Z-Ligustilide, a major phthalide isolated from a widely used traditional Chinese medicine Ligusticum chuanxiong, possesses various pharmacological activities including neuroprotective, anti-inflammatory, antiproliferative and vasorelaxing effects. However, it is unstable and inclined to degrade in natural conditions, which limits its study and application greatly. In this study, degradation behavior of Z-ligustilide and its degradation products stored at room temperature under direct sunlight were investigated and structure elucidated by HPLC-UV, UPLC-QTOF-MS and NMR. Z-ligustilide degradation and total five degradation products were generated and detected. Two degradation products were unequivocally identified as senkyunolide I and senkyunolide H by comparison with reference compounds. Another two degradation products were further isolated by semi-preparative HPLC and structure elucidated as (E)-6, 7-trans-dihydroxyligustilide and (Z)-6, 7-epoxyligustilide by 1H and 13C NMR, respectively. The degradation pathways of Z-ligustilide were finally proposed. Oxidation, hydrolysis and isomerization are the major degradation reactions.

Objective To evaluate the effect of traditional Chinese medicine sputum discharge liquid on preventing ventilator-associated pneumonia(VAP).Methods A randomized double-blind,placebo-controlled study was con-ducted,according to the inclusion and exclusion criteria,patients with respiratory failure and mechanical ventilation in the intensive care unit (ICU)of a hospital in 2011 -2014 were selected and divided into treatment group and con-trol group.Treatment group received sputum discharge liquid in addition to conventional treatment,control group adopted simulation agent based on conventional treatment.The incidence,treatment effectiveness,occurrence time, and prognosis of VAP between two groups of patients were compared.Results A total of 139 patients were monitored,70 cases in treatment group and 69 in control group.The incidence of VAP in treatment group and con-trol group were 37.14% (n =26)and 57.97%(n =40)respectively;the average onset time of VAP in treatment group and control group were (76±3.2)hours and (45±8.9)hours after admission to ICU respectively;treatment effectiveness rates in treatment and control group were 88.46% and 55.00% respectively;the incidence,occurrence time,and treatment effectiveness rates of VAP between two groups of patients were both significantly different (all P <0.05).There were no significant difference in blood routine,liver and kidney function,urine routine,stool rou-tine,and electrocardiogram results between two groups of patients (all P >0.05 ).Conclusion Intervention in patients with mechanical ventilation by sputum discharge liquid can reduce the incidence of VAP,and has a positive effect on the prognosis of disease and pulmonary infection in patients.

To investigate the clinicopathological features of endometrial endometrioid adenocarcinoma(EEA)with adnexal involvement.Methods The clinicopathological data of 86 EEA patients who underwent surgical treatment at our center from January 2000 to December 2015 were analyzed retrospectively.The clinicopathological features were compared between patients with occult adnexal involvement and those with gross adnexal involvement.Results A total of 86 EEA patients with adnexal involvement(mean age:58.1 years)were included in this study,accounting for 5.4%(86/1592)of the EEA patients during the same period.Among these 86 patients,there were 13 premenopausal patients(15.1%)including 2 premenopausal patients aged under 40 years.Gross adnexal involvement was found in 47 patients(54.7%),while occult adnexal involvement was found in 39 patients(45.3%)in pathology evaluation.Ovarian metastasis was found in 34 patients(39.5%),followed by both ovarian and tubal metastasis in 19 patients(22.1%)and tubal metastasis in 33 patients(38.4%).The expressionss of estrogen receptor(χ=8.086,P=0.042)and progesterone receptor(PR)(χ=9.149,P=0.026)were significantly different between gross adnexal involvement group and occult adnexal involvement group,whereas no significant difference was found in other clinicopathological features(all P>0.05).The non-conditional Logistic regression analysis showed that,compared with PR no-expression group,the rate of occult microscopic adnexal involvement in PR low-expression group was 6.375 times of that of the gross adnexal involvement(P=0.005,95%CI:1.768-22.976),and the rate of occult microscopic adnexal involvement in the PR high-expression group was 3.719 times of that of gross adnexal involvement(P=0.048,95%CI:1.009-13.702). Conclusion PR expression level is remarkably lower in EEA patients with gross adnexal involvement than those with occult adenxal involvement.

OBJECTIVETo discuss the changes in Wnt pathway inhibiting factors in esophageal precancerosis lesions induced by methyl benzyl nitrosamine (MBNA) and the effect of Gexia Zhuyu decoction.

METHODWistar rats were subcutaneously injected with MBNA (3.5 mg x kg(-1) for twice per week to establish the model. Since the 1st day after the model establishment, they were orally administered with Gexia Zhuyu decoction (16, 8 mg x kg(-1)). At the 10th week, esophageal tissues were collected to observe the pathological changes of esophageal mucosa, detect SFRP1, sFRP4, Axin1, Axin2 and GSK-3β mRNA levels.by fluorescent quantitation PCR analysis and β-catenin protein level by Western blotting.

RESULTBeing induced by MBNA, rats in the model group showed slight atypical hyperplasia in the histopathological examination. Compared with the normal group, Gexia Zhuyu decoction dose high and low groups showed no significant pathomorphological and histological changes. The model group showed lower gene transcription levels of esophageal tissues sFRP1, sFRP4, Axin1 and Axin2 (P < 0.05 or P < 0.01) and higher β-catenin protein expression level (P < 0.01) than the normal control group. The Gexia Zhuyu decoction low dose group showed higher gene transcription levels of esophageal tissues sFRP1, sFRP4, Axin1 and Axin2 (P < 0.05 or P < 0.01) and lower β-catenin protein expression level (P < 0.01) than the normal control group.

CONCLUSIONUp-regulated β-catenin protein level and down-regulated Wnt pathway could enhance Wnt pathway activity of MBNA-induced esophageal precancerous lesions. Gexia Zhuyu decoction could down-regulate the β-catenin protein level and up-regulate the transcription level of Wnt pathway inhibiting factors, but could not block MBNA-induced esophageal precancerosis lesions.

Animals ; Axin Protein ; genetics ; metabolism ; Drugs, Chinese Herbal ; administration & dosage ; Esophageal Diseases ; drug therapy ; genetics ; metabolism ; pathology ; Glycogen Synthase Kinase 3 ; genetics ; metabolism ; Glycogen Synthase Kinase 3 beta ; Humans ; Male ; Necrosis ; Nitrosamines ; adverse effects ; Proteins ; genetics ; metabolism ; Rats ; Rats, Wistar ; Wnt Proteins ; genetics ; metabolism ; Wnt Signaling Pathway ; drug effects

Examinations of visual function have been widely performed with the increasing awareness of visual function recently. In addition to regular examinations in Ophthalmology and Optometry, examinations of visual function are also very important in clinic. Nowadays, they are considered as the basis of some diagnosis, and mainly divided into two methods: regular examinations of visual function and examinations based on psychophysics. In order to serve clinic and research better, the combination of them is highly required.

Objective To investigate the association between platelet glycoprotein Ibα (GPIbα) gene HPA-2a/b polymorphisms and the risk of Kawasaki disease (KD) and that complicated with coronary artery lesion (CAL).Methods A total of 30 patients with KD and 60 healthy controls were genotyped by polymerase chain reaction-restriction fragment length polymorphism and agarose gel electrophoresis for the HPA-2a/b polymorphism in GPIbα gene.Results For HPA-2a/b polymorphism in GPIbα gene,there was only genotype TC and CC of HPA-2a/b polymorphism in GPIbα gene in children with KD and healthy controls,and genotype TF was not found in both groups.There were no significant differences between KD patients and the controls in genotype frequencies of CC,TC and TT and allele frequencies of C and T (x2 =0.052,0.048,all P ＞ 0.05) ; also there was no significant difference between KD patients with CAL and that without CAL in genotype and allele frequencies (x2 =2.672,2.481,all P ＞ 0.05).Conclusion No association is found between HPA-2a/b polymorphism in GPIbα gene and the risk of KD or its complication of CAL in this study.

OBJECTIVETo explore the value of percutaneous radiofrequency ablation (PRFA) combined with transcatheter arterial chemoembolization (TACE) and percutaneous ethanol injection (PEI) in the management of recurrent small hepatocellular carcinoma.

METHODSBetween March 2001 and March 2005, 52 patients with recurrent hepatocellular carcinoma (tumor size< or =5 cm) underwent PRFA, and 14 of the patients (tumor size 3-5 cm) also received TACE and PEI, and their clinical data were analyzed retrospectively.

RESULTSMRI or CT after PRFA revealed complete coagulative necrosis of the tumor in 38 cases (tumor size <3 cm). In the 14 patients (tumor size 3-5 cm) with also TACE and PEI, complete necrosis occurred in 11 cases (78.6%). In the patients involved in this study, the 1-, 2-, 3- and 4-year survival rates were 96.2%, 69.4%, 45.5% and 30.0%, respectively.

CONCLUSIONSPRFA is an effective modality for local treatment of recurrent small hepatocellular carcinoma, capable of total elimination of tumors <3 cm. For tumors of 3-5 cm, combination with TACE and PEI may help increase the tumor necrosis rate following the ablation and raise the patients' survival rate.

Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Carcinoma, Hepatocellular ; pathology ; therapy ; Catheter Ablation ; Chemoembolization, Therapeutic ; Combined Modality Therapy ; Ethanol ; administration & dosage ; Female ; Humans ; Liver Neoplasms ; pathology ; therapy ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; therapy ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo investigate the clinicpathologic features and diagnosis of plasmablastic lymphoma (PBL).

METHODSEleven cases of PBL were collected and followed up, with review of the literature. HIV and EBV status and their relationships with the tumor were specially compared as well.

RESULTSIn the current cohort, 10 patients were serologically HIV negative; the male to female ratio was 8 to 3, and the median age was 57 years. Ten cases showed extranodal involvement and one case was nodal based. At presentation, five patients had mid-facial involvement, including sinonasal area (3 cases) and oral cavity (2 cases). Histologically, six were PBL of oral mucosa type, and five were PBL with plasmacytic differentiation. In all cases, the neoplastic cells expressed CD138 and MUM-1, and were negative for CD20 and CD3ε; the median Ki-67 index was 80%. Five cases were EBER1/2 in situ hybridization positive. IgH or/and Igκ gene rearrangement was detected in all five cases examined.

CONCLUSIONSMost patients were no congenital or acquired immunodeficiency in the retrospective study. Of the died patients, EBER1/2 in situ hybridization were negative and their disease staging were Ⅳ, The neoplastic cells were immunoblastic or plasmablastic, sometimes the plasmacytoid cell can be seen and the neoplastic cell had mature plasma cell phenotype, the pathologic diagnosis of the lymphoma is still controversial now. Differentiate with plasma cell neoplasm is difficult, it is necessary to accumulate more cases for advanced study and observation in the future.

Female ; Gene Rearrangement ; Humans ; In Situ Hybridization ; Male ; Middle Aged ; Multiple Myeloma ; Plasma Cells ; Plasmablastic Lymphoma ; diagnosis ; pathology ; RNA, Viral ; metabolism ; Retrospective Studies

BACKGROUND: To solve the dislocation following hip arthroplasty, a double mobility acetabular prosthesis has been developed, and its effect still needs to be confirmed through follow-up observation.OBJECTIVE: To explore the early clinical effectiveness of total hip replacement with double mobility acetabular prosthesis.METHODS: Thirty patients admitted from January 2013 to November 2015, were given total hip replacement with double mobility acetabular prosthesis, and were then followed up for 1 year. The hip function and loosening were evaluated by Harris hip scores, Beijing program scaling and imaging examination.RESULTS AND CONCLUSION: (1) All patients were followed up for 1 year. (2) The mean Harris hip score was significantly increased from preoperatively (39.7±3.87) to postoperatively (93.6±3.82), and the mean score of the Beijing program scaling was also significantly increased from (10.5±2.46) to (17.3±1.87) (both P < 0.05). (3) All patients suffered from moderate to severe pain before replacement, and 28 patients complained mild or no pain and 2 patients with moderate pain after operation. X-ray showed a stable hip. (4) To conclude, the total hip arthroplasty with double mobility acetabular prosthesis achieves satisfactory short-term treatment outcomes, but its long-term effect needs to be observed further.

Nowadays,obesity and its related diseases such astype 2 diabetes mellitus (T2DM) and metabolic syndrome (MS) have already become a serious social and medical problem.In addition to oral aitidiabeticdrugs,insulin injection and other traditional treatments,metabolic surgery has gradually been recognized in recent years.However,there are lack of adequate surgical data and evidence-based evidenceof metabolic surgeryin Chinabecause of its postoperative risks,complications and low body mass index in T2DM patients in China.This article summarizes the status and limitations of metabolic surgery.