Objective To compare and analyze clinical and pathological data of autopsyconfirmed invasive fungal disease (IFD) in elderly patients in order to achieve a better understanding of the clinical and pathological characteristics of IFD.Methods A total of 18 cases of IFD were diagnosed by autopsy from 1984 to 2014 at Beijing Hospital.Clinical and pathological data of IFD,including risk factors,clinical manifestation,X-ray and pathological characteristics,were analyzed retrospectively.Results The 18 cases were all male wvith an average age of (83.7±7.2) years and each patient had at least one risk factor for IFD.Of them,14 patients (77.8％) suffered malignancies of various origins.With respect to the pathogens,Mucor (6 cases) was the most common one,followed by Aspergilla (4 cases),Mycotoruloides (4 cases) and Cryptococci (2 cases).The lung was the most frequently implicated organ wvith 13 cases (72.2％),followed by the gastrointestinal tract.Vascular erosion was an important pathological characteristic of fungal infection,whose presentations included vasculitis,hemorrhage and embolism in tissues and organs.14 patients died from fungal infection-related causes,of which.massive hemorrhage as a result of vascular erosion by fungal infection was responsible for four patients' deaths.Conclusions Malignancies are an important risk factor for invasive fungal disease in elderly patients.Vascular erosion is a significant character of fungal infection.

Objective To investigate early diagnosis and treatment of tumor of duodenal papilla.Methods Their clinical data of 64 cases of tumor of duodenal papilla confirmed by operation and pathology were analyzed retrospectively.They included 60 cases of carcinoma of duodenal papilla and 4 cases of adenoma.Results The main clinical symptoms were jaundice(42 cases),digestive tract symptoms(35 cases),recurrent cholangitis(7 cases) and hemorrhage of upper digestive tract(1 case).The diagnosis rate accuracy of ERCP,Fiberoptic duodenoendoscopy,MRCP,BUS and CT were 100%,97.3%,82.4%,82.8% and 76.1% respectively.Fifly-five cases underwent pancreatoduodenectomy,5 cases received local resection,and the remaining 4 cases were treated by palliative surgery.The surgical complication rate was 16.1% and the surgical mortality rate was 3.6%.The 1-year,3-year and 5-year survival rate of pancreatoduodenectomy were 67.4%,40.6% and 36.3%.Conclusions Jaundice and abdommal pain are the main symptoms of tumor of duodenal papilla.Fiberoptic duodenoendoscopy and ERCP are most effective methods for diagnosis of tumor of duodenal papilla.It is essential to early select radical resection operation so as to improve the results of surgical treatment.

Objective To evaluate the promotional effectiveness of different TCM appropriate technology packages; To provide a scientific basis for improving the technology package. Methods 8 assessment indexes, including input costs, the number of experts, the number of people with senior professional post, the number of grassroots people under the guidance of experts, the number of training hours, the number of people receiving training, evaluating rate and the number of users were selected. TOPSIS method was used to evaluate the promotional effectiveness of five kinds of TCM packages in grassroots. Results The Ci values for appropriate technology packages were 0.76 for pains in neck, shoulder, waist and lower extremities, 0.49 for gynecological diseases, 0.44 for infantile diarrhea, 0.66 for chronic gastropathy, and 0.00 for tumors. Conclusion The effectiveness of promotion of TCM appropriate technology packages from high to low is pains in neck, shoulder, waist and lower extremities package, chronic gastropathy package, gynecological diseases package, infantile diarrhea package, tumors package.

Angelicae Sinensis Radix (ASR) is the root of Angelica sinensis which is a fragrant and perennial herb native to China,Japan,and Korea.In traditional Chinese medicine (TCM),the plant is useful for replenishing and invigorating blood,relieving pain,and moistening the intestines,resulting in its application for the treatment of menstrual disorders,and as an emollient and laxative for chronic constipation of the aged and debilitated.An in-depth review of the literature brings to light a great number of chemical constituents that have been isolated from ASR as well as both preclinical (in vivo and in vitro) and clinical studies,which over the years,have sought to investigate the medicinal relevance of some of these phytoconstituents and/or extract(s) prepared from ASR.The purpose of this review is therefore to present some major pharmacological and pharmacokinetic research findings on some selected phytoconstituents of ASR with emphasis on the current trends in terms of research techniques or design.This review would also provide a wealth of information for users/practitioners of TCM regarding the use of ASR or its products for maximum efficiency and minimal toxicity or side effects.

Objective To explore laboratory diagnosis tests for lupus anticoagulant associated by coagulation factors(F Ⅷ,F Ⅸ and F Ⅺ)deficiency.Methods We investigated the coagulation factors'activity,coagulation factors'antibodies,anticardiolipin antibodies,lupus anticoagulant and thrombin generation in thirteen patients of lupus anticoagulant associated by coagulation factors(F Ⅷ,F Ⅸ and F Ⅺ)deficiency,ten hemophilia A patients, forty-eight healthy people. In these thirteen patients,there were five patients with schizophrenia and had been taking chlorderazin for a long time,two patients with antiphospholipid syndrome, one patient with pemphigus, five patients in which causes of disease were unknown.Among these patients,two patients has haemorrhage,eleven patients don't have reduced.The antibodies of these coagulation factors and LA were positive.Six patients in this group were ACA poslhve,and seven patients were ACA negative.The lag time of eleven non-haemorrage patients with LA positive associated by F Ⅷ,F Ⅸ and F Ⅺ deficiency was(5.60±1.18)min,higher than that of control group which was(1.88±0.25)min.This differenee had statistically significant(t=10.05,P＜0.01).The time to peak was(8.11±1.91)min,significantly higher than that of control group which was (4.10±0.36)min(t=8.83,P＜0.01).The endogenous thrombin potential(ETP)was(1 640.87±higher than that of hemophilia A patients which was(38.50±6.20)%(t=9.77,P＜0.01).The time to peak of hemophilia A patients was(8.01±1.81)min,significantly higher than that of control group which Was(4.10±0.36)min(t=8.20,P＜0.01).The lag time of control group and hemophilia A patients was (1.88±0.25)min and(2.01±0.84)min,respectively.There was no significant difierence of the lag time between these two groups(t=1.26,P＞0.05).Conclusions Diseases like lupus anticoagulant associated bv coagulation factors(F Ⅷ,F Ⅸ and F Ⅺ)deficiency and inherited hemophilia should use APTT,PT,should be used as confirmation tests. LA and ACA may serve as indication test for identifying the causes of these diseases. ETP and ETP percentage are quite good parametem for predicting the bleeding risk of patients with LA positive associated by coagulation factors(F Ⅷ,F Ⅸ and F Ⅺ)deficiency.

Objective To explore the mechanism of Huagan Jiedu decoction in treatment of chronic hepatitis B by testing the influence of the decoction on Serum IL-2, IL-4 and IFN-γ of rat models of chronic hepatic injury. Methods The model of Chronic hepatic injury was established by subcutaneously injecting 40% CCl4-olive oil solution in rats according to the ratio of 3ml per kg. of body weight. 60 healthy rats were divided randomly into a normal group, a model group, a low dose of Huagan Jiedu decoction group, a large dose of Huagan Jiedu decoction group, and a control group (Qingre Jiedu tablet group), 15 cases in each group. The Serum IL-2, IL-4 and IFN-γ were detected in each group separately. Results Compared with the normal group, the Serum IL-2 and IFN-γ were decreased (t=2.401, 2.337, P=0.0349, 0.0378) and the Serum IL-4 was increased (t=2.896, P=0.00861 ) in the model group; Compared with the model group, the Serum IL-2 and IFN-γ were increased (t=2.417, 2.344, P=0.0341, 0.0372, P＜0.05; t=3.114, 2.988, P=0.0052, 0.0068) in the large Huagan Jiedu decoction group and the control group, while the Serum IFN-γ was increased (t=3.049, P=0.0062) in the low dose of Huagan Jiedu decoction group and the Serum IL-4 was decreased (t=3.102, 3.017, 2.979, P=0.0061, 0.0065, 0.0069)in both Huagan Jiedu decoction groups and the control group. Conclusion Large dose of Huagan Jiedu decoction has sound therapeutic effects on rats with chronic hepatic injury by decreaseing the content of the Serum IL-4 and increasing IL-2 and IFN-γ, and adjusting th1/th2 balance.

To evaluate the different anesthesia in elderly patients with gastric cancer surgery influence blood con-centrations of melatonin and its correlation with postoperative agitation. The agitation scroes were evaluated and re-corded,and the blood samples were taken twice:before induction as well as just at the end of surgery,then making correlation analysis. The agitation scroes were significantly lower in group ET than in group T(P<0.01);the level of postoperative blood concentrations of melatonin was higher in group ET than that in group T(P<0.01);the agi-tation scroes and the level of postoperative blood concentrations of melatonin were negatively correlated ( r =-0.429,P<0.05).

Objective To evaluate the immune effects of virus-like particles ( VLPs) of VP1 pro-teins derived from norovirus GⅠ. 1 and GⅡ. 4 genotypes expressed in Hansenula polymorpha expression sys-tem. Methods SDS-PAGE and Western blot assay were performed to detect the purity of GⅠ. 1 and GⅡ. 4 VP1 proteins after purification. Morphologies of the recombinant VLPs were observed under transmission electron microscopy ( TEM) . Sizes and distributions of the VLPs were analyzed by dynamic light scattering analyzer. BT50(50% of blocking titer) was detected by HBGA (histo-blood group antigen) blocking assay in BALB/c mice immunized with different regimens. Results SDS-PAGE analysis of the purified recombinant GⅠ. 1 and GⅡ. 4 VP1 proteins showed that their purity were greater than 90%. Western blot assay con-firmed the specific bands of VLPs. TEM images showed that the sizes of purified GⅠ. 1 and GⅡ. 4 VP1 VLPs were at a mean diameter of 30-50 nm with clear border and high homogeneity, which was similar to that of wild virus. BT50 significantly increased in the groups, in which Al( OH) 3 was used as adjuvant. Con-clusion Animal studies have shown that administration of GⅠ. 1 and GⅡ. 4 VP1 VLPs in the presence of Al( OH) 3 induces detectable HBGA-blocking antibody, indicating that GⅠ. 1 and GⅡ. 4 VP1 VLPs are promising candidates for norovirus vaccine.

Objective To analyze and summarize the treatment strategies for unstable angina with no-reflow phenomenon after PTCA during early percutaneous interventional procedures.Methods A total of 32 cases with unstable angina were divided into two groups:one group with drug therapy and the other group with drug therapy and thrombus aspiration catheter.The patients were chosen when there was no-reflow phenomenon after PTCA during early percutaneous interventional procedures and their clinical data were compared and analyzed.Blood flow TIMI grade,myocardial perfusion grade (MBG),TIMI myocardial perfusion (TMP) grade and other indexes were observed and recorded.Results The general conditions had no statistical difference between two groups.Compared with the drug therapy group,the proportion of patients with TIMI,MBG and TMP grade 3 was higher in aspiration and drug therapy group (89％ VS 71％ P＜0.05).Conclusion Drug therapy and thrombus aspiration catheter in treatment helps to improve myocardial perfusion level for unstable angina with no no-reflow phenomenon after PTCA during early percutaneous interventional procedures.

AIM:To evaluate effects of different chemotherapeutic agents on reversing the acquired resistance to TRAIL gene and clarify the involved mechanisms in DLD1-TRAIL/R colon cancer cells.METHODS: Human colon cancer cell line DLD1-TRAIL/R cells that were resistant to TRAIL-expressing adenovector(Ad/gTRAIL) were treated with Ad/gTRAIL combined with different chemotherapeutic agents.Then,the cell viability was measured by MTT method,and apoptotic signaling conditions,including activation of caspase-3 and caspase-8,expression of Bax and Bcl-XL,were measured by Western blotting analysis.RESULTS: In vitro data showed that several chemotherapeutic agents,including 5-fluorouracil(5-FU) and mitomycin c(MMC),overcome the acquired resistance to TRAIL gene in DLD1-TRAIL/R colon cancer cells.The combination of Ad/gTRAIL and 5-FU effectively suppressed tumor growth in vivo in subcutaneous tumors established from DLD1-TRAIL/R cells.Further data showed that treatment with the combination of Ad/gTRAIL and 5-FU or MMC led to enhance the activation of caspase-3.Moreover,MMC but not 5-FU induced overexpression of Bax gene that was sufficient to overcome the resistance to TRAIL gene in DLD1-TRAIL/R cells.CONCLUSION: Chemotherapeutic agents,such as 5-FU and MMC,overcome the acquired resistance to TRAIL gene in DLD1-TRAIL/R cells.The candidate mechanisms for MMC but not 5-FU to overcome this resistance might involve the induction of over-expressed Bax protein in DLD1-TRAIL/R cells.