Objective To evaluate the synergistic effect of DSA and MSCTA in interventional therapy for lung cancer. Methods Interventional therapy was performed in 46 patients with lung cancer. With real time helical thin slice CT scanning, MSCTA of tumor feeding artery was performed in 26 patients. Images obtained from enhanced MSCT scanning were processed at the console workstation. Spatial anatomical characteristics of tumor feeding artery were observed by using different rotations of view. DSA study and the interventional therapy were followed up in 26 patients with lung cancer. Results All tumor feeding arteries in 26 patients with lung cancer were observed by using VR, MIP and MPR, which could exactly display the origin, course and diameter of the vessels. DSA had a high consistency with MSCTA in displaying the tumor vascularity, tumor stain, and the origin of tumor-feeding artery in the patients who received MSCTA and the interventional therapy. The number of catheter used, the dosage of contrast medium, the sequence of subtraction, the fluoroscopic time and operation time in the group with use of CTA was less than that in the group without use of CTA, and the difference between two groups was statistically significant (P < 0.05), while no significant difference in detecting feeding artery existed between two groups (P > 0.05). Conclusion The anatomical characteristics of tumor-feeding artery in patients with lung cancer can be stereoscopically and clearly displayed on preoperative routine MSCTA, providing useful information and thus making the interventional procedure more safe and effective. Simultaneous use of DSA and MSCTA is reasonable and practicable, which has synergistic effect in interventional therapy for lung cancer.

The Qinghai⁃Tibet Plateau is known as one of the highest endemic areas of echinococcosis However，the dog infection rates of Echinococcus granulosus in the plateau regions were similar to other non⁃Tibetan areas with the high endemic，and most of the rates were below 40%. The infected dogs with E. multilocularis were ubiquitous in Ganzi Prefecture of Sichuan Province and Qinghai Province where many survey data were done and available，which was much different from those in non⁃Ti⁃betan areas where the geographical distribution of dogs infected with E. multilocularis was sporadic. The total infection rates of Echinococcus in dogs kept stable from 1983 to 2009 in Ganzi Prefecture of Sichuan Province and did not show much variation from 2000 to 2014 in Qinghai Province as well. Since 2006，the national comprehensive prevention and control strategy and mea⁃ sures against echinococcosis have been launched in China，and significant progress has been made. In the endemic Tibetan area of Sichuan，the general Echinococcus infection rates in dogs were 28.10%，15.87%，19.22%，3.28% and 1.11% from 2009 to 2013，respectively，and the Echinococcus coproantigen⁃positive rate in Gannan Prefecture of Gansu Province and parts of Qing⁃ hai Province also decreased. This paper reviews the literature on the characteristics of dog infections in the Qinghai⁃Tibetan Plateau，so as to provide useful information to support echinococcosis control and prevention there.

OBJECTIVE: To test cathepsin L as a biomarker of myocardial ischemia by examination of cathepsin L expression in plasma after myocardial ischemia and ischemia-reperfusion in rats. METHODS: The rat models were established and divided in acute myocardial ischemia model (myocardial ischemia 30 min, 1 h, 2 h groups), ischemia-reperfusion model (ischemia-reperfusion group), and isoflurane-pretreated ischemia-reperfusion model (isoflurane-pretreated group), respectively. Normal control group and sham-operated group were established as contrast. The contents of cathepsin L in plasma were examined by ELISA and myocardial infarction areas were measured after TTC staining. RESULTS: No statistical significant changes were found among the experimental groups compared with the normal control group and sham-operated group (P>0.05). The cathepsin L from the ischemia-reperfusion group increased to 2.37 times compared with the normal control group (P<0.05). The cathepsin L and myocardium infarction size of isoflurane-pretreated group decreased compared with the ischemia-reperfusion group (P<0.05). CONCLUSION The cathepsin L in plasma is not a promising biomarker of acute myocardial ischemia. Isoflurane preconditioning can reduce the cathepsin L in plasma caused by ischemia-reperfusion injury.
Animals ; Biomarkers/blood* ; Cathepsin L/analysis* ; Isoflurane ; Myocardial Infarction/metabolism* ; Myocardial Ischemia ; Myocardial Reperfusion Injury/metabolism* ; Myocardium ; Rats

Quality control is one of the key scientific tissues in the modernization of traditional Chinese medicines (TCM). In order to overcome the deficiencies of assessment indexes, including little systematization and quantification, as well as loose association with clinical efficacy and dosage, a new integrated method named controllability pyramid ( CP) is first proposed in this paper. In addition, some study cases are used to explain how this model is constructed. We hope the establishment of CP could promote the clinical-orien- ted integrated innovation research of TCM, and provide control strategy and technology examples for improving the quality of Chinese medicines and clinical efficacy.
China ; Drug Evaluation ; methods ; standards ; Drug Therapy ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; standards ; Humans ; Medicine, Chinese Traditional ; standards ; Quality Control

Good medicinal herbs, good drugs. Good evaluation method and indices are the prerequisite of good medicinal herbs. However, there exist numerous indices for quality evaluation and control in Chinese medicinal materials. However, most of these indices are non-interrelated each other, as well as having little relationship with efficiency and safety. The results of different evaluatior methods may not be consistent, even contradictory. Considering the complex material properties of Chinese medicinal materials, single method and index is difficult to objectively and comprehensively reflect the quality. Therefore, it is essential to explore the integrated evaluation methods. In this paper, oriented by the integrated evaluation strategies for traditional Chinese medicine quality, a new method called integrated quality index (IQI) by the integration of empirical evaluation, chemical evaluation, and biological evaluation was proposed. In addition, a study case of hypertoxic herb Aconitum carmichaelii Debx. was provided to explain this method in detail. The results suggested that in the view of specifications, the average weight of Jiangyou aconite was the greatest, followed by Weishan aconite, Butuo aconite, Hanzhong aconite, and Anxian aconite; from the point of chemical components, Jiangyou aconite had the characteristic with strong efficacy and weak toxicity, next was Hanzhong aconite, Butuo aconite, Weishan aconite, and Anxian aconite; taking toxicity price as the index, Hanzhong aconite and Jiangyou aconite have the lower toxicity, while Butuo aconite, Weishan aconite, and Anxian aconite have the relatively higher one. After the normalization and integration of evaluation results, we calculated the IQI value of Jiangyou aconite, Hanzhong aconite, Butuo aconite, Weishan aconite, and Anxian aconite were 0.842 +/- 0.091, 0.597 +/- 0.047, 0.442 +/- 0.033, 0.454 +/- 0.038, 0.170 +/- 0.021, respectively. The quality of Jiangyou aconite is significantly better than the others (P < 0.05) followed by Hanzhong aconite, which is consistent with the traditional understanding of genuineness. It can be concluded that IQI achieves the integrated control and evaluation for the quality of Chinese medicinal materials, and it is an exploration for building the good medicinal herbs standards. In addition, IQI provides technical supports for the geoherbalism evaluation, selective breeding, the development of precision decoction pieces, high quality and favourable price in market circulation, and rational drug use.
Aconitum ; chemistry ; Drugs, Chinese Herbal ; standards ; Medicine, Chinese Traditional ; standards

The specification of decoction pieces and quality uniformity are the important factors to influence the efficacy of clinical medicine. Considering the deficiency of diversity, poor quality uniformity and confusion of decoction pieces specifications, we first propose a new idea of precision decoction pieces (PDP) based on clinical demands and fresh-processed technology. In order to explain the idea, a study case of aconite SUP is provided, including the optimized specification design, processing technology, extraction effects, quality uniformity, and toxic and efficacy variation and so on. The results showed that preparing 5 mm PDP by fresh-cutting is rather simple and practicable, with high efficiency and large yield; then, this technology could significantly decrease the ingredients loss and increase the efficacy components; moreover, it was helpful for achieving the quality uniformity and best extraction effects. This work revealed the quality superiority of PDP, and provided a good strategy and example for the standard of decoction pieces specification and modernization of processing technology.
Aconitum ; chemistry ; Chemistry, Pharmaceutical ; methods ; Chromatography, High Pressure Liquid ; Particle Size ; Plant Extracts ; chemistry ; pharmacology ; Quality Control

Objective To report the clinical results of managing distal tibial fractures with a hybrid external skeletal fixator.Methods From January 2006 to June 2013,39 patients with distal tibia fracture were managed with limited-close or limited-open reduction and a hybrid external skeletal fixator.They were 26 men and 13 women,with an average age of 40.1 years (range,from 23 to 65 years).According to AO classification,15 fractures were of type A3,8 of type B2,10 of type B3,2 of type C2 and 4 of type C3.According to Gustilo classification,of the 12 open fractures,8 were of type Ⅱ,3 of type Ⅲ a and one of type Ⅲ b.According to Tscherne classification of soft tissue injury,4 cases were of grade l,24 of grade 2,and 11 of grade 3.Open fractures were managed first with radical debridement.Those complicated with fibular fracture were managed first with open reduction and internal fixation of distal fibula followed by close or limited-open reduction and minimal internal fixation depending on the position of distal tibial fracture.Next,the hybrid external skeletal fixation was applied.Five cases were immobilized with trans-articular fixators.The data were recorded regarding interval from injury to surgery,operation time,perioperative blood loss,hospital stay,time of external fixation,time of bony union,and complications.The ankle function was evaluated clinically with the Maryland Scale system at the final follow-ups.Results The 39 patients were followed up for 12 to 18 months (average,14.5 months).Primary incision healing was achieved in 37 cases,but the other 2 patients with open fracture suffered delayed wound healing which was cured by dressing changes for 4 weeks.Altogether,38 cases achieved normal fracture union and their average time of external fixation was 13.5 weeks.The time for complete infusion of fracture lines on X-rays averaged 19.7 weeks.Delayed union occurred in one case whose fracture united after removal of the external fixator,internal fixation with a locking plate and autogenous bone grafting.One case was complicated with pin track infection which was healed after debridement,drainage for 8 weeks and removal of the external fixator.No neurovascular complications were observed.According to the Maryland Scale system,the ankle function was excellent in 8 cases,good in 24 and fair in 7,with an excellent and good rate of 82.1％.Conclusions The hybrid external skeletal fixator is good for distal tibial fractures,because it can cffectively protect the skin and minimize invasion to the soft tissues,reducing incidences of skin necrosis and wound infection.Moreover,since it is flexible in screwing and structure formulation,it facilitates wound management,eslpecially in the management of open fractures.

Objective To investigate the copy number variants of a developmental delay patient by applying single nucleotide polymorphisms array technique and to analyze the relationship between the clinical manifestation and copy number variants.Methods Single nucleotide polymorphisms array was used to detect genomic copy number variants in a child with development delay and her phenotypic normal parents.Results The patient had a 7. 9-Mb deletion at 8p23.3-p23.1 and a 27.4-Mb duplication at 8p23.1-p11.23, which were conifrmed as pathogenic copy number variants after comparative analysis with database.Conclusions Single nucleotide polymorphisms array could serve as a useful method to diagnose developmental delay patients and analyze pathogenesis.

Objective:To compare the similarities and differences of doctor -patient trust building mechanism between doctors in urban and rural areas from the perspective of rural residents by the empirical study .Methods:Based on the field research and secondary in -depth interviews to the related personnel in H County of Beijing .Re-sults:There had obvious difference of doctor -patient trust building mechanism between doctors in urban and rural areas from the perspective of rural residents .Trust building mechanism between village doctors were mainly the trust of the similar social background , between the doctors in township health centers and city hospital were the trust based on reputation , institution-based trust , and relationship-based trust .Conclusion:The difference of re-gional and cultural between urban and rural areas ,the nature of medical institutions the relationship with doctors , reputation of medical institution and medical and health care system in urban and rural areas ,maybe the reasons that The difference of doctor -patient trust building mechanism between doctors in urban and rural areas .

Background and purpose: Astrocytoma is the most common neuroepithelial neoplasm, and its grading has profound effect on its treatment and prognosis. To investigate the application of stepwise discriminant analysis in grading astrocytomas, this study developed two models of stepwise discriminant analysis according to relevant factors of astrocytoma. Methods: From January 2008 to April 2009, 111 primary astrocytoma patients were enrolled. Each patient was scored based on location, signal intensity on T1WI, signal intensity on T2WI, enhancement, edema, border, cyst or solidness, and mass effect of their magnetic resonance images. With their age score of grading, Fisher stepwise discriminant analysis and the Logistic discdminant were used. The results from the two models were then evaluated and compared. Results: According to Fisher stepwise diseriminant analysis, the predictive accuracy was 87.7% with 80.0% sensitivity, 91.5% specificity and 0.942 area of ROC curve. However, the predictive accuracy of Logistic discriminant analysis was 84.9% with 80.0% sensitivity, 86.8% specificity and 0.940 area of ROC curve. There were no statistically significant differences in terms of accuracy (P=0.250) and areas under ROC curve (Z=0.433, P=0.665) between the two models. Conclusion: Two stepwise discriminant analysis models are meaningful to predict the grading of astrocytoms, and the application of Fisher stepwise discriminant analysis is simpler than the Logistic discriminant analysis.