Objective To research the optimal conditions for extraction of Daoguleebusi-7 capsule. Methods A comprehensive investigation for the process of extraction by water and ethanol was made using orthogonal experiments.Results The optimal process conditions were: gardenia and another drug were added into 12 volumes of water, extracted 2 times and two hours per time; Sophorae Flavescentis and other four dugs were added into 12 volumes of 85% ethanol,extracted 3 times and two hours per time, elecampane was crushed and screened through 100 mesh sieve to electuary.Conclusion The extraction process is simple and feasible for operation.

Objective To explore the effect of carbohydrate administration on postoperative insulin resistance after gastroenteric tumor resection.Methods Sixty elective gastroenteric tumor resection patients were divided into observation group and control group by random number table method,with 30 cases in each.Observation group was given carbohydrate administration before surgery,that was 2 h before anesthesia oral carbohydrates 300 ml containing 50 g glucose;control group was treated according to the traditional methods,preoperative fasting 12 h,6 h forbidden to drink.The blood samples were collected to measure the levels of fasting blood glucose (FBG) and fasting insulin (FINS) at 3 h before operation and 1,3,7 d postoperation respectively.Homeostasis model assessment (HOMA) was applied to calculate the insulin resistance index.Results The levels of FBG,FINS,HOMA-IR at 1,3 d postoperation in two groups were significantly higher than those at 3 h preoperation [observation group:(10.65 ± 1.78),(7.32 ± 1.48) mmol/L vs.(5.09 ±0.43) mmol/L,(25.78 ± 12.43),(16.23 ±7.56) mU/L vs.(10.48 ± 1.57) mU/L,11.67 ±6.32,5.12 ± 2.11 vs.2.35 ± 0.54;control group:(11.18 ± 1.25),(8.04 ± 1.53) mmol/L vs.(5.12 ± 0.39) mmol/L,(39.67 ± 10.37),(24.34 ± 6.78) mU/L vs.(9.98 ± 2.04) mU/L,19.07 ± 5.49,8.56 ± 2.87 vs.2.28 ± 0.39](P ＜ 0.05).The levels of FINS,HOMA-IR at 1,3 d postoperation in control group were higher than those in observation group (P ＜ 0.05).The levels of FINS and HOMA-IR at 7 d postoperation in observation group were returned to the 3 h preoperative (P ＞ 0.05),while the levels in control group [(16.32 ± 4.56) mU/L,3.87 ± 1.12] was still higher than those at 3 h preoperation (P ＜0.05).Conclusion Carbohydrate administration may shorten the insulin resistance durion after gastroenteric tumor resection,and reduce the intensity of insulin resistance,thus contributing to the rehabilitation of patients.

OBJECTIVE To investigate the clinical distribution and drug resistance status of Stenotrophomonas maltophilia and provide clinical guidance for treatment.METHODS Sixty clinical isolates of S.maltophilia were identified with GNI+ cards of VITEK-32.Drug sensitivitiy were detected by Kirby-Bauer disc diffusion method.The data were analyzed by WHONET5.3 software.RESULTS Thirty-eight strains were isolated from sputum(63.3%).Infection caused by S.maltophilia mainly occurred at the departments of respiratory diseases,ICU,old cadre,et al.Sixty isolates of S.maltophilia were highly resistant to imipenem,aminoglycosides and most of ?-lactam antibiotic,but showed the lowest resistance rate(16.7%) to SMZ/TMP.Then resistance rate of S.maltophilia to minocycline,levofloxacin,cefoperazone/sulbactam,piperacillin/tazobactam,and ticarcillin/clavulanic acid was 18.3%,20.0%,21.7%,25.0% and 30.0%,respectively.CONCLUSIONS The drug resistance of S.maltophilia is extremely severe.Among different areas of china the drug resistance is obviously different.Treatment based on drug susceptibility test should be adapted as soon as possible.

Objective:To study the role of 14-3-3εand Cdc25B in germinal vesicle (GV)-stage arrest of mouse oocytes,and to pay foundation for further study on the molecular mechanism of PKA/Cdc25B/14-3-3εpathway in GV-stage arrest of mouse oocytes.Methods:The eukaryotic expression vectors of pcDNA3.1-ZEO-HA-14-3-3ε, pcDNA3.1-MYC-Cdc25B-WT, pcDNA3.1-MYC-Cdc25B-S321A, and pcDNA3.1-MYC-Cdc25B-S321D were transcribed into mRNA invitro.The mouse GV-stage oocytes were collected after superovulation and divided into no injection group,TE buffer microinjection group,14-3-3εmRNA injection group,14-3-3εmRNAs + Cdc25B-WT mRNA injection group,and 14-3-3εmRNA + Cdc25B-S321A mRNA injection group,14-3-3εmRNA+Cdc25B-S321D mRNA injection group.The protein expression levels of HA-14-3-3εand MYC-Cdc25B and the phosphorylation status of Cdc2-pTyr15 were observed by Western blotting method.The morphological changes and germinal vesicle breakdown (GVDB)rates of mouse oocytes were observed under phase-contrast microscope. Results:None of the oocytes in no injection group, TE buffer microinjection group, 14-3-3εmRNA injection group,14-3-3εmRNA + Cdc25B-WT mRNAs injection group and 14-3-3εmRNA + Cdc25B-S321D mRNA were able to undergo GVBD until at least 20 h after injection (P>0.05 );the GVBD rates of oocytes in 14-3-3εmRNA+Cdc25B-S321A mRNA group at 1 h (5.00%±0.68%),2 h (62.00%±3.56%)and 3 h (100.00%± 0.00%)after injection were significantly higher than those in no injection group and TE buffer injection group (P<0.01);the oocytes in 14-3-3εmRNA+ Cdc25B-Ser321A mRNA group at 20 h (79.00%±2.80%)after injection progressed to MII (P<0.01).Conclusion:14-3-3εcan regulate the transition from GV to GVBD of mouse oocytes by means of phosphorylation and dephosphorylation of S321-Cdc25B.

Objective:To construct superparamagnetic iron oxide nanoparticles targeting tumor angiogenesis and evaluate their potential value as contrast agent in magnetic resonance imaging (MRI) .Methods:Ultrasmall superparamagnetic iron oxide (USPIO) nanoparticles targeting tumor angiogenesis were prepared by using co-precipitation chemical method. Cyclic RGD(cRGD) containing the sequence of Arg-Gly-Asp were conjugated USPIO nanoparticles by using chemical conjugative method to prepare superparamagnetic imaging agent targeting tumor angiogenic vessles. The physical and chemical properties of cRGD-USPIO nanoparticles were detected. The specific binding capabilities of cRGD-USPIO and USPIO to human lung adenocarcinoma cells (A549) and human umbilical vein endothelial cells (HUVEC) were tested by Prussian blue staining. A549 xenografts were established in nude mice, then USPIO and cRGD-USPIO were injected though tail vein, and the MRI signal enhancement effect of cRGD-USPIO was evaluated.Results:We successfully prepared the cRGD-USPIO nanoparticles. Its core diameter was 5-10 nm and the average diameter was (43.97±10.10) nm and the quality saturation magnetic intensity was 59.94 A·m~2·kg~(-1). Cell-binding test suggested that cRGD-USPIO group showed strengthened positive staining. In vivo MRI experiments showed that signals of tumor were significantly reduced in cRGD-USPIO group than that in USPIO group (P<0.01). Conclusion:The constructed cRGD-USPIO nanoparticles can be developed as a potential tumor-specific MRI contrast agent for the early diagnosis of cancer.

Objective To investigate causes and effects of medial meniscus extrusion in patients with knee osteoarthritis.Methods A total of 120 patients diagnosed as knee osteoarthritis between January 2011 and March 2012 were enrolled in this study,including 60 patients with medial meniscal extrusion confirmed by MRI (extrusion group) and other 60 patients without medial meniscal extrusion (control group).The extrusion distance of medial meniscus and tibiofemoral angle were measured on MRI.The correlation between tibiofemoral angle and extrusion distance were analyzed.The incidences of genu varum,medial meniscus injury and cartilage lesion of medial tibiofemoral joint were compared between two groups.The effect of medial meniscal extrusion on meniscus injury and effect of genu varum on meniscal extrusion were analyzed.Results In extrusion group,the extrusion distances of medial menisci ranged from 3.76 to 11.6 mm (average,8.3±1.79 mm); all patients had genu varum,and the tibiofemoral angle ranged from 174°to 181°(average,179.0°±2.2°); the incidence of medial meniscus injury was 50.0％ (30/60) in the anterior horn,93.3％ (56/60) in the body,and 93.3％ (56/60) in the posterior horn; the incidence of medial meniscus tear in the root of the posterior horn was 23.3％ (14/60); the incidences of cartilage degeneration in medial tibial plateau and medial femoral condyle both were 100％ (60/60); a significant negative correlation was observed between dimension of tibiofemoral angle and extrusion distance of medial meniscus.In control group,the extrusion distances of medial menisci ranged from 0 to 2.61 mm (average,0.57±0.80 mm); four patients had genu varum,and the tibiofemoral angle in all patients was 180°; the incidence of medial meniscus injury was 0 in the anterior horn,16.7％ (10/60) in the body,and 70.0％ (42/60) in the posterior horn; no medial meniscus tear was found in the root of the posterior horn; the incidence of cartilage degeneration was 26.7％(16/60) in medial tibial plateau and 30.0％ (18/60) in medial femoral condyle.The odd ratio of meniscus injury and the number of genu varum (extrusion group/control group) was 6.0 and 15.0,respectively.Compared with the control group,the incidences and severities of medial meniscus injury and cartilage lesion of medial tibiofemoral joint were higher in extrusion group.Conclusion Genu varum may be one cause of medial meniscal extrusion.Medial meniscal extrusion increases incidence of medial meniscus injury and has a significant influence on generation and development of osteoarthritis in medial tibiofemoral joint.

Objective To analyse the cost-effectiveness analysis of the focal injection treatment under the guidance of contrast enhanced ultrasound(CEUS) for the severe abdominal parenchymal organs trauma.Methods One hundred and twelve patients with severe abdominal parenchymal organs trauma,including 42 hepatic injuries,52 splenic injuries and 33 renal injuries,were rolled in this study. The cost-effectiveness of this group was compared with that of surgery group. Results Treatment duration of single organ trauma under the guidance of CEUS was 20 - 30 minutes. During the first 72 hours after the focal injection, blood pressure and heart rate were improved ( P ＜0.05). Free intraperitoneal liquid did not increase on immediate US image of post-therapy and then it disappeared gradually. Heart rate returned to normal level after injection treatment ( P ＜0. 001 ). Lengths of stay in hospital was 3 - 11 (5.4 ± 2.4)days, which was not different with 3 - 9(5.1± 1.9) of surgery group( P ＞0.05). Treatment cost was 0.32 - 0.43 (0.36 ±0. 14) ten thousand RMB, which was obviously less than 3. 1 - 4. 2 (3.6 ± 10.8) ten thousand RMB of surgery group ( P ＜ 0.01 ). Conclusions The efficacy of the focal injection treatment of the severe abdominal parenchymal organs trauma under the guidance of CEUS was consistent with that of the operative treatment, but its cost was less. Especially it benefited for reserving organs and less pain.

Objective To investigate the effect of the different position on hemodynamic moni-tored by FloTrac/Vigileo system in patients undergoing laparoscopic appendectomy.Methods Sixty patients undergoing laparoscopic appendectomy,ASA Ⅰ or Ⅱ,were randomly divided into three groups (n=20):group A,B and C underwent the trendelenburg position of 10 degrees,20 degrees and 30 degrees,respectively.HR,MAP,cardiac output (CO),cardiac index (CI)and stroke volume (SV)were recorded before pneumoperitoneum (T0 ),1 min after pneumoperitoneum (T1 ),5 min af-ter trendelenburg position (T2 ),20 min after pneumoperitoneum (T3 ),1 min after the end of pneu-moperitoneum (T4 )and 5 min after the end of trendelenburg position (T5 )after induction of anesthe-sia.The time of pneumoperitoneum and operation was recorded.Results Compared with T0 ,HR and MAP increased significantly at T1-T3 in three groups(P<0.05);Compared with group C,CO and SV decreased significantly at T2-T3 in group A and group B (P<0.05).Compared with T1 ,CO and SV increased at T2-T3 in group C (P<0.05).Compared with group C,the time of pneumoperitoneum and operation was longer in group A and B (P<0.05).Conclusion During the operation of laparo-scopic appendectomy,the change of the hemodynamic is in clinical safe range,and the time of pneu-moperitoneum and operation is shorter in the position of 30°than 10°and 20°in laparoscopic appen-dectomy.

The primary aim of this research is to systematically sort out and analyze available clinical documents for chronic congestive heart failure in traditional Chinese medicine (TCM) and integrated traditional Chinese and Western medicine, and to explore the diagnosis and treatment rule of TCM syndrome factors with data mining method.

Objective To investigate the spectrum,diagnosis,time of therapy and management of the congeni-tal heart disease(CHD)in patients with Down′s syndrome(DS).Methods A retrospective report was undertaken of 96 cases in children with DS accompanied by CHD in Department of Pediatric Cardiology,Beijing Anzhen Hospital Af-filiated to Capital Medical University.Data were collected and analyzed about their clinical characteristics,and types of cardiovascular abnormalities,and the important laboratory examinations such as echocardiography and catheterization as well as the procedures of diagnosis and treatments were summarized.Then the interventions,complications and prognosis of different patients were estimated.Results (1)Single congenital heart disease was found in 33 cases (34.38%),a-mong which ventricular septal defect was the most common (14 cases,14.58%),followed by atrioventricular septal de-fect and atrial septal defect (equally,7 cases,7.29%).Multi -cardiovascular abnormalities were discovered in 63 ca-ses,and patent ductus arteriosus turned out to be the most common (42 cases,66.67%).(2)Cat-heterization was car-ried out in 18 cases of serious pulmonary arterial hypertension,and 8 cases were proved resistant pulmonary arterial hy-pertension without operation opportunity.The other 8 cases were estimated as high pulmonary arterial hypertension and medical therapy was suggested before reassessment to reduce surgical risks.(3)Operations were undertaken in 61 ca-ses,among which percutaneous interventional occlusion was performed in 7 cases and surgical interventions were per-formed in 54 patients,in which perioperation complications and death were found in 5 cases and 4 cases,respectively. Conclusions Operation interventions are practicable and most cases recovered well with systematic examinations and assessment in patients with DS and cardiovascular malformations.Early diagnosis and timely interventions are highly suggested.Also close attentions should be paid to follow -up and re -estimation after medical therapy.