Objective:To establish an HPLC method for the simultaneous determination of 18α-glycyrrhizic acid and 18β-glycyr-rhizic acid in diammonium glycyrrhizinate .Methods:A Diamonsil C18 column (200 mm ×4.6 mm, 5 μm) was used with the mobile phase of water (water-60%perchloric acid solution:48∶0.5, adjusting pH to 8.0 with ammonium hydroxide)-methanol (48∶52). The detection wavelength was set at 248 nm and the flow rate was 1.0 ml· min-1 .The column temperature was 30℃and the injection volume was 20 μl.Results:18α-Glycyrrhizic acid and 18β-glycyrrhizic acid were well separated .They had a good linear relationship within the range of 0.005 0-1.000 0 mg· ml-1(r=0.999 7 and 0.999 3).The average recovery was 99.7%and 99.1%, and RSD was 0.9%and 0.4%, respectively (n=9).Conclusion:The method is accurate, simple and reproducible, which can be used for the simultaneous determination of the two constituents in diammonium glycyrrhizinate .

Objective To survey small dense low-density lipoprotein cholesterol(sdLDL-C)distribution among different popula-tions,and analyze its relationship with lipid component.Methods 986 cases of people who underwent medical examination in the hospital were recruited in the study.There were 654 people with normal concentrations of serum blood lipids(normal blood lipids group),according to sex and age they were divided into groups.The people whose serum lipids concentrations increased above the normal range were divided into TG increasing group,LDL-C increasing group and joint increasing group according to the type of lip-ids componet increased.Serum sdLDL-C,LDL-C,TG,TC,HDL-C,ApoAⅠ and ApoB were determind in the people mentioned a-bove,and the correlation between sdLDL-C and TG,TC,HDL-C,ApoAⅠ,ApoB concentrations were analyzed.Results SdLDL-C began to decline after the age of 70,the difference was statistically significant(P <0.05 );the ensemble average of the males was higher than that of females,the difference was statistically significant(P <0.05).The serum sdLDL-C cocentrations of all the serum lipis increasing groups were significantly higher than those of normal blood lipids group,the difference was statistically significant (P <0.05 ).SdLDL-C concentrations were positively correlated with TC,TG,ApoB(r =0.254,0.589,0.302),and was negative correlated with HDL-C and ApoA Ⅰ (r = - 0.421,- 0.275,- 0.311 ).Conclusion There was a positive correlation between sdLDL-C and TC,TG,ApoB,and sdLDL-C was negatively correlated with HDL-C,ApoAⅠ,which can accurately reflect the overall status of lipid metabolism.

Objective To study the effects of HVHF on cytokines in elderly patients with septic shock and MODS. Methods 22 elderly patients with septic shock and MODS were included in this prospective and interventional study. Before HVHF and 1,3,6,9,12,18 and 24 hour after HVHF, blood sample and ultrafiltration fluid were collected for cytokines analysis(radioimmunoassay). Results All patients finished HVHF. No severe side effects were observed,and the APACHEⅡ and MODS scores were decreased during HVHF(P

0.05) between two groups.After EGDT,the level of cTnI in EGDT group was obviously dowered on the 7th day (0.16?0.22?g/L) and 14th day (0.09?0.13?g/L) compared with those in control group (0.39?0.43,0.29?0.29?g/L,P

Objective To evaluate the predictive value of brain natriuretic peptide (BNP) on mortality in elderly patient with severe sepsis or septic shock. Method Eighty-three elderly patients meeting with criteria of severe sepsis or septic shock by the American College of Chest Physicians and the Society of Critical Care Medicine (ACCP/SCCM) in 2001, admitted in Intensive Care Unit (ICU) of Zhejiang Hospital during May 2004 to June 2007, were enrolled, and patients with chronic renal failure were excluded. The patients were divided into survivor and non - survivor group according to whether they survived within 28 days staying in ICU, the difference of plasma BNP level,serum C-creative protein (CRP) concentration, APACHE II and SOFA scores on admission day and BNP level on the third day between the two groups were compared; thereafter, the relationship between muhiple variables including age, admission day, BNP, CRP, APACHE 11 and SOFA scores, the 3rd day BNP level and 28-day mortality were analyzed by Logistic regression, and meanwhile the independent predictors for ICU moaality among which were determined. Results BNP levels on both admission day and the 3rd day were significantly higher in nomurvivor group than those in survivor group[ ( 1056.38±676.34) pg/ml vs. (611.59±610.02) pg/ml,p =0.002 and (1448.48+891.11) pg/ml vs. (522.41±575.20) pg/ml, P<0.001, respectively]. By Logistic regression analysis, BNP level on the 3rd day and SOFA score on admission day were independent predictors of ICU mortality, The receiver operating characteristic (ROC) curves indicated that values of areas under the curve of the admission day and the 3rd day BNP levels for 28-days mortality were 0.735 (95% CI,0. 621～0. 848, P <0.001) andO.836 (95% CI, 0.746～0,926,P<0.001), respectively. Conclusions Plasma BNP inereaseds in majority of eldedy patients with severe sepsis or septic shock, which may serve as irdex for prognosis in elderly severe septic paients.

Objective To report a pedigree with late-onset Pompe' s disease complicated with cerebral vascular diseases as to summarize their clinical,pathological and molecular genetic characteristics.Methods We investigated the clinical and pathological data of the two affected siblings with late-onset Pompe' s disease complicated with cerebral vascular diseases.All the 5 members of this pedigree accepted the GAA gene analysis.ResultsBoth affected siblings had progressive pelvic girdle muscle weakness from young adult age,and recently developed vertigo and ataxia.Brain imaging of them revealed multiple cerebral hemorrhage,infarction and diffuse ischemic white matter lesions.The brother had multiple aneurysms and stenoses of cerebral arteries revealed by brain CTA.However,his sister was only found to have multi-beaded stenoses of cerebral arteries.The muscle pathology of the brother showed typical vacuolar degeneration and glycogen storage in muscle fibers. The GAA enzyme activity of 2 siblings were dramatically lower than normal.A heterozygous 19 bp-deletion (c.1388-c.1406,exon 9) were found in GAA gene in the 2 siblings and their healthy mother. Conclusions Cerebrovascular involvement should be a special phenotype of Pompe' s disease.A novel heterozygous mutation c.1388del19 in GAA gene was found in this pedigree,but the relationship between the mutation and the rare clinical phenotype needs further study.

Background and purpose: Primary pulmonary myxoid sarcoma (PPMS) is a very rare lung tumor that has recently been shown to harbor EWSR1-CREB1 translocation. This study aimed to investigate the clinicopatho-logical characteristics and differential diagnosis of PPMS. Methods: The clinical and pathological features of 6 cases of PPMS with EWSR1 gene rearrangement were reviewed. Immunohistochemistry and fluorescence in situ hybridization (FISH) study were performed. Results: Six patients were enrolled in this study, including 4 male patients and 2 female patients with an age range of 23 to 64 years (median age, 44 years). All tumors involved pulmonary parenchyma, with a predominant endobronchial component in 1 and adjacent to bronchus in 5 patients. Microscopically, the tumor was lobulated and composed of cords of polygonal, spindle cells within myxoid stroma. Tumors were immunoreactive for only Vimentin and weakly focal for epithelial membrane antigen (EMA). All tumors were shown to harbor EWSR1 gene rearrangement by FISH. Follow-up of all patients showed that 1 patient developed a pleura and bone metastasis but was still alive and 5 were disease-free after 4-29 months. Conclusion: PPMS is an extremely rare sarcoma with low-grade malignant potential. This is characterized by distinct histological features and EWSR1 gene rearrangement. It is important that understanding tumor spectrum and genetic feature can contribute to diagnosis and differential diagnosis of PPMS.

Objective To evaluate the effect of health education path on advanced schistosomiasis patients with splenomega-ly in perioperative period. Methods A total of 60 advanced schistosomiasis patients with splenomegaly in perioperative period were randomly divided into an observation group and a control group (30 cases each group). The patients in the observation group were intervened by the nursing and health education from admission to discharge according to the standardized process of health education path,while those in the control group were implemented with the conventional health education. Then the satis-faction of nursing work,hospital stays,hospitalization expenses and mastery of health knowledge of the patients in the two groups were investigated and the results were compared. Results The satisfaction rates of nursing work of patients in the obser-vation group and the control group were 90%and 60%,respectively,the difference between them was statistically significant (χ2=7.57,P<0.05). The average hospitals stays of the above two groups were 14.0 ± 3.5 d and 19.0 ± 6.8 d(t=2.85,P<0.01),respectively,and the average hospitalization expenses were(1.5 ± 0.5)thousand Yuan and(2.2 ± 0.7)thousand Yuan (t=24.57,P<0.01),respectively,both of the differences were statistically significant. On the 10th day after surgery,the mas-tery rates of the health knowledge of the two groups were 96.7%and 50.0%,respectively,the difference was statistically signifi-cant(χ2=16.86,P<0.001). Conclusions The implementation of the health education path can promote the rehabilitation of advanced schistosomiasis patients with splenomegaly,and increase the satisfaction as well as improve the mastery of the health knowledge of the patients. Meanwhile,it also can cut down the hospital stays and save the hospitalization expenses.

This study was performed to prepare immobilized β-glucosidase and snailase, then optimize and compare the process conditions for conversion of icariin. Immobilized β-glucosidase and snailase were prepared using crosslink-embedding method. The best conditions of the preparation process were optimized by single factor analysis and the properties of immobilized β-glucosidase and snailase were investigated. The reaction conditions including temperature, pH, substrate ratio, substrate concentration, reaction time and reusing times of the conversion of icariin using immobilized β-glucosidase or snailase were optimized. Immobilized β-glucosidase and snailase exhibited better heat stabilities and could remain about 60% activity after storage at 4 degrees C for 4 weeks. The optimized conditions for the conversion of icariin were as follows, the temperature of 50 degrees C, pH of 5.0, enzyme and substrate ratio of 1 : 1, substrate concentration of 0.1 mg x mL(-1), reaction time of 6 h for β-glucosidase and 2 h for snailase, respectively. In 5 experiments, the average conversion ratio of immobilized β-glucosidase and snailase was 70.76% and 74.97%. The results suggest an effect of promoted stabilities, prolonged lifetimes in both β-glucosidase and snailase after immobilization. The immobilized β-glucosidase and snailase exhibited a higher conversion rate and reusability compared to the free β-glucosidase and snailase. Moreover, the conversion rate of immobilized snailase was higher than that of immobilized β-glucosidase. The process of icariin conversion using immobilized β-glucosidase and snailase was moderate and feasible, which suggests that immobilized enzymes may hold a promise for industrial usage.

Objective To investigate the influence of left ventricular-arterial coupling(VAC) on clinical prognosis of elderly patients with septic shock.Methods A total of 56 elderly septic shoek patients were enrolled in this study,all of whom were admitted to Department of Intensive Care Unit in Zhejiang Hospital from August 2014 to October 2015.The patients were divided into two groups according to the status of left ventricular-arterial coupling when septic shock was diagnosed,which were left ventricular-arterial uncoupling group(UC group) and left ventricular-arterial coupling group(C group).Various parameters were recorded,including blood lactate level,central venous oxygen saturation(ScvO2),serum level of N-terminal pro-brain natriuretic peptide(NT-proBNP) and cardiac troponin Ⅰ (cTN Ⅰ),dose of vasoactive drugs,the total fluid volume and urine volume per hour within 24 hours.The 28-day survival rate was a key index of prognosis.Multivariate logistic regression was taken to analyze risk factors related to death within 28 day.Results Compared with C group,UC group had lower values of left ventricular ejection fraction[(42.43 ±4.76)％ vs (53.17±3.01)％;P＜0.01] and cardiac index[(2.36±0.68) L· min-1 · m 2vs (2.93±0.45)L · min-1 · m-2;P ＜0.01].Yet serum levels of NT-proBNP[lg NT-proBNP 3.93 ±0.53 vs 3.40 ±0.63;P =0.004] and cTN Ⅰ [lg cTN Ⅰ-0.16 ± 0.68 vs-1.03 ± 0.69;P ＜ 0.001] in UC group were higher than those in C group.Moreover,the total fluid volume within 24 hours [(3 806.3 ± 831.4) ml vs (3 142.0±770.0) ml;P =0.016],blood lactate level[(5.61 ±2.68) mmol/L vs (3.93 ± 1.59)mmol/L;P =0.043] and dose of norepinephrine[(0.630 ±0.300) μg · kg-1 · min-1 vs (0.292 ±0.234)μg · kg-1 · min-1;P =0.001] in UC group were greater than those in C group,while ScvO2 [(60.75 ±2.91)％ vs (64.42 ±2.19)％;P＜0.001] and urine volume per hour[(0.518 ±0.358) ml vs (0.926 ±0.678) ml;P =0.007] were less than those in C group.Compared with C group,UC group had a lower 28-day survival rate [43.2％ (19/44) vs 9/12;P =0.049].Ea/Ees ratio was negatively correlated with LVEF,ScvO2 (r =-0.686,P ＜ 0.001;r =-0.411,P =0.002),positively correlated with NT-proBNP,cTN Ⅰ (r =0.294,P =0.028;r =0.363,P =0.006),yet no obvious correlation was noticed with blood lactate level (r =0.170,P =0.21).Multiple logistic regression analysis showed that VAC(OR =11.187,95％ CI 2.489-50.285;P =0.002),lactate level (OR =1.727,95 ％ CI 1.164-2.563;P =0.007) and lg cTN Ⅰ (OR =0.247,95 ％ CI 0.079-0.779;P =0.017) were independent risk factors affecting 28-day mortality.Conclutions In elderly patients with septic shock,left ventricular-arterial uncoupling indicates a lower 28-day survival rate,worse cardiac function and tissue perfusion.Ea/Ees ratio might sever as a predictive indicator of 28-day mortality.