AIM: To establish a HPLC method for determing naringin,rhein,emodin,chrysophanol,honokiol and magnolol in Da,Xiao-Chengqi Decoction bought from Taiwan. METHODS: The seperation was performed on Licrospher C_(18) column(150 mm?4.6 mm,5 ?m) with acetonitrile-0.5% HAc(gradient elution) as mobile phase and the detection wavelength was set at 270 nm. RESULTS: In the eight samples measured the content of naringin was from 0.54 to 44.20 mg/g;rhein from 0.51 and 2.10 mg/g;honokiol from 0.44 to 6.65 mg/g;emodin from 0.02 to 0.23 mg/g;magnolol from 1.09 to 2.29 mg/g,chrysophanol from 0.09 to 2.70 mg/g.However,honokiol and magnolol were not detected in some samples. CONCLUSION: This established method is fully validated with respect to linearity,precision,reproducibility and accuracy and successfully applied to quantifying the six constituents in eight commercial samples.The overall results demonstrate that this proposed method is simple,reliable,and suitable for the quality control of Da,Xiao-Chengqi Decoction.

Some patients with cervix cancer occurred effusion in the uterine cavity after radiotherapy, 18 cases of them were given hysterectomy. 55.6 percent of the cases occured in 2 years after radiotherapy. The clinical manifestations were lower abdominal mass and pain. There were signs such as enlarged uterus or pelvic mass. It was found that the uterine body had malignancy in 16 cases and the cervix in 11 cases after operation. The causes of effusion were probably the adhension of upper vagina and cervix tube, secondary carcinoma and recurrence of cervix tumor. Therefore, these patients have to be treated actively, and prevention must be paid attention to.

Objective To evaluate the long-term efficacy and safety of thermal balloon endometrial ablation (TBEA) for patients with menorrhagia. Methods From February 2004 to January 2008,105 women with menorrhagia was admitted to our hospital and treated by TBEA. The clinical data,including menstrual cycle and blood volume,as well as TBEA complications such as abdominal pain,infection,bleeding and conglutination,were followed up for a long period in the patients. Results Among the 105 patients,two were lost for follow-up,and one died of malignant tumor of the urinary system in 56 days after the TBEA,the other 102 (97.1%) patients achieved an follow-up for 3 (102 patients),6 (101 patients),12 (99 patients),24 (66 patients),or 36 months (51 patients) succesively. At each of the time point,the success/amenorrhea rates were 93.1% (95/102)/38.2% (39/102),93.1% (94/101)/33.7% (34/101),91.9% (91/99)/32.3% (32/99),93.9% (62/66)/34.8% (23/66),and 92.2% (47/51)/31.4% (16/51),respectively. No severe perioperative complications such as perforation of the uterus and adjacent organs,massive bleeding or infection due to mechanical or thermal injuries occurred. After the operation,11 (10.5%) patients had uterus contraction-like pain,which was relieved by analgesic drugs within 6 hours;8 (7.9%) patients had adhesion of the tissues around the cervix uteri and/or uterine cavity,4 of them were cured by dilation of the uterus,3 received surgical separation,and 1 underwent resection of the uterus. No significant difference in the effective rate and rate of amenorrhea was found between the 36-and 12-month follow-up results (?2=0.000,P=1.000 and ?2=0.014,P=0.906,respectively),or between 24-and 12-month follow-up results (?2=0.034,P=0.854;?2=0.114,P=0.736). Conclusion TBEA shows good long-term efficacy and safety,as an applicable alternative in the treatment of menorrhagia.

Abstract: Cell death is a fundamental biological phenomenon that is essential for the survival and development of organisms. Cell death can be either a spontaneous programmed process by the host or an accidentally triggered process. According to the different signaling pathway activated by various stimulates, programmed cell death exhibits the lytic or non-lytic morphology. For example, apoptosis, a typical non-lytic form of cell death, exhibits cell shrinkage and induces the formation of apoptotic bodies. Pyroptosis mediated by cysteine-containing aspartate-specific protease-1/11 (caspase-1/11) and necroptosis can induce inflammatory reactions and promote cell lysis to release inflammatory cytokines via triggering the pore-forming mechanism of the cell membrane, representing a typical modes of lytic cell death. In addition, the release of reactive oxygen species caused by the damaged mitochondria may further trigger ferroptosis during the pathogen infection. Programmed cell death can play an immune defensive role by eliminating infected cells and intracellular pathogens and stimulating the innate immune response through the resulting cell corpses. Here, we discuss the molecular mechanisms of five programmed cell death pathways: apoptosis, pyroptosis, ferroptosis, necroptosis and PANoptosis. We describe their roles in the innate immune defense against bacterial infections and give a brief statement of the interactions between the different programmed cell death, hoping to provide new insights for in-depth study of the pathogenic mechanisms of infectious diseases.

Aim To investigate the protection of ramipril,BQ-123 and their combination against myocardial ischemia/reperfusion(I/R)injury in vivo in anesthetized rats,and to explore the mechanism of action of drugs on myocardial oxidation-antioxidation system.Methods Healthy male Wistar rats were divided into 5 groups randomly,sham operated(Sham)group,I/R group,ramipril(RAM)group,BQ-123(BQ)group and ramipril and BQ-123(R&B)group.All groups but not sham were subjected to I/R procedure.Twenty four hours before ligation,ramipril(1 mg·kg~(-1))was intragastrically administered to rats in RAM and R&B groups.The equal volume of normal saline was given to rats in other groups.BQ-123(10 μg·kg~(-1)· min-1)was infused intravenously from 10 min before ligation to the end of 30 min ischemia to rats in BQ and R&B groups.The equal volume of normal saline was given to other groups.HR,MAP and the change of ST-segment were observed;ventricular arrhythmias were monitored during ischemia;the infarct size was examined by TTC staining;the activity of myocardial T-SOD,Mn-SOD,CAT and the content of MDA were detected by spectrophotometer.Results Compared with I/R group,the elevation of ST-segment was decreased,onset of VPC and VT was delayed,duration of VPC and VT was shortened,incidence of VPC,VT and VF was decreased,IS and IS/AAR were improved,activity of T-SOD,Mn-SOD and CAT was increased,the content of MDA was decreased in RAM,BQ and R&B groups.Compared with RAM and BQ alone group,onset of VPC and VT,duration of VPC and VT,size,activity of T-SOD and Mn-SOD and content of MDA were changed dramatically in R&B group.Conclusions Ramipril,BQ-123 and the combined use of these two agents protected myocardium from I/R injury in vivo.The protective effects of the combination on delaying onset of VA,shortening duration of VA,decreasing infarct size and content of MDA,and increasing activity of SOD are better than those of using ramipril or BQ-123 alone.

Objective To investigate the clinical treatment of infective endocarditis with vegetations in pregnant women and the outcomes of the gestation. Methods Nine cases of pregnant women diagnosed as infective endocarditis with vegetations in Beijing Anzhen Hospital, Capital Medical University from January 2001 to October 2015 were enrolled in retrospective analysis. Consultations were held by doctors from department of obstetrics, anesthesiology, cardiology, cardial surgery and extracorporeal circulation to decide the individualized treatment plan for the 9 cases of pregnant women after admissions. Clinical treatments including general treatment, anti-infection treatment, cardiac surgery, and termination of pregnancy surgery were completed through collaboration among related departments. The clinical characters, therapeutic regimens, maternal and neonatal outcomes of the 9 cases were analyzed. Results (1)Clinical characters: the ages of the 9 cases of pregnant women were from 25 to 36 years old. The onset gestational ages were from 19 to 36 weeks. Clinical symptoms: fever, cough, sputum and progressive anemia were the main symptoms. Patients had cyanosis of lips, could not lie on the back or even be orthopnea, when heart failure happened. Heart murmur was audible and splenomegaly was touched in physical examination. Blood cultures were positive. Basic heart disease types: 7 cases of congenital heart diseases included 2 cases of aortic insufficiency, 1 case of mitral insufficiency, 1 case of patent ductus arteriosus, 1 case of right ventricular outflow tract stenosis and 2 cases of ventricular septal defect.Two cases of rheumatic heart diseases included 1 case of mitral stenosis, 1 case of mitral stenosis after artificial disc changed and jammed. According to endocardial vegetations attached position there were 3 cases of mitral valve vegetations, 2 cases of pulmonary valve vegetations, 3 cases of aortic vegetations and 1 case of right ventricular outflow tract neoplasm. Preoperative heart function classification:1 case of levelⅡ, 3 cases of levelⅢ, 5 cases of levelⅣ.(2)Treatments:general treatment included oxygen uptake, rest in bed, cardiac strengthen and diuretic therapy, etc. Combined and adequate antibiotics were applied in anti-infection treatment according to drug sensitive test. Nine cases of pregnant women were all performed surgical treatment of heart diseases and removal of the endocardial vegetations. Caesarean sections were performed for 2 cases in second trimester and for 7 cases in last trimester. Cardiac surgery and caesarean section were operated in 6 cases at the same time among 22-34 weeks of pregnancy. Cardiac surgery were respectively operated in 2 cases 11 days and 32 days after the caesarean section at 33, 37 weeks of pregnancy. While Cardiac surgery was operated (at 26 weeks of pregnancy) before the caesarean section (at 37 weeks of pregnancy) in another 1 case. (3) Maternal and neonatal outcomes:7 cases of pregnant women were rescued successfully, while 2 cases of pregnant women were death. Postoperative heart function classification: 1 case of level Ⅰ, 2 cases of levelⅡ, 4 cases of levelⅢand 2 cases of levelⅥ. Neonatal survivals were 6 cases including 2case of full-term infants, 4 cases of preterm infants. Stillbirth or neonatal death were 3 cases, which included 2 cases performed caesarean section in second trimester and 1 case of very low weight infant who was given up treatment by family because of severe asphyxia. Followed up periods were from 1 to 7 years with an average time of (2.0 ± 1.6) years. Infants and young children grew and developed well during the period of follow up. Conclusions The risk is extremely high of pregnancy with infective endocarditis with vegetations. But there is still a way to save the maternal and neonatal life by using a multidisciplinary collaboration formulation and implementation of individualized treatment plan and selecting the appropriate time for heart surgery and the termination of pregnancy.

Aim: To establish the HPLC and LC-MC methods for the quality analysis of the different species of Radix Paeoniae Alba cultivated in Bozhou. Methods: The LC-MS method was applied to analyze the chemical composition of the cultivated species, the HPLC method was applied to determine the contents of paeoniforin, ben-zoic acid and paeonivayin in crude drugs and processing products. Results: 10 characteristic peaks were identified by LC-MS with reference standards. The significant difference was observed in the chemical compositions of 3 cultivated species. The significant difference was observed in the chemical compositions of 3 cultivated species. The content of paeoniflorin was increased significantly after traditional processing. The results indicated the 4-year-old pubang and 5-year-old xiantiao are the best cultivated species. Conclusion: The methods are simple, rapid and precise to assess and control the quality of different species of Radix Paeoniae Alba cultivated in Bozhou.

Objective:To discuss the therapeutic effect of blood purification on hemorrhagic fever with renal syndrome combined with acute renal failure.Methods:60 patients with hemorrhagic fever with renal syndrome combined with acute renal failure were selected,and they were divided into two groups according to the odd and even number of hospitalization.The observation group (31 cases) received hemodialysis therapy.The control group (29 cases) received veno-venous hemofiltration therapy.The renal function,serum ion,blood routine indexes and the incidence of adverse reactions during treatment was detected and compared between two groups.Results:There were no statistical significance on K+,HCO3-,BUN,Cr between two groups (P＞0.05).After treatment,the K+,BUN,Cr levels were decreased in two groups (P＜0.05).The values of observation group were lower than those of the control group (P＜0.05).The level of HCO3-was increased in two groups,and it was higher in observation group than that of the control group (P＜0.05).Before treatment,there was no statistical significance on Hb,Hc,PLT between two groups (P＞0.05).After treatment,the Hb,Hc,PLT levels were increased in two groups (P＜0.05),but there were no statistical significance between two groups (P＞0.05).During 1 year of follow-up,the 6 months and 12 months survival rate of observation group was higher than that of the control group (P＜0.05).During treatment,there were no statistical significance on the incidence of adverse reactions between two groups (P＞0.05).Conclusions:The hemofiltration therapy has a good therapeutic effect on blood purification on hemorrhagic fever with renal syndrome combined with acute renal failure,and it can regulate the electrolyte balance,improve the renal function and increase the survival rate,which is equivalent to veno-venous hemofiltration therapy in amelioration of blood state.

Objective To investigate effects of ischemic postconditioning on the nitric oxide ( NO) and nitric oxide synthase ( NOS) in diabetic rat brain tissues .Methods Thirty Wistar rats were diabetic models induced by intraperitoneal injuction of stepto-zotocin (STZ), and randomly divided into three groups: Control group (normal, diabetic), cerebral ischemia group, and ischemic postconditioning ( I-POST) group.The rats of cerebral ischemia group and ischemic postconditioning group were made model of cere -bral ischemia by ligation carotid artery .Hematoxylin-eosin ( HE) was used to observe their pathological changes in control and diabetic groups.Enzyme-linked immunosorbent assay ( ELISA) method was used to detect the expression and changes of NO and NOS in the sera in each group .Western Blot method was used to investigate the expression and changes of NOS in the retinal tissues in each group .Results For I-POST group , brain tissue defects were decreased , neuronal cells were increased , serum inducible NOS ( iNOS) content was significantly lower than endothelial NOS (eNOS) and neuronal NOS (nNOS) ( P <0.05), brain tissue iNOS expression was significantly weaker than ischemia group ( P <0.05 ) and was not different from normal group ( P >0.05 ) .Conclusions Is-chemic postconditioning can protect the brain tissue of diabetic rats by inhibiting NOS activity especially iNOS .

Objective To improve the diagnosis rate and decrease misdiagnosis through analyzing the clinical and experimental features of neuroblastoma (NB) in children.Methods The clinical and experimental features associated with the misdiagnosis factors of 22 NB cases were analyzed retrospectively.Results Of the 22 cases,leg pain in 15 cases (68.18 ％),fever in 19 cases (86.36 ％),anemia in 20 cases (90.90 ％),abdominal pain and bloating in 15 cases (68.18 ％),exophthalmoses and bruises eyes in 4 cases (18.18 ％) and easily perspire in 20 cases (90.90 ％).Abdomen was the most common primary site founding in 16 cases (accounting for 72.72 ％),followed by mediastinum founding in 4 cases (accounting for 18.18 ％),other sites were 2 cases (9.09 ％).Laboratory results showed that anemia was the most common cause in 20 cases (90.90 ％),oligoleukocythemia in 2 cases (9.09 ％) and less in thrombocytopenia about 3 cases (13.63 ％).Elevated values were recorded in 77.77 ％ of patients for vanillylmandelic acid (VMA),86.36 ％ for ferritin (Fer),90.90 ％ for lactate dehydrogenase (LDH),and in 100.00 ％ for neuron specific enolase (NSE).20 cases were found metastasis when diagnosed,which accounted for 90.90 ％.16 cases (72.72 ％) were found tumour cells which determined in bone marrow and 20 cases (90.90 ％) were positive for CD56-FITC/CD81-PE/CD45-Percp by flow cytometry (FCM).12 (54.54 ％) of 22 NB cases were misdiagnosed for rheumatoid diseases (4 cases),dyspepsia (4 cases),leukemia (3 cases) and thrambocytopenia (1 case).In 22 cases,20 cases (90.90 ％) were positive for CT scan.16 cases (72.72 ％) were positive for abdominal B ultrasonography,and 14 cases (63.63 ％) were positive for radionuclide bone scan.Conclusion Bultrasonography and CT scan will contribute to find the primary focus of NB at early stage.VMA,bone marrow smear,biopsy and FCM detection could reduce misdiagnose rate.