BACKGROUNDXanthogranulomatous cholecystitis (XGC) is a rare type of gallbladder inflammation. Unlike other cholecystitis, it can be easily misdiagnosed as gallbladder cancer based on radiological images. In response to misdiagnosis, extended surgical treatments are inappropriately given to patients, which is not beneficial to their health and/or recovery. In this study, we set out to determine whether tumor biomarkers can help to avoid misdiagnosis in patients with XGC.

METHODSBetween January 2005 and January 2012, a total of 37 preoperative patients at Sir Run Run Shaw Hospital were suspicious of having gallbladder cancer and was pathologically confirmed to be XGC after surgical operations. Before operations, all patients received a tumor biomarker test to verify diagnosis, which included serum CA 19-9, carcinoembryonic antigen (CEA), and CA 12-5.

RESULTSA measured amount (54.05%) of cases (20 in 37) had at least one elevation over the thresholds of CA 19-9 (37 IU/L), CEA (5 ng/ml), and CA 12-5 (35 IU/L), which increased the suspicion of malignancy and consequently enhanced the difficulty to make right diagnosis of XGC as benign. 45.95% of cases (17 in 37) had an elevation in CA 19-9. 2.70% of cases (one in 37) had an elevation in CEA and 24.32% of cases (nine in 37) had an elevation in CA 12-5. Analysis with Fisher's exact test discovered that the presence of common bile duct stone was a contributor to elevations of CA19-9 in patients with XGC. However, even in cases without common bile duct stones, 42.86% of patients (nine in 21) had elevations of at least one tumor biomarker. Among them, 26.09% of patients (six in 21) had elevations of CA 19-9, with the maximum of 536.29 IU/L.

CONCLUSIONSThe elevations of tumor biomarkers in XGC were frequent, suggesting their inabilities to clarify the disease's nature, especially when there was a suspicion of gallbladder cancer. Intraoperative frozen pathology of gallbladder might be a possible solution. However, it is against the en bloc surgical principle and has the potential to cause tumor cell spreading. More research should be conducted, such as the discovery of a novel biomarker, so that XGC can less likely be misdiagnosed as malignancy until the final pathological judgment.

Adult ; Aged ; Aged, 80 and over ; Biomarkers, Tumor ; blood ; CA-125 Antigen ; blood ; CA-19-9 Antigen ; blood ; Carcinoembryonic Antigen ; blood ; Cholecystitis ; blood ; diagnosis ; Female ; Granuloma ; blood ; diagnosis ; Humans ; Male ; Middle Aged ; Xanthomatosis ; blood ; diagnosis

Cholangiopancreatography, Endoscopic Retrograde ; Duodenum ; surgery ; Humans ; Retrospective Studies

Objective To evaluate 99tcm-DTPA nuclear dynamic imaging in distinguishing the renal occupied disease.Methods A total of 164 in-patients with renal occupied disease who underwent surgery were included.According to the pathological diagnosis,119 patients had malignant tumors,and 45 patients had benign diseases.All patients’ imaging was retrospectively analyzed.Application of 99Tcm-DTPA nuclear dynamic imaging in renal occupied disease was compared with ultrasonography (US),computed tomography (CT),magnetic resonance imaging (MRI),intravenous pyelogram (IVP),and positron emission tomography (PET)-CT.Results The accuracy rates of different imaging methods in distinguishing between renal malignant and benign disease were 99Tcm-DTPA (84 ％,45 ％),US (72 ％,64 ％),CT ( 91％,92 ％),MRI (50 ％,67 ％),IVP (50 ％, 17 ％), respectively.The diagnostic accuracy rate of PET-CT for malignant tumors was 67 ％.The accuracy rates of 99Tcm-DTPA in distinguishing different phases of renal cell carcinoma were statistically significant (x 2 =83.4, P ＜ 0.01), while the accuracy rates in distinguishing renal cyst from renal angiomyolipoma were not statistically different.With the greater diameter, the diagnostic accordance rate is higher (x 2 =16.05,P ＜ 0.05).Conclusion 99Tcm-DTPA could be used not only to evaluate the renal function quantificationally,but also be helpful to distinguish renal malignant tumor from benign disease.

Objective To establish a micellar electrokinetic capillary chromatography method for content determination of geniposide in Biyuanshu Oral Liquid. Methods Acetaminophen was used as an internal standard, and the separation was performed on an uncoated fused silica capillary of 52 cm × 50 μm ID (42 cm effective length) with the separation voltage of 25.0 kV. The running buffer contained 50 mmol/L borax, 100 mmol/L sodium dodecyl sulfate and 15％ acetonitrile (pH=10). The sample was injected by pressure (10 s, 0.5 psi) and detected at 238 nm. Results Geniposide was in good linearity range of 15.02–320.48 μg/mL (r=0.9995). The repeatability (low, medium and high concentration of samples) and intermediate precision assays gave satisfactory RSD values of less than 1.77％and 2.01％, respectively. The average recovery of geniposide in Biyuanshu Oral Liquid was 97.50％ and the RSD was 4.43％. The contents of geniposide determined by micellar electrokinetic capillary chromatography were in accordance with the results of HPLC analysis. Conclusion The method is simple, fast, accurate and precise, which can be used for the content determination of geniposide in Biyuanshu Oral Liquid.

Exposure of endothelial cells (ECs) to hypoxia leads to a decrease in EC proliferation. However, the mechanism by which hypoxia inhibits EC proliferation is unclear. Perlecan has been reported to play an important role in regulating EC proliferation. We hypothesized that perlecan was involved in the hypoxia-induced inhibition of EC proliferation. To test this hypothesis, rat cardiac microvascular ECs were cultured under normoxic or hypoxic conditions for 12 h and harvested for determination of perlecan mRNA expression using real-time reverse transcription-polymerase chain reaction (RT-PCR). The results showed that exposure of ECs to hypoxia for 12 h induced a decrease in perlecan mRNA expression (61.72%, P<0.05). Concomitantly, the down-regulation of endogenous perlecan induced by hypoxia or the neutralization of endogenous perlecan with anti-perlecan antibody significantly inhibited EC proliferation and responsiveness to basic fibroblast growth factor (bFGF), and decreased focal adhesion kinase (FAK) expression and extracellular signal-regulated kinase 1/2 (ERK1/2) activation. These data indicate that down-regulation of perlecan expression contributes to hypoxia-induced inhibition of rat cardiac microvascular EC proliferation by suppressing FAK-mediated and ERK1/2-dependent growth signals.
Animals ; Capillaries ; cytology ; Cell Hypoxia ; Cell Proliferation ; Cells, Cultured ; Coronary Circulation ; Down-Regulation ; Endothelial Cells ; cytology ; metabolism ; Focal Adhesion Kinase 1 ; metabolism ; Heparan Sulfate Proteoglycans ; genetics ; metabolism ; MAP Kinase Signaling System ; Male ; Oxygen ; metabolism ; RNA, Messenger ; genetics ; metabolism ; Rats ; Rats, Sprague-Dawley ; Real-Time Polymerase Chain Reaction

Objective To analyze the treatment outcome and related influencing factors of Tibet- an nationality new smear-positive pulmonary tuberculosis patients in Qinghai Province，so as to provide evidence for tuberculosis control and treatment among Tibetan population． Methods Statistical analysis was conducted on 5 564 Tibetan nationality new smear-positive pulmonary tuberculosis cases in Qinghai province who were reported in the China Tuberculosis Information Management System and approved to receive treatment from 2008 to 2017． The main influencing factors were detected by unconditional Logistic regression model analysis，dependent variable was successful treatment or not，independent variables were other factors related to the treatment outcome． Ｒesults The treatment success rate of Tibetan nationality new smear-positive pulmonary tuberculosis cases was 87. 1% ( 4 848 /5 564) ，and the adverse outcome rate was 12. 9% ( 716 /5 564) ． Unconditional Logistic regression model analysis indicated that non-full- course supervision management，living in agricultural and pastoral area，having severe disease，floating population，and age older than 60 years were risk factors of adverse outcome． The odds ratio( OＲ) 95% confidence interval( CI) of the above risk factors were 13. 044( 10. 671-15. 944) ，2. 305( 1. 703-3. 119) ， 2. 090( 1. 346-3. 243) ，1. 967( 1. 443-2. 682) ，and 1. 909( 1. 410-2. 586) ． Clinical consultation，farmers and herdsmen were protective factors． The OＲ( 95% CI) were 0. 451( 0. 375-0. 543) ，and 0. 786( 0. 627- 0. 985) ． Conclusions Treatment success rate of Tibetan nationality new smear positive pulmonary tuberculosis cases was low． Therefore，the directly observed treatment short-course ( DOTS) strategy should be strictly implemented and the full-course supervision management should be strengthened to improve the treatment success rate． More attention should be paid to the elderly，severe，floating，agricultural and pastoral populations among the Tibetan population．

Objective: To summarize the distributing rule of TCM syndrome elements of common diseases by analyzing the literature of Depression,Chronic Hepatitis B,Chronic Renal Failure,Chronic Obstructive Pulmonary Disease,Menopausal Syndrome.Methods: We selected eligible literatures,then established database with EpiData 3.0 software and computed the frequency of TCM syndrome elements with SPSS 12.0 software.Results: ①Liver,heart,spleen,lung and kidney are common TCM syndrome elements of location of disease.②Yin deficiency,yang deficiency,heat,qi stasis,qi deficiency,blood stasis,damp and phlegm are common TCM syndrome elements of nature of disease.③There are TCM syndrome types between 62 and 148,but the sum of frequency of leading syndrome types which includes disease information is mostly no more than 50%.There are TCM syndrome elements between 19 and 47,but the sum of frequency of leading syndrome elements which includes disease information is mostly above 80%.Conclusion: It is convenient to study TCM syndrome from the aspect of TCM syndrome elements,so we should thoroughly keep on studying TCM syndrome elements.

Quantitative structure-property relationships (QSPR) were developed to predict the pK(a) values of sulfa drugs via heuristic method (HM) and gene expression programming (GEP). The descriptors of 31 sulfa drugs were calculated by the software CODESSA, which can calculate constitutional, topological, geometrical, electrostatic, and quantum chemical descriptors. HM was also used for the preselection of 4 appropriate molecular descriptors. Linear and nonlinear QSPR models were developed based on the HM and GEP separately and two prediction models lead to a good correlation coefficient (R) of 0.90 and 0.95. The two QSPR models are tseful in predicting pK(a) during the discovery of new drugs and providing theory information for studying the new drugs.
Algorithms ; Gene Expression ; Models, Chemical ; Quantitative Structure-Activity Relationship ; Software ; Sulfonamides ; chemistry

OBJECTIVETo establish a new method for the determination of fangchinoline and tetrandrine in Stephania tetrandra and Fengtongan capsule by noanqueous capillary electrophoresis.

METHODSeparation was carried out in an uncoated fused capillary (50 cm x 75 microm i.d.) with a running buffer containing 50 mmol x L(-1) ammonium acetate, 1.0% acetic acid and 20% acetonitrile in methanol. A separation voltage of 20 kV and a UV detector wavelength at 214 nm were adopted. Sample was introduced from the anode.

RESULTThe calibration ranges were 1.00, 500 mg x L(-1) for both analytes. Under the optimum conditions, the relative standard deviation (RSD, n = 6) for the migration time of each analyte were 0.09%, 1.9% (intra-day) and 0.63%, 1.9% (inter-day); The RSD for the peak area of each analyte were 0.45%, 5.9% (intra-day) and 2.3%, 5.6% (inter-day), respectively. The contents of the analytes were determined easily with average recoveries 102% for fangchinoline and 105% for tetrandrine in S. tetrandra and 94.6% for fangchinoline and 98.7% for tetrandrine in Fengtongan capsules, respectively.

CONCLUSIONThe proposed method is simple, rapid, accurate and higher repeatable, and can be used to control of the quality of S. tetrandra and Fengtongan capsules.

Benzylisoquinolines ; analysis ; Calibration ; Capillary Electrochromatography ; methods ; Capsules ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; standards ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Quality Control ; Reproducibility of Results ; Stephania tetrandra ; chemistry

Aged ; Aged, 80 and over ; Foreign-Body Migration ; etiology ; Hernia, Inguinal ; surgery ; Humans ; Intestinal Obstruction ; etiology ; Male ; Postoperative Complications ; etiology ; Surgical Mesh