Objective In order to deeper understand DCIS,improve the rate of diagnosis and therapeutic efficacy.Methods The clinical data of 123 DCIS treated at the First Affiliated Hospital of China Medical University were retrospectively analyzed in regards to age at onset of disease,clinical features,breast ultrasound examination,mammography examination,pathology,immunohistochemistry examination,and surgical methods.Results(1) The average age at onset was(47.7?9.3) years.(2)The major features on physical examination were breast lump in 79cases,nipple discharge in 19cases,and breast pain with glandular thickening in 30 cases.(3)Among 45 cases that underwent both ultrasound and mammography examination,in 17cases(60%) and 30 cases(66.7%) respectively,might be positive for malignancy,but the difference between the 2 melhods was not significant.With the use of both methods togather,diagmosis of possible malignant lesion was made in 37 cases(82.2%).(4) Sixty-five cases underwent breast ultrasound examination,substantive mass was found in 43 cases(66%),blood flow signals in 41 cases(63%),ductal dilatation in 52 cases(80%) and intraductal spotty strong light beam in 33 cases(50.7%).(5) Fifty-two cases underwent breast mammography examination,which showed sand-like calcification,mass with calcification clusters,localized gland density and breast tumor.(6)The immunohistochemistry examination included estrogen receptor(ER),progesterone receptor(PR),p53 and c-erbB-2,but the rate of positive expressios of those indices showed no significance difference between DCIS and DIS with microvasion(DCIS-MI).(7)Six cases underwent radical mastectomy(of which there were 3 cases of DCIS-MI).Modified radical mastectomy was done in 86 cases,including 59 cases of DCIS,27 cases of DCIS-MI.Lymph node metastasis was found in 2 cases of DCIS,and 5 cases of DCIS-MI.ConclusionsCombined breast ultrasound and mammography can increase the rate of DCIS diagnosis.

Rapidly and accurately quantitative analysis of whole-cell sugars in some strains of actinomycetes by GC-MS was performed in this paper. After the polysaccharides were hydrolyzed, deoxidized and esterified , the alditol acetate derivates was analyzed by GC-MS. The derivates of rhamnose, ribose, arabinose , xylose, madurose, mannose, glucose, galactose were separated commendably under this condition. The ratio of the peak area was calculated to get the relative percentage of the various sugars.

Objective This study investigates the relationship of serum irfflammatory cytokine levels with intracranial pressure (ICP) in patients with severe traumatic brain injury (TBI) after surgery.Methods A total of 32 cases with severe TBI and placement of ICP monitor were prospectively enrolled.Serum was collected before surgery and every 12 h after surgery.Cytokines levels of interleukin (IL)-1β,IL-8,and tumor necrosis factor (TNF)-α were analyzed and compared with outcome of patients.Hourly values of ICP were recorded.The degree of ICP above treatment threshold (20 mm Hg) were calculated every 12 h as pressure times time dose(PTD-ICP20),which was compared with serum cytokine levels before (Pre) and after (Post) the 12-hour time period using linear regression method.Results Serum IL-1β (P＜0.05),IL-8 (P＜0.01) and TNF-a (P＜0.01) levels elevated dramatically after severe TBI and were significantly associated with outcome of patients.Mean PTD-ICP20 was (42.9 ± 60.2)mm Hg/h and was correlated with increased Pre-IL-8 (r=0.554,P＜0.001),Pre-TNF-α (r=0.597,P＜0.001),Post-IL-8 (r=0.629,P＜0.001) and Post-TNF-α (r=0.538,P＜0.001) levels.Conclusion Serum IL-8 and TNF-α demonstrated the most promising candidate bio.rnarkers of impending ICP elevation in this study.These findings indicate a feasible way of monitoring patients with severe TBI.

Objective To compare the effects of propofol,nidazolarm versus etomidate combined with sufentanil for anesthesia induction on intraocular pressure.Methods Forty-five ASA Ⅰ or Ⅱ patients,aged 20-40 yr,scheduled for surgery under general surgery,were randomly divided into 3 groups(n =15 each):propofol group(group P); midazolam group(group M)and etomidate group(group E).Anesthesia was induced with iv injection of propofol 2 mg/kg,midazolam 0.2 mg/kg,and etomidate 0.3 mg/kg in P,M and E groups respectively,and then with iv injection of sufentanil 0.2 μg/kg and cisatracurium 0.2 mg/kg in all the groups.The patients were then tracheal intubated.Intraocular pressure(IOP)and MAP were recorded at 1 m in before induction of anesthesia (T0),before intubation(T1),and at 0,1 and 2 min after intubation(T2-4).Results Compared with group P,the incidence of intraocujar hypotension was significantly decreased in group M(P ＜ 0.01).Compared with group E,the incidence of intraocular hypertension was significantly decreased in P and M groups(P ＜ 0.05),The correlation coefficient between MAP and IOP was 0.831,0.889 or 0.806 in group P,M or E respectively(P ＜0.05),and there was no significant difference in the correlation coefficient among the three groups(P ＞ 0.05).Conclusion Midazolam combined with sufentanil for anesthesia induction exerts less influence on lOP and the degree of MAP fluctuations is a major factor contributing to the change in IOP.

[Objective]To investigate the value of degree centrality(DC),a novel resting-state fMRI parameter,in voxel-wise whole-brain functional networks analysis in primary insomnia(PI)after acupuncture therapy.[Methods]The resting state fMRI were performed in 29 PI patients and 22 age,education,and sex-matched normal healthy subjects. Analysis of DC map changes between the two patient groups and the control group were performed by two sample t test.(threshold at P<0.05).[Results]Compared with the control group,patients with PI showed significantly reduced DC value in middle temporal gyrus(MTG. R);hippocampus(HIP. B);parahippocampal gyrus(PHG. R);putamen(PUT. R);cuneus(CUN. L).[Conclusions]Changes of DC value occurred in some region of brain in the PI patient groups when compared with the control group. It was indicated that DC ,as a novel resting-state fMRI parameter in the voxel-wise whole-brain functional networks ,might be an appealing alternative approach for further study on pathologic and neuropsychological states of PI.

Objective To understand the impairment and compensation mechanism of brain function in pa-tients with non-fluent aphasia after ischemic stroke. The fractional amplitude of low frequency fluctuation (fALFF) method was used to analyze the functional magnetic resonance imaging (fMRI) data in the resting state between the aphasia patients and the normal controls. Methods The scans of the resting state of fMRI were performed in 17 aphasia patients and 19 age-, education-, and sex-matched healthy control subjects. The scan sequence was single-shot echo planar image,DPARSF software was used to analyze fALFF data of the aphasia patients and the healthy controls. Results Compared to the control group, the value in right superior temporal gurus, inferior parietal lob-ule, frontal lobe cortex, and postcentral gurus were significantly increased in the aphasia group. The fALFF in bilat-eral cerebellum and right thalamus were also decreased in the aphasia group. Conclusions The fALFF values in some brain region in the aphasia group were abnormal in the resting state , indicating a few pathological change of brain function in patients with non-fluent aphasia after ischemic stroke.

OBJECTIVETo study the chemical constituents of Piper longum.

METHODThe whole plant of air-dried P. longum. was extracted with 95% EtOH. The EtOH extract was suspended in H2O and extracted with petroleum ether, CHC13 and n-BuOH, successively. The compounds were isolated and purified by column chromatography from the CHCl3 fraction, and identified based on spectral analyses (MS,1H-NMR, 13C-NMR).

RESULTThreeteen compounds were isolated from P. longum, and were characterized as 1-(3',4'-methylenedioxyphenyl)-1E-tetradecene (1), 3-(3', 4'-methylenedioxophenyl)-propenal (2), piperoic acid (3), 3',4'-di-hydroxy-biabola-1,10-diene (4), eudesm-4(15)-ene-1beta, 6alpha-diol (5), 7-epi- eudesm-4( 15)-ene-1beta, 6beta-diol (6), guineesine (7), piperine (8), pipericide (9), 2E, 4E-dienamide (10), (2E, 4E, 8E) -N-isobutylhenicosa-2,4,8-trienamide (11), piperlonguminine (12), methyl piperate (13),

CONCLUSIONCompounds 1-6 were obtained from P. longum for the first time.

BACKGROUND:As a kind of undifferentiated precursor cells,the phenotypic differentiation of bone marrow mesenchymal stem cells (BMSCs) remains immaturity,thus it presents weak rejection following transplantation.However,the in vitro directional differentiation of BMSCs into neuronal cells is easy affected by various factors.OBJECTIVE:To observe the immunomodulatory effect and the potential of BMSCs differentiate into neuronal-like cells.DESIGN,TIME AND SETTING:A contrast observation was conducted at the Department of Cytology,Third People's Hospital of Wuxi from January 2008 to March 2009.MATERIALS:Bone marrow was harvested from chips of cancellous or ilium bone dudng hip joint surgery.METHODS:Firstly,the BMSCs were separated and cultured to establish mixed lymphocyte reaction (MLR) system.Secondly,2 samples of peripheral blood mononuclear cells (1×10~5/well) were added into 96-well plate,and then BMSCs treated by mitomycin were added according to different ratios (BMSCs/peripheral blood monouclear cells).At the end,the cells were cultured as follows:Method 1:DMEM+10% fetal calf serum+1 μmol/L RA +20 μg/L basic fibroblast growth factor+20 μg/L epidermal growth factor.Method 2:DMEM+2% dimethyl sulfoxide +100 μmol/L butylated hydroxyanisole.MAIN OUTCOME MEASURES:The growth rate of lymphocyte was measured by ~3H-Thymidine,and the effect of BMSCs on lymphocyte proliferation was observed.Additionally,the differentiation potential of BMSCs into neuronel cells was determined by immunofluorescenca and immunohistochemistrical staining.RESULTS:①The BMSCs inhibited lymphocyte proliferation in MLR system and the influence on proliferation of lymphocyte was direct related to ratio of BMSCs.②Under a light microscope,cytoplasm of BMScs were shrinkd,which presented typical perikaryon morphology at hour 2 after culture with method 1.The majority of BMSCs were formed neuronal-like cells without number changes at hours 3-5,which turned to be dipolar or multipolar neuronal shapes at day 3.There were 60%-70% neuronspecific enolase,45%-50% glial fibrillary acidic protein were positive expressed.However,the positive rate of nidogen was decreased 3.4%.Cells cultured with method 2 became smaller after 2 hours,formed dipolar or multipolar body cells,and most of cells were died after 48 hours.The 40%-50% neuronspecific enolase,35%-40% glial fibrillary acidic protein was found to be positive.The positive rate of nidogen was temporary increased to 63% at hour 2 after culture；however,it was decreased to 1.6% after 48 hours.CONCLUSION:BMSCs can differentiate into neuronal-like cells,as well as inhibit lymphocyte proliferation in MLR system,which possess down regulation effect on alloimmunity-reaction.

Objective To explore the outcome for kidney transplant recipients who suffered from cancers after transplantation. Methods De novo cancer data in 59 transplant recipients were collected. 6 cases of native renal cell carcinomas, 4 cases of native pelvo-ureteral carcinomas, 14 cases of bladder cancers, 7 cases of prostate cancers, 9 cases of hepatocellular carcinomas, 3 cases of gastric carcinomas, 2 cases of colon cancers, 1 case of pancreatic cancer, 4 cases of breast cancers, 3 cases of cervical cancers, 2 cases of skin cancers, 2 cases of non-small cell lung cancers, 1 case of thyroid cancer and 1 case of post-transplant lymphoproliferative disease. These data were compared with those from 59 patients in general population with the same gender, age and tumor stage. Results Overall incidence rate for de novo malignancy post-transplantation was 1. 9 % (59/3150). Urinary cancers were the most common. Compared to the general population, the overall survival was significantly worsened in transplant recipients (P<0. 01), and 5-year survival rate in transplantation group and control group was 30 % vs 75 0 %. Multivariate analyses demonstrated cancer stage to he a negative risk factor for survival of transplant recipients with de novo cancer, and surgery and functioning graft to be the positive survival predictors. Conclusion Transplant recipients experience worse outcomes than the general population for these cancers. These data suggest that cancers in transplant recipients are more aggressive biologically at the time of diagnosis.

OBJECTIVETo study the chemical constituents of Piper longum.

METHODThe whole plant of air-dried P. longum was extracted with 95% EtOH. The EtOH extract was suspended in H2O and extracted with petroleum ether, CHCl3 and n-BuOH, successively. The compounds were isolated and purified by column chromatography from the CHCl3 fraction, and identified based on spectral analyses (MS, 1H-NMR, 13C-NMR).

RESULTEleven compounds were isolated from P. longum, and were characterized as coumaperine (1), N-5-(4-hydroxy-3-methoxyphenyl)-2E-pentenoyl piperidine (2), piperolactam A (3), 1-[1-oxo-5 (3,4-methylenedioxyphenyl) -2E,4E-pentadienyl] -pirrolidine (4), 1-[1-oxo-5 (3,4-methylenedioxyphenyl) -2E-pentenyl] -pirrolidine (5), 1-[1-oxo-9 (3,4-methylene dioxyphenyl)-2E, 8E-nonadienyl] -pyrrolidine (6), (R)-(-) -turmerone (7), octahydro-4-hydroy-3alpha-methyl-7-methylene-alpha-(1-methylethyl)-1H-indene-1-methanol (8), (+) -aphanamol I (9), bisdemethoxycurcumin (10), demethoxycurcumin (11).

CONCLUSIONCompounds 1-11 were obtained from P. longum for the first time.