In the present study, an ultra performance liquid chromatography coupled with time-of-flight mass spectrometry (UPLC/Q-TOFMS) based on chemical profiling approach to evaluate chemical constitution between mixed decoction and co-decoction of monkshood-pinellia combination of the eighteen incompatible medications (Shi Ba Fan) was proposed. Two different kinds of decoctions, namely monkshood-pinellia co-decoction: water extract of the two herbs together, and monkshood-pinellia mixed decoction: water extract of each individual herbs mixed together, were prepared. Batches of these two kinds of decoction samples were subjected to UPLC/Q-TOFMS analysis, the datasets were processed with MassLynx 4.1 to holistically compare the difference between these two kinds of decoction samples. The most changed components during decocting were analyzed. Using the proposed approach, global chemical difference was found between co-decoction and mixed decoction, mesaconitine, aconitine and hypaconitine were identified as the most changed components (changed most significantly) during decocting. Result shows significant difference between two kinds of decoction samples, and the significant differences are probably related to the incompatibility of monkshood and pinellia.

[Summary] A 61-year-old female patient was diagnosed as ACTH independent Cushing′ syndrome, right adrenal adenoma, right facial infection. The situation was well controlled with antibacterial agents, abscess incision drainage and ketoconazole therapy. The patient received partial adrenolectomy of her right adrenal gland 16 months later. This case indicated that anti-adrenal agents could be a reasonable choice when the Cushing′syndrome patients were acompanied with severe infection.

Objective To quantitatively investigate the effect of low-dose ionizing radiation on the frequencies of chromosome aberrations and micronucleus-containing cells of radiation workers.Methods Nine electronic databases were systematically searched on the basis of the published studies evaluating the effects of low-dose ionizing radiation on the frequencies of chromosome aberrations and micronucleuscontaining cells.Of the 195 studies searched,21 studies were identified with a total of 1 970 626 cells under studying.Cochrane' s Q and I2 statistics were used to evaluate heterogeneity among studies and pooling odds ratio (OR) with 95％ confidence intervals (CI) were calculated using random-effect models or fixed-effect models,and publication bias were also calculated.Meta-analysis was performed using Stata 12.0.Results The pooling OR of chromosome-type aberrations [OR =3.03 (2.59,3.56)],dicentric plus centric rings [OR =4.12 (2.99,5.67)],translocations [OR =2.73 (1.67,4.46)],micronucleuscontaining cells [OR =1.70 (1.40-2.06)] were higher for radiation workers when compared with control group.Conclusions The frequencies of chromosome aberrations and micronucleus cell of peripheral lymphocytes are significantly high in radiation workers who were occupationally exposed to low-dose ionizing radiation.It should be noted that the radiation protection of radiological workers be enhanced.

Objective To quantitatively analyze the effects of high background radiation area (HBRA) on the frequencies of translocation and unstable chromosome aberrations in human peripheral blood lymphocytes.Methods Based on the data from 9 published articles retrieved from 7 electronic databases,the Meta-analysis was performed to evaluate the effects of high natural background radiation (HNBR) on the frequencies of chromosome aberrations in the peripheral blood lymphocytes in 17 777 persons from HBRA and 10 386 from the control area (CA).Cochrane's Q and I2 statistics were used to evaluate heterogeneity among studies and pooling odds ratio (OR) with 95％ confidence intervals (95％ CI) were calculated using random-effect models.Publication bias was also calculated by funnel plot,Egger linear regression test and Begg rank correlation test.Results The pooling OR of translocation [OR(95％ CI) =1.57(1.10-2.24)] and unstable chromosome aberration [OR(95％ CI) =2.04(1.32-3.14)] of long-term exposed inhabitants living in HBRA were higher than control.The subgroup analysis showed that,fortranslocation,the OR (95％ CI) were 1.24 (1.09-1.42,I2 =0.00) for male,1.37 (1.17-1.60,I2 =0.00) for female,1.17 (1.05-1.30,I2 =69.50％) for adults,and 1.38 (1.25-1.51,I2 =0.00) for Chinese.For unstable chromosome aberration,the OR (95％ CI) were 3.78 (2.40-5.97,I2 =0.00) for female,2.60 (2.25-3.00,I2 =69.60％) for adults,1.03(0.85-1.24,I2 =0.00) for children,3.19 (2.46-4.13,I2 =21.60％) for Iranian,and 1.64 (1.33-2.02,I2 =0.00) for Chinese.HBRA,age and sex differences were the reasons of above heterogeneity.Conclusions To the inhabitants living in HBRA,the frequencies of translocation and unstable chromosome aberration of peripheral blood lymphocytes are higher than those in control area.More comprehensive analysis should be performed to assess the health risk in HBRA inhabitants,which may arise new stragety in radiation protection.

Objective To realize the clinical characteristics of fungemia in premature infants.Methods Clinical characteristics of fungemia in premature infants in the intensive care unit of a children''s hospital between January 2011 and December 2015 were analyzed retrospectively, general condition of premature infants, laboratory-related indicators, and antimicrobial susceptibility testing results were compared.Results From January 2011 to December 2015, 42 premature infants with confirmed fungemia were treated in this hospital, 22 (52.38％) of whom were with fungemia caused by Candida albicans(C.albicans), 13 (30.95％) by Candida parapsilosis (C.parapsilosis), 3 by Candida krusei (C.krusei), and 4 by other fungi.Patients were grouped according to the main pathogens causing infection: C.parapsilosis group and C.albicans group.Maternal genitourinary tract infection rate and incidence of fungal meningitis in C.albicans group were both higher than C.parapsilosis group(27.27％ vs 7.69％, 27.27％ vs 0.00％ respectively), peripherally inserted central catheter (PICC) rate in C.albicans group was lower than that in C.parapsilosis group(22.73％ vs 69.23％), platelet count in C.parapsilosis group was lower than C.albicans group, differences were all statistically significant (all P<0.05).Conclusion The major fungi causing fungemia in premature infants were C.parapsilosis and C.albicans, maternal reproductive system infection during pregnancy can easily lead to candidemia, premature infants with candidemia are more vulnerable to developing fungal meningitis;PICC is more likely to lead to C.parapsilosis fungemia, and platelet decline is more obvious.

ObjectiveTo study the value of the exfoliative cytology of prostatic fluid obtained from patients with elevated PSA in prostate cancer diagnosis.MethodsProstatic fluid was obtained from 130 patients with elevated PSA before prostate biopsy and then the Wright's stain and cytological class were done.Each cytological class and patient's age,PSA,total prostate volume,prostatic fluid volume and the number of leukocyte in the prostatic fluid were recorded.The relationship of leukocyte number and patient's age,PSA and prostate volume was analyzed by Spearman correlation test.ResultsProstate biopsy pathology results showed that there were 77 (59.2％) cancer cases and 53 (40.8％) non-cancer cases.Patient numbers in cytological class 1 to 5 were 28 (21.5％),32 (24.6％),22 (16.9％),36 (27.7％),12(9.2％),respectively.The prostate fluid cytology had a specificity of 100％ and high sensitivity of 62.5％(10/16) in patients with PSA≥20 μg/L.PSA value had significant difference between class 1,2,3,4and 5.Significant correlation was found among the prostatic fluid volume,total leukocyte number and prostate volume.Prostate volume,leukycyte density and total leukycyte number was significant higher in noncancer patients than in prostate cancer patients.ConclusionsThe exfoliative cytology of prostatic fluid is a valuable method in detecting prostate cancer,particularly in patients with high PSA levels.It has the advantages of non-invasion and less injury than prostate biopsy.There is a relationship between elevated PSA value and high leukocyte numbers.

Objective To investigate the changes in nunmber and function of natural killer ( NK ) cells in patients with newly-diagnosed type 1 diabetes mellitus.Methods Cell courning was performed in peripheral blood mononuclear cell ( PBMC ) subsets in 43 cases with newly diagnosed type 1 diabetes ( T1D ),14 cases with newly diagnosed type 2 diabetes( T2D ) and 21 cases of normal controls by flow cytometry sorting.And then,isolating and collecting NK cells were performed in T1D patients and normal controls.Real time PCR was performed to evaluate the mRNA expression levels of NK cell activity related genes IFN-γ,perforin,NKp46,and NKp30 in NK cells.Results Compared to normal controls,both the proportion and the absolute counting of NK cells in PBMC from patients with T1D were significantly decreased [( 102±86 )/μl vs ( 355±264 )/μ1,P＜0.01],while only the proportion of CD4+ cell were slightly increased( P＜0.05 ).No statistical difference was observed regarding CD8+ T cells ( P＞0.05 ).mRNA expression levels of NK cell activity related genes perforin and NKp46 in NK cells were remarkably down-regulated ( P＜0.05 ),while IFN-γ and NKp30 were not changed compared with normal controls.Conclusions The reduced number and functional deficiency of NK cells may lead to the immune dysfunction in T1D and play an important role in the development of T1D.

Objective To explore the effect of WeChat intervention on mood ,coping style and satisfaction of the patients with musculoskeletal injury in emergency department .Methods Seventy-six patients with acute musculoskeletal injury in the emer-gency department of a grade 3A hospital in Zhengzhou City from September 2016 to March 2017 were selected and randomly divided into the control group and intervention group ,38 cases in each group .The control group was given the conventional guidance ,health education and telephone follow up ;while on this basis ,the intervention group received the musculoskeletal injury related information with WeChat sent by the emergency informatization research group ,the personalized guidance and answering the patient′s questions by network communication were performed .The mood ,coping style and patient satisfaction after 1 week intervention were com-pared between the two groups .Results The Brief Profile of Mood State score after 1 week intervention in the intervention group was (41 .55 ± 8 .40) points and the Grogan Patient Satisfaction Questionnaire score was (83 .45 ± 8 .07) ,which were lower than (46 .13 ± 9 .37) points and (94 .58 ± 9 .49) points ,the difference was statistically significant (P<0 .05);in the intervention group , the face-face coping ,avoidance coping and surrender coping were significantly improved (P<0 .05) .Conclusion After 1 weeks of in-tervention ,patients in the intervention group were better than those in the control group in mood ,medical coping and satisfac-tion ,It is a kind of intervention method worthy of popularization .

Objective To analyze the effect of carotid artery stenting (CAS) on cerebralblood flow and cerebrovascular reactivity in patients with severe carotid stenosis.Methods Twenty patients with unilateral severe internal carotid artery stenosis,conformed by carotid color ultrasonography or MR angiography in our hospital from August 2014 to December 2015,were chosen in our study.CAS was performed;relative cerebral blood flow (rCBF) detection and relative cerebrovascular reactivity (rCVR) assessment were performed by single photon emission computed tomography (SPECT) combined with carbon dioxide (CO2) inhalation within one week before surgery and 3 months after surgery.Four regions of interest (ROIs) in the bilateral middle cerebral artery (MCA) territory of internal carotid stenosis were selected for data analysis.The changes of rCBF and rCVR before and after CAS between the ipsilateral and contralateral ROIs of these patients were compared.Results In these 20 patients,80 ROIs from each patient were obtained.Preoperative ipsilateral rCBF averaged 0.883±0.075,and contralateral rCBF averaged 0.929±0.033;preoperative ipsilateral rCVR averaged 0.010±0.055,and contralateral rCBF averaged 0.124±0.053;postoperative ipsilateral rCBF and rCVR averaged 0.927±0.040 and 0.092±0.058,and contralateral rCBF averaged 0.938±0.038 and 0.127±0.054.Postoperative ipsilateral rCBF and rCVR were significantly improved as compared with preoperative ones (P＜0.05).Postoperative contralateral rCBF and rCVR were improved as compared with preoperative ones,without significant differences (P＞.05).Conclusions CAS can not only improve rCBF and rCVR of the MCA in the carotid artery stenosis,but also improve the contralateral side.

Objective To observe the correlation between degrees ofextracranial cerebral artery stenosis and pressure ratio across stenosis.Methods The patients with ≥ 50％ stenosis,admitted to our hospital and conformed by DSA from September 2015 to February 2017,were collected in this study.Collateral circulation compensation was assessed by DSA.The distal stenosis pressure (Pd) and stenosis pressure (Pa) were measured by pressure wire system;the pressure ratio across stenosis was recorded.Correlations of pressure ratio with stenosis rate and collateral circulation compensation were analyzed by Spearman correlation.Results Thirty one stenotic extracranial cerebral arteries (9 of carotid stenosis,12 of vertebral artery stenosis and 10 of subclavian artery stenosis) in 28 patients were collected.There were no perioperative complications or adverse events.The vascular stenosis rate showed negative correlation with pressure ratio (r=-0.615,P=0.000).In the subgroups,pressure gradient was negatively correlated with carotid artery stenosis rate (r=-0.948,P=-0.000),vertebral artery stenosis rate (r=-0.757,P=0.004) and subclavian artery stenosis (r=-0.759,P=0.011).Pressure ratio and collateral circulation compensation showed negative correlated relation (r=-0.475,P=0.007).Conclusion The pressure ratio across stenosis gets worse impairment with increase of severity of stenosis,and the collateral circulation influences the pressure ratio.