OBJECTIVE:To compare the effects of2different treatment methods on the assaying of triptolide alcohol in tripterygium wilfordii cut crude drug.METHODS:After concentration,tripterygium wilfordii cut crude drug water decoction underwent column chromatographic separation after adsorption with neutral alumina(Method1)and neutral alumina column chromatographic separation after ethanol precipitation and extraction by chloroform(Method2),respectively.Triptolide alcohol was determined by HPLC and the assaying result underwent pairing and t tests.RESULTS:There was significant difference between the2methods with the content determined by Method1significantly higher than that by Method2(P

Purpose:To study the efficacy and the side effect of morphine sulphate controlled release tablets by rectal administration in the treatment of cancer pain. Methods:40 patients with cancer pain were randomly divided into two groups. The rectal administration of morphine sulphate controlled release tablet (30 mg,q12h) was given in group Ⅰ, oral in group Ⅱ. The effect were compared. Results:The analgesic effect was good and no significant difference was found in the 2 groups. Conclusions:The rectal adminstration of morphine sulphate controlled release tablets may be used successfully to provided relief of cancer pain.

Objective To investigate the diagnostic value of volume imaging for breast assessment (VIBRANT) dynamic enhanced MR for benign and malignant breast mass.Methods Ninety-eight patients with breast mass underwent both bilateral molybdenum target radiography and VIBRANT dynamic enhanced MR examination.The sensitivity,specificity,positive predictive value,negative predictive value and diagnosis accuracy between two methods were compared.Results There were 113 lesions including 65 lesions in 57 malignant cases and 48 lesions in 41 benign cases.The sensitivity,specificity,positive predictive value and negative predictive value of molybdenum target radiography were 67.69％ (44/65),68.75％ (33/48),74.58％ (44/59) and 61.11％ (33/54),respectively.The values of VIBRANT dynamic enhanced MR were 84.62％ ( 55/65 ),89.58％ (43/48),91.67％ (55/60) and 81.13％ (43/53),respectively.The difference of the diagnosis accuracy between two methods had statistical significance (P ＜0.05).Conclusion The diagnostic value of VIBRANT dynamic enhanced MR for benign and malignant breast mass is higher than molybdenum target radiography.

Objective To investigate the effect of activated PI3-K on epithelial-mesenchymal transdifferentiation of HKCs induced by transforming growth factor?1 (TGF-?1). Methods The human kidney proximal tubular epithelial cells (HKCs) cultured on plastic plates were divided into following groups: cultured with free serum medium (FSM); culture in the different concentrations of TGF-?1; cultured in the presence of recombinant human TGF-?1 and PI3-K inhibitor Wortmannin. The expression of total and phosphor-Akt (t-Akt and p-Akt) was assessed at different time points by Western blot,? smooth muscle actin(?-SMA) and E-cadherin were detected by Western blot. Results A marked increase in p-Akt was seen in HKC at 1h after being induced by TGF-?1, and its protein level was enhanced in a TGF-?1 concentration-dependent manner. Protein level of ?-SMA was increased markedly at 48 hours after the treatment of TGF-?1, but protein level of E-cadherin was decreased 48 hours after treatment of TGF-?1. Addition of PI3-K inhibitor Wortmannin (10nmol/L) largely abrogated the effect of TGF-?1. Wortmannin was showed to down-regulate ?-SMA and p-Akt expression and in response to TGF-?1 and up-regulate E-cadherin expression. Conclusion PI3-K was activated in epithelial-mesenchymal trans-differentiation of HKCs promoted by TGF-?1, and PI3-K inhibitor Wortmannin can significantly inhibit TGF-?1 induction of EMT.

The authors first expound the connotations and origin of the legal person management structure and then discuss the following issues: the dual relation of agency by agreement characteristic of medical institutions, the need to take management structure as the priority of hospital reform in delegating powers to lower levels, the primary strategies and major means of the legal person management structure of corporations, and questions related to the management structure of the medical industry abroad: who should become the agent of the patient, how to unify the interests of the agent and the consignor by means of reasonable remuneration designs, etc. Finally the authors give an account of the inspiration that can be drawn from the legal person management structure to the public hospital property right system reform in China.

Objective: To investigate whether the signaling of PI3K/Akt is involved in epithelial-mesenchymal transdifferentiation (EMT) of human kidney tubular epithelial cell (HKC) promoted by transforming growth factor (TGF)-?_1. Methods: the HKC was cultured on plastic plates in the presence or absence of recombinant human TGF-?_1 and PI3K inhibitor wortmannin. The expression of total- and phosphor-Akt and ?-SMA was assessed at different time point by Western blot. Results: In HKC, basic level of p-Akt, ?-SMA expression was found in the normal condition. Profound increase of p-Akt was seen at 0.5 h after induction of 10 ng/ml TGF-?_1 in HKC.?-SMA increased markedly at 48 h after the treatment of TGF-?_1. Adding PI3K inhibitor wortmannin (10 nmol/L) largely abrogated the effect of TGF-?_1. Wortmannin was shown to down-regulate ?-SMA and p-Akt expression in response to TGF-?_1. Conlusion: PI3K/Akt is a downstream mediator in EMT of HKC promoted by TGF-?_1, and PI3K inhibitor wortmannin can significantly inhibit EMT induced by TGF-?_1.

BACKGROUND: The renal transplanted recipients were in poor immunosuppressive state. Compared to common person, the bladder transitional carcinoma in recipients was aggressive and easy to recurrence. Looking for a more effective therapy method to decrease the recurrence of recipients' bladder transitional carcinoma is the hot and difficult problem in clinical study.OBJECTIVE: To analyze the efficacy and safety of submucosal injection epirubicin following transurethral resection of bladder tumor (TUR-Bt) to treat the recurrence of bladder transitional cell carcinoma in renal transplantation recipients.METHODS: Totally 9 renal transplantation recipients with transitional cell carcinoma of bladder were retrospectively studied. The patients' periods without cancer, the frequency of recurrence within one year, the rates of side effect, the changes of tumor grading following recurrence and allograff function were recorded when the routine method and submucosal injection epirubicin following TUR-Bt were used in different period respectively.RESULTS AND CONCLUSION: Submucosal injection epirubicin following transurethral resection of bladder tumor was safe and effective to treat bladder transitional cell carcinoma recurrence in renal transplantation recipients. Compared to the routine perfusion, periods without cancer and the frequency of recurrence within 1 year were significantly decreased, which can elevate recipients life quality and long-term survival rates.

OBJECTIVE:To explore the effects of risperidone combined Ningxin yizhi capsule on the cognitive function,neuro-logic function and living quality of cerebral infarction. METHODS:110 patients with cerebral infarction were randomly divided in-to control group(55 cases)and observation group(55 cases). All patients received aspirin,statins,penicillins,physical rehabilita-tion and other conventional treatment;based on it,control group orally received Risperidone tablet with initial dose of 0.5 mg, once a day,1 week later,the amount of drugs was adjusted according to the patient's tolerance and conditions,0.5 mg was in-creased every week,with maximum dose of less than 2 mg,no other antipsychotic drugs except risperidone. Observation group ad-ditionally received 0.9 g Ningxin yizhi capsule,3 times a day. The treatment course for both groups was 2 months. Montreal cogni-tive assessment (MoCA) score,neurobehavioral cognitive status tests scale (NCSE),National Institutes of Health Stroke Scale (NIHSS)score,activities of daily living scale(ADL)score and table of daily living-Barthel Index(Barthel-Index)before and af-ter treatment,and the incidence of adverse reactions in 2 groups were observed. RESULTS:Before treatment,there were no signifi-cant differences in the MoCA scores,NCSE scores,NIHSS scores,ADL scores and Barthel-Index in 2 groups (P>0.05). After treatment,the MoCA scores,NCSE scores,ADL scores and Barthel-Index in 2 groups were significantly higher than before,and observation group was higher than control group,NIHSS scores were significantly lower than before,and observation group was lower than control group,the difference was statistically significant(P<0.05). And there was no significant difference in the inci-dence of adverse reactions(P>0.05). CONCLUSIONS:Based on the conventional treatment,risperidone combined Ningxin yizhi capsule can significantly improve the cognitive function,neurologic function and living quality of cerebral infarction,with good safety.

Objective To investigate the safety and superiority of fast track surgery (FTS)in elderly patients during the perioperative peri-od of laparoscopic cholecystectomy (LC).Methods The clinical data of 124 elderly patients who underwent LC at the Department of Gen-eral Surgery in our institution between January 2010 and March 2014 were assessed,with 62 cases assigned to FTS group and 62 cases to conventional method group.Anal exhaust time,feeding time,off-bed activity time,and length of hospital stay were compared between the two groups,and postoperative results and adverse reactions were recorded.Continuous data were analyzed using the independent-samples t test,and categorical data were compared using the chi-square test.Results Compared with the control method group,patients in the FTS group showed earlier postoperative anal exhaust,feeding,and off-bed activity,a shorter length of hospital stay,and a lower incidence of postoperative cardiovascular and cerebrovascular complications (P<0.05).Conclusion FTS is an effective approach to accelerate rehabil-itation in elderly patients after LC.

Objective To preliminary study clinical efficacy and toxicity of endostatin (ES) combined radiotherapy and chemotherapy in advanced non-small cell lung cancer (NSCLC),and evaluate its effectiveness and safety.Methods We retrospectively reviewed 64 patients with Ⅲ B-Ⅳ stage NSCLC of Harbin Medical University Cancer Hospital from February 2009 to February 2012.The patients were divided into two groups:chemoradiotherapy group,39 patients and ES add chemoradiotherapy group,25 patients.The short-term effect,the total efficiency,median survival time,progression-free survival time and disease-free survival time were compared.Results The total effective rate of chemoradiotherapy group was 76.9％,while the total effective rate of ES add chemotherapy group was 84.0％ (x2 =0.47,P =0.492).Chemoradiotherapy group,compared to ES add chemotherapy group,the median survival time,median progression-free survival time,median disease-free survival time were 11.52 months vs 16.51 months (x2 =3.74,P =0.042),7.32 months vs 10.37 months (x2 =5.32,P =0.025) and 5.21 months vs 7.57 months (x2 =4.56,P =0.035) respectively.The mainly adverse drug reactions were hematologic toxicity and gastrointestinal reactions,but there were no significant differences between the two groups; radiotherapy side effects mainly showed the grade 1 to 2 radiationinduced lung injury and radiation esophagitis (chemotherapy group had one case of grade 3 radiation-induced lung injury),but also had no significant differences between the two groups.Conclusion ES combined chemoradiotherapy can achieve a better short-term clinical efficacy without increasing adverse effects of radiotherapy or chemotherapy in advanced non-small cell lung cancer.