Objective To establish the quality control standard for Shuanggen Qingnao Granules.Methods TLC was used to identify Yiyiren SEMENCOICIS,Yujin RADIXCURCUMAE,Banlangen RADIX ISATIDIS. HPLC was used to determine the content of Puerarin in Shuanggen Qingnao Granules.Results The TLC spots developed were fairly clear,and the bland test showed no interference.Puerarin showed a good linear relationship in the range of 5.184～40.50?g/mL,the average recovery of Puerarin was 99.93%,and RSD=1.81%.Conclusion The method is accurate and quick,and can be used for the quality control of Shuanggen Qingnao Granules.

Objective To evaluate the effects of dexmedetomidine combined with subanesthetic dose of ketamine on the emergence agitation in the patients undergoing thoracotomy.Methods Eighty ASA physical status Ⅱ or Ⅲ patients,aged 55-75 yr,weighing 50-75 kg,scheduled for elective esophageal cancer resection,were randomly divided into 4 groups (n =20 each) using a random number table:normal saline group (NS group),dexmedetomidine group (group D),subanesthetic dose of ketamine group (group K),and dexmedetomidine combined with ketamine group (group DK).In DK and K groups,ketamine 0.5 mg/kg was injected intravenously (within 1 min) at 10 min before the end of the operation.In DK and D groups,dexmedetomidine 0.5 μg/kg was infused intravenously over 10 min starting from 10 min before the end of operation.In group NS,the equal volume of normal saline was infused intravenously over 10 min starting from l0 min before the end of operation.The emergence time,extubation time,duration of ICU stay,occurrence and degree of agitation,and development of cardiovascular events and hypoxemia within 24 h after operation were recorded.Ramsay sedation scores were recorded before induction of anesthesia (T1),immediately after completion of administration at the end of surgery (T2),and at 0,5,10 and 30 min after extubation (T3-6).Results There was no significant difference in the emergence time,extubation time,and duration of ICU stay between the four groups.Compared with group NS,Ramsay sedation scores were significantly increased at T3-6,the incidence and degree of agitation were decreased,and the incidence of cardiovascular events and hyoxemia was decreased in D,K and DK groups.Compared with D or K group,Ramsay sedation scores were significantly increased at T3-6,the incidence and degree of agitation were decreased,and the incidence of cardiovascular events and hyoxemia was decreased in group DK.Conclusion Dexmedetomidine combined with subanesthetic dose of ketamine can prevent the emergence agitation in the patients undergoing thoracotomy,which provides better efficacy than either alone.

Objective To investigate precipitants of epileptic seizure, and to explore the correlation between various precipitants and relationship between precipitants and clinical features of epilepsy.Methods Data were collected from 154 patients attending a tertiary-care epilepsy clinic of Nanjing Brain Hospital between April 2015 and April 2016.The patients with epilepsy were older than 16 years, had a clinical history of one year or more, and one seizure at least a year and one seizure at least in the latest three months.An enclosed questionnaire was combined with open interview to identify and characterize seizure precipitants and clinical characteristics of patients.Patients were asked respectively whether there were some precipitants three months before and during last three months.Correlation between seizure precipitants and relationship between precipitants and clinical characteristics, such as age, gender, course, seizure frequency and so on, were calculated.Results A total of 125 (81.2%) participants reported at least one precipitant.Common precipitants (in descending order) were as follows: emotional stress (56.0%), sleep disorder (38.4%), fatigue (27.2%), missed medication (20.0%).There were one to six different precipitants for one patient, and 60.8% of patients had two or more precipitants.There was a correlation between emotional stress and sleep disorders as well as fatigue (χ2=4.665, 8.668;P<0.05).Patients with idiopathic epilepsy were more sensitive to sleep disorders.There was no relationship between total precipitants and clinical features such as age, gender, age of onset, duration, type of seizure, seizure frequency, number of drug taking and so on.Conclusions Seizure precipitants were found widespread.The most common precipitants were found to be emotional stress, sleep disorders, fatigue and missed medication.There existed a correlation between emotional stress and sleep disorders as well as fatigue.There was no connection between total precipitants and patient′s demographic characteristics as well as clinical features.However, the type of seizure precipitants was different in patients with different demographic and clinical characteristics.

Plague, infectious disease in modern medicine, refers to a type of disease with strong pathogenicity and infectiousness, it refers to the infectious diseases of western medicine. Due to its wide variety, the knowledge and understanding of plagues of Traditional Chinese Medicine (TCM) doctors in different stages have evolved and developed with the times. This article, via collating ancient documents, differentiatesthe classification in TCM and analyzes itsrelated theories to perfect the type of plagues in TCM, providing the theoretical basis for the research of plague in modern times.

Objective To evaluate the effects of sub anesthetic dose of ketamine combined with sufentanil on postoperative patient-controlled intravenous analgesia (PCIA)in patients undergoing radical resection of esophageal cancer.Methods Ninety patients,ASAⅠorⅡ,aged 55-75 years old,se-lected for radical resection of esophageal cancer were randomly divided into three groups:group S1,group S2,group SK,30 patients in each group were treated with PCIA.Group S1,2 μg/kg sufentanyl;group S2,2.5 μg/kg sufentanyl;group SK 2 μg/kg sufentanyl+90 μg·kg-1·h-1 ketamine.6 mg of granisetron was added to each group,and then diluted into 100 ml of normal saline.All patients were administered load-ing doses of 5 ml analgesics 30 min before the end of the operation.The VAS score,Ramsay sedation score, SBP,DBP,HR,SpO2 and adverse effects were recorded respectively at 4,8,24 and 48 hours after opera-tion.The total times of pressing PCIA were also recorded in 48 h after operation.Results There was no statistically significant difference in Ramsay sedation score,SBP,DBP,HR and SpO2 at 4,8,24,48 hours after operation in the three groups.Compared with group S1,the VAS score and total number of pressing PCIA times in groups SK and S2 were significantly lower in 48 h after operation (P <0.05).Compared with group S2,VAS score and the total number of pressing PCIA times in group SK were significantly de-creased in 48 h after operation (P <0.05).Two patients from group SK occurred respiratory depression 48 h after operation.There was no statistically significant difference in incidence of adverse effects in the three groups.Conclusion Sub anesthetic dose of ketamine combined with sufentanil on PCIA can reduce postoper-ative sufentanil consumption and significantly relieve the postoperative pain in patients undergoing radical re-section of esophageal cancer.The analgesic effect is better than using sufentanil alone.

Objective To investigate the chest HRCT characteristics of pediatric perinuclear anti-neutrophil cytoplasmic antibody (p-ANCA) associated systemic vasculitis. Methods Retrospectively analysis of the clinical and HRCT data of 15 pediatric cases diagnosed as p-ANCA related pneumonia according to the classification and diagnostic criteria of Chapel Hill meeting of 1994 in our hospital were retrospectively analyzed. They were 13 girls and 2 boys. The age range was 1—17 years and the median was about 10 years old, In the 15 patients, 12 were diagnosed as primary MPA, 2 were secondary MPA, 1 was CSS. Two radiologists with 10 years of radiological experience read the CT imaging together. Results 1 of 12 primary MPA were found large opacities and ground glass shades in both sides of lung,especially the posterior parts on CT images with bilateral pleural effusion; 1 case had focal opacities in left lower lobe, around with thickened interlobular septa and pleural effusion; Another 1 case only had focal thickened interstitial in right middle lobe; The other 9 cases showed scattered or diffused ground glass opacity, with thickened pulmonary interstitial and (or) pleura. 1 of the 2 secondary MPA who had hemoptysis showed ground glass opacity on CT images with no thickened septal nodules or pleural effusion. The other one who had renal anomalies and no respiratory symptoms showed subpleural nodules with halo sign in right low lobe. The CSS showed diffused patchy ground glass opacity, consolidation of both lingular lobes, nodules of centri-and peri-lobular, thickened septa near the pleura, obviously thickened bronchial wall, slightly widened bronchial lumen and thickened pleura. Conclusion The classic imaging features of p-ANCA pneumonia on HRCT is the non-specific small pulmonary vessel hemorrhage.

This study aimed to examine the diagnosis performance of 99mTc-methoxyisobutylisonitrisonitrile (99mTc-MIBI) and multimodality imaging [ultrasound,single-photon emission computed tomography/computed tomography (SPECT/CT)] for hyperparathyroidism (HPT).From Nov.2009 to Dec.2015,clinical data of a total of 43 HPT patients (16 males and 27 females;26-70 years old,average age:51.60±10.66 years old) were retrospectively analyzed.Among them,19 patients with primary hyperparathyroidism (PHPT) underwent 99mTc-MIBI planar imaging,24 [15 with PHPT and 9 with secondary hyperparathyroidism (SHPT)] underwent SPECT/CT hybrid imaging,and 41 (33 with PHPT and 8 with SHPT) had neck ultrasound imaging.Final diagnosis was determined by pathological examination after surgery.The positive rate was compared between different imaging modalities,and the correlation analysis was conducted between imaging results and lesion size or serum parathyroid hormone (PTH) level.The results showed that the total positive rates of 99mTc-MIBI imaging,ultrasound,and the two combined imaging in the 43 HPT cases were 90.70％ (39/43),58.54％ (24/41),and 100％ (41/41),respectively.According to lesion numbers,the positive rates were 79.10％ (53/67),53.23％ (33/62),and 88.71％ (55/62),respectively.SPECT/CT hybrid images were positive in all the 24 patients who underwent this examination.The mean maximum diameters of the lesions in 99mTc-MIBI positive and negative patients were 1.96±0.95 cm and 1.36±0.67 cm respectively,with statistically significant difference noted (P=0.03).The T/NT of 99mTc-MIBI imaging at the early phase was correlated positively with serum PTH level (r=0.40,P=0.01).The T/NT of 99mTc-MIBI imaging at both the early phase and the delay phase was correlated positively with lesion size (r=0.51,and r=0.45,respectively;P＜0.01 for both).It was concluded that 99mTc-MIBI imaging presents significant value for location diagnosis of HPT,especially when combined with SPECT/CT hybrid imaging or ultrasound.The 99mTc-MIBI uptake correlates positively with serum PTH level and lesion size.

OBJECTIVETo observe the expression of phospholipid scramblase 1 (PLSCR1) in matrine (MAT) induced differentiation of all-trans retinoic acid (ATRA) resistant acute promyelocytic leukemia (APL) cells, and to explore its correlation to cyclic adenosine monophosphate (cAMP)/protein kinase A (PKA) signal pathway.

METHODSNB4 (an APL cell line sensitive to ATRA) and NB4-R1 (a resistant strain of ATRA) were observed as subjects in this study. Effects of combined treatment of 0.1 mmol/L MAT and 1 [mol/L ATRA on the differentiation of two cell lines were detected using nitroblue tetrazolium (NBT) reduction test and flow cytometry (CD11b). Expressions of PML/RARot and PLSCR1 protein/gene were detected using Western blot and Real-time fluorescence quantitative PCR assay. Meanwhile, H89, PKA antagonist, was used to observe cell differentiation antigen and changes of aforesaid proteins and genes.

RESULTSMAT combined ATRA could significantly elevate positive rates of NBT and CD11 b in NB4-R1 cells, and significantly down-regulate the expression of PML/RARapha-fusion protein/gene (P < 0.05, P < 0.01). ATRA used alone could obviously enhance the expression of PLSCRI in NB4 cells at protein and mRNA levels (P < 0.01). But the expression of PLSCR1 was up-regulated in NB4-R1 cells, but with statistical.difference only at the protein level (P <0. 01). In combination of MAT, PLSCR1 protein expression was further elevated in the two cell lines (P < 0.01). Besides, there was statistical difference in mRNA expressions in NB4-R1 cells (P < 0.05). All these actions could be reversed by treatment of 10 micromol/L H89 (P < 0.05, P < 0.01).

CONCLUSIONMAT combined ATRA could significantly induce the differentiation of NB4-R1 cells, and inhibit the expression of PML/RARalpha fusion gene/protein, which might be associated with up-regulating PLSCR1 expression.

Alkaloids ; Antineoplastic Agents ; Cell Differentiation ; Cell Line, Tumor ; Down-Regulation ; Humans ; Leukemia, Promyelocytic, Acute ; metabolism ; Phospholipid Transfer Proteins ; metabolism ; Quinolizines ; RNA, Messenger ; Signal Transduction ; Tretinoin ; Tumor Cells, Cultured ; Up-Regulation

Objective To explore the value of susceptibility-weighted imaging (SWI) for the assessment of chronic renal injury. Methods Thirty-nine patients with clinical diagnosis of chronic renal injury (RI group) who underwent routine renal MRI and SWI examination were retrospectively analyzed. They were divided into mild injured group (15 cases) and moderate to severe injured group (24 cases) by estimated glomerular filtration rate (eGFR). At the same time, 17 volunteers without chronic renal injury who had normal serum creatinine (Scr) and blood urea nitrogen were recruited as control group. All subjects underwent routine renal MRI and SWI examination. The ratios of cortex to medulla were measured and calculated in both kidneys' magnitude image and susceptibility weighted image, which were indicated as C/MMAG and C/MSWI. Independent sample t test was used to compare the differences of C/MMAG and C/MSWI between control group and RI group, and paired sample t test was used to compare the differences betweenC/MMAG and C/MSWI in each group. One-way ANOVA was used to compare the difference of C/MMAG and C/MSWI between the control group and the different RI groups. ROC was employed to assess the diagnostic efficacy of C/MMAG and C/MSWI in renal injury. Pearson linear correlation analysis was used to evaluate the correlation between C/MMAG, C/MSWI and eGFR, Scr in patients with renal injury. Results The C/MMAG and C/MSWI in the RI group were 1.101±0.039 and 1.071±0.046, respectively. C/MSWI was obviously lower than C/MMAG, and the difference was statistically significant (t=5.056, P<0.01). There was no significant difference between C/MMAG and C/MSWI in the control group (P>0.05). The C/MMAG and C/MSWI in the RI group were obviously lower than those in the control group, and the difference was statistically significant (t=4.564, 6.122;P<0.01).The C/MMAG and C/MSWI in the mild injured group and the moderate to severe injured group were significantly lower than those in the control group, the difference was statistically significant (P<0.05). While the differences of those between mild injured group and moderate to severe injured group showed no statistical significance (P>0.05). The area under ROC of C/MMAG and C/MSWI in diagnosis of renal injury were 0.853 and 0.952, respectively. C/MMAG was positively correlated with eGFR (r=0.460,P<0.01). Conclusions Susceptibility-weighted imaging can be used to assess chronic renal injury. Although it cannot reflect the degree of renal function damage, it has some value in the early diagnosis of mild renal injury.

Objective To investigate the effects of different doses of pituitary adenylate cyclase- activating polypeptide(PACAP)on the functional and morphological outcome in a mice model of Parkinson' s disease(PD)rendered by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine(MPTP).Methods Male mice were treated with PACAP 0.02, 0.20 or 2.00 ?g by iv bolus for 7 days after MPTP was administered, and were compared with the saline-treated mice.The immunohistochemistry and Western blot were used to detect the alterations of PD biomarker including tyrosine hydroxylase(TH), dopamine transporter(DAT)and vesicular monoamine transporter2(VAMT2).In addition, monoamine neurotransmitters in the striatum of mice were measured by the high performance liquid chromatography (HPLC).Results TH immunohistochemistry indicated that the number of TH-positive neurons in the substantia nigra was increased in all PACAP-treated mice(PACAP(0.02 ?g/d)group was 93.33?4.87, F=85.85,P