non-urachal adenocarcinoma, and extended partial cystectomy is the first choice for urachal adenocarcinoma. Female and distant metastasis are independent risk factors affecting the prognosis of patients.

Objective To summarize our experience in robotic-assisted laparoscopic surgery for adrenal diseases Methods The clinical data of 243 patients with adrenal tumor treated by robotic-assisted laparoscopic surgery from March 2010 to February 2017 were retrospectively reviewed.There were 99 men and 144 women.The mean age was 51.6 years (range, 19-84).Tumors located at left adrenal in 140 cases, right in 97 cases,and both sides in 6 cases.The average diameter was 3.32 cm (range, 0.8-12 cm).However, there were 41 cases whose tumor diameter were greater than 5 cm.Results There were 2 cases of conversion during operation, 1 case converted to open surgery and the other to the traditional laparoscope surgery.The mean operative time was 35 min (range, 20-130 min).Estimated blood loss was 80 ml (range,20-1 200 ml).Blood transfusion was needed in 6 cases.The mean postoperative hospital stay was 5d (range, 3-20 d).The pathological diagnosis included 37 cases of pheochromocytoma, 149 cases of cortical adenoma, 3 cases of cortical carcinoma, 5 cases of metastatic tumor, 9 cases of adrenal myelolipoma, 3 cases of adrenal cyst, 2 cases of bronchogenic cyst, 25 cases of adrenal nodular hyperplasia,2 cases of angiomyolipomas, 1 case of mature teratoma, 1 case of diffuse large B-Cell lymphoma, 1 case of angioma, and 4 cases of neurofibromatosis.Conclusions Robotic-assisted laparoscopic adrenalectomy was safe and effective.Robotic-assisted laparoscopic surgery has the advantages over laparoscopic surgery in treatment of complicated adrenal tumor, such as large adrenal tumors, pheochromocytoma, bilateral adrenal diseases, overweight and obese patients with adrenal diseases.

Objective: To analyze a family with recurrent fetal copy number variations (microdeletion and microduplication, respectively) of 1p31.1 using single nucleotide polymorphism-based array (SNP-array) and G banding chromosomal karyotyping. Methods: Amniocentesis and chorionic villus sampling were performed for a woman during the two pregnancies. Whole genome SNP-array was used to detect genomic imbalance of the fetus. The couple was also subjected to G-banding chromosomal analysis and SNP-array analysis. Results: SNP-array showed a 1p31.1 (70 164 686-83 474 843)×1 and a 1p31.1 (70 164 686-83 479 747) × 3 in the fetuses during the two pregnancies, respectively. SNP array results of the couple appeared to be normal. The mother of the fetuses had a 46, XX, inv(1)(p31.1p32.1) karyotype. Conclusion The paracentric inversion in chromosome 1 in the gravida probably underlies the recurrent 1p31.1 copy number variations in the fetuses. SNP-array combined with G banding chromosomal analysis are suitable for prenatal diagnosis for recurrent microdeletion and microduplication in the same chromosomal region, and can provide detailed information for genetic counseling.

The contents of chlorogenic acid, 3,5-O-caffeoylquinic acid, galuteolin and quercitrin in Sanvitalia procumbens and Chrysanthemum morifolium cv. 'Hangju' and 'Gongju' were determined by RP-HPLC. The main active ingredient of S. procumbens was similar to C. morifolium cv. 'Hangju' and 'Gongju'. The content varied significantly. The contents of chlorogenic acid, quercitrin and galuteolin in S. procumbens were 7.46, 46.58, 26.01 mg x g(-1), respectively, and they were the highest among the samples. The content of 3,5-O-caffeoylquinic acid in C. morifolium cv. 'Hangju' was 14.70 mg x g(-1), it was the highest among the samples. The data of the study provide a basis for further research and development of S. procumbens.
Asteraceae ; chemistry ; Chlorogenic Acid ; analogs & derivatives ; analysis ; Chromatography, High Pressure Liquid ; Chrysanthemum ; chemistry ; Drugs, Chinese Herbal ; analysis ; Quinic Acid ; analogs & derivatives ; analysis