Objective To establish a method for the determination of bilirubin in Xihuang capsules.Methods HPLC method was applied and the chromatographic conditions were as follows: Hypersil BDS C18 column(150 mm ? 4.6 mm,5 ?m)with methanol-chloroform-1 % phosphoric acid(84︰9︰7)as the mobile phase.The flow rate was 1.0 mL ? min-1 with the detected wavelength at 450 nm and the column temperature at 25 ℃.Results The calibration curve for bilirubin was linear in the range of 0.01 ~ 0.07 ?g.The average recovery was 98.07 %(RSD = 1.05 %).Conclusion This method is simple,accurate,specific and could be used for the quality control of bilirubin in Xihuang capsules.

Objective:To explore the ethical issues in liver cirrhosis and hepatic encephalopathy and integratet-hem into health education. Methods:36 patients with hepatic encephalopathy and their family members were car-ried out medical ethics education and adopted relevant nursing care. Results:It was proved that integrating medi-cal ethical knowledge into health education could greatly relieve patients′pressure and emotion swing, so as to ob-tain better treatment effect. Conclusion:Through carrying out effective ethics education for the patients with liver cirrhosis and hepatic encephalopathy, strictly complying with the principle of medical ethics that keeping secret for patients, protecting the subjects maximally, holding the issues between ethics and medical moral and cooperating with comprehensive treatment and nursing care, the death rate of hepatic encephalopathy can be largely reduced and relationship between doctors, nurses and patients can be improved.

Objective To study the clinicopathological characteristics and immunophenotype of solid pseudopapillary neoplasm (SPN) of the pancreas.Methods Retrospective analysis was performed for the clinical materials,pathological features and immunohistochemical phenotype characteristics of the 23 SPN cases.Results Ratio of male to female was 1:10;the average age was 32 years.10(43％) patients had no clinical symptoms,12 (52％) patients had abdominal pain,abdominal distention or diarrhea;1 patient had jaundice.Tumors were in the head of pancreas in 10(43％) cases,and were in the tail or body of pancreas in 13 cases.Grossly,tumors were solid-cystic or solid;the maximum diameter were from 1.3 cm to 17 cm,with the average of 5.9 cm;12 (52％) cases appeared encapsulated.Histopathologically,21 (91％) cases appeared to exhibit a fibrous capsule surrounding the tumors,and the fibrous capsule invasion were observed in all these cases;Pancreas tissues were involved in 8(35％) cases.Tumor cells arranged in sheets,nests and pseudopapillary patterns.Hemorrhage,necrosis and cystic degeneration were often seen.Tumor cells were positive for vimentin,β-catenin,CK,CD10,PR,CD56 and Syn.Tumor were mostly negative for CgA and Ki-67.23 cases were followed up for 2 to 44 months,and all were alive.Conclusion SPN is a low degree malignant tumor often seen in young women with various histological patterns and multiple immunophenotypes.Definite diagnosis of SPN can be made by combining clinicopathological characteristics with a panel of immunohistochemicat marks.SPN grows slowly,often responds to surgical resection and rarely recur.

OBJECTIVE:To establish a method for simultaneously determination of glycyrrhizic acid and glycyrrhetinic acid in Yaotongning capsule. METHODS:HPLC was performed on the column of Agilent TC-C18 with mobile phase of methanol-0.2 mol/L ammonium acetate(gradient elution) at a flow rate of 1.0 ml/min;detection wavelength was 250 nm and column temperature was 25 ℃ and injection volume was 10 μl. RESULTS:The linear range was 0.007 1-0.178 0 mg/ml(r=0.999 8)for glycyrrhizin acid and 0.354 8-8.720 0 μg/ml of glycyrrhetinic acid(r=0.999 8);RSDs of precision,stability and reproducibility tests were no more than 1.74%,average recoveries were 95.49%-100.62%(RSD=1.98%,n=9)and 96.80%-102.26%(RSD=1.83%,n=9),respec-tively. CONCLUSIONS:The method is simple,reproducible,accurate and reliable,and can be used for the simultaneous determi-nation of glycyrrhizic acid and glycyrrhetinic acid in Yaotongning capsule.

Objective To explore the feasibility and clinical significance of combined detection of human plasma and feces expression level of microRNA-92a-1 (miRNA-92a-1) as colorectal tumour screening marker.Methods From August to October in 2011,the feces and plasma samples of 60 colorectal cancer (CRC) patients,23 colorectal adenoma (CRA) patients and 30 healthy controls were collected.The expression level of miRNA-92a-1 was determined by quantitative reverse transcription-polymerase chain reaction.Mann-Whitney's U test was applied for the difference test between groups.Then,according to the receiver operating characteristic (ROC) curve analysis the cut-off point was determined and the sensitivity and specificity were analyzed.Results Compared with healthy controls,the expressions of miRNA-92a-1 in plasma of CRC and CRA patients increased (U=288.5 and 151.0,both P＜0.01).Compared with healthy controls,the expression of miRNA-92a-1 in feces of CRC patients increased (U=627.5,P=0.0199).According to ROC curve analysis,when the cut-off point was ＞1.22,the sensitivities of plasma miRNA-92a-1 in CRC patients and CRA patients were 85.0％ (51/60) and 73.9％ (17/23) respectively.The specificity of healthy controls was 76.7％ (23/30).When the cut-off point was ＞1.14,the sensitivities of feces miRNA-92a-1 in CRC patients and CRA patients were 31.7％(19/60) and 26.1％(6/23) respectively.The specificity of healthy controls was 90.0 ％ (27/30).Combined the detection results of plasma and feces,the sensitivities of miRNA-92a-1 in CRC patients and CRA patients was 88.3％ (53/60) and 82.6％ (19/23) respectively.The specificity in healthy controls was 73.3％ (22/30).The sensitivity was higher than that of single sample testing.Conclusions The sensitivity and specificity are high in the combined detection of plasma and feces miRNA-92a-1 expression level in CRC patients and CRA patients,miRNA-92a-1 may be a potential CRC screening marker.

Objective This study was focused on the association between neutrophil extracellular traps (NETs) and interstitial lung disease (ILD) in patients with dermatomyositis (DM).Methods Thirty six patients who satisfied the Bohan & Peter criteria for DM were recruited to this study,among whom 19 were complicated with ILD.Forty seven age and sex matched healthy Chinese volunteers were selected to be control subjects.The plasma samples of these patients were tested for the formation and degradation of NETs.Results DM plasma induced more NETs formation than control plasma did [(246±93) RFUs vs (192±53) RFUs,P=0.002].Compared to control,DM plasma exhibited a signficantry decreased ability to degrade NETs.Further mere,compared with DM patients without ILD (DMNL),DM patients with ILD (DML) could not degrade NETs completely [(83±13)％ vs (59±21)％,P＜0.01].All four DM patients with subacute ILD exhibited a significantly lower ability to degrade NETs than patients with chronic or asymptomatic ILD [(36±14)％ vs (65±19)％,P=0.0139].Conclusion These data show that more NETs formation is induced by plasma and DML fails to completely degrade NETs.These suggest that NETs may play a role in the pathogenesis of DM and DM-associated ILD.

Objective To express the recombinant mouse histidyl-tRNA synthetase (HARS) and maltose binding protein (MBP) gene in Escherichia coli and obtain the purified protein which possesses antigen specificity.Methods Total RNA was extracted from the myocytes of C57BL/6 mouse and reversely transcripted to cDNA.The gene of N-terminal origin of 591 base pairs was amplified,then cloned into pMALc-5e vector.The recombinant plasmid was transformed into Rosetta-gami B,then IPTG was used to induce the expression of HARS-MBP.Fusion protein was purified by affinity chromatograph.The molecular weight (MW) of HARS-MBP was roughly determined by SDS-PAGE.The antigen specificity was identified by Western blotting using anti-Jo-1 serum from patients,commercial anti-HARS and anti-MBP antibodies.Results The recombinant HARS-MBP protein gene was efficiently expressed in Escherichia coli,and the MW was consistent with predicted MW of 66 000.The fusion protein was specifically combined with its antibody.Conclusion The HARS-MBP fusion protein could be efficiently and steadily synthesized in Escherichia coli,which shows satisfactory antigen specificity and provides the key requirement for making a deep study of HARS in the pathogenesis of idiopathic inflammatory myopathy(IIM) and animal modeling of IIM.

Objective To establish a new murine model of experimental autoimmune myositis by immunizing with MYBPC2 protein. Methods The purified Myosin-binding protein C, fast type (MYBPC2) was emulsified with complete Freundˊs adjuvant, then C57BL/6 mice were immunized by multi-point subcutaneous injection (0, 7 days), and intraperitoneal injection of pertussis toxin 2 μg simultaneously. The pathological changes of mice with different immunizing dose at the preconceived time were ex-plored. Mean-while, mice were immunized with 600 μg each time, and the muscle endurance was tested on the 21th day. The expression of major histocompatibility complex (MHC) class-Ⅰ and the surface biomarkers of the inflammatory cells in muscle tissues were observed. Mann-Whitney U test was used for statistical analysis. Results ① With the increase of immunizing dosage, muscle damage and inflammation tended to be more serious. On the 21th and 28th day, muscle lesions were most significant. Muscle fiber degeneration and necrosis and inflammatory cell infiltration could be seen in the experimental group. ② Compared with the control group, muscle endurance of mice in the experimental group decreased significantly [(6.1 ±1.3) min versus (9.2±1.6) min, U=2.00, P=0.017]. The MHC class-Ⅰ on the muscle fiber surface of the experimental group was positive, scattered infiltration of CD4 +, CD8+ T ly-mphocytes and CD68 + macrophages between muscle fibers and around the vascular areas could be observed, and CD20+B lymphocytes mainly distributed in the area around the blood vessels, nevertheless rarely seen between muscle fibers. Conclusion Exper-imental autoimmune myositis models of mice have been successfully induced by immunizing with MYBPC2 in China for the first time, and similar clinical and pathological features of human polymyositis could be observed. This new model can be used for studying the pathogenesis of autoimmune myositis.

At present, the global prevalence of Helicobacter pylori (Hp) infection is still high. Although bismuth-containing quadruple regimens are recommended by international consensus and guidelines as a first-line treatment for Hp infection, the compliance is decreasing due to more drugs needed and higher adverse events. In recent years, many studies on eradication regimen containing high-dose proton pump inhibitor (PPI) and amoxicillin, a low-resistance and acid-labile antibiotic, demonstrated that the dual therapy could achieve high eradication rate equivalent to the mainstream fist-line therapies and had the advantages of less adverse events, simpler drug composition and higher compliance. However, there are discrepancies in dosage and frequencies of drugs in dual therapies, and cannot reach a unified regimen. This article reviewed all kinds of the dual therapy regimens, which might be helpful for determining the optimal dosage, frequencies, and treatment course, so as to standardize the dual therapy.

Since 2015, the European Society of Gastrointestinal Endoscopy (ESGE), the Japan Gastroenterological Endoscopy Society (JGES), the Digestive Endoscopy Specialized Committee of Chinese Medical Doctor Association Endoscopy Physician Branch, the Asia-Pacific working group and the International Consensus Group have updated the guidelines for acute non-variceal upper gastrointestinal bleeding (ANVUGIB). This article summarized these recently published guidelines and made a systematic comparison from the aspects of pre-endoscopic management, endoscopic management, post-endoscopic management and secondary prophylaxis for providing a reference for standardizing the management process of ANVUGIB.