Objective To study the processing method,extraction technology and quality evaluation analysis of Paeonialactiflora Pall, so as to provide reference for selecting the best method and improving its quality .Methods One year and 3 years Chinese herbal medicine Paeonialactiflora Pall was used.The use of raw materials and cooked products for processing methods to paeoniflorinas the representative , and the content was determined by high performance liquid chromatography.With the optimization of orthogonal test, the methods for the determination of effective components of radix paeoniaealba were summarized and the quality control methods were analyzed .Results The content of paeoniflorin in raw paeonialactiflora pall was (6.33 ±0.52)%,and the content of paeoniflorinin cooked Paeonialactiflora Pall was (5.74 ±0.45)%, which was with statistical significance(P <0.05).The content of paeoniflorin in raw paeonialactiflora pall was (5.90 ±0.38)%,and 4.85 ±0.45% in three years cooked paeonialactiflora pall, and the differenceswere with statistical significance(P<0.05).Extracted three times with 70% ethanol, time 65 min, 6 times the amount of solvent,the paeoniflorin high cream rate was highest.By means of induction, several active ingredients should be screened out to control the content of paeonialactiflora pall to publish multiple indicatorsquality control methods .Conclusion The preparation method of Chinese herb paeonialactiflora pall has showed that the active ingredient content is morein raw herb.To establish quality control method of multiple indicators of paeonialactiflora pall based on raw herb,gradually improve the quality of more comprehensive paeonialactiflora pall quality control model.To optimize the extraction of Chinese herbal medicine,provide scientific reference for the sustainable utilization and industrial production of paeonialactiflorapall.

Objective To study the diagnosis,surgical indications, and results of surgical treatment for hepatic hemangioma. Methods The data of 37 patients with hepatic hemangioma treated by hepatectomy in our department from July 2005 to July 2008 were analyzed retrospectively. The diagnoses were made by ultrasound, enhanced CT and MRI. Surgical indications included: (1) diameter >5 cm, located at the left lateral section or the lower edge of the liver with symptoms. (2) diameter >10 cm or recent rapid growth. The hemangioma were located in the left liver in 10 patients, right liver in 17, caudate lobe in 3, middle hepatic lobe in 2, multiple tumors in left and right livers in 5.The preoperative liver function was grade A in all patients. Results Five patients underwent right hepatectomy, 2 underwent left hepatectomy, 10 underwent left lateral sectionectomy, 3 underwent caudate lobectomy, 5 underwent central hepatectomy, 8 underwent right anterior sectionectomy, 4 underwent combined hepatic resections and 2 underwent prophylactic exploration of the common bile duct. Pringle's maneuver was applied in 28 patients, and total hepatic vascular exclusion in 7. The occlusion time ranged from 8-36 and 10-40 minutes (average: 22.2±14.3 min and 21.6±12.1 min),respectively. 400 ml of intraoperative blood transfusion was given to 4 patients each. All operations were successfully carried out. The specimens measured 5-20 cm. There was no peri-operative death.The postoperative complications were: pleural effusion (n=4); subphrenic (n=2). Histologic diagnosis confirmed hepatic cavernous hemangioma in all patients. All patients were regularly followed-up (ranged 6 months-4 years), and no recurrence was detected. Conclusion In carefully selected patients, liver resection for hepatic hemangioma is safe and effective.

Objective To evaluate the predictors of maternal and fetal outcome of pregnancy for systemic lupus erythematosus(SLE)patients.MethodsNinety-four patients with 96 pregnancies which were evaluated retrospectively from Jan 1990 to Jan 2008 in Peking Union Medicai College Hospital were divided into two groups:disease stable during pregnancy(group A)and lupus flares during pregnancy (group B).Statistical analysis was performed by X2 or Fisher exact test and Student's t-test.A binary logistic regression model was used to evaluate the predictors of matemal and fetal outcome.Results There were 36 pregnancies with stable lupus disease(group A)and 60 pregnancies with lupus flares(group B).of the 96 pregnancies.18 resulted in therapeutic abortion and 7 in fetal loss,71 resulted in a live birth,3 in neonatal death.The rates of preterm delivery,small gestational age(SGA)and neonatal asphyxia in group B were higher than those in group A(P＜0.05).By binary logistic regression analysis,preeclampsia/eclampsia low serum platelet count and SLE flares were associated with poor fetal outcome(β=2.463,2.228.2.769 respectively.P＜0.05).,rhere were 56 pregnancies with stable lupus disease at the conception with 22(39.3%)occurred lupus flares during pregnancies.Twenty-four preeclampsia and 2 eclampsia were seen in all the pregnancies.Fifty-two pregnancies were complicated with lupus nephritis,and 25 pregnancies(48.1%,25/52)of which were disease stable at the conception,and among 22 pregnancies with disease stable over one year.twelve of which occurred lupus nephritis flares.Three pregnancies which have disease activity within one year before pregnancy all occurred lupus nephritis flares.There were four maternal death which all occurred at the postpartum.By binary logistic regression analysis,lupus nephritis flares were associated with preeclampsia/eclampsia(B=2.658,P＜0.05),and proteinuria at the conception before dilivery were significantly associated with SLE flares(13=3.263,P＜0.05).Conclusion An increase of fetal loss,preterm delivery,SGA and neonatal asphyxia was seen in patients with lupus flares during pregnancy compared with those with stable disease.About 1/3 lupus activity may increase after pregnancy.Preeclampsia and eclampsia were increased when there were lupus nephritis flares.

The gut-brain axis (GBA) is a nerve-endocrine mediated bidirectional communication system between the gut and brain, which links the cognition and emotion in brain to peripheral intestinal function. In recent years, many researches have showed that colonized intestinal microbiota plays an important role in the communication between gut and brain. On one hand, microbiota can influence the development and function of brain via GBA. On the other hand, brain can also change the composition of gut microbiota. These findings gradually become a novel medical research highlight, i.e. the microbiota-gut-brain axis. This paper reviews the interaction between gut microbiota and brain via GBA in order to provide supports for studying functions of gastrointestinal tract and brain, as well as the treatment of related diseases.

Objective To evaluate the maternal and fetal outcomes of pregnant women with lupus nephritis (LN) and the risk factors.Methods Ninety-three patients with 97 pregnancies from January 1st,1990 to December 31st,2012 in Peking Union Medical College Hospital were evaluated retrospectively.Objects of study were divided into three groups:stable lupus before pregnancy (stable group,52 cases),active lupus before pregnancy (active group,26 cases),and newly diagnosed LN during pregnancy (19 cases).Adverse maternal outcomes included exacerbated disease during pregnancy,preeclampsia,increased proteinuria and impaired renal function during pregnancy or postpartum,maternal death,thrombocytopenia and hypocomplementemia.Adverse fetal or neonatal outcomes included therapeutically termination of pregnancy,fetal loss,neonatal death,preterm labor,small gestational age and asphyxia.Statistical analysis was performed by Chi-square test or Fisher's exact test.A binary logistic regression model was used to evaluate the risk factors for adverse maternal and fetal outcomes.Results (1) Adverse maternal outcomes:There was no significant difference between exacerbated cases during pregnancies in stable group and that in active group [53.8 ％ (28/52) vs 61.5 ％ (16/26),x2 =0.417,P＞0.05].After deleting abortions before 20 weeks of gestation (5 cases in stable group and 4 cases in active group),there was no significant difference between preeclampsia incidence in stable group and that in active group [36.2％ (17/47) vs 59.1％ (13/22),x2 =3.204,P＞0.05].In nineteen newly diagnosed LN women,eighteen cases were over 20 weeks of gestation,during which preeclampsia incidence was 6/18.(2) Adverse fetal or neonatal outcomes:Therapeutically termination of pregnancy rate was higher in active group than that in stable group[42.3％(10/26) vs 7.7％(4/52),Fisher's exact test,P＜0.01].After deleting patients who required termination of pregnancy (three cases in stable group) and therapeutically termination of pregnancy (four cases in stable group and ten cases in active group),the rate of fetal loss and neonatal death was higher in active group than that in stable group [5/16 vs 6.7％(3/45),Fisher's exact test,P＜0.05].The rate of adverse fetal or neonatal outcomes was higher in active group than that in stable group [92.3％(24/26) vs50％(26/52),x2=13.483,P＜0.001].Among the nineteen newly diagnosed LN cases during pregnancy,the numbers of therapeutically termination of pregnancy and fetal loss were five and three cases respectively; among eleven live birth cases,two newborns died from severe asphyxia,and nine cases were preterm birth.(3) Binary logistic regression analysis showed that the independent risk factors for exacerbated lupus during pregnancy were hypocomplementemia (OR =0.300,95％ CI:0.104-0.863) and thrombocytopenia (OR =0.054,95％CI∶0.007-0.439).The independent risk factors for preeclampsia in LN pregnant women were thrombocytopenia (OR=0.151,95％CI:0.046-0.499) and LN recurrence or first diagnosed during pregnancy (OR=0.135,95％CI:0.027-0.679).The independent risk factors for adverse fetal or neonatal outcomes were preeclampsia (OR=0.134,95％CI:0.028-0.637) and lupus active during pregnancy (OR =0.026,95 ％ CI:0.005-0.138).Conclusions Active lupus before pregnancy is associated with poor maternal and fetal outcomes in lupus nephritis pregnancy.All pregnancies with LN should be planned,preferably after more than six months of quiescent disease.Blood pressure,renal function,proteinuria and level of platelet and serum complements should be closely monitored.

Objective:In the research, the traditional mercury sphygmomanometer was used to press the puncture point to evaluate the hemostatic effect.Methods:Eighty patients with acute cerebral infarction diagnosed clinically in Xuanwu Hospital of Capital Medical University from June 2018 to December 2019 were examined by magnetic resonance perfusion examination. The serial number of the patient was randomly divided into the group by random digital table, and the puncture point was pressed by mercury sphygmomanometer after needle extraction in the auxiliary pressing group, and the individual systolic blood pressure intensity was set as the pressing intensity, while the control group adopted independent vertical pressing technique. After examination, the puncture points of the two groups were qualitatively evaluated, such as secondary bleeding, hematoma, ecchymosis, normal and so on.Results:In the auxiliary compression group, there were 3 cases of secondary hemorrhage, 1 case of hematoma, 0 cases of ecchymosis and 36 cases of normal, while in the control group, there were 4 cases of bleeding, 2 case of hematoma, 1 case of ecchymosis and 33 cases of normal ( χ2value was 4.372-34.225, P<0.05). Conclusion:Traditional mercury sphygmomanometer-assisted pressing puncture point can make personalized nursing hemostasis plan for patients with acute cerebral infarction, reduce the phenomenon of puncture point bleeding, ecchymosis, and even subcutaneous hematoma caused by unstable pressing and unequal force, and practice high-quality nursing service.

OBJECTIVE: To investigate the diagnosis of frontal, ethmoid sinus cyst with eye symptoms as initial amount,and the curative effect of nasal endoscopic operation. METHOD: To retrospectively analyze clinical data of sixteen patients with frontal, ethmoid sinus cyst from February 2006 to March 2008. RESULT: Diagnostic accordance rate of paranasal sinus MRI and CT examination In 16 patients is 100%. Fourteen patients' ocular symptoms disappeared after nasal endoscope operation treatment, two of them improved. None of them recurrened after the fol low-up 3-6 years up to now, all the patients had satisfactory curative effect. CONCLUSION Paranasal sinuses and or bital cavity have close relationship , patients with sinus lesions always firstly visit Ophthalmology doctor. The results of MRI and CT examination are of great value for diagnosis. Patients with frontal, ethmoid sinus cyst with eye symptoms as initial amount should be early diagnosed. The treatment of nasal endoscope operation is safe, effective and is worth of firstly chosen.
Cysts ; diagnosis ; surgery ; Endoscopy ; methods ; Ethmoid Bone ; Ethmoid Sinus ; Female ; Frontal Sinus ; Humans ; Magnetic Resonance Imaging ; Male ; Nasal Surgical Procedures ; Paranasal Sinus Diseases ; diagnosis ; surgery ; Retrospective Studies

Objective To explore the mechanism of high mobility group protein 1 (HMGB1) involved in endoplasmic reticulum stress (ERS) induced by brain ischemia/reperfusion (I/R),based on I/R-HMGB1-ERS as the breakthrough point.Methods The brain of rats birthed 1-3 days was harvested,and the brain cells were cultured in vitro,which were used in the experiment when the cells were in the third passage.The cells were divided into two groups:cells in blank control group were cultured under the normal conditions without any treatment,and the cells in hypoxia/reoxygenation group were cultured with 99.9％ nitrogen for 60 minutes (hypoxia) followed by opening the bottle neck for reoxygenation 120 minutes to simulate I/R model.The HMGB1 gene was silenced by using small interfering RNA (siRNA,siRNA and transfection reagent Lipofectamine 2000 mixture gradient was transfected into the cultured cells) as HMGB1-siRNA transfection group,and blank control (without any treatment) and negative control group (transfected with control siRNA) served as controls.The mRNA and protein expressions of HMGB1 and ERS related molecules were determined by real-time reverse transcription-polymerase chain reaction (RT-PCR) and Western Blot.Results ① In cells of hypoxia/reoxygenation group,the mRNA and protein expressions of HMGB1 and ESR related proteins,including glucose regulating protein 78 (GRP78),C/EBP homologous protein (CHOP) and caspase-12,were significantly higher than those of blank control group with statistical difference (the value in blank control group was served as baseline 1,HMGB1 mRNA:3.19±0.48 vs.1,t =2.183,P =0.008;GRP78 mRNA:2.07±0.33 vs.1,t =3.292,P =0.016;CHOP mRNA:1.93±0.28 vs.1,t =2.573,P =0.021;caspase-12 mRNA:2.42±0.42 vs.1,t =2.261,P =0.027:HMGB1 protein:2.28±0.36 vs.1,t =2.042,P =0.009;GRP78 protein:1.33±0.24 vs.1,t =2.781,P =0.016;CHOP protein:1.67±0.34 vs.1,t =2.174,P =0.021;easpase-12 protein:1.36±0.44 vs.1,t =3.192,P =0.008).It was indicated that ERS related molecules involved in cell hypoxia/reoxygenation process.2② After HMGB1 gene was silenced by siRNA,the cells after hypoxia/reoxygenation showed a decrease in the mRNA and protein expressions of HMGB1 and ERS related moleculars as compared with those of blank control group and negative control group (served the value in blank control group as baseline 1,HMGB1 mRNA:0.27±0.12 vs.1,1.02 ± 0.04;GRP78 mRNA:0.16 ± 0.13 vs.1,0.96 ± 0.04;CHOP mRNA:0.47 ± 0.09 vs.1,0.98 ± 0.07;caspase-12 mRNA:0.31 ±0.11 vs.1,1.05±0.02;HMGBI protein:0.23±0.04 vs.1,1.08±0.01;GRP78 protein:0.14±0.09 vs.1,1.35±0.03;CHOP protein:0.32±0.10 vs.1,0.93±0.06;caspase-12 protein:0.27±0.09 vs.1,0.97±0.08;P ＜ 0.05 or P ＜ 0.01).It was indicated that HMGB1 involved in ERS related with GPR7,CHOP,caspase-12.Conclusion Hypoxia/reoxygenation brain intracellular HMGB1 and ERS related molecules expression levels were significantly up-regulated,and silencing HMGB1 gene can significantly inhibit the expression levels of these molecules,and I/R-HMGB 1-ERS pathway may participate in the mechanism of brain I/R injury.

Objective To investigate the mechanism of brain derived neurotrophic factor (BDNF) regulated by differ-ent isoforms of tyrosine kinase receptor B (TrkB) in epileptic hippocampal neurons. Methods Primary hippocampal neu-rons were cultured in vitro for 7 days, and divided into two groups, ALLN (calcineurin inhibitor) group and Anisomycin (trans-lation inhibitor) group. ALLN group included control group, control+BDNF group, epilepsy group, epilepsy+BDNF group, control+ALLN group, epilepsy+ALLN group and epilepsy+ALLN+BDNF group. Anisomycin group was sub-divided into con-trol group, control+BDNF group, epilepsy group, epilepsy+BDNF group, control+Anisomycin group, epilepsy+Anisomycin group and epilepsy+Anisomycin+BDNF group. The immunofluorescent technique was used to identificate the hippocampal neurons. Epileptiform discharges were detected by electrophysiological techniques. Western blot assay was used to deter-mine the protein expression of TrkB and phosphorylated TrkB (p-TrkB) in all cell groups. Results (1) In ALLN group, the gray value of p-TrkB/TrkB was higher in control+BDNF group compared with that of control group, the value was higher in epilepsy+BDNF group than that of epilepsy group but was lower than that of control+BDNF group. The gray value of p-TrkB/TrkB was lower in epilepsy+ALLN+BDNF group than that of epilepsy+BDNF group, but no significant difference compared with that of epilepsy+ALLN group. (2) In Anisomycin group:the gray value of p-TrkB/TrkB was higher in control+BDNF group than that of control group. The gray value of p-TrkB/TrkB was higher in epilepsy+BDNF group than that of epilepsy group, but which was lower than that of control+BDNF group. The gray value of p-TrkB/TrkB was higher in epilepsy+Aniso-mycin+BDNF group than that of epilepsy+BDNF group and epilepsy+Anisomycin group. Conclusion The decreased ex-pression of TrkB.T can improve the inhibition of BDNF/TrkB signaling, and BDNF can activate BDNF/TrkB signal pathway in epileptic hippocampal neurons. The increased TrkB.FL protein level by ALLN can’t improve the inhibition of BDNF/TrkB signal pathway.

Objective To investigate the clinical value of the combination of routine magnetic resonance imaging (MRI),magnetic resonance cholangiopancreatography (MRCP),diffusion weighted imaging (DWI)and enhanced magnetic resonance imaging in the diagnosis of recurrent pyogenic cholangitis (RPC).Methods The clinical and MRI data of 2 1 cases of RPC confirmed by surgery or puncture were retrospectivly analyized.Results All of 2 1 patients were performded with routine MRI (FSE T2 WI,FSPGR T1 WI and FIASTA),MRCP and DWI.1 2 cases were underwent three-dimensional dynamic contrast-enhanced MRI with a liver volume accelerated acquisition sequence (LAVA).The raw data was uploaded to GE ADW4.4 station and the three dimensional MRCP and DWI were analyzed.(1)All of 21 cases were hepatolithiasis complicated with irregular expansion.11 cases were involved left intra-hepatic bile duct,7 cases were right intrahepatic duct,and 3 cases were involved left and right intrahepatic bile duct.Wall thickening was in 19 cases,normal biliary duct wall was in 2 cases.(2)Common bile duct disease:calculus of intrahepatic and extrahepatic bile duct complicated with bile duct dilatation were in 8 cases.Calculus of intrahepatic bile duct were individually in 13 cases.(3)Gall-bladder disease:there were 5 cases of gallstone,9 cases of chronic cholecystitis,3 cases of acute cholecystitis and 4 cases of chole-cystectomy.(4)Liver parenchyma disease:there were 6 cases of liver atrophy in all the cases (left lobe atrophy of 4 cases,right lobe atrophy of 4 cases).The inflammatory changes around dilated bile ducts were found in 1 2 cases.The MRI findings of those were slight patchy hyperintensity signal on conventional T2 WI,the area of hyperintensity signal on T2 WI was extended on DWI.On dynamic contrast-enhanced MRI,the inflammatory areas were uniformity minor enhancement on arterial phase,and hardening in-creases on portal and delayed phase.Conclusion Multi-sequences MRI can be more fully reflected the pathologic changes of RPC, which is important for imaging diagnosis of the disease.