Objective To investigate the value of ADC histogram analysis in the assessment of response to neoadjuvant chemotherapy (NACT) in patients with in locally advanced breast cancer (LABC). Methods Thirty?five female patients with invasive ductal carcinoma proved by pathology before NACT and treated with operation after NACT were retrospectively analyzed. All patients were received MR examination (including non?enhanced MRI, enhanced?MRI, and DWI) breast before NACT. After neoadjuvant chemotherapy, 19 of 35 patients were categorized as responders and 16 were categorized as non?responders according response evaluation criteria in solid tumors criteria. Per?patient weighted ADC histograms were generated. Mean ADC, mode ADC, maximum ADC, minimum ADC, median ADC, skewness, and kurtosis were analyzed by using t test between responders and non responders groups. ROC curves were constructed to determine the optimum threshold for each histogram parameter to differentiate non?responders and responders in breast cancers. The optimal threshold values, determined by maximal Youden index were selected when significant differences existed in two groups. Results Mean, minimum, skewness, and kurtosis of ADC between responders and non?responders group were(0.955 ± 0.135)× 10?3mm2/s,(0.535 ± 0.115)×10?3mm2/s,0.85±0.61, 2.93±0.17,and(1.103±0.233)×10?3 mm2/s,(0.650±0.104)×10?3mm2/s,-0.42± 0.17, 3.11 ± 0.25,respectively. Significant differences were found mean ADC, minimum ADC, skewness, and kurtosis (t=2.345, 3.096, 8.051 and 2.524,P<0.05), and there was no differences in mode, median, maximum between responders and non?responders(P>0.05).We set the optimal threshold criteria of mean ADC (0.956×10?3mm2/s), minimum ADC (0.580×10?3mm2/s), skewness (0.890), sensitivity, specificity of three parameters for predicting responders in LABC were 73.7%,62.5%, 78.9%,68.8%, and 63.2%,75.0%, respectively, and the areas under ROC curve of mean ADC, minimum ADC, skewness was 0.678, 0.770, and 0.890, respectively. Kurtosis of responders and non?responders did not get cutoff value for much more overlap. Conclusion ADC histogram analysis is valuable in predicting LABC in patients with NACT effect, the minimum and skewness of ADC is highest sensitivity, specificity, respectively.

This study is to establish the HPLC fingerprint and determine eight components of Callicarpa nudiflora, and provide a scientific basis for the identification and quality control. The Waters sunfire C18 column (4.6 mm x 250 mm, 5 µm) was used and the detection wavelength was 330 nm . The column temperature was 30 °C. The mobile phases were acetonitrile (A) and 0.1% formic acid (B) eluting in a gradient program at a flow rate of 1.0 mL · min(-1). The chromatographic fingerprint similarity evaluation system for tradition Chinese medicine(2012) was used for analysis. C. nudiflora from different samples were of high similarity in fingerprint and the separation of ten components was good. There was an obvious difference between other samples and C. nudiflora leaves. In quantitative analysis, the ten components showed good regression(R2 > 0 999 0) with linear ranges, and their recoveries were in the range of 96.0%-105.0%. The established qualitative and quantitative methods are highly specific, simple and accurate, which can be used for the identification and quality control of C. nudiflora.
Callicarpa ; chemistry ; Chromatography, High Pressure Liquid ; methods ; Drugs, Chinese Herbal ; analysis ; isolation & purification ; Plants, Medicinal ; chemistry

To investigate the metabolic rate and metabolites of 9-dehydro-17-dehydro-andrographolide, which is the main active ingredient in Xiyanping injection, by using the in vitro rat liver microsome incubation system. 9-dehydro-17-dehydro-andrographolide was incubated together with liver microsome mixed with NADPH. Its metabolic rate was studied by determining its residual concentrations with the UHPLC-MS/MS method; Its metabolites were identified by the UPLC-TOF-MS(E) method. The results showed that 9-dehydro-17-dehydro-andrographolide was metabolized faster than rat liver microsomes mixed with coenzymes, with t½ and CL of (19.7 ± 0.5) min and (35.1 ± 0.8) mL x min(-1) x g(-1) (protein), respectively. Based on the high resolution mass spectrum data and information from literatures, altogether nine metabolites of 9-dehydro-17-dehydro-andrographolide were identified in the incubation system, particularly hydroxylated and dehydrogenized products. The results of identification would provide a basis for screening out more active andrographolide derivatives.
Animals ; Chromatography, High Pressure Liquid ; Diterpenes ; chemistry ; metabolism ; Drugs, Chinese Herbal ; chemistry ; metabolism ; Microsomes, Liver ; chemistry ; metabolism ; Molecular Structure ; Rats ; Tandem Mass Spectrometry

Objective To investigate the maximum-tolerated dose (MTD) of cisplatin in docetaxel,cisplatin,and fluorouracil (TPF) induction chemotherapy followed by intensity-modulated radiotherapy (IMRT) and concomitant chemotherapy as well as the safety and short-term efficacy of TPF induction chemotherapy in the treatment of locally advanced nasopharyngeal carcinoma (NPC).Methods Thirtythree patients with locally advanced NPC were enrolled in this trial.The MTD of cisplatin was determined by dose escalation study,and the short-term efficacy and toxicities were evaluated.Results When the doses of docetaxel and fluorouracil were 60 mg/m2 d1 and 550 mg/m2 d1-5,respectively,the MTD of cisplatin was 65 mg/m2 d1.In this regimen (repeated every 3 weeks),grade 3-4 toxicities included neutropenia (67％),febrile neutropenia (9％),diarrhea (21％),and oral mucositis (6％).Except those who experienced dose-limited toxicity,other patients completed the whole treatment schedule.After TPF induction chemotherapy,the overall response rate was 97％,and the complete response rate was 21％.Conclusions In the endemic areas of NPC,induction chemotherapy with docetaxel (60 mg/m2 d1),cisplatin (65 mg/m2 d1),and fluorouracil (550 mg/m2 d1-5),which is repeated every 3 weeks,is proved safe and effective for Asian patients with locally advanced NPC.

Objective To investigate the association of duration of untreated psychosis(DUP) and the gray matter volumes in patients with first-episode schizophrenia.Methods 39 patients with first-episode schizophrenia were divided into two groups according to DUP:long-DUP group and short-DUP group.All the subjects underwent T1 weighted magnetic resonance imaging.After transformed with MRIcro software,all the images underwent standardization,segmentation,modulation and smoothing with Statistical Parametric Mapping 5 (SPM5) software.The gray matter volumes of the two groups underwent two-sample t-test with a Voxel-based morphometry (VBM)using SPM5 software.Results Long-DUP schizophrenic patients presented significantly reduced GM volume in the left thalamus(MNI:-6,-16,2;cluster=141 voxels)and the left temporal lobe(MNI:-46,-58,-6;cluster=69 Voxels),compared with short-DUP schizophrenic patients.Conclusion Delayed DUP may increase the loss of gray matter in schizophrenia.

Blepharospasm is a focal dystonia of the orbicularis oculi muscles, producing excessive eye closure. The etiology and pathogenesis is still unclear now. lt is usually appearing in adult period and predominant in females. The symptoms are typically triggered by stress, fatigue, intense light or individual factors. At advanced stages patients develop functional blindness. At present the main treatments include: botulinum toxin ( BTX ) , surgical procedures, systemic and ocular drugs and traditional Chinese medicine treatment. BTX administration has been an effective treatment. Surgical procedures have good effect but should be limited to the rare patients that do not respond to botulinum toxin treatment. A great variety of drugs have poor results. Chinese medicine has a certain therapeutic effect. Transcranial magnetic stimulation can improve symptoms. The epidemiology, anatomy, physiology, clinical manifestations, differential diagnosis, pathogenesis and treatment system were reviewed in this paper.

(1.Department of Anesthesiology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing 210002, Jiang-su, China;2.Department of Anesthesiology, General Hospital of Shenyang Military Region, PLA, Shenyang 110000, China)
le-blind, 60 patients scheduled for OPCABG were randomly divided into 4 groups: control group( group C) and 3 dexmedetomidine group(group D1、D2、D2).Patients in each group received saline or dexmedetomidine 0.2μg/kg, 0.4μg/kg, 0.6μg/kg respectively. Hemodynamic variables such as HR、MAP、CVP、MPAP、PCWP、SVRI and PVRI were recorded after entering into the operationroom ( T0 ) , before the anesthesia induction( T1 ) , at 5 minutes after tracheal intubation ( T2 ) , during the sternotomy( T3 ) , at the end of an-astomosis of left anterior descending(T4), at the end of anastomosis of right coronary artery or 1eft circum flex coronary artery(T5) and after operation ( T6 ) .Body tempreture and urine volume were recorded during the operation.Total quantity of analgesics consumption and heart adverse reaction( bradyarrhythmia, tachycardia, hypotension, hypertension etc) were also recorded. Results At T2 -T6 , there was a significant decline in HR, MAP, SVRI, PVRI and CI in group D2 and group D3 compared with group C (P<0.05).SVRI and PVRI in group C and group D2 significantly increased at T3 -T6 compared with those at at T0(P<0.05).At T2 and T6, HR and MAP in group group D2 signicantly increased compared with group D3([57 ±6]times/min vs [52 ±4] times/min, [72 ±7]mmHg vs [63 ±5]mmHg;[72 ±5]times/min vs [55 ±6]times/min, [68 ±5]mmHg vs [63 ±5]mmHg)].At T4 -T6, significant difference was found in CI, SVRI and PVRI between group D2and group D3(P<0.05).In comparison to group C, hypertension, tachycardia in-cidence, noradrenaline amount and isosorbide mononitrate amount declined significant in group D2and group D3(P<0.05);hypoten-sion and bradycardia incidence increased significantly while isosorbide mononitrate amount reduced significantly(P <0.05). Conclusion In OPCABG, dexmedetomidine infused at 0.4μg/(kg· h) after a loading dose of 0.5μg/(kg· 10 min) is useful in maintaining stable hemodynamics which contributes to oxygen balance and reduces myocardium injury in patients.

G (E165E) in exon 1 of KRT6A gene, were found in this patient. Conclusions A novel single nucleotide polymorphism of KRT16 gene which can result in the change of amino acid sequence is firstly reported and some known single nucleotide polymorphisms in KRT16 and KRT6A genes are also found in this study.

?AIM:To analyze the clinical features of Terrien marginal degeneration ( TMD) .?METHODS:Fifty-six patients(90 eyes) admitted in our hospital from January 2013 to January 2015 were selected as observation group.At the same period, 56 healthy (88 eyes) for corneal examination were as control group to analyze the clinical features of TMD. With immunohistochemistry and enzyme linked immunoassay method ( ELISA), the levels of HLA-DR, HLA-DQ and tumor necrosis factor-α( TNF-α) in blood samples of TMD patients were tested.?RESULTS:The transparent degree of the eye, lipid deposition in TMD patients with early, advanced, swelling and hole-wearing period were significantly different (χ2=10.85,χ2=65.32, P<0.05).Astigmatism in TMD patients with early and advanced, swelling and hole -wearing period were significantly different (P<0.05).The levels of HLA-DR, HLA-DQ and TNF-αin blood samples between the two groups were significantly different ( t=45.326, t=23.564, t=19.86, P<0.05).?CONCLUSION: Terrien's marginal degenerative is an inflammatory disease characterized by increased levels of TNF-α, HLA-DQ, and HLA-DR in peripheral blood, decreased corneal transparency, astigmatism and lipid deposition.This research provides experiment evidence for the mechanism of TMD.

Objective To evaluate the ergotropic effect of bone cement on pedicle screw fixation in treatment of osteopo-rotic thoracolumbar fracture.Methods Fifty-three patients with osteoporotic thoracolumbar fracture, admitted from Jun. 2013 to Dec. 2014, were included for treatment by augmentation of pedicle screw fixation with bone cement. All patients underwent pre-operative examination of bone mineral density with T-score ≤-2.5 and augmentation of pedicle screw fixation with injection of 1.5 ml bone cement in adjacent to fractured vertebra. All patients were treated with anti-osteoporosis therapy pre- and post-operation, ob-served and recorded with basic conditions and complications. At pre-operation, one-week post-operation and last follow-up, pain vi-sual analogue scale (VAS) and neurological function score (ASIA) of all patients were recorded, and the compression rats of anterior and posterior edge of fractured vertebra, and compression rats of spinal canal and Cobb angel of all patients were measured.Results All the 53 patients were successfully undergone operation in about 90-140 min with blood loss of about 150-350 ml. No spinal cord or nerve injury, dural tear and obvious leakage of bone cement and screw loosening occurred during operation. All patients were followed up for 12 to 36 months and the neurological function obviously recovered contrasted with pre-operation. X-ray and CT examination at last follow-up showed good fractures healing, good position and non-loosening of internal fixation device and non-leakage of bone cement. At one week post-operation and last follow-up, VAS, compression rats of anterior edge and posterior edge of fractured vertebra, compression rats of spinal canal and Cobb angel were significantly lower than those at pre-operation (P<0.05), but no significant differences existed on these parameters between 1 week post-operation and last follow-up (P>0.05).Conclusions Augmentation of pedicle screw fixation with bone cement can effectively strengthen the initial stability of pedicle screw in osteo-porosis, restore the height of fractured vertebra and reduce the compression of spinal canal, which will help the correction of spinal kyphosis and neurological function recovery. This method can well maintain long-term stability of internal fixation in osteoporosis and height of fractured vertebra, and significantly reduce the risks of long-term screw loosening and vertebral collapse.