We report a case of symptomatic bradycardia caused by consumption of a Chinese herbal medicine which was initially undisclosed to the attending emergency physician. The scientific name of the herb is Panax japonicus. Electrocardiogram revealed sinus bradycardia. Laboratory tests were normal except for the detection of a high serum digoxin level. Further interrogation of the patient eventually disclosed ingestion of the herb which, however, did not contain any digoxin. Other active ingredients in the herb include various types of ginsenoside. These are digoxin-like substances that had caused the observed false-positive detection of digoxin by fluorescence polarization immunoassay due to cross-reactivity. Our case-report provides an important insight about a blind-spot in the field of laboratory medicine (clinical pathology), namely, the false positive detection of digoxin due to crossreactivity in the immunoassay when we come across digoxin-like substances in clinical scenarios, which has barely received attention in the medical literature. It also conveys a clear educational message that with full understanding of the laboratory methodology and its mechanistic rationale there are actually some tricks-of-the-trade that allow us to optimize the specificity of the biochemical tests and the treatment of digoxin-like substances overdose.

OBJECTIVE:To evaluate the bioequivalence of the domestic pidotimod granules with the imported pidotimod syrup as control.METHODS:20 healthy male volunteers were treated with a single dose(800 mg)of pidotimod granules(test formulation)or pidotimod syrup(reference formulation)by a randomized crossover design,with plasma concentrations of pidotimod determined by HPLC and pharmacokinetic parameters of pidotimod computed,and the bioequivalence between two formulations was evaluated using DAS2.0 program.RESULTS:The pharmacokinetic parameters of the reference formation vs.the test formulation of pidotimod were expressed as follows:t1/2(2.70?0.80)h vs.(2.62?0.84)h;Cmax(4.04?0.59)?g?mL-1 vs.(3.87 ?0.66)?g?mL-1;tmax(2.28?0.44)h vs.(2.13 ?0.43)h;AUC0～14(22.11?4.20)mg?h?L-1 vs.(23.00?4.25)mg?h?L-1;AUC0～∞(22.85?4.42)mg?h?L-1 vs.(23.83?4.52)mg?h?L-1.The relative bioequivalence of the test formulation as against the control was(106.08?22.05)%.CONCLUSION:The pidotimod granules and pidotimod syrup are bioequivalent.

Objective To explore effect of quercetin on growth of cervical cancer,and its relationship to expression heparanase, and to investigate the possible mechanism of the inhibition effect of quercetin on cervical cancer .Methods HeLa cells were injected into nude mouse to establish the model of cervical cancer.30 nude mice with palpable tumors were randomly assigned to five groups:25,50,100 mg/kg quercetin groups,PI-88 positive group and blank control group.Transmission electron microscope was used to observe the ultrastructural changes of the vascular endothelial cells in each group.The expression of heparanase protein was detected by Western blot.Used blank control group for grey reference, relative grey value of each group was calculated for the further statistical analysis.Results 50,100 mg/kg quercetin groups and group of PI -88 made the volume of tumor tissues smaller.In 50 mg/kg quercetin group, swelling of VEC and mitochondria in tumor tissues was observed.In 100 mg/kg quercetin group, the disappearance of membraneaceous structures was found.In PI-88 positive group, the atresia of lumen, vacuole-shaped smooth endoplasmic reticulum and a dead cell were observed.50 and 100 mg/kg quercetin groups decreased the heparanase protein levels significantly(P<0.05).Furthermore, PI-88 positive group could decrease the heparanase protein levels significantly(P<0.05), compared to 50 and 100 mg/kg quercetin groups.However, the difference between the 25 mg/kg quercetin group and blank control group showed no statistical significance.Conclusion The growth of cervical cancer could be inhibited by 50, 100 mg/kg quercetin.Meanwhile, the ultrastructural changes of tumor endothelial cells could be induced by 50,100 mg/kg quercetin.These changes may relate with the decrease of heparanase protein level .

The contribution of particles to cardiovascular mortality and morbidity has been enlightened by epidemiologic and experimental studies. However, adverse biological effects of the particles with different sizes on cardiovascular cells have not been well recognized. In this study, sub-cultured human umbilical vein endothelial cells (HUVECs) were exposed to increasing concentrations of pure quartz particles (DQ) of three sizes (DQPM1, <1 μm; DQPM3-5, 3-5 μm; DQPM5, 5 μm) and carbon black particles of two sizes (CB0.1, <0.1 μm; CB1, <1 μm) for 24 h. Cytotoxicity was estimated by measuring the activity of lactate dehydrogenase (LDH) and cell viability. Nitric oxide (NO) generation and cytokines (TNF-α and IL-1β) releases were analyzed by using NO assay and enzyme-linked immunoabsorbent assay (ELISA), respectively. It was found that both particles induced adverse biological effects on HUVECs in a dose-dependent manner. The size of particle directly influenced the biological activity. For quartz, the smaller particles induced stronger cytotoxicity and higher levels of cytokine responses than those particles of big size. For carbon black particles, CB0.1 was more capable of inducing adverse responses on HUVECs than CB1 only at lower particle concentrations, in contrast to those at higher concentrations. Meanwhile, our data also revealed that quartz particles performed stronger cell damage and produced higher levels of TNF-α than carbon black particles, even if particles size was similar. In conclusion, particle size as well as particle composition should be both considered in assessing vascular endothelial cells injury and inflammation responses induced by particles.

Medical service system integration follows the logic of system innovation and development.Case studies of the UK,the USA and Australia found that medical delivery system integration is the product of a series of mixed factors.Health care financing and payment mechanism reform,physician team building,stair-cased movement to grassroots of healthcare service,shared clinical norms utilization as well as its gradual development constitute the general logic of such an integration.In the evolution process,the check and balance between the government and market,equity and efficiency have been affecting the integration process all the way.In light of these logics,China should speed up its transform of the integration concept,improve the integration elements,and strengthen the guidance of integration principles during its integration of the medical service integration.

Humans ; Occupational Health ; Refuse Disposal

Objective To isolate and purify melanin from yeast cells of Penicillium mameffei (PM) and to analyze its physicochemical features.Methods PM yeast cells were cultured in minimal medium containing levodopa (L-dopa) with continuous shaking at 37 ℃.Melanin was isolated from the yeast cells of PM by cell walllysing enzyme,denaturant,concentrated hot acid,and purified by sodium hydroxide and concentrated hydrochloric acid.The physicochemical properties of isolated melanin were assessed on the basis of combined chemical analysis and spectroscopic methods including ultraviolet-visible (UV-vis),Fourier transform infrared (FT-IR) and electronparamagnetic resonance (EPR).Results Similar to synthetic dopa-melanin,the isolated melanin from PM was alkali soluble,acid-resistant,insoluble in water and most organic solvents,precipitated at or below PH 3,and could be bleached by hydrogen peroxide.UV-vis spectrophotometric analysis showed that the PM-derived melanin had a typical absorption peak at 205 nm and the absorbance decreased with the increase of wavelength.FT-IR spectroscopy displayed two absorption peaks at about 3 μm and 6 μm,which was characteristic of classic melanin.EPR spectroscopy revealed that the isolated melanin contained stable free radicals.Conclusion Yeast cells of PM can use exogenous L-dopa to synthesize dopa-melanin.

Medical simulation training of US Armed Forces has formed a research , development and organization system, with the DOD as the chief investor and the CSC as the center .The main research fields are Combat Casualty Training Consortium Initiative , Medical Practice Initiative , Patient Focused Initiative and the Developer Tools Initiative . This article analyzes the organizational system ,operation mode ,development of its technology and areas of focus of medical simulation〗training in U.S.Armed Forces using intelligence investigation and intelligence analysis .We can learn from the successful experience of U.S.Armed Forces and combine it with our actual needs in our own development of medical simulation training.

Objective To analyze domestic and foreign papers on H5N1 virus research using literature metrology and visualized knowledge mapping.Methods Pajek, Bibexcel,and VoSviewer software were used based on Web of Knowledge platform.Results Study on H5N1 virus has been a research focus wide since 2005 and a series of institutions and investi-gators have appeared, with US being the leader in this area and followed by China.The most popular topics of studies on H5N1 included its virology, epidemiology, basic research, anti-virus drugs and vaccines.Conclusion Studies on H5N1 have received more attention, which suggests that more efforts have to be made in China in terms of communication and co-operation with key institutions and famous researchers so as to achieve more success in key areas.