Objective To study TLC and HPLC fingerprint of Paeoniae Radix Alba;To provide reliable methods for its quality control and evaluation. Methods TLC was performed to detect paeoniflorin with CHCl3-EtOAc-methanol-formic acid (40∶5∶10∶0.2) as the developing solvent system. The HPLC chromatographic separation was performed on Kromasil C18 column (250 mm× 4.6 mm, 5μm, 12 nm). The mobile phase was a mixture of acetonitrile-0.05%phosphoric acid in gradient elution with flow rate of 1 mL/min. The detection wavelength was set at 254 nm, and the column temperature was 35 ℃. Results The TLC spots were clear. Fifteen common peaks including paeoniflorin (the ninth peak) in the HPLC profile were found in ten batches of samples of Paeoniae Radix Alba in different growing areas, the fingerprints of samples from Anhui Province and Zhejiang Province showed little difference. Conclusion Fingerprint of Paeoniae Radix Alba showed unique features, and can be used to control its quality.

Preliminary screening test and interfering test were used to study the bacterial endotoxin test (BET) for Shengmai Injection (SI). The results showed that there is no interference when the SI is diluted by 10 times and limulus reagent with a sensibility of 0.25EU/mL is used for BET.

Objective To investigate clinical value of procalcitonin (PCT ) in guiding treatment of infection in elderly patients with heart failure .Methods A total of 120 cases of elderly patients with heart failure and infection were divided into control group (50 cases) ,receiving conventional anti-infection treatment ,and observation group(70 cases) ,receiving adjusted anti-infection treat-ment based on serum PCT levels .Treatment efficiency ,cost of treatment ,hospitalization duration and other indicators were com -pared between the two groups .Results Effective rate of observation group was 78 .57% ,which was not significantly different with the 78 .00% of control group ( P > 0 .05) .Cost of treatment ,hospitalization duration ,application time of antibiotics ,antibacterial drug costs ,superinfection and mortality were significantly different between the two groups (P< 0 .05) .After treatment ,levels of e-rythrocyte sedimentation rate ,C-reaction protein ,white blood cells and neutrophil in the two groups were significantly improved (P< 0 .05) .After treatment ,C-reaction protein level of observation group was lower than control group (P < 0 .05) .Conclusion PCT based anti-infection treatment could help shorten the treatment time ,reducing treatment costs and improving outcomes ,and might be worthy of clinical application .

Objective To determine the value of complexed prostate-specific antigen (cPSA) in predicting metastasis in patients with prostate cancer.Methods From January 2012 to April 2014,the clinical data of 74 patients with newly diagnosed prostate cancer in our hospital was retrospective reviewed.The prostate cancer was diagnosed by transrectal ultrasound guided biopsy and postoperative pathologic diagnosis.The patients were divided to 2 groups according to metastases status.There were 38 patients in the group of metastasis and 36 patients in the group of without metastasis.In metastasis group,the bone metastasis was found in 36 cases.There is only one case with lung metastasis and one case with lymph node metastasis.In the group without metastasis,the T stages classification were T1-T2 in 17 cases and T3-T4 in 19 cases.While,10 cases with T1-T2 stage and 28 cases with T3-T4 stage were confirmed in the group with metastasis.There was no statistical significance of T stages and mean age in two groups (P＞0.05).The level of cPSA in the serum was detected by chemiluminescent immunoassay,the level of tPSA,fPSA were detected by electro-chemiluminescent immunoassay,fPSA/tPSA,cPSA/tPSA were evaluated and the corresponding specificity were calculated.The correlation of age with tPSA,cPSA were analysed.The differences in PSA,fPSA/tPSA,cPSA/tPSA were compared between metastasis and non-metastasis group.ROC curve analysis was used to determine the diagnostic value of cPSA and tPSA,In the meantime,area of ROC curves were compared by Z test.Results The age was not related to the value of tPSA (r=-0.09,P=0.12) and cPSA(r=-0.38,P=0.14).The median levels of tPSA,fPSA,and cPSA are 29.88μg/L,2.18 μg/L and 18.86 μg/L in the group without metastasis,respectively.The median levels of tPSA,fPSA,and cPSA were 410.05 μg/L,51.50 μ.g/L and 290.40 μg/L in the group with metastasis,respectively.Significant differences of those results could be found in two groups (P＜0.05).fPSA/tPSA was 0.07 and cPSA/tPSA was 0.79 in the group without metastasis.fPSA/tPSA was 0.08 and cPSA/tPSA was 0.80 in the group of metastasis.fPSA/tPSA (P=0.77),cPSA/tPSA (P=0.64) in patients with metastasis were not greater than in those without metastasis (P＞0.05).The area under the curve of tPSA and cPSA were 0.83 (95％ CI 0.73-0.93) and 0.82 (95％CI 0.73-0.92) respectively.Analysis of ROC curves showed that the AUC for cPSA is not significant different from tPSA (Z=1.64,P=0.10).The specificity of cPSA was 22.2％ which is higher than that of tPSA (19.4％) at a sensitivity of 92.1％ in predicting metastasis comparing with the patients without metastasis.The sensitivity could reach to 90.0％ when the cut off value of tPSA was 9μg/L or the cut off value of cPSA was 7 μg/L.Conclusions In our study,a preliminary validation that cPSA is useful for predicting the metastasis in patients with prostate cancer was made.

Objective To observe a new phosphodiesterase-4 inhibitor Ro 20-1724 on ketamine anesthesia-induced learning and memory impairment and cAMP/PKA-CREB-BDNF signal pathway in immature rats.Methods Twenty-four 21 day-old SD rats were randomly divided into 4 groups (n=6 each):control group (group C) ;ketamine group (group K) ;ketamine+Ro 20-1724 group(group K+Ro) and ketamine+vehicle (0.1％ ethanol) group (group K+E).Ketamine 70 mg/kg was injected intraperitoneally(IP) once a day for 7 consecutive days in groups K,K+Ro,and K+E.Ro 20-1724 0.5 mg/kg and equal volume of vehicle were injected IP at 30 min after IP ketamine each time respectively.Morris water maze was used to assess learning and memory ability after 2 days normal feeding,the escape latency and frequency of passing the platform were recorded.The animals were killed after water maze test and the cAMP,PKA,p-CREB,and BDNF protein expression in hippocampus were detected.Results Repetitive ketamine anesthesia significantly prolonged the escape latency (P＜0.01),decreased the frequency of passing the platform(P＜0.01),and down-regulated the expression of cAMP,PKA,p-CREB,and BDNF protein ((280±31) pmol/mg vs (210± 19) mol/mg,P＜0.01 ; 1.32±0.11 vs 1.13±0.12,P＜0.01 ; 2.61 ±0.22 vs 2.03 ± ±0.19,P＜0.01 ; 1.51 ±0.14 vs 1.16±0.10,P＜0.05) ; Compared with group K,Ro 20-172,significantly attenuated the escape latency time(P＜0.05,P＜0.01)and increased the frequency of passing the platform(P＜0.01),and ameliorated the expression of cAMP,PKA,p-CREB,and BDNF protein ((210± 19) pmoL/mg vs (240± 27) pmol/mg,P ＜0.05;1.13±0.12 vs 1.28±0.12,P＜0.05;2.03±0.19 vs 2.32±0.21,2.32±0.21;1.16±0.10 vs 1.37±0.11,P＜0.01).There was no difference between group K+Ro and group C,and between group K+E and group K(P＞0.05).Conclusion ketamine anesthesia-induced learning and memory impairment can be improved by Ro 20-1724,and cAMP/PKA-CREB-BDNF signal pathway in hippocampus participated in the changes.

Objective To valuate the effect of Ro20-1724 on ketamine-induced apoptosis in hippocampal neurons of neonatal rats.Methods Hippocampal neurons from newborn Sprague-Dawley rats were obtained and cultured in vitro.The primary hippocampal neurons were randomly divided into 4 groups (n =24 each) using a random number table:control group (group C),ketamine group (group K),solvent control group (group E),and Ro20-1724 group (R group).The neurons were incubated for 72 h in the normal culture medium in group C.The neurons were incubated for 72 h in the culture medium containing ketamine 150 μmol/L in group K.In E and R groups,after the neurons were incubated for 30 min in the culture medium containing ketamine 150 μmol/L,the culture medium was then replaced,0.01％ ethanol (final concentration) and 1 × 10-3 μmol/L Ro20-1724 (final concentration) were added to the culture medium,respectively,and the neurons were then incubated for 72 h.After 72 h incubation,the cell viability was detected by MTT assay,the cell apoptosis was detected by flow cytometry,the expression of Bcl-2 mRNA and Bax mRNA was determined by RT-PCR,and synaptophysin Ⅰ expression was detected by Western blot.The apoptosis rate was calculated.Results Compared with group C,the survival rate was significantly decreased,the apoptosis rate was increased,the expression of Bcl-2 mRNA and synaptophysin Ⅰ was down-regnlated,and Bax mRNA expression was up-regulated in K and E groups (P ＜ 0.05 or 0.01).Compared with group K,the survival rate was significantly increased,the apoptosis rate was decreased,the expression of Bcl-2 mRNA and synaptophysin Ⅰ was up-regulated,and Bax mRNA expression was downregulated in R group (P ＜ 0.05 or 0.01).Conclusion Ro20-1724 can inhibit ketamine-induced apoptosis in hippocampal neurons of neonatal rats and correction of Bcl-2/Bax imbalance is involved in the mechanism.

Objective: To investigate the expression of Th1/Th2 inflammatory cytokines IL-2, interferon-γ (IFN-γ), IL-4, and IL-10 in rat treatment model of dextran sulfate sodium (DSS) -induced ulcerative colitis. Methods: Forty Sprague Dawley (SD) male rats were divided into a normal group, a colitis model group, a sulfasalazine(SASP)-treatment group (SASP group) and a Jiechangning-treatment group (Jiechangning group) (each groupn=10). Disease activity index (DAI) and colorectal histological damage scale were assessed. The expression levels of cytokines IL-2, IFN-γ, IL-4, and IL-10 in the serum and the colon mucosa tissues were detected by enzyme-linked immuno sorbent assay (ELISA) and real time polymerase chain reaction (RT-PCR).
Results: Compared with the colitis model group, the DAI and colorectal histological damage scale were decreased in the Jiechangning group (bothP<0.05), but there was no obvious difference compared with the SASP group (P>0.05). There was no signiifcant difference in IL-2 expression both in the serum and the colon mucosa tissues before or after the treatment in various groups (P>0.05). Compared with the colitis model group, IFN-γ level both in the serum and the colon mucosa tissues was decreased in the SASP group and the Jiechangning group, with significant difference in the serum (bothP<0.05), but there was significant difference in the colon mucosa tissues only in the Jiechangning group (P<0.05). The serum IL-4 level in the SASP group and the Jiechangning group was increased compared with that in the colitis control group, with significant difference only in the Jiechangning group (P<0.05). There was no difference in IL-4 level in the colon mucosa tissues whether treated or not (P>0.05). IL-10 level both in the serum and the colon mucosa tissues in the SASP group and the Jiechangning group was increased compared with that in the colitis model group, with significant difference (allP<0.05). There was no difference in the expression level of cytokines IL-2, IFN-γ, IL-4, and IL-10 both in the serum and the colon mucosa tissues between the SASP group and the Jiechangning group (allP>0.05).
Conclusion: DSS can break the balance of Th1/Th2 expression in the colon. Jiechangning enema can ameliorate DSS-induced acute experimental colitis in rats by decreasing IFN-γ level and increasing IL-10 level both in the serum and the colon mucosa tissues to regulate the Th1/Th2 balance and improve immunity.

Objective To explore an optimal treatment and to study the prognosis related factors of breast cancer patients with local recurrence after mastectomy. Methods From 2002. 7 to 2005. 2, 477female patients with loco-regional recurrence of breast cancer treated in Tianjin Cancer Hospital were analyzed retrospectively. Results In 477 cases, recurrence within 1 year after mastectomy accounted for 26. 2% , recurrence within 2 years accounted for 61. 2%. There were 310 cases with metastasis after local recurrence was diagnosed, accounting for 65.0%. 5-year total survival rate after recurrence is 48.4%.Local control rates varied in subgroups with different recurrence site, clinical subtypes, radiotherapy fields,with or without radiotherapy, surgical resection or excisional biopsy ( P<0. 05 ). There was a statistical difference in distant metastasis rate and 5-year survival rate among subgroups which had different clinical stage of primary tumor, disease-free interval, clinical subtypes or treatment methods ( P<0. 05 ). Simplistic treatment option, late clinical stage of primary tumor and triple-negative breast cancer were the independent factors predicting poor prognosis for recurrent breast cancer ( P<0.05 ). Conclusions Multi-site recurrence and triple-negative breast cancer lead to a poor local control. Local expansion of radiotherapy combined with surgery improves the local control rate. Patients with late clinical stage of primary tumor,recurrence within 2 years, triple-negative breast cancer are likely to have distant metastasis when recurrence is diagnosed. Combined treatment program improves survival rate.

Objective To compare the advantages and disadvantages of retroperitoneal laparoscopic sur -gery and open surgery in treatment of adrenal adenoma , in order to provide the clinical evidence for the selection of surgical treatment of adrenal adenoma .Methods 120 cases undergoing surgical treatment from Jan .2005 to Dec.2010 were randomly divided into laparoscopic group and open surgery group .Operation indicators , postop-erative recovery indicators , postoperative clinical manifestations , success of operation , complications and follow-up data were evaluated and compared between the 2 groups.Results 3 cases in laparoscopic group and 4 cases in open surgery group withdrew.The operation time, intraoperative blood loss, and blood transfusion cases were (89.6 ±18.4)min vs (124.2 ±27.3)min, (70.2 ±17.2)ml vs (205.7 ±51.9)ml, and 8 cases vs 20 cases in laparo-scopic group and open surgery group .Extubation time, starting feeding time, time of getting out of bed, and length of hospital stay were (2.8 ±1.3)d vs (4.2 ±2.0)d, (1.7 ±1.1)d vs (2.9 ±1.4)d, (2.6 ±1.2)d vs (5.1 ± 3.1)d and (6.2 ±3.1)d vs (13.5 ±5.4)d in laparoscopic group and open surgery group .Postoperative analge-sic using cases and drainage volume were 11 cases vs 43 cases, and(15.4 ±4.2)ml vs(45.1 ±12.7)ml in lapa-roscopic group and open surgery group .The difference had statistical significance (P＜0.01).The cost was simi-lar between the 2 groups(P>0.05).The open surgery group had no death or relapse within 1 year, while 5 cases in laparoscopic group converted to laparotomy , with 1 case of death and 2 cases of relapse within 1 year.The complications incidence was 3.51%(2/57)in laparoscopic group, obviously lower than 16.07%(9/56)in open surgery group(P＜0.01).Conclusions Compared to the traditional open surgery, retroperitoneal laparoscopic sur-gery has advantages of less trauma, fewer complications, and faster postoperative recovery in treatment of adrenal ade-noma.Experience and skills of surgeon need to be improved to reduce the possibility of failure or recurrence .

Objective To investigate the distribution and antimicrobial resistance of major pathogens causing bloodstream infection in a tertiary hospital,so as to guide the clinical rational use of antimicrobial agents.Methods Blood specimens from patients with suspected bloodstream infection in this hospital between January 2012 and January 2015 were cultured,identified and performed antimicrobial susceptibility testing,the major pathogens and antimi-crobial susceptibility testing results were analyzed statistically.Results A total of 1 658 strains of pathogens were isolated from 19 326 blood culture specimens,isolation rate was 8.58%,in which gram-negative bacilli,gram-posi-tive cocci,and fungi accounted for 58.57% (n=971 ),39.38% (n=653),and 2.05% (n=34)respectively,the major gram-negative bacillus,gram-positive coccus,and fungus were Escherichia coli ,coagulase-negative staphylo-cocci (CNS),and Candida albicans respectively.The isolated pathogens mainly distributed in departments of hema-tology,gastroenterology,and cardiovascular surgery.Detection rates of extended-spectrumβ-lactamases (ESBLs)-producing Escherichia coli and Klebsiella pneumoniae were 56.35% and 36.14% respectively,but were highly sen-sitive to cefoperazone/sulbactam and carbapenems (resistance rates <3%).The percentage of methicillin-resistant coagulase-negative staphylococcus (MRCNS ) and methicillin-resistant Staphylococcus aureus (MRSA ) were 78.60% and 32.28%respectively,but were highly sensitive to vancomycin and linezolid(resistance rates < 1 %). Conclusion Escherichia coli and CNS are predominant pathogens causing bloodstream infection in this hospital,antimicro-bial resistance rates are high;regular analysis on distribution and antimicrobial resistance of pathogens causing bloodstream infection is helpful for the prevention and control of infection caused by multidrug-resistant organisms.