Objective:To establish an HPLC method for the simultaneous determination of telmisartan and amlodipine besylate in tablets. Methods:The isocratic separation was achieved on a Phenomenex C18 column (150 mm × 4. 6 mm, 5 μm) with the mobile phase composed of 50 mmol·L-1 sodium dihydrogen phosphate buffer (pH 6. 0, 0. 5% triethylamine)-acetonitrile (40:60, v/v). The flow rate was 1. 0 ml·min-1 , the detection wavelength was 254 nm, the column temperature was 30℃ and the sample size was 20μl. Results:Telmisartan could be well separated from amlodipine besylate under the conditions mentioned above. The linearity be-tween the peak area and the concentration was obtained within the range of 4. 0-80. 0 μg·ml-1(r=0. 999 9) for telmisartan and 1. 0-20. 0 μg·ml-1(r=0. 999 9) for amlodipine besylate. The mean recovery of telmisartan and amlodipine besylate was 99. 90% and 100. 52%, and RSD was 0. 74% and 1. 48%, respectively (n=9). Conclusion:The method is specific, stable and accurate in the determination of compound telmisartan tablets.

Lymphocytic hypophysitis(LH) is a rare but increasingly recognized autoimmune endocrine condition that causes partial or total hypopituitarism and is often associated with peripartum young women.We here report a 28-year-old patient who had a spontaneous and uneventful pregnancy following LH that had been treated with transspenoidal surgery and followed by anti-inflammatory agent.The woman failed to lactate and developed frontal headaches 3 months after normal delivery of her first child 3 years ago.Lab test showed the reduced concentrations of thyroxine,estradial and cortisol,suggesting hypopituitarism.Magnetic resonance imaging of the brain with contrast was performed and showed a uniformly enhancing pituitary mass with elevated optic chiasm.She underwent transsphenoidal surgery and histological examination of the resected specimen was consistent with lymphocytic hypophysitis.Anti-inflamation was started with prednisolone 40 mg per day because of a recurrence of headache that had completely recovered after surgery and regularly withdrawn to a long term maintenance dose of 10 mg per day.Physiological thyroxine replacement therapy was maintained.Her menstruation was restored without sex hormone replacement after 3 months.Three years after surgery,she got pregnant spontaneously and had normal breastfeeding after delivery.LH did not recur during this peripartum.

Adults-onset nesidioblastosis,as a differential diagnosis of organic hyperinsulinemic hypoglycemia,is very rare and has been recognised as "noninsulinoma pancreatogenous hypoglycaemia syndrome(NIPHS)".Here we described an extremely rare case of NIPHS in an eldly type 2 diabetes mellitus with insulin therapy.A 84-year old male was diagnosed as type 2 diabetes six years ago and switched from an oral hypoglycemic drug to pro-mixed insulin treatment 3 years ago.According to medical records,he had good-glucose control over few hypoglycemia.He was admitted to hospital due to frequent fasting hypoglycaemic episodes and comas despite withdrawal of any anti-diabetes drugs and continous infusion of homogenate meal at night.Lab test showed low fasting glucose level and inappropriate high insulin/C-peptide level,and anti-insulin antibody was negative.A characteristic of hyperinsulinemic hypoglycemia with high C-peptide level was consistent with the possible diagnosis of insulinoma,but localizing studies including computed tomography of the abdomen and somatostatin receptor scintigraphy were negative.Surgical exploration by the palpation and intraoperative ultrasonography failed to detect any mass in the pancreas and 70% distal pancreatectomy was performed.Histological examination of the resected pancrease revealed an increased number and size of islets consistent with nesidioblastosis.After transient decline,his serum insulin travelled back to the level before pancreaectomy,but recurrent fasting hypoglycemia was mild and controlled by regular night eating postpancreaectomy.Abstract:SUMM ARY Adults-onset nesid ioblastosis,as a d ifferential d iagnosis of organic hyperinsulinem ic hypo-glycem ia,is very rare and has been recognised as"noninsulinoma pancreatogenous hypoglycaem ia syn-drome(NIPHS)".Here we described an extremely rare case ofNIPHS in an eldly type 2 d iabetesmelli-tus with insulin therapy.A 84-year old male was d iagnosed as type 2 d iabetes six years ago and switched from an oral hypoglycem ic drug to pro-m ixed insulin treatment 3 years ago.Accord ing tomed ical records,he had good-glucose control over few hypoglycem ia.He was adm itted to hospital due to frequent fasting hypoglycaem ic episodes and comas despite withdrawal of any anti-d iabetes drugs and continous infusion of homogenate meal at night.Lab test showed low fasting glucose level and inappropriate high insulin /C-peptide level,and anti-insulin antibody was negative.A characteristic of hyperinsulinem ic hypoglycem ia with high C-peptide level was consistentwith the possible d iagnosis of insulinoma,but localizing stud ies includ ing computed tomography of the abdomen and somatostatin receptor scintigraphy were negative.Surgical exploration by the palpation and intraoperative ultrasonography failed to detect any mass in the pancreas and 70% d istal pancreatectomy was performed.H istological exam ination of the resected pancre-ase revealed an increased number and size of islets consistent with nesid ioblastosis.After transient de-cline,his serum insulin travelled back to the level before pancreaectomy,but recurrent fasting hypoglyce-m ia was m ild and controlled by regular night eating postpancreaectomy.

Background Familial hyperaldosteronism type Ⅱ(FH-Ⅱ) is characterized by autosomal dominant inheritance and hyperaldosteronism.Linkage analysis demonstrated chromosome 7q22 most likely harbor the genetic defect.Objective To identify the disease locus in a Chinese pedigree with FH-Ⅱ using genetic linkage analysis.Methods Haplotypes of the FH-Ⅱ pedigree were analyzed using four microsatellite markers(D7S531,D7S2521,D7S511,D7S481) at 7p22 to determine the critical region,and multipoint logarithm of odds(LOD) scores were calculated to assess linkage with FH-Ⅱ.Results Several members(affected members) in the family had hypertension,hypokalemia,hyperaldosteronism,low renin activity.Hypertension and hypokalemia was improved by spironolactone test.Dexamethasone suppression test was performed but without clinical or hyperaldosteronism improvement in three affected members,confirmed FH-Ⅱ family pedigree.The same haplotypes D7S531(ac,n=24)-D7S2521(ac,n=11)-D7S511(ca,n=21)-D7S481(ac,n=16) were shared by all known affected members and one suspicious member,but also by one unaffected member of the family,making it unlikely that this region contains the causative gene mutation.In this FH-Ⅱ family,the LOD scores of the four markers were

Objective To investigate the testing capabilities of clinical transfusion laboratories in medical institutions in Beijing for the regulatory authorities to formulate administrative policies in this regard.Methods Experts assigned by Beijing Clinical Transfusion Quality Control Center made on-site inspections at the transfusion laboratories in medical institutions using quality control products.They recorded the complete testing process of the operators as well as the instruments,detection reagents in use and the testing results,with statistics and analysis made to the data so collected.Results The pass rate of these on-site inspections was lower than that of the external quality assessment.Some laboratories failed to complete the testing of the quality control products in time and the actual operations in some laboratories were inconsistent to the guidelines.55.9％ of level Ⅰ hospitals and 25.6％ of level Ⅱ hospitals were found with insufficient and inadequate instruments and process layout to meet the needs of clinical blood transfusion.Some of the technicians were found without sufficient trainings in their professional knowledge and basic skills,resulting in their poor competence against emergency cases and weakness in independent problem solving.In addition,the records of detection process and results were found to be substandard.Conclusions Transfusion laboratories in Beijing need to improve their testing capabilities in general.

AIM To establish a quantitative analysis of multi-components by single-marker (QAMS) method for the simultaneous content determination of four saikosaponins in Xiaozheng Pellets (Bupleuri Radix,Cyperi Rhi-zoma,Rhei Radix et Rhizoma,etc.).METHODS The analysis of 5％ ammonia-methanol extract of this drug was performed on a Waters Xbridge C18column (250 mm ×4.6 mm,5 μm),with the mobile phase comprising of acetonitrile-water flowing at 1.0 mL/min in a gradient elution manner,and the detection wavelengths were set at 210 nm and 254 nm.With saikosaponin a as a internal standard,the relative correction factors of saikosaponins b1,b2 and c were calculated,followed by the determination of their contents.RESULTS Four saikosaponins showed good linear relationships within their own ranges (r ≥ 0.999 5),whose average recoveries were 98.08％-102.94％ with the RSDs of 0.85％-1.82％.The results obtained by QAMS approximated those obtained by external standard method.CONCLUSION This simple,precise and feasible method can be used for the quality control of Xiaozheng Pellets.

Objective To investigate the treatment of Pipkin fractures and curative effect. Methods From January 2003 to November 2009, we treated 19 cases of posterior dislocation of the hip with fracture of the femoral head,with type Ⅰ 8 cases, type Ⅱ6 cases, type Ⅲ 1 case, type Ⅳ4 cases. Seventeen patients were treated according to the illness with internal fixation treatment. Results Among type Ⅰ 8 cases, 2 cases were good with conservative treatment, 3 were excellent and 3 were good with surgical treatment;Among type Ⅱ6 cases, 3 were excellent, 2 were good, 1 was fair; 1 patient of type Ⅲ was fair; In 4 cases of type Ⅳ, 1 case was excellent, 2 cases were good, 1 case was fair. Conclusions Surgical treatment as soon as quickly is preferred for posterior dislocation of the hip with fracture of the femoral head( Pipkin fractures) , but the surgical time and methods should be chosen according to patients' detailed illness. It is important reserving the hip bone for preventing traumatic arthritis, and surgical skills to protect blood supply should not be ignored.

ObjectiveTo apply the Schwann cell neurilemma channel(SCNC) in promoting the regeneration of injuried spinal cord.MethodsSpinal cords of rats after laminectomy at T8/9 were divided in 3 groups randomly: 10 rats were transplanted with SCNC(Group A);10 rats only made models(Group B);10 rats were as normal control group(Group C).All rats received behaviour survey and inclined plane test every week 8 weeks after operation.6 weeks after operation,they were measured with cortical somatosensory evoked potential(CSEP).And 8 weeks after operation,all specimens were studied histologically.ResultsCSEP could be recorded in group A and C,but not in group B.There were marked differenties between group A or C and group B in behavior survey,inclined plane test.Amount of nerve fibers regenerated through the injury gap in group A was significantly larger than that in group B.ConclusionSCNC could facilitate axonal regeneration and promote the repairing of injuried spinal cord.

Objective To synthesize poly asparagine derivatives and to evaluate its safety at the cellular level, which provide research platform for its potential application as drug carrier. Methods Polysuccinimide was synthesized by ther?mal polymerization of L-polyaspartic acid, and the target product of PSI-Phe-EA was obtained by the ring-opening reaction of polysuccinimide using L-phenylalanine methyl ester hydrochloride and ethanol amine. The structure of PSI-Phe-EA were characterized by 1H NMR. The rate of ring-opening of PSI was calculated by internal standard method of 1H NMR. The change of hydrophilicity was studied by the comparison of solubility. The cytotoxicity and morphology modification by PSI-Phe-EA at designate concentrations was investigated by MTT method and inverted microscopy respectively. The effects on cell cycles were analyzed by flow cytometry after propidium iodide (PI) staining. Results 1H NMR results confirmed the structure of PSI-Phe-EA and the ring-openning rate of PSI was 40%. The hydrophilicity of PSI-Phe-EA was greatly in?creased upon ring opening using ethanol amine. MTT test showed that the cell survival rates of NIH 3T3 and HepG2 cells were higher than 80%under the examined concentration (<100 mg/L). Inverted microscopy showed that 50 mg/L of PSI-Phe-EA treatment had no adverse effects on cell morphology. Cell cycle analysis indicated that PSI-Phe-EA treatment had no in?fluence on cell cycles of NIH 3T3 and HepG2 cell lines. Conclusion PSI-Phe-EA showed high hydrophilicity without sig?nificant effects on the cells survival, cells morphology and cell cycles. It is a kind of safe polymer material.

Objective To investigate the relation among the results of thyroid fine needle aspiration cytology(FNAC),thyroid ultrasonography(US)and histopathologic diagnosis about the thyroid nodules detected by physical examination,meanwhile to analyze the etiopathogenesis of the nodtries and to evaluate the risk of thyroid cancer and the clinical diagnostic value of FNAC.Methods The data of thyroid FNAC results of the thyrroid nodules detected by physical examination in 271 cases were analyzed and compared with thyroid US and histopathologie diagnosis.Resuit (1)The FNAC results showed that the incidences of malignant and suspected mali-gnant lesions were 1.48%and 5.90%respectively.The rate of benign lesions was 78.60%and that of goiter was 29.15%,Hashimoto's thyroiditis 26.57%and thyroid adenoma 15.13%.Benign lesions were more common than malignant ones.(2)Comparison of the FNAC and US results of the thyroid nodules showed that of 96 cases with single nodule the rates of malignancy and suspected malignancy were 3.12%and 7.29%,but of 137 cases with multiple nodules the rates of the two lesions were 0.73%and 6.57%.In 108 cases with smaller nodules(≤1.5 cm)the rate of malignancy and suspected malignaney found with FNAC were 0.93%and 7.41%,while in 125 cases with greater nodules (＞1.5 cm)the rate of the two lesions were 2.40%and 6.42%.In 99 solid nodules the rates of malignancy and suspected malignancy were 2.02%and 12.12%,while in 85 cystic or mixed nodules the rates of the two lesions were 2.35%and 2.35%.In the above-mentioned three groups,only the suspected malignaney rate in solid nodules was higher than these in cystic or mixed ones with significant difference (P=0.013).(3)As compared with the cytological and histological diagnoses in 24 cases,the diagnostic accuracy of FNAC was 75.00%and the rates of false positive and false negative were 25.00%and 0,respectively.Conclusions The common causes of the thyroid nodules detected in physieal examination are goiter,Hashimoto's thyroiditis and thyroid adenoma.FNAC is a reliable method to define the benign or malignant nature of thyroid nodules with a high diagnostic accuracy.US features of the nodule alone,no matter it is single,solid or of greater size do not sufficiently increase the incidence of thyroid carcinoma.