Objective To establish a HPLC method for determination of geniposide content in Qingkailing Capsule. Methods HPLC with Gracesmart C18 was used and detection wavelength was 238 nm with acetonitrile-water (15∶85) as mobile phase. The flow rate was 1.0 mL/min. Results The standard curve was linear over the range of 0.060 4～0.302 0 ?g (r=0.999 8). The average recovery was 98.73%, and RSD was 1.61%. Conclusion This method is reliable, accurate and suitable for the determination of geniposide in Qingkailing Capsule.

Objective To investigate the trend in incidence, causative drugs, clinical types and treatment of drug eruption. Methods Clinical data were collected from 922 inpatients with drug eruption in Huashan Hospital, Fudan University from January 2009 to December 2013, and analyzed retrospectively. Results From 2009 to 2013, the percentage of inpatients with drug eruption among all inpatients in the Department of Dermatology in a given year varied from 9.45% to 10.01%, and the percentage of inpatients with severe drug eruption among inpatients with drug eruption from 17.45% to 28.24%. Of the 922 cases, 371 (40.2%)were caused by single drugs, and 551 (59.8%)by multiple drugs. Among the 371 cases of drug eruption caused by single drugs, the top five causative drugs were traditional Chinese medicine(72 cases), cephalosporins(38 cases), amoxicillin(27 cases), antipyretic analgesics(26 cases)and tetanus antitoxin (24 cases)in 278 cases of non-severe drug eruption, antiepileptic agents (33 cases), allopurinol (28 cases), antipyretic analgesics (7 cases), cephalosporins (6 cases)and traditional Chinese medicine (6 cases)in 93 cases of severe drug eruption. Of the 922 patients, 422 (45.8%)presented with maculopapular eruption, 259 (28.1%)with urticaria, 135(14.6%)with Stevens-Johnson syndrome, 49(5.3%)with toxic epidermal necrolysis, 33(3.6%)with drug reaction with eosinophilia and systemic symptoms (DRESS), and 7 (0.8%)with acute generalized exanthematous pustulosis (AGEP). A total of 791 (85.8%)patients with drug eruption received glucocorticoid treatment. The dose of glucocorticoids was(47.61 ± 12.07)mg prednisone equivalent per day in 550 patients with non-severe drug eruption, and (73.10 ± 18.23)mg prednisone equivalent per day in 221 patients with severe drug eruption. Totally, 110 (11.0%) patients with drug eruption were treated with combined intravenous immunoglobulin (IVIG)because of poor response to glucocorticoids alone. Of 224 patients with severe drug eruption, only 2 (0.9%)died. Conclusions Carbamazepine and allopurinol are the main causative drugs for severe drug eruption, while traditional Chinese medicine is the first causative drug for non-severe drug eruption. From 2009 to 2013, the annual mortality of severe drug eruption decreased considerably.

Objective To compare the onset time, duration and adverse effects of stellate ganglion block (SGB) with different concentrations of lidocaine. Methods Two hundred and forty ASA Ⅰ or Ⅱ patients (97 male, 143 female) aged 37-76 yr weighing 48-79 kg were randomly divided into 3 groups ( n = 80 each): group A, B and C received unilateral SGB with 8 ml of 0.6%, 0.8% and 1.0% lidocaine respectively. Unilateral SGB was performed by the same anesthesiologist in all patients. Successful SGB was verified by Homer's syndrome. The onset time, duration and adverse effects were recorded. Results Homer's syndrome was observed in all patients. There was no significant difference in onset time among the 3 groups. The duration of action was significantly longer in group B and C than in group A and in group C than in group B. There was no significant difference in the adverse effects including recurrent laryngeal nerve block, brachial plexus block, local anesthetic intoxication and transient loss of consciousness among the 3 groups. Conclusion SGB can be induced with either 0.6%, 0.8% or 1.0% lidocaine with comparable effectiveness. We suggest using lower concentration of lidocaine.

Objective To study the effect of sitz bath with 1.6%concentrated brine solution and metronidazole on perianal infection in acute leukemia patients. Methods Seventy-six acute leukemia patients admitted from June 2010 to December 2014 with perianal infections were randomly divided into the control group and the observation group in equal number. The two groups were given routine nursing care and symptomatic supportive treatment . Apart from the basic nursing , the control group was treated with sitz bath with 10 min 1 ∶ 5000 potassium permanganate. The observation group was treated with sitz bath with 1.6% brine solution and 0.1%metronidazole two times every day and another one if defecation was done. The perianal infections of two groups were compared in 7 days. Result The total effectiveness in the observation group was significantly better than that of the control group (P < 0.05). Conclusions Sits bath with 1.6% brine solution and metronidazole two times a day is more effective than with 1 ∶ 5000 potassium permanganate. It is economic and convenient, safe and effective for the treatment of perianal infections and therefore worth popularizing in clinical application.

To investigate the mechanism of electroacupuncturein treating chronic fatigue syndrome(CFS) in term of the neuro-endocrine system by observing the regulative effect of EA on hypothalamic-pituitary-adrenal index (HPA index) and corticotropin releasing hormone mRNA (CRH mRNA) in CFS model rats. Methods: The rats were randomly divided into control group, model group, and electroacupuncture group. Model and electroacupuncture groups were forced to swim in cold water to make CFS model, while rats in electroacupuncture group were treated with electroacupuncture treatment at the same time. Electroacupuncture group was given at Baihui(GV 20) and Zusanli(ST 36). Evaluation of the model was processed according to the behavior changes of the rats. Hypothalamic, pituitary, and adrenal were weighted to calculate HPA index. CRH mRNA in hypothalamic was measured by fluorescence quantitative polymerase chain reaction (FQPCR). Results: The model rats had behavior changes,and both physical and mental fatigue was observed. HPA index raised and expression of CRH mRNA in hypothalamus increased in CFS rats. After electroacupuncture treatment, the physical and mental fatigue was improved, and the hypothalamic index and CRH mRNA decreased significantly, while the pituitary and adrenal index only had little decrease. Conclusion: Cold water swim press could mimic the pathogenesis and make similar manifestations in rats with the common clinical symptoms. CFS has close relationship with increase of HPA index and CRH mRNA expression. Electroacupuncture can regulate the function of HPA axis to deal with CFS.

Objective To determine the median effective concentration (EC50) of epidural lidocaine inhibiting herpetic neuralgia.Methods The patients with thoracic or lumbar herpetic neuralgia,aged 20-60 yr,with body mass index of 18-25 kg/m2,of ASA physical status Ⅰ or Ⅱ,were included in the study.Epidural catheter was placed under the guidance of the digital subtraction angiography (DSA).An injection of iohexol mixed with lidocaine was given under the guidance of DSA to make sure that drug solution covered all the injured nerve roots.The initial concentration of lidocaine was 0.37％.The concentration was determined by up-and-down sequential allocation.Each time the concentration of lidocaine increased/decreased in the next patient depending on whether or not the analgesia was effective.The ratio between the two successive concentrations was 1.06.Effective analgesia was defined as VAS score ≤ 1 within 30 min after administration.The EC50 and 95 ％ confidence interval of lidocaine inhibiting herpetic neuralgia were calculated using Dixon formula.Results The EC50 of lidocaine inhibiting herpetic neuralgia was 0.199 ％ and the 95 ％ confidence interval was 0.168 ％-0.216 ％.Conclusion The EC50 of epidural lidocaine required to inhibit herpetic neuralgia is 0.199％.

Two eases of Hashimoto's encephalopathy (HE) are reported and relative literature is reviewed in this article.Both cases were female,with disturbance of consciousness and dementia as initial symptoms.Marked increase of anti-thyroid antibodies was found in serum of the patients.The symptoms disappeared after steroids and maintenance therapies.A total of 126 cases of HE in Chinese literature were retrieved from 2006 to 2015 through the databases of China National Knowledge Infrastructure and Wanfang Med Online.The male/female radio was 1 ∶ 6 with an average age of 51.3 years.The clinical manifestations included cognitive impairment (44.5％),epilepsy (38.3％),psychiatric disorders (27.3％),stroke-like symptoms (25.8％),disturbance of consciousness (24.2％),and extrapyramidal symptoms (20.3％).Good response to steroids was observed in 77.2％ HE patients.Analysis indicates that HE is an autoimmune disease with the presence of neurological and psychiatric manifestations,elevated titers of anti-thyroid antibodies in serum and well response to steroids,with a good prognosis.

Objective To evaluate the expressions of TBX2 and MDM2 protein in urothelial carcinoma of bladder.Methods The expressions of TBX2 and MDM2 protein were examined by immunohistochemistry EnvisionTM Plus method in 90 cases of urothelial carcinoma of bladder and 20 cases of normal bladder mucosa tissue.Results The positive rate of TBX2 and MDM2 protein was 0 in normal bladder mucosa tissues.The positive rate of TBX2 in urothelial carcinoma of bladder was 65.6％ (59/90).With the increased of TBX2 expression degree,the carcinoma tissue was worse cell differentiation,later clinical stage,more prone to recurrence (P ＜ 0.01).The positive rate of MDM2 in urothelial carcinoma of bladder was 31.1％(28/90).With the decreased of carcinoma tissue differentiation degree,the positive rate of MDM2 was increased (P ＜ 0.01).The positive rate of MDM2 in recurrence patients was 57.5％ (23/40),in non-recurrence patients was 10.0％ (5/50),there was statistical difference (P ＜ 0.01).The positive rate of MDM2 in pTNM stage Ta-T1 was 0,in pTNM stage T2-T3 was 73.7％ (28/38),there was statistical difference (P ＜0.01).There was positive correlation between the expression of TBX2 and MDM2 in carcinoma tissue (r =0.487,P ＜ 0.05).Conclusions The over expression of TBX2 and MDM2 protein may closely associated with aggressive biological behavior and recurrence in urothelial carcinoma of bladder.Combined analysis of TBX2 and MDM2 may provide a theoretical basis for prognostic information and treatment of patients with urothelial carcinoma of bladder.

Background Studies showed that 577 nm subliminal micropulse photocoagulation for retinal diseases is more effective and much safer than 577 nm laser,but its mechanism and sensitive target cells are still unelucidated.Objective This study was to compare the histomorphology changes of rabbit retinas following 577 nm subliminal micropulse excitation and 577 nm laser for retinal photocoagulation and offer a conference for the clinical application of 577 nm subliminal micropulse excitation.Methods Twenty-six Chinese pigment rabbits were randomly divided into normal control group (2 rabbits),577 nm laser photocoagulation group (6 rabbits) and subliminal micropulse photocoagulation group (18 rabbits),in which the rabbits from subliminal micropulse photocoagulation group were subgrouped into 9％,12％ and 15％ subthreshold photocoagulation groups according to the different workload rates,and retinal photocoagulation was performed based on grouping.No treatment was carried out in the normal control group.Fundus camera and OCT were obtained after photocoagulation,and the rabbits were sacrificed to prepare the specimen of eyeball wall.Hematoxylin and eosin staining was employed to examine the histopathological change of choroid and retina under the light microscope.Results The retinal morphology was normal on the fundus color photography and OCT in the normal control group.Obscure of retinal structure and slight edema of retinal neuroepithelial layer with obscure of retinal pigment epithelium (RPE) was found respectively in the 9％ and 12％ subthreshold photocoagulation group,and serious edema of retinal neuroepithelial layer with local RPE elevation was visible in the 15％ subthreshold photocoagulation group.The laser spot was invisible in various subliminal micro pulse groups.However,retinal photocoagulation spots,multifocal elevation of retinal layer and serious detachment of retinal neuroepithelium were found in the 577 nm laser group.Retinal histopathological examination revealed that the photoreceptors,bipolar cells and retinal ganglion cell (RGC) layers were normal,while choroidal vessel deformation and bleeding were visible in the 9％ and 12％ subthreshold photocoagulation groups,and only photoreceptor membrane swelling was seen in the 15％ subthreshold photocoagulation group.However,retinal structure abnormality was displayed in 577 nm laser group,including the structural disorders of inner and outer nuclear layers and RGC layer as well as thinning of RPE layer.Conclusions 577 nm nicropulse laser under threshold is sensitive for RPE and choroid rather than retina neurepithelium,which can play a treating role and also does not damage retina seriously.However,577 nm laser photocoagulation results in retinal structure damage.

Objective To observe the effects of different levels manganese (Mn) on spatial learning and memory in neonate rats.Methods Neonate rats were distributed to control (normal saline) and MnCl210,20,30mg/kg groups randomly.Each groups included 10 litters in a cage with a dam.Neonate rats were intraperitoneal injection exposed to MnCl2 over PND 1-21.All groups were evaluated behavioral performance using open field and Morris water maze.Blood and hippocampus Mn levels were determined using ICP-MS.Results 1) For each group,blood Mn were (35.58 ± 13.77) μg/L,(80.00 ± 12.98) μg/L,(238.51 ± 31.43) μg/L,(348.47 ±34.07) μg/L and hippocampus Mn were (576.82 ± 79.78) μg/g,(798.33 ± 40.60) μg/g,(1017.23 ± 117.23)μg/g,(1278.76 ± 281.48) μg/g respectively.Blood and hippocampus Mn concentrations in Mn-exposed groups were significant increased compared to control (P ＜ 0.01),and there was a positive correlation in blood Mn and hippocampus Mn(OR =0.91,95％ CI=0.81-0.96,P＜ 0.01).2) Therewere no significant differences on travelled distance in open field among all groups,which meant that Mn exposure had no effect on their locomotion.3) In the hidden platform trials of the Morris water maze test,only on 3rd day,Mn-expose groups spent more time to find the platform compared to the control(P ＜ 0.01).The average escape latency were(21.77 ± 7.10)s,(33.78 ± 9.95)s,(37.17 ± 13.68) s,(41.92 ± 16.74) s respectively.Though the latency were increased with the Mn exposure levels increasing among the Mn-expose groups,no statistically significant differences were observed.There were no statistically effects on latency to find the platform of all groups in other training days.The result in probe trails showed that there were no statistically effects on swimming velocity,the number of crossing over the former platform and the time spent in the targeted quadrant.Conclusion Mn exposure exerts effects on the learning,but no doseeffect relationship.There are no effects on memory of neonate rats of Mn exposure.