Objective To study the recent clinical efficacy of compound matrine injections combined with three-dimensional conformal intensity modulated radiotherapy in the treatment of locally advanced pancreatic cancer.Methods 48 cases of untreated locally advanced pancreatic cancer were randomly divided into treatment group (compound matrine injections combined with three-dimensional conformal intensity modulated radiotherapy) and control group (three-dimensional conformal intensity modulated radiationtherapy),there were 24 cases in each group.Three-dimensional conformal intensity modulated radiation therapy used 95 ％ isodose coverage PTV.Using 6 MV X-ray irradiation,2 Gy/day,5 times/week,the total radiation dose was 50 Gy/25 times/5 weeks to complete.Treatment group:one week before treatment infusion of compound matrine injections 20 ml/time,l/d,21-day was one cycle.Control group:simple intensity modulated radiotherapy.Results After treatment,the clinical benefit response rate of the treatment group was 87.5 ％ (21/24),the control group was 70.83 ％ (17/24),the difference was statistically significant (P =0.045).Term efficacy rate of the treatment group was 79.17 ％ (19/24),the control group was 50.00 ％ (12/24),the difference was statistically significant (P =0.035).Adverse reactions were hematologic toxicity,leukopenia occurred in the treatment group was 16.67 ％ (4/24),but the control group was 45.83 ％ (11/24),the difference was statistically significant (P =0.029).Conclusion The effects of compound matrine injections combined with three-dimensional conformal intensity modulated radiotherapy for locally advanced pancreatic cancer are good,they can relieve pain,improve short-term efficacy,reduc side effects,and improve the quality of life.

BACKGROUND:Qingre Huoxue Xiaozhong composition Ⅰ and Ⅱ made by ourselves are effective in treating bone fracture complicated by soft tissue injury.However,its mechanism is still unclear.OBJECTIVE:To observe the effect of Qingre Huoxue Xiaozhong composition on the levels of intedeukin 1β(IL-1β) and interleukin 6(IL-6) in serum of patients with closed bone injury-induced soft tissue injury.DESIGN:Randomized controlled observation.SETTING:Wards of the Department of Traditional Chinese Medicine,the 401 Hospital of Chinese PLA.PARTICIPANTS: Eighty-eight inpatients with bone fracture at early and moderate stages accompanied by soft tissue injury were chosen as volunteers to be studied in the Department of Traditional Chinese Medicine,the 401 Hospital of Chinese PLA between February 2000 and February 2002.The involved inpatients were assigned into 2 groups according to the table of random digit:Oingre Huoxue Xiaozhong composition Ⅰ + Ⅱ group (n=45) and Qingre Huoxue Xiaozhong composition Ⅱ group (n=43).Oingre Huoxue Xiaozhong composition Ⅰ was for internal administration,and Qingre Huoxue Xiaozhong composition Ⅱ was for external fumigation.METHODS:①Treatment of bone injury:Both caltrate D pellets and pills for strengthening bone joints were used in two groups.②Treatment of soft tissue injury: In the Qingre Huoxue Xiaozhong composition Ⅰ+ Ⅱ group,Qingre Huoxue Xiaozhong composition Ⅰ was decocted.Each decoction was 450 mL,and was packed into 3 pouches, 150 mL/pouch,three times a day;Qingre Huoxue Xiaozhong composition Ⅱ was decocted.Each decoction was 600 mL,and was packedinto 4 Douches,150 mL/pouch.Four pouches of Qingre Huoxue Xiaozhong composition Ⅱ was diluted by 2 000 mL water,then heated and used for fume-washing, twice a day, 20 to 30 minutes once. Four pouches could be used for fume-washing for 2 days successively. In the Oingre Huoxue Xiaozhong compositionⅡgroup, only Oingre Huoxue Xiaozhong composition Ⅱ was used to fume-wash the lesioned region.The concrete method was the same as that in the Qingre Huoxue Xiaozhong composition Ⅰ+Ⅱ group.In each group, ten days were set as one course of treatment,and totally, there are 2 courses of treatment.IL-1β and IL-6 levels in serum of patients were detected by with ELISA kit before.one and two courses after treatment, and compared separately.MAIN OUTCOME MEASURES: Levels of IL-1β and IL-6 in serum of patients in two groups before, one and two courses after treatment.RESULTS: In the eingre Huoxue Xiaozhong composition Ⅰ+Ⅱ group,the level of IL-1β and IL-6 was respectively significantly lower after 2 courses of treatment as compared with the previous one and one course after treatment (P＜0.05-0.01), also at the same time point in compared with the Qingre Huoxue Xiaozhong composition Ⅱ group (P＜0.05).In addition, in the Oingre Huoxue Xiaozhong composition Ⅰ+Ⅱ group,the level of IL-1β and IL-6 was respectively significantly decreased after one course of treatment as compared with before treatment (P＜0.05). In the Oingre Huoxue Xiaozhong composition Ⅱ group,after 2 courses of treatment,the level of IL-1β was significantly decreased as compared with before treatment, and the level of IL-β was also significantly decreased as compared with before treatment and after one course of treatment (P＜0.05).CONCLUSION: Qingre Huoxue Xiaozhong composition Ⅰ+Ⅱ can be used to treat bone fracture accompanied by soft tissue injury by inhibiting the levels of IL-1β and IL-6. The effect of the combination of Oingre Huoxue Xiaozhong composition Ⅰ and Ⅱ is superior to that of each alone.

Objective To measure the expression of granulocyte colony-stimulating factor receptor (G-CSFR) in human melanocytes and to evaluate the biologic effect of recombinant human granulocyte colony-stimulating factor (rhG-CSF) on human melanocytes.Methods Melanocytes were obtained from circumcision specimens of healthy males,and neutrophils were isolated from heparin-andcoagulated peripheral blood of healthy human followed by a primary culture.Then,the melanocytes in third passage were cultured with or without the presence of various concentrations (200,400,600,800 μg/L) of rhG-CSF for 72 hours.The growth and morphology of melanocytes were observed.Flow cytometry was performed to detect the expression of G-CSFR in untreated human melanocytes,neutrophils and erythroleukemia cells (HEL 92.1.7).Western blot and reverse transcription PCR (RT-PCR) were carried out to measure the expression of G-CSFR protein and mRNA respectively in the neutrophils,HEL 92.1.7 cells,treated or untreated human melanocytes.Methyl thiazolyl tetrazolium (MTT) assay was performed to evaluate the proliferation,and dopa-oxidation assay to estimate the tyrosinase activity,of treated melanocytes.Results The expression rate of G-CSFR was 76.81％ ± 10.70％ in human melanocytes,significantly higher than that in the HEL 92.1.7 cells (2.53％ ± 1.54％,P ＜ 0.01 ),but lower than that in the neutrophils (85.76％ ± 15.71％,P ＜ 0.05).Both G-CSFR protein and mRNA were expressed in melanocytes,and there was no significant differences in the expression level of G-CSFR protein and mRNA among melanocytes treated with different concentrations of rhG-CSF (both P ＞ 0.05).The expression levels of G-CSFR protein and mRNA in the melanecytes were significantly higher than those in the HEL 92.1.7 cells (both P ＜ 0.01 ),but lower than those in the neutrophils (P ＜ 0.05 or ＜ 0.01 ).rhG-CSF at 200-800 μg/L displayed a significantly promotive effect on the proliferation of melanocytes (P ＜ 0.01 or ＜ 0.05 ),and the effect was in a dose-dependent manner when rhG-CSF ranged from 200 to 600 μg/L (P ＜ 0.01 ).The rhG-CSF at 600 μg/L and 12-O-tetradecanoyl-phorbol-13-acetate (TPA) at 20 μg/L showed an equivalent effect on the proliferation of melanocytes (164.04％ ± 13.0％ vs.165.62％ ± 10.6％,P ＞ 0.05).However,rhG-CSF from 200 to 800 μg/L had no significant impact on the tyrosinase activity of melanocytes (all P ＞ 0.05 ).Conclusions G-CSFR is expressed in human melanocytes. rhG-CSF can promote the proliferation of cultured human melanocytes,but has no obvious influence on the tyrosinase activity of melanocytes.

Objective To evaluate left atrial (LA) function by real-time three-dimensional echocardiography (RT-3D) and speckle tracking imaging (STI) after circumferential ablation of pulmonay vein ostia for atrial fibrillation guided by carto mapping system. Methods Thirty patients who had ablation procedure for paroxysmal atrial fibillation were accepted echocardiography to estimate the LA function at pre-operation,3 days and 3 months of post-operation. The LA maximal, minimal and pre-systolic volume (LAVmax, LAVmin and LAVp), LA passive ejection fraction (LAPEF), LA active ejection fraction (LAAEF) were measured by RT-3DE respectively. The strain rate curve was acquired in each LA segment (anterior, posterior, lateral, inferior and septal) by STI. Systolic strain rate (SRs), early diastolic strain (SRe) and late diastolic strain rate(SRa) of each left atrial segments were measured. Results Comparing with preoperative,3 days post-ablation SRs,SRe and SRa decreased significantly in each wall of LA. After 3 months,SRa and SRe in anterior, inferior and septal were significantly improved, however, SRs showed no significant difference. LAVmax and LAVpre were significantly decreased. LAPEF and LAAEF were significantly improved. Conclusions The patients with circumferential pulmonary vein ablation were in a deterioration after three days. The pump function and conduit functions of left atrial were increased after 3 months.

Background Fungal keratitis is one of primary infectious ocular diseases in China.Conventional diagnostic method is fungal cultivation.In vivo laser confocal microscope is a noninvasive examination of ocular surface.However,the study on features of in vivo laser confocal microscope images of frequent fungal keratitis is still not thorough.Objective This study was to analyze laser confocal microscope imaging features of four typical fungal keratitis.Methods The clinical data of 65 eyes from 65 patients with fungal keratitis were retrospectively analyzed.The patients were initially diagnosed in Nanjing General Hospital of Nanjing Military Command PLA from January 2007 to November 2011, and laser confocal microscope examination of ocular surface and fungal cultivation were performed.The characteristics of laser confocal microscope images were investigated,including shape and type of hypha,distribution of spores and the relationship of hypha with lesion.The differentiation between fungal hypha and other corneal tissues was summarized.Results Fungal cultivation showed that among the 65 patients,Fusarium,Aspergillus,Candida and Alternaria were common pathogenic fungus with the infected proportion 63.0％ , 16.9％,3.0％ and 4.6％ ,respectively, and 12.5％ patients were infected by other fungus.In the images of laser confocal microscope,hyphae of Fusarium presented the branch-like high reflective structure in the corneal superficial stromal layer and thinning line shape in the deep stromal layer.Few inflammatory cells were found.The peudohyphae and spores from Candida were seen in corneal superficial and mid stroma layers, with few inflammatory cells and many proliferating stromal fibers in the lesions.The hyphae of Aspergillus presented worm-like, showing the thinner and shorter shapes in comparison with those of Candida.The hyphae of Alternaria were long,straight and thick in shape,and spherical chlamydospores were found on the hyphal tip.The hyphae, subepithelial plexus, dendritic cells, fibrosis of the cornea all showed high reflection under the laser confocal microscope, but evidently differences appeared in shape,distribution and course in corneas.Conclusions Hyphae are the main basis to diagnose fungal keratitis and differentiate fungi.As a non-invasive examination method,laser confocal microscope can provide useful information for the early diagnosis and treatment of fungal keratitis in vivo.

Objective To pay attention to screening family disease and gene examination in patient with congenital adrenal hyperplasia (CAH). Method In this study, we investigated clinical data and performed gene sequencing of the pedigree and his family members with CAH. Results Based on clinical data, 3 of 6 family members were diagnosed CAH. Bone age of two boys nearly reach the maximum value. Genetic sequencing result indicated a T>A mutation of 1 004 position in CYP21A2 gene, which induced protein change I172N. Conclusion Disease screening and gene examine should be actively executed in patient with CAH in order to obtain diagnosis and start treatment as early as possible.

BACKGROUND:Previous studies have demonstrated that normal rat liver homogenate supernatant can induce human umbilical cord mesenchymal stem cels to differentiate into hepatocyte-like cels with partial hepatocyte functions. However, whether fibrotic liver homogenate supernatant can work or how the inducing effect is remains unclear. OBJECTIVE:To investigate the differentiation potential of human umbilical cord mesenchymal stem cels into hepatocytes under the normal liver and fibrotic liver microenvironment in vitro. METHODS:Liver fibrosis was induced in the SD rats by repeated intraperitoneal injections of 3% thioacetamide at a dose of 200 mg/kg body mass, twice a week for 4 weeks, and then fibrotic liver tissues and normal liver tissues were used to prepare liver homogenate supernatants. Passage 3 human umbilical cord mesenchymal stem cels were used and divided into standard control group (cels were cultured in DMEM/F12 with 10% fetal bovine serum), fibrotic liver homogenate supernatants group (cels were cultured in DMEM/F12 with 10% fetal bovine serum and 50 g/L fibrotic liver homogenate supernatants), normal liver homogenate supernatants group (cels were cultured in DMEM/F12 with 10% fetal bovine serum and 100 g/L normal liver homogenate supernatants). The morphological changes of the cels in each group were recorded under inverted microscope; the protein levels of CK18, AFP, CYP3A4, CYP2E1, CYP2D6 and TPH2 were evaluated using western blot assay. Furthermore, the concentration of albumin in the cels was measured. RESULTS AND CONCLUSION:After a 7-day inducement, the stem cels in liver homogenate supernatants groups lost their fusiform shape and changed into hepatocyte-like cels with the morphous of round shape. Compared with the standard control group, the hepatocyte-like cels in the two liver homogenate supernatants groups exhibited human hepatocyte biomarkers, CK18 and AFP. The standard control group cels could express a little amount of CYP2E1, while cels in the two liver homogenate supernatants groups could express CYP3A4, CYP2E1, CYP2D6, TPH2. Compared with the standard control group, the expression level of CYP2E1 in the two liver homogenate supernatants groups increased significantly (P < 0.01), and however, the relative levels of CYP3A4, CYP2E1, CYP2D6, TPH2 in the two liver homogenate supernatants groups showed no statistical significance (P > 0.05). At the same time, compared with the standard control group, the concentration of albumin in the two liver homogenate supernatants groups markedly increased (P < 0.01), but there was no difference between the two liver homogenate supernatants groups (P > 0.05). Experimental findings demonstrated that both of normal liver tissue and fibrotic liver tissue microenvironments could induce human umbilical cord mesenchymal stem cels to differentiate into hepatocyte-like cels. To achieve the same effect, compared with normal liver tissue, fibrotic liver tissue required lower concentrations, suggesting that fibrotic liver tissue microenvironment may be more conducive to differentiation of umbilical cord mesenchymal stem cels into hepatocytes.

Objective: Fungal keratitis is one of the most common diseases leading to blindness.It has a high incidence in China,and its early diagnosis and treatment are of vital importance.We aimed to investigate the value of laser confocal corneal microscopy in the clinical diagnosis of fungal keratitis.Methods: We conducted laser confocal corneal microscopy on 37 patients suspected of fungal keratitis,and compared the results with those obtained from the corneal tissue smears and fungal cultivation.Results: The fungus-infected corneas histologically exhibited defected epithelial cells,damaged subepithelial nerves and disordered stroma with reduced transparence.The hyphae showed bright,disordered,interlaced thread-or short rod-like structures.The positive rates of smear examination,fungus cultivation and laser confocal corneal microscopy were 48.65,62.16 and 78.39% for the 37 eyes,75.00,87.50 and100% for the 16 untreated eyes,and 28.57,42.85 and 61.90% for the other 21 pretreated eyes.Conclusion: Confocal laser corneal microscopy,rapid,effective and noninvasive,can be used as an important new alternative in the diagnosis of fungal keratitis

Objective: To study the effect of ?-cyanoacrylate on corneal perforation in rabbits. Methods:Eighteen adult rabbits were divided into a left eye group and a right eye group.Bilateral corneas of the rabbits were perforated and subsequently occluded with ?-alkyl cyanoacrylate synthetic adhesive in the former group and by separated single points using the 10-0 polyglactin thread in the latter.The time for the obliteration of the corneal perforations and intraocular pressure(IOP) were recorded preoperatively and 3 days after the operation in both the two groups.The ocular contents of the two groups were observed by slit-lamp biomicroscopy after the operation.Results: The mean time of the corneal perforation obliteration was shorter in the left than in the right eyes.IOP was recovered to normal within 3 days postoperatively and the ocular contents were stabilized,with no significant difference in IOP between the two groups 3 days after the operation.Conclusion: ?-Cyanoacrylate is an effective adhesive agent for corneal perforation.

The patent information of ultrasound countercurrent extraction used in traditional Chinese medicine was analyzed in this paper by the samples from Derwent World Patent Database (DWPI) and the Chinese Patent Abstracts Database (CNABS). The application of ultrasound countercurrent was discussed with the patent applicant,the amount of the annual distribution, and the pharmaceutical raw materials and other aspects. While the technical parameters published in the patent was deeply analyzed, such as material crushing, extraction solvent, extraction time and temperature, extraction equipment and ultrasonic frequency. Thought above research, various technical parameters of ultrasound countercurrent extraction used in traditional Chinese was summarize. The analysis conclusion of the paper can be used in discovering the technical advantages, optimizing extraction conditions, and providing a reference to extraction technological innovation of traditional Chinese medicine.
Medicine, Chinese Traditional ; Patents as Topic ; Solvents ; Technology, Pharmaceutical ; Temperature ; Ultrasonics