Objective To investigate the effect of calcium acetate in treatment of elderly patients with CAPD in peritoneal dialysis patients with hyperphosphatemia and efficacy.MethodsFrom March 2013 to January 2016,46 elderly patients with CAPD were randomly divided into experimental group and control group.The control group were used calcium 1.5mmol/L Liquor Dialysisintraperitoneus CAPD treatment,and control diet.Besides these treatments,the experimental group were given calcium acetate tablets 668mg/3 times every day after a meal, 2 tablets each time.All patients were detected before treatment and 4,6 and 10 weeks after the serum calcium, phosphorus and calcium and phosphorus in blood iPTH index, calculate the product of calcium and phosphorus,record and statistical analysis.ResultsTwo groups after 4 week of treatment, all outcome measures were decreased;the experimental group blood phosphorus decreased significantly after 6 weeks treatment;it after 10 weeks of treatment, serum calcium(t=5.202),phosphorus(t=7.767),blood iPTH(t=-10.324) and the calcium phosphorus product (t=-4.106) compared with that before treatment,there were statistically significant differences(P<0.01);the control group after 10 weeks of treatment, with all outcome measures there were no significant differences.The experimental group after 10 weeks of treatment,serum calcium(t=-4.055),phosphorus (t=-9.037),blood iPTH(t=9.940) and the calcium phosphorus product(t=-4.211)compared with the control group,the differences were statistically significant(P<0.01).ConclusionCalcium acetate treatment can significantly reduce the blood serum of aged CAPD in peritoneal dialysis patients with high phosphorus,effectively prolong the survival time and improve the quality of life during treatment.

Objective To investigate chemical constituents in the leaves of Euphorbia soongarica(Xinjiang origin).Methods The leaves were extracted with 95% EtOH and partitioned with petroleum ether,CHCl3,and n-BuOH,respectively.Compounds were isolated by using repeated silical gel column chromatography and Sephadex LH-20 column chromatography.Results Eight compounds were identified on the basis of physiochemical properties and spectral data as chrysoeriol(Ⅰ),phthalic acid,bis-(2,5-dimethylhexyl) ester(Ⅱ),fraxetin(Ⅲ),3-(4-O-?-D-glucopyranosyloxy-3,5-dimethoxy)-phenyl-2E-propenol(Ⅳ),fraxin(Ⅴ),3-methylellagic acid-3′-O-?-D-xylopyranoside(Ⅵ),3,3′-dimethylellagic acid-4-O-sulphate(Ⅶ),and(+)-isolariciresinol-9-O-?-D-xylopyranoside(Ⅷ).Conclusion Compound Ⅶ is a new natural product,the other seven compounds are obtained from this plant for the first time.

Objective To investigate the effect of the combined use of ultrasound (US) elastography and color Dop-pler on the differential diagnosis and TNM staging of benign or malignant breast neoplasm. Methods A cohort of 58 biop-sy-proved cases, who underwent US elastographic and Doppler US imaging, were included in the current study. The pathological results after operation were considered the‘gold standard’of diagnosis. ROC curves were used to compare the changing rates of the diameter and area, elastographic indices and Doppler blood flow score in diagnosis of breast cancer. Re-sults Compared with other indices, the area changing rate showed the highest diagnostic ability with the AUC=0.914. More-over, the combined use of the elastography and color Doppler US increased the AUC to 0.981. The elastographic indices for neoplasm in the advanced-stage (stageⅡ~Ⅳ) were high than those of early-stage (stage 0~Ⅰ). The elastographic and Dop-pler scores increased with the progress of the TNM stages. Conclusion The changing rate of elastographic area can be used to accurately diagnose the breast neoplasm. Moreover, the combined use of US elastography and color Doppler US can in-crease the accuracy of the diagnosis, and may also provide useful information for the TNM staging.

Objective To explore the effects of intracellular calcium concentration ([Ca2 + ]i )and signal transducers and activators of transcription 3 (STAT3 )signaling pathway on the invasion of Vibrio vuknificus (Vv )clinical isolates B2 into dendritic cells (DC).Methods The co-culture model of Vv B2 and DC 2.4 was constructed.Apoptosis and necrosis rates in different invasion phases were detected by flow cytometry.The calcium fluorescence probe Fluo-8-AM was used to detect the change of [Ca2 + ]i ,and Western blot and immunofluorescent techniques were used to explore the relative molecular expressions and intracellular distributions of STAT3 and phosphorylation STAT3 [p-STAT3 (705 )].Data were analyzed by t-test.Results After co-culture ofVv B2 and DC 2.4,the apoptosis rates of 1 ,2,3 and 4 h were (13.10±4.72)%,(30.10±3.52)%,(46.20±15 .61)% and(31 .00 ±19.10)%,respectively.The differences were statistical significant between Vv standard strain (1 .1758)and Vv B2 (t=4.30,22.33, 4.30 and 4.30,respectively;P =0.040,0.002,0.040 and 0.040,respectively).The necrosis rates of 1 , 2,3 and 4 h in co-culture of Vv B2 and DC 2.4 were(19.70 ±3.50 )%,(39.20±4.60 )%,(40.90 ± 13.80)% and (62.10 ± 8.20 )%,respectively.The differences were statistical significant between Vv 1 .1758 andVv B2 (t=9.93,14.09,4.30 and 14.09,respectively;P =0.010,0.005 ,0.049 and 0.005 , respectively).Compared to Vv 1 .1758,Vv B2 induced more apparent cell apoptosis and necrosis within the same time.By fluorescence microscope,intensity of calcium was enhanced with the rising of apoptosis. Although the total expression of STAT3 increased,the relative molecular expression of p-STAT3 (705 ) decreased.There was no significant difference in its distribution in cells compared to the blank group. Conclusion The rapid apoptosis and necrosis of DC during Vv B2 invasion into DC may be caused by increasing [Ca2 + ]i and inhibiting phosphorylation of p-STAT3 (705)simultaneously.

Background and purpose:Tamoxifen is the main endocrine therapy of premenopausal breast cancer with positive hormone receptors but numerous patients have developed advanced refractory breast cancer due to drug resistance.Our study investigated the role of combining oophorectomy and exemestane in the treatment of advanced refractory breast cancer.Methods:Oophorectomy was carried out in all patients.Exemestane was administered orally (25 mg/d) one week after the operation.The median time of progression (TTP),the median survival time as well as the survival rate were calculated using the Kaplan-Meier methods.Results:Seventeen patients ranging between the ages of 26 and 44 years (median:36 years) were treated resulting in an overall response rate of 64.70%,TTP was 8 months and the median survival time was 31 months.The survival rates for 1 year,3 years and 5 years were 88.24%,64.71%,29.41%,respectively.No grade Ⅲ and Ⅳ side effects appeared.Conclusion:Oophorectomy when combined with exemestane showed antitumor activity for advanced refractory premenopausal breast cancer through positive hormone receptor and it is also well-tolerated.

Objective To evaluate operative methods and the clinical effect for comminuted calcaneal fractures.Methods 21 cases(24 feet)of comminuted calcaneal fractures were treated by one stage bone grafting plus open reduction and internal fixation with plastic calcaneus titanium plate.The fractures were classified according to the Sanders system into Sanders Ⅱ,Ⅲ and Ⅳ subgroups.Results All cases were followed up for 9～20 months(14months in average).All cases recovered with good healing of fracture.According to Maryland score,the results were excellent in 14 feet,good in 7 feet,fair in 2 feet,and poor in 1 foot.The excellent and good rate was 87.5％.Conclusions By using the method of internal fixation with plastic calcaneus titanium plate,fracture site can be well exposed,which is helpful to recover calcaneus to its normal length,width,height,Gissane angle and Bohler angle.A reliable internal fixation is helpful for early stage functional excise after surgery,which can maximize the recovery of the ankle function.

Objective To study the relationship of high-sensitivity C-reactive protein (hs-CRP),homocysteine (Hcy) and blood pressure variability in elderly patients with essential hypertension.Methods As the total coefficient of variation of 24-hour systolic blood pressure variability(BPsVC),the patients with essential hypertension were divided into two groups:the high-BPsVC group(n =72 cases) and the low-BPsVC group(n =48 cases).The hs-CRP and Hcy in serum in patients were detected.Results The hs-CRP were (2.52 ± 0.78) mg/L in the high-BPsVC group and (1.59 ± 0.61) mg/L in the low-BPsVC group.There was a significant difference (t =0.2766,P ＜ 0.05).The Hcy were(15.6 ±6.2) μmol/L in the high-BPsVC group and(13.7 ± 5.9) μmol/L in the low-BPsVC group.There was a significant difference(t =0.3742,P ＜ 0.05).Condusion There was a close relationship between hsCRP,Hcy and blood pressure variability in elderly patients with essential hypertension.

Objective To study the effectiveness of valsartan on the insulin resistance and high-sensitivity C-reactive protein(hs-CRP) of patients with essential hypertension.Methods One hundred and thirty patients with essential hypertension were randomly divided into two groups,the control group (n =65 cases) and the treatment group (n =65 cases).The patients in the control group were treated through amlodipine,while the patients in the treatment group were treated valsartan.They were all treated for six months.The insulin resistance(IR) and hs-CRP were compared.Results The systolic blood pressure and diastolic blood pressure were decreased after treatment in both groups (t =6.3706,6.4418,7.0519,7.2577,all P ＜ 0.01).There wasn't a significant difference between two groups (P ＞0.05).The IR and hs-CRP were decreased in both groups (t =6.3478,1.9977,4.0581,12.0722,all P ＜ 0.01).There was a significant difference between two groups (t =7.6049,4.6893,all P ＜ 0.05).Conclusion Valsartan can improve the insulin resistance and hs-CRP,which weren't dependent on lowing blood pressure.

AIM:To investigate the role of damaged mitochondria in dendritic cell ( DC) apoptosis induced by Vibrio vulnificus (Vv) and its possible mechanism.METHODS: DC2.4 cells were co-cultured with Vv 1.1758 strain. Fluorescent probes DCFH-DA and Fluo-8-AM were used to detect reactive oxygen species ( ROS) and intracellular Ca 2+concentration in the invaded cells , respectively .The cellular apoptotic rates and mitochondrial membrane potential (Δψm ) were measured by flow cytometry.The expression of nuclear factor-kappa B p65 (NF-κB p65) and tumor necrosis factor-al-pha (TNF-α) was detected by Western blotting.RESULTS:Vv 1.1758 induced DC2.4 cell apoptosis.Vv 1.1758 bacte-ria invaded into the DC2.4 cells by binding with cellular membrane though the end of the body .In the invaded DC2.4 cells, the visible mitochondrial damage, elevated ROS and intracellular Ca2+levels, and declinedΔψm were presented.Af-ter 1 h of co-culture, NF-κB p65 began to rise and reached the peak at 5 h, and then slightly decreased at 6 h.The TNF-αlevel increased after 2 h of co-culture and reached the peak at 6 h.CONCLUSION:The damaged mitochondria play an important role in DC apoptosis induced by Vv , and its possible mechanism may associate with the elevation of ROS and in-tracellular Ca2+level, and the declined Δψm.Meanwhile, NF-κB p65 and TNF-αare potential critical signaling molecules in the process of apoptosis .

The aim is to study the intestinal absorption of different combinations of active compounds out of Gegenqinlian decoction. Rat single pass intestinal perfusion model with jugular vein cannulated was used. Samples were obtained continuously from the outlet perfusate and the mesenteric vein. The levels of puerarin, daidzin, liquilitin, baicalin, wogonoside, jatrorrhizine, berberine and palmatine were determined by LC-MS/MS and their permeability coefficients were calculated. The results showed that Glycyrrhiza could promote the absorption of the active ingredients in Pueraria which is the monarch herb; meanwhile, Pueraria also played a role in promoting the absorption of liquilitin. Based on the Gegenqinlian decoction and the different combinations experiments, the results concerning the absorption of baicalin and wogonoside were as follows. For baicalin, Pueraria and Glycyrrhiza could promote its absorption and the effect of Pueraria was more obvious. For wogonoside, Pueraria could also promote its absorption, while Glycyrrhiza played a opposite role. Pueraria and Glycyrrhiza both played a part in promoting the absorption of jateorhizine, berberine and palmatine, the effective compounds in Coptis.