Thirty nine compounds in the volatile oils of the flowerbuds of Panax quinquefolium L.cultivated in China were isolated and identified with gas chromatography/mass spectre metry. To our great surprise,β-famensene,a sesquiterpene compound of them,alone account for 48.67% of the total volatile oils contents. This experimental result was contrasted with the volatile oils components of the different parts of Panax quinquefolium L.and Panax ginseng,anidentical genus plant,on chemical components and relative quantities.It was discovered that the only one common component is β-famensene in them and it is the highest value in determined relative contents. Above result provides scientific basis for biological synthesis of triterpenoid saponins.

Objective To evaluate the value of MR and CT examinations in the diagnosis of nasopharyngeal carcinoma (NPC) and compare 2008 staging system with 1992 staging system and 2002 UICC staging system for NPC. Methods MR and CT images of seventy-six cases with NPC were studied. According to 2008 staging system and taking MR as a standard, differences between these two examinations were evaluated under the new NPC staging system, and three staging system were compared by MR findings. Results MR was inconsistent with CT in eveluating invasion of medial pterygoid muscle(22,24 cases), lateral pterygoid muscle( 15, 11 cases), skull base(35, 32 cases) and intracranial fossa( 11,6 cases), but no statistical diffence existed ( P ＞ 0. 05 ). There were statistical difference ( P ＜ 0. 05 )between MR and CT in determining invasion of parapharyngeal space( 50, 61 cases), retropharyngeal lymph node metastasis(48, 23 cases), stage T1 (18, 11 cases), T2 (15, 22 cases), N0 (18, 24 cases) and N1(33, 27 cases) with differences of 11 cases, 25 cases, 7 cases, 7 cases, 6 cases and 6cases respectively.For invasion of parapharyngeal space, CT showed 11 cases more than MR while 5 cases were comfirmed as compression by local tumor and 6 cases were proved as retropharyngeal lymph node metastasis according to MR. For retropharyngeal lymph node metastasis, MR presented 25 cases more than CT. These two reasons above mainly caused the differences of T-staging and N-staging. For 2008 staging system, when compared with 1992 staging system, there were 9 cases upstaging and 1 case downstaging in T classification, 16 cases upstaging in N classification, and 15 cases upstaging and 1 case downstaging in clinical classification; and when compared with 2002 UICC staging system, there were 7 cases, 10 cases and 12 cases upstaging in T,N, and clinical staging respectively. Conclusions Compared with MR examination which was regarded as standard by 2008 staging system of NPC, there were some differences in demonstrating invasion of parapharyngeal space and retropharyngeal lymph node metastasis by CT. Compared to 1992 staging system and 2002 UICC staging system, 2008 staging system mainly made T and N classification of tumor upstage,resulting in upstaging in clinical classification.

Objective To evaluate 3.0T MR diffusion weighted imaging (DWI) and ADC value in diagnosis, histological grade, tumor staging and short-time therapeutic outcome of clear cell renal cell carcinomas (CCRCC). Methods DWI of 51 patients of CCRCC confirmed with surgery and pathology were retrospectively reviewed. ADC values of tumors and the corresponding areas of lateral normal renal parenchyma were measured. Taking ADC value at 1.8×10~(-3) mm~2/s as a cut-off value, the patients were divided into two groups. The tumors' histological grade, T-staging, clinical staging, tumor short-term control rate within 1 year follow-up were compared between the two groups with statistical test. Results Statistical difference of ADC value was observed between CCRCC ([1.778±0.582]×10~(-3) mm~2/s) and those of normal renal parenchyma ([2.314±0.223]×10~(-3) mm~2/s) (P<0.01). ADC values of 24 patients were less than 1.8×10~(-3) mm~2/s and those of 27 patients were more than or equal to 1.8×10~(-3) mm~2/s. There were statistical differences in histological grade, T-staging, clinical staging, tumor short-term control rate within 1 year follow-up between the two groups (P＜0.01). Conclusion 3.0T MR DWI can accurately differentiate CCRCC from normal renal parenchyma. Quantitative analysis of ADC value is helpful to evaluate the histological grade, tumor staging and short-term therapeutic outcome of CCRCC.

Objective To evaluate 3.0T MR diffusion weighted imaging (DWI) and ADC value in diagnosis of different pathological types and grades of malignant renal tumors. Methods DWI images of 66 patients of malignant renal tumors proved pathologically were retrospectively reviewed. ADC values of tumors and the corresponding areas of lateral normal renal parenchyma were measured and analyzed statistically. Results There was significant difference between the mean ADC value of malignant renal carcinomas ([1.653±0.598]×10~(-3) mm~2/s) and that of normal renal parenchyma ([2.305±0.218]×10~(-3) mm~2/s, P<0.001). ROC curve showed that taking ADC value of lower than 2.0×10~(-3) mm~2/s as a threshold for diagnosing renal malignant tumor, the specificity, sensitivity and accuracy was 93.94%, 71.21% and 82.58%, respectively. Statistical differences were found between clear cell carcinoma and non-clear cell carcinoma (P=0.001), as well as clear cell carcinoma grade Ⅰ and Ⅲ (P=0.002), grade Ⅱ and Ⅲ (P=0.004) respectively. However, no statistical difference was observed between grade Ⅰ and Ⅱ (P=1.000). Conclusion 3.0T MR DWI can be used in diagnosis of malignant renal tumors, and ADC value may help to differentiate the pathological type and grade.

Objective To investigate the value of DWI before treatment on predicting sensitivity of concurrent chemoradiation in nasopharyngeal carcinoma.Methods Seventy patients with nasopharyngeal carcinoma proved by nasopharyngoscope and biopsy pathology conducted DWI before concurrent chemoradiation and reexamined on receiving dose of 50 Gy.The mean, maximum and minimum ADC value of tumor were measured on DWI and maximum area of tumor before and during treatment ( on dose of 50 Gy) was delineated to calculate the tumor regression rate ( RS0-50 ).The patients were classified into three groups according to the RS0-50 as sensitive, moderate, and resistant therapeutic effect.Patients were classified into different groups according to the pathologic type and clinical stage respectively .Spearman correlation analysis was used between RS 0-50 and ADC values of all tumors , different pathologic types and clinical stages , respectively.ROC was used to evaluate the cutoff and value of ADC which had highest correlation to RS0-50 on predicting therapeutic effect.Results DWI of 3 patients were excluded due to obvious swallow artifact which influenced the measurement , and finally 67 patients were included in this study, with pathological type of nonkeratinized differentiated undifferentiated carcinoma in 49 cases, nonkeratinized undifferentiated carcinoma in 18 cases, clinical T1 stage in 7 cases, T2 in 14 cases, T3 in 17 cases and T4 in 29 cases.During treatment , there were 13 cases with sensitive therapeutic effect , 42 cases with moderate therapeutic effect and 12 cases with resistant therapeutic effect.RS0-50 [ ( 65.6 ± 3.1) %] showed mildly and moderately negative correlation to mean ADC [(1.06 ±0.19) ×10 -3 mm2/s] and maximum ADC [(1.29 ±0.33) ×10 -3 mm2/s] respectively ( r =-0.276, P =0.024 and r =-0.434, P=0.001, respectively).ROC showed when setting threshold at maximum ADC value of lower than 1.06 ×10 -3 mm2/s for predicting sensitive therapeutic effect , the specificity , sensitivity , and accuracy was 69.2%(9/13), 88.9%(48/54) and 85.1% (57/67), respectively, and when setting threshold at maximum ADC value of higher than and equal to 1.30 ×10 -3 mm2/s for predicting resistant therapeutic effect, the specificity, sensitivity, and accuracy was 75.0% (9/12), 65.5% (36/55) and 67.2%(45/67), respectively.Conclusion Pretreatment maximum ADC value were able to predict the tumor regression rate and sensitivity of concurrent chemoradiation in nasopharyngeal carcinoma .

Objective:To determine whether chewing gum during the postoperative period facilitates the recovery of bowel function in patients after radical cystectomy with ileum urinary diversion.Methods:In the study,60 patients who underwent radical cystectomy followed by ileum urinary diversions during Nov.2014 and Nov.2015 in Department of Urology of Peking University First Hospital were randomized into three groups:gum chewing group,placebo group treated with the abdomen physical therapy machine and control group treated with ordinary method.Time to flatus,time to bowel movement,incidence of postoperative distension of the abdomen and abdominal pain,and gut related complications (such as ileus,intestinal fistula,and volrulus)of all the patients were recorded and analysed.Results:In gum chewing group,the median time to flatus was 57 hours (49 -72 hours),and the median time to bowel movement was 95 hours (88 -109 hours),which were significantly shortened compared with the other two groups of patients (82 hours,109 hours in placebo group and 81 hours,108 hours in control group, respectively).No significant difference of the median time to flatus and to bowel movement was observed between placebo group and control group.There were no significant differences in the incidence of post-operative distension of the abdomen and abdominal pain,and gut related complications among the three groups.Conclusion:Chewing gum had stimulatory effect on bowel function recovery after cystectomy fol-lowed by ileum urinary diversion.Chewing gum was safe and simple,and could be routinely used for postoperative treatment after cystectomy and ileum urinary diversion.

Objective To investigate the clinical efficacy of enhanced recovery after surgery (ERAS) in the radical gastrectomy for gastric cancer.Methods The clinical data of 140 patients undergoing radical gastrectomy for gastric cancer at the Affiliated Hospital of Qingdao University from April 2011 to June 2013 were prospectively analyzed.A double-blind,randomized,controlled study was performed in the 140 patients,and all of them were divided into the ERAS group (patients undergoing perioperative management according to enhanced recovery rehabilitation program) and the control group (patients undergoing perioperative management) based on a random numble table.The inflammatory markers,nutritional index and postoperative recovery of patients were observed.Patients of the ERAS group were followed up by telephone interview within the first 24 hours after discharge,and by outpatient examination since the second week after discharge.The follow-up was ended at postoperative day 30.Patients of the control group were reexamined at the third week after discharge.The measurement data with normal distribution was presented as x ± s.The comparison between groups was evaluated with an independent sample t test.The trend analyses for variables were done using repeated measures ANOVA.The count data were analyzed using the chi-square test or Fisher exact probability.Results Eighty patients were screened for eligibility,and were allocated into the ERAS group (40 patients) and the control group (40 patients).The total protein in serum (TP),albumin (Alb),prealbumin,TNF-α,IL-6,c-reactive protein,resting energy expenditure (REE),glycemic index,insulin index and Insulin resistance index in the 2 groups showed a range of variations at postoperative day 1,3,and 5,and these were (61 ±5)g/L,(34 ±3)g/L,(160 ± 18)g/L,(12.3 ±2.3)mmol/L,(101 ±34)ng/L,(43 ± 11)g/L,(1 336 ± 105)kal/d,(7.6 ±0.8)mmol/L,(16.8 ±3.5)mU/L and 5.7 ±1.3 in the ERAS group at postoperative day 1,and (58 ± 4) g/L,(31 ± 4) g/L,(147 ± 18) g/L,(15.3 ± 2.2) mmol/L,(122 ±37)ng/L,(56 ±27) g/L,(1 450 ± 164)kal/d,(9.3 ± 1.4) mmol/L,(30.5 ±6.8) mU/L and 12.5 ±3.2 in the control group,respectively,showing a significant difference between the 2 groups (F =31.63,8.03,67.36,147.04,9.63,6.84,16.10,54.85,104.51,139.47,P ＜0.05).The duration of fever,time to flatus,duration of hospital stay,hospital expenses,numeric rating scale and quality of life (QOL) were (2.9 ±0.9) days,(2.9 ± 0.6) days,(7.6 ± 2.1) days,(28 495 ± 4 722) yuan,1.4 ± 1.0 and 15.4 ± 0.9 in the ERAS group after operation,and (3.8 ±0.6)days,(3.5 ±0.7)days,(8.9 ±2.6)days,(35 318 ±7 610)yuan,2.4 ± 1.1 and 14.4 ± 1.2 in the control group,respectively,with a significant difference between the 2 groups (t =-0.91,-3.66,-2.85,-4.82,-4.20,3.92,P ＜0.05).Two patients were complicated with respiratory diseases,1 patient received reoperation and 1 was readmitted to the hospital at postoperative day 30 in the ERAS group.Three patients had respiratory diseases,1 received reoperation and 2 were readmitted to the hospital at postoperative day 30 in the control group,with no significant difference between the 2 groups (P ＞ 0.05).Conclusions ERAS is safe and feasible for the perioperative treatment of patients with gastric cancer,meanwhile it could reduce the surgical stress,shorten the duration of hospital stay and improve QOL and postoperative complications,ERAS might take effects by reducing insulin resistance and decreasing REE.Registry This study was registered with the Chinese Clinical Trial Registry with the registry number of ChiCTR-TRC-10001611.

BACKGROUND: Angiotensin Ⅱ (Ang-Ⅱ) can stimulate vascular endothelial cells to excrete endothelin, a kind of potent vasoconstrictor. The content of endothelin in blood or cell culture media directly reflects the function and injured status of vascular endothelial cells. Therefore, it is significant for strengthening vascular endothelial cells to resist the injured factors. Tea polyphenols is a mainly active component of tea, and it is considered as a reagent for anti-atherosclerosis, protecting injuries of vascular endothelial cells and preventing cardiovascular diseases. OBJECTIVE: To observe the effects of tea polyphenols in different concentrations on endothelin content in vascular endothelial cells induced by Ang-Ⅱ at various time points through establishing Ang-Ⅱ-induced vascular endothelial cell injury models and further to investigate the protective effect of tea polyphenols on vascular endothelial cells. DESIGN: Observational study.SETTING: Aerospace and Diving Medical Center, Navy General Hospital of Chinese PLA.MATERIALS: The experiment was carried out in Laboratory of Aerospace and Diving Medical Center, Navy General Hospital of Chinese PLA from March to September 2005. Main materials were detailed as follows: Ang-Ⅱ (Sigma Company), tea polyphenols (Department of Tea Science, Zhejiang University) and vascular endothelial cells (human large artery vascular endothelial cell system, CBI Company, USA).METHODS: Cultured vascular endothelial cells were divided into 4 groups: ① Control group: The normal culture media was added in the isopyknic vascular endothelial cells, and 100 μL supernatant was extracted before and at 0.5, 6 and 24 hours after filling moisturized liquid. ② Ang-Ⅱ group: Cell culture media containing 10-7 mol/L Ang-Ⅱ was added in the vascular endothelial cells, and other operations were as the same as those in the control group. ③ High-concentration tea polyphenols + Ang-Ⅱ group: Cell culture media containing 50 mg/L tea polyphenols was added in the vascular endothelial cells, and other operations were as the same as those in the Ang-Ⅱ group. ④ Low-concentration tea polyphenols + Ang-Ⅱ group: Cell culture media containing 25 mg/L tea polyphenols. 100 μL supernatant was extracted before and after 0.5, 6 and 24 hours treatment in each group. Thereafter, radioimmunoassay was used to measure the content of endothelin. MAIN OUTCOME MEASURES: Content of endothelin.RESULTS: ① Content of endothelin in Ang-Ⅱ group was higher than that in the control group (P ＜ 0.01). ② At 6 and 24 hours after high-concentration tea polyphenols incubation, content of endothelin in high-concentration tea polyphenols + Ang-Ⅱ group was lower than that in Ang-Ⅱ group (P ＜ 0.01). Moreover, the content of endothelin in low-concentration tea polyphenols + Ang-Ⅱ group was lower than that in both high-concentration tea polyphenols + Ang-Ⅱ group and angiotensin Ⅱ group (P ＜ 0.01). CONCLUSION: Tea polyphenols has inhibitory effects on endothelin releasing function of vascular endothelial cells induced by Ang-Ⅱ, suggesting that tea polyphenols has protective effect on vascular endothelial cells, and the effect of low-concentration tea polyphenols is superior to that of the high-concentration one.

Objective To analyze the massive explosions and burn at Tianjin Port in 2015 resulted in a mass casualty event,and the entire course of response of a hospital to deal with such major sudden accident in order to find a rational strategy for optimal use of medical resources and reduce the critical mortality.Methods This study was done by a retrospective analysis of data from one trauma center at an academic hospital.Data including outcome,triage,severity and pattern of injuries,patient flow,and medical resources used were obtained by the review of hospital records.Results This disaster caused 165 deaths,8 missing contact,and 797 non-fatal casualties.The Pingjin Hospital admitted 298 casualties,and 29 of them were seriously injured referred to by Tianjin Emergency Medical Center.Excessive triage rate made after transfer to another hospital was 62.07% with 11 of the 29 severely injured patients.Maximum (also the first)surge had 147 injured patients arrived around one hour after incident,the second surge had 31 seriously injured patients occurred around 4 hours after incident.Of them,17 patients needed surgery and 17 patients were admitted to the intensive care unit.Conclusions These data showed that the number of casualties in the first surge was substantially larger than predicted and those casualties had less severe trauma,whereas the number of the injured in the second surge was less but the trauma was more severe.In order to maintain the hospital surge capacity,an effective re-triage and a hospital-wide damage control principle can be used to deal with.

Biopsy, Fine-Needle ; methods ; Breast ; pathology ; Breast Neoplasms ; pathology ; Carcinoma, Ductal, Breast ; pathology ; Female ; Humans ; Immunohistochemistry ; methods ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Paraffin Embedding ; methods ; Receptor, ErbB-2 ; metabolism