Objective To determine whether leflunomide could control the proinflammatory cytokine expression induced by anthralin via inhibiting the activation of nuclear factor ?B (NF-?B). Methods The expression of NF-?B inhibitory protein ? (I?B?), was analyzed by using Western blot method. MTT assay and RT-PCR were used to assess the proliferating activity and mRNA expression of intercellular adhesion molecule-1 (ICAM-1) of HaCaT keratinocytes, respectively. Results Leflunomide inhibited the degradation of I?B? by anthralin, i.e. the activation of NF-?B signaling pathway, in a dose-dependent manner. The inhibition of keratinocyte growth by anthralin did not correlate with the activation of NF-?B. Under the experimental conditions used, leflunomide was shown to be able to significantly inhibit the over-expression of ICAM-1 on keratinocytes induced by anthralin; this inhibition occurred in a dose dependent manner. Conclusions Growth inhibition by topical anti-psoriatic medication anhtralin is unrelated to the NF-?B-dependent signaling pathway, and leflunomide can control ICAM-1 expression induced by anthralin via inhibiting the activation of NF-?B.

Objective To provide reference for clinical pharmacist participating in management of nausea and vomiting induced by tumor chemotherapy. Methods The process of pharmaceutical care for a patient with severe vomiting caused by adjuvant chemotherapy after gastric cancer operation was described. Antiemetic application and drug adverse reactions were analyzed. A new treatment plan was given by clinical pharmacist. Results The suggestions were adopted by clinician. The vomiting was controlled and drug adverse reactions were dealt with. Conclusion To reduce the risk and improve the income of antiemetic,clinical pharmacists should pay more attention to clinical practice guideline,drug interaction and adverse reactions, provide the most suitable suggestions for clinicians according to pharmacology and evidence-based medicine.

The paper proposed a new method to design and fabricate a flexible neural microelectrode arrays (MEA) for retinal prosthesis, the ion-beam technology was introduced to decrease the width of conductive wires and the distances between wires, a high density MEA (120 microelectrodes with a matrix of 10 x 12) was fabricated on a single layer of polymer from this. The MEA was proved to possess a fine electrochemical property. In vitro test, the average impedance of MEA on 1 kHz was 16 k omega +/- 2 k omega and the average phase difference was -85 degrees +/-30 degrees.
Micro-Electrical-Mechanical Systems ; Microelectrodes ; Prosthesis Design ; Visual Prosthesis

Objective To evaluate clinical and pathologic factors associated with pelvic lymph node metastasis in patients with early-stage squamous cell carcinoma of the uterine cervir.Methods From February 2004 to January 2007,135 patients with stage Ⅰ b-Ⅱ a cervical squamous cell carcinoma in Women's Hospital,School of Medicine,Zhejiang University,were retrospectively studied.The relationship between pelvic lymph node metastasis and age,clinical stage,tumor size,grade of differentiation,depth of muscular invasion,lymphatic vascular space invasion,pretreatment level of serum squamous cell carcinoma antigen,pretreatment plasma level of fibrinogen,pretreatment leveh of hemoglobin and platelet were evaluated by univariate and multivariate analyses.Results Totally 3996 lymph nodes were dissected in 135 patients,with an average of 29.6 lymph nodes in each patient.12.6%of the patients(17/135)had metastasized pelvic lymph nodes.Univariate analysis indicated that tumor size(P=0.003),depth of muscular invasion(P=0.004),vasular space invasion(P<0.01),pretreatment levels of platelet(P=0.006)and fibrinogen(P<0.01)were significantly related to pelvic lymph node metastasis.Multivariate logistic regression analysis showed that lymphatic vascular space invasion(OR:3.674,95%CI:1.825-7.393,P<0.01)and pretreatment plasma level of fibrinogen(OR:4.568,95%CI:1.779-11.725,P=0.002)were significantly related to pelvic lymph node metastasis in patients with early-stage squamous cell carcinoma of the uterine cervix.Conclusion In early-stage cervical squamous cell carcinoma,lymphatic vascular space invasion and higher pretreatment plasma levels of fibrinogen are risk factors of pelvic lymph node metastasis.

Objective To compare the differences between external standard method and relative correction factor method for determination of the flavonoids from Sorbus tianschanica Rupr.Methods Using HPLC external standard method for determination of hyperoside,rutin,isoquercitrin,quercetin-3-O-(6″-O-malonyl)-β-D-glucoside,astragalin and Kaempferol-3-O-(6″-O-malonyl)-β-D-glucopyranoside in Sorbus tianschanica Rupr.,HPLC relative correction factor method was adopted to establish relative correction factor of the other five flavonoids above with hyperoside as reference.The difference was evaluated by comparing the external standard method with the relative correction factor method.Results There was no significant difference between the T test external standard method and relative correction factor method(P>0.05).Conclusion External standard method and relative correction factor method can be used for determination of the flavonoids from Sorbus tianschanica Rupr.,but in the case of lack of reference substance or mass detection,using the relative correction factor method for determination of rutin,hyperoside isoquercitrin,quercetin-3-O-(6″-O-malonyl)-β-D-glucoside,astragalin and kaempferol-3-O-(6″-O-malonyl)-β-D-glucopyranoside in Sorbus tianschanica Rupr.It was more feasible and it can be used as a new quality evaluation method in determination of flavonoid components from Sorbus tianschanica Rupr.

Objective To investigate the clinical characteristics and evaluate surgical experiences in Hashimoto's disease patients suffering from coexistent thyroid nodules. Method Clinical data in 299 cases of Hashimoto's disease coexistent with thyroid nodules treated surgically from Jun 1985 to Dec 2004 were analyzed. Results The coexistent rate of Hashimoto's disease (HD) with thyroid carcinoma (TC) . thyroid adenoma.nodular goiter.hypothyroidism and hyperthyroidism was 17. 4% , 34. 4% , 5. 7% , 3. 7% and 2. 3% respectively. The coexistent rate of HD with TC was 9. 2% before 1995, and 19. 7% after 1996. There were 35 cases of papillary carcinoma, 11 cases of follicular carcinoma, 4 cases of mixed type and one case of lymphoma. There were 17 cases of occult thyroid carcinoma, accounting for 32.7% of the malignancy. Operative procedures included biopsy only and thyroidectomy according to frozen pathology. Conclusions There is a high incidence of coexistent thyroid neoplasm in patients with Hashimoto's disease, the incidence of thyroid carcinoma especially occult carcinoma is rising recently.

Objective To evaluate the value and feasibility of Microsim medical simulation training system in medical students' clinical thinking training. Method 96 students of 5-year program of medicine of Grade 2009 and Grade 2010 were the research object. These students were randomly divided into two groups (group A:After 3 weeks' clinical practice in respiratory medicine, taking 1 week Microsim training. group B: Taking 4 weeks clinical practice in respiratory medicine. Each group has 48 students.). The examination and teaching satisfaction of the two groups were observed after the end of the internship. SPSS 17.0 statistical software was used to analyze the collected data (measurement data matching t test, counting data by chi-square test). Results The Microsim system score: group A was (89.37±7.18), group B was (61.95±15.34). The difference between groups was statistically signifi-cant. The following scores suggested the assessment of students' ability of clinical thinking: ability to analyze problems [group A (89.95±4.02) vs. group B (75.51±6.34)], the ability to deal with the prob-lem [group A (78.81±8.09) vs. group B (59.67±9.33)], treatment scheme [group A (86.74±6.59) vs. group B (70.39±7.05)] and the treatment effect [group A (88.61±8.16) vs. group B (63.54±11.48)]. In these aspects, the two groups had statistically significant difference, but communication [group A (82.47 ±5.23) vs. group B (84.09 ±3.72)] had no statistically significant difference between the two groups. 89.6% (43) of the participants believed that the Microsim medical simulation training system could significantly improve the clinical thinking ability, but only 58.3% (28) of the students believed that the basic theory of knowledge could be consolidated. Conclusion Microsim medical simulation training system can improve the students' ability of clinical thinking and clinical comprehensive treat-ment ability. It can be used as an effective complement to clinical practice teaching.

ObjectiveTo develop a quantitative method for simultaneously determining multi-components in Rhei Radix et Rhizoma using one chemical reference substance.MethodsThe contents of multi-components were calculated by the UV relative correction factors (RCFs) of chrysophanol,physcion,and rhein to emodin.ResultsThe values of RCFs at 274 nm for rhein,chrysophanol,and physcion to emodin were 0.712,0.674,and 1.051.The calibration curves were linear over the ranges of 0.02-4.08,0.02-4.12,0.07- 12.92,and 0.02-3.68 μg/mL for rhein,emodin,chrysophanol,and physcion,respectively.The contents of emodin in 18 samples were determined by the extemal standard method,and the contents of the other three anthraquinone aglycones were calculated according to their RCFs.ConclusionNo significant difference is found in comparison with the classical method,indicating that the RCFs have high reliability within their linear ranges and could be used in quality control of Rhei Radix et Rhizoma.The quantitative analysis of multi-component with a single marker is especially suitable for herbal medicines containing unstable or hard to be purified components as quality control markers.

Objective To approach the normal manifestations of the hypopharynx of the adults at the level of cricoid cartilage as seen on CT images, and to evaluate their clinical value. Methods Eighty-four CT images of the normal hypopharynx were reviewed. The hypopharynx was divided into three regions:(1) the piriform sinus, (2) the retropharynx area, and (3) the postcricoid region. The postcricoid region of hypopharynx was subdivided into three levels as follows : (1) the upper margin slice of the cricoid cartilage at the cricoarytenoid joint level, (2) the middle portion slice of the cricoid cartilage, and (3)the inferior margin slice of the cricoid cartilage. The anteroposterior and transverse diameters, and anterior and posterior wall thicknesses in the postcricoid region were measured. Depiction of the layers of the musculature and adjacent fat planes was evaluated. Statistical comparisons of measured results were made by using ttest and x2 test. Results The posterior wall tended to be (0. 9±0. 4) mm thicker than the anterior wall. The average transverse extension of the postcricoid musculature was (4. 5±0. 3)mm shorter in female than that in male at CT images. There were statistically significant differences related to sex (at the upper margin level of the cricoid cartilage : the transverse extension was (38. 6±3. 3)mm in male, (34. d±2. 5) mm in female, t = 6. 26,P < 0. 05 ; at the middle portion level of the crieoid cartilage: (33.6±3. 6) mm in male,(28.9±2.8) mm in female t =6.36, P <0.01;at the inferior margin level of the cricoid cartilage:(28.6 ±3. 1) nun in male, (24. 0 ±2. 1) mm in female, t = 7.52, P <0. 01). The transverse diameter tended to taper (10. 1±2. 4) mm from the upper cricoid slice level to the lower cricoid slice levelDemonstration of the intramural fat planes of the postcricoid region decreased from the upper [ 81.0%(68/84)] to the lower region [23.8% (20/84)] of the cricoid cartilage. In fat planes around the postcricoid region at all levels, the posterior fat plane was seen least frequently, and the left-sided fat plane was seen most frequently. There was a statistically significant difference at every level(at the upper margin level of the cricoid cartilage, the visibilities of the left-sided, the right-sided, and the posterior fat plane around the postcricoid region were 77.4% (65/84), 72. 6% (61/84), and 28. 6% (24/84) ,x<'2> =24. 64,P <0.01 ; at the middle portion level of the cricoid cartilage, the visibilities were 89.3% (75/84), 75.0%(63/84), and 34.5% (29/84) ,x<'2> =24. 76, P <0. 01 ; at the inferior margin level of the cricoid cartilage:the visibilities were 95.2% (80/84), 88. 1% (74/84), and 52. 4% (44/84), x<'2> = 13.59, P < 0. 01.Conclusion Knowledge of the normal appearances and variations of the hypopharynx at the level of cricoid cartilage is essential in detecting abnormalities in this area.

To separate and identify the chemical constituents from the leaves of Broussonetia papyrifera (Linn.) Vent, various columns including Diaion HP-20, Toyopearl HW-40C, Sephadex LH-20, silica gel were employed for the isolation and purification of compounds from the leaves of B.papyrifera. The structures of the compounds were elucidated by their physiochemical characteristics and spectral data. Nineteen compounds were isolated from the leaves of B.papyrifera and their structures were identified as apigenin (1), apigenin-7-O-β-D-glucopyranoside (2), chrysoerid-7-O-β-D-glucopyranoside (3), apigenin-7-O-β-D-glucopyranuronide (4), vitexin-7-O-β-D-glucopyranoside (5), luteolin (6), 5,7,4′-trihydroxyl-6-C-[a-L-rhamnopyranosyl(1→2)]-β-D-glucopyranosyl flavone (7), 5,7,4′-trihydroxyl-8-C-[a-L-rhamnopyranosyl(1→2)]-β-D-glucopyranosyl flavone (8), saponaretin (9), vitexin (10), benzyl benzoate-2,6-di-O-β-D-glucopyranoside (11), (2R,3R,5R,6S,9R)-3-hydroxy-5,6-epoxy-β-ionol-2-O-β-D-glucopyranoside (12), (2R,3R,5R,6S,9R)-3-hydroxyl-5,6-epoxy-acetyl-β-ionol-2-O-β-D-glucopyranoside (13), ficustriol (14), (6S,9S)-roseoside (15), 3β-hydroxy-5α,6α-epoxy-β-ionone-2α-O-β-D-glucopyranoside (16), icariside B1 (17), sammangaoside A (18), 3-hydroxy-5α,6α-epoxy-β-ionone (19). Compounds 11, 12 and 13 are new compounds, the others are isolated from this genus Broussonetia for the first time.