OBJECTIVE:To prepare compound astragali capsules and to establish its quality control standards.METH?ODS:The qualitation identification of the principal agents like American ginseng and asiatic cornelian cherry fruit were de?termined by TLC;the principal agent-astragalosideⅠin the astragali were identified by HPLC-ELSD.RESULTS:The condition for TLC qualitation was feasible and the spots were clear;good linear relationship was achieved when the detection concentration of astragalosideⅠwas within the range of2.8?g～8.4?g(r=0.9999);the average recovery was99.93%,RSD=1.17%.CONCLUSION:The preparing technique of this preparation was simple and the quality was stable,the quan?titation control method is simple,accurate and with high precision.

Objective:To establish the industry standard for growth hormone quantitative labelling immunoassay kit, and to validate it by chemiluminescence labeling and time-resolved fluorescence labeling method which are suitable for the standard.Methods: Different assay method kits, including magnetic particle chemiluminescent assay, electrochemiluminescence assay, chemiluminescence assay and time-resolved fluorescent assay, were used to verified the blank limitation, linearity, accuracy, precision, specificity and stability in accordance with protocol industry standard.Results: Other verification results could meet requirements of the protocol industry standard besides accuracy in part of kits couldn't achieve to anticipative remand (relative deviation couldn't be more than ±10%).Conclusion: According to the verification results, the accuracy requirements was adjusted to ±15%. The other items of industry standard were maintained. The industry standard for growth hormone quantitative labeling immunoassay kit is ultimately established. The standard would contribute to unity quality standard of growth hormone quantitative labeling immunoassay kit, and provide the basis for the supervision and administration of its production, examination, circulation, clinical application and other areas.

The research on the training program of medical education postgraduates will help to cultivate medical education talents with professional knowledge and ability, so as to further promote the specialization and sustainable development of medical education. In the practice of educational research, under the guidance of personnel training objectives, a relatively complete theoretical curriculum system has been set up around students' ideological and political quality, scientific research ability, theoretical and practical knowledge learning and application. In addition, the practical courses of postgraduate training have been rationally designed, and the evaluation methods of the effects have been planned scientifically and reasonably. Through the research, we can make the postgraduate training work of medical education has rules to follow, which plays a key role in improving the quality of education and training.

Objective: To investigate the effect of individualized contrast administration in improving the enhancement homogeneity in vessels and image quality in coronary CT angiography (CCTA). Methods: Sixty CCTA patients were randomly divided into two groups with different contrast injection protocols: treatment group (n=30) was treated with weight-dependent injection protocol at 22 mg/(g•s) of idion, injection velocity=body mass×22/contrast agent concentration. Control group (n=30) was treated with a different injection protocol. The iodine flow rate in this group was determined by patient body mass index (BMI), iodine flow rate=1.2 g/s, 1.4 g/s and 1.6 g/s. Injection flow rate= iodine flow rate/contrast agent concentration. Theiohexol (350 mg/mL) was used in both groups, and the injection time was fixed at 10 s and contrast agent dose=injection velocity×injection time. The other scanning parameters were the same. The enhancement change rate in AS and the three major arteries was calculated for the patient population. The subjective image quality scores were also compared. Results: The change rates of vascular enhancement at interested blood vessels in treatment group (12.9%, 11.8%, 11.0% and 11.1%, respectively) were significantly lower than those in in control group (23.3%, 18.7%, 16.7% and 20.5%, respectively) (P=0.001). There was no significant difference between the two groups in subjective image quality score (P=0.095). Conclusion: Individualized contrast injection protocol in CCTA can provide us with a more uniform enhancement in coronary arteries, and improve the overall image quality.

Objective To discuss the blood perfusion characteristic of benign and malignant gallbladder disease by contrast-enhanced ultrasound(CEUS).Methods The enhancement characteristic of 62 patients with occupying lesions in gallbladder were observed.Four case of cholecystolithiasis accompany biliary sludge were proven by surgery and remaining 58 case were confirmed by histopathological examination.Their enhancement time and enhancement pattern were analyzed.Results The Time-to peak of benign and malignant disease were (22.4± 4.0)s and (27.7± 2.6)s (t =5.756,P ＜0.01),the Time-to-hypoenhancement of benign and malignant disease were (58.0 ± 7.3)s and (41.5 ± 4.0)s (t =10.33,P ＜0.01),respectively.The peak intensity of benign and malignant disease were (19.2 ± 3.6)dB and (25.1 ± 2.9) dB (t =6.85,P ＜0.01),the mean transit time of benign and malignant disease were (22.72 ± 4.7)s and (6.3± 6.4)s (t =15.001,P ＜0.01),respectively.The destruction of the gallbladder wall of benign and malignant disease were 0％ (0/36) and 57.7％ (15/26) (x2 =25.05,P ＜ 0.01),the inhomogeneous enhancement of benign except biliary sludge and malignant disease were 43.8％ (14/32) and 57.7％ (15/26) (x2 =1.115,P =0.291,respectively).In early phase,78.1％ (25/32) and 80.8 ％ (21/26) of benign disease except biliary sludge and malignant showed hyperenhancement respectively(x2 =3.15,P =0.207).In later phase,84.4％ (27/32) and 76.9％ (20/26) of benign disease except biliary sludge and malignant showed hypoenhancement respectively(x2 =3.615,P =0.164).Conclusions CEUS can obtain the information of blood perfusion and make quantitatively analysis about the enhancement time.It also facilitate the diagnosis of solid occupying lesion in gallbladder.

AIM: To investigate the mechanism of basil polysaccharide in inhibiting the invasion and metastasis ability of ovarian cancer,and to evaluate the potency of hypoxia tumour microenvironment in affecting the action of basil polysaccharide.METHODS: The human ovarian cancer cell line SKOV3 was cultured with basil polysaccharide under normoxia(21% O2,5% CO2) and hypoxia(1% O2,5% CO2,94% N2),respectively.Morphology of this cell line in different groups under different oxygen concentrations was observed under inverted phase contrast microscope.The cell invasiveness was tested by transwell method and the activities of matrix metalloproteinase-2(MMP-2) among each group were analyzed by gelatin zymography.The expressions of OPN mRNA and protein levels were detected by RT-PCR and immunohistochemistry,respectively.RESULTS: Compared to the control group,basil polysaccharide decreased the invasiveness and migrating ability and inhibited the secretion of MMP-2 in SKOV3 cells.Basil polysaccharide also reduced the expression level of osteopontin(transcriptional level and protein level) of the SKOV3 cells in both normoxic and hypoxic conditions.Moreover,these functions of basil polysaccharide were more obviously in hypoxia.CONCLUSION: The migrating ability of the SKOV3 cells is enhanced under hypoxic condition.Basil polysaccharide may inhibit the invasiveness and migrating ability of SKOV3 cells through reducing osteopontin expression and MMP-2 secretion.

BACKGROUND:The choice of schwannoma resection is strongly associated with whether the tumor was completely resected, whether stretch during resection injures spinal nerves, and final y with the prognosis of treatment.
OBJECTIVE:To evaluate the spinal stabilization after laminectomy combining unilateral or bilateral nail-rod system for schwannoma in the spinal canal or intervertebral foramen.
METHODS:A total of 48 cases of schwannoma in the spinal canal or intervertebral foramen of neck, chest and waist underwent laminectomy combining unilateral or bilateral nail-rod system. 34 cases in spinal canal received bilateral nail-rod system, and 14 cases in the intervertebral foramen received unilateral nail-rod system.
RESULTS AND CONCLUSION:At 3 days and 3, 6, 12 months after internal fixation, radiograph results demonstrated that location of implants was good. Bone graft fusion was found. No spinal instability and vertebral slippage occurred. Neural functional score Bodford (1997) and quality of life score were significantly increased after treatment (P<0.01). Muscle strength assessed by Lovett grade was significantly elevated after treatment (P<0.01). Pain evaluated by Virtual Rescan grade was significantly lessened after treatment (P<0.01). Schwannoma was completely resected in 48 patients. After treatment, six patients affected leakage of cerebrospinal fluid. One case experienced infection of cerebrospinal fluid. One case had to undergo secondary operation due to the infection. Three cases received nerve root resection due to tumor erosion. These experimental results confirmed that laminectomy combining unilateral or bilateral nail-rod system for schwannoma in the spinal canal or intervertebral foramen has the advantage of the tumor ful y exposed to the operator, which can help completely resect schwannoma and effectively avoid spinal nerve injury. Even more important thing is that the spinal stability is reconstructed by unilateral or bilateral nail-rod system, which prevents the occurrence of vertebral slippage and vertebral destabilization. Long-term effect stil needs further research.

OBJECTIVETo analyze the clinical and laboratory characteristics of Gitelman syndrome.

METHODSSeventeen patients with Gitelman syndrome (male/female: 11/6) were analyzed for their clinical symptoms, laboratory test results, imaging findings, treatments and outcomes.

RESULTSFifteen of the 17 patients presented with varying degrees of lower limb weakness, and 8 experienced flaccid paralysis. The laboratory tests showed hypokalemia (17/17), hypomagnesemia (17/17) and hypocalcemia (17/17). Blood renin activity (17/17), angiotensin II (14/17) and aldosterone levels (7/17) were significantly higher in the patients than in normal subjects. The symptoms were relieved by potassium alone or in combination with indomethacin, spironolactone and other potassium magnesium asparaginate, but the serum potassium and magnesium failed to recover the normal levels after the treatments.

CONCLUSIONThe primary clinical manifestations of Gitelman syndrome are lower extremity weakness with hypokalemia and hypomagnesemia. Combined drug therapies including potassium, magnesium, aldosterone antagonists and other drugs are recommended. The prognosis of the patients is favorable.

Adolescent ; Adult ; Child ; Female ; Gitelman Syndrome ; diagnosis ; drug therapy ; Humans ; Indomethacin ; therapeutic use ; Male ; Middle Aged ; Potassium Chloride ; therapeutic use ; Potassium Magnesium Aspartate ; therapeutic use ; Retrospective Studies ; Spironolactone ; therapeutic use ; Young Adult

Abstract: Objective　This paper aims to explore the effect of live attenuated varicella vaccine on the sensitivity of tuberculin skin test(TST), and to provide reference for tuberculin skin test in the future. Methods　TST and emergency varicella vaccine were administered to students in grade one of a high school in Wuxi, Jiangsu province, who had both TB and varicella cases. Independent-samples t test was used to analyze the mean diameter of induration of TST in day 0, day 83 and day 195. The retrospective cohort study was used to analyze the effect of live attenuated varicella vaccine on TST. 　　Results　The mean induration diameter of 45 students who participated in three TST tests on day 0, day 83 and day 195 were analyzed by independent sample t test. On day 0, there was a difference in the mean diameter of TST induration between the unvaccinated and vaccinated groups(1.630±2.837 vs 5.818±4.530) (t=-3.692, P=0.001). On day 83, there was no difference in the mean diameter of TST induration between the two groups(0.001±0.001 vs 0.114±0.533) (t=-1.000, P=0.329). On day 195, there was a difference in the mean diameter of TST induration between the two groups(1.913±3.774 vs 5.023±5.126) (t=-2.309, P=0.026). Moreover, the retrospective cohort study showed that the mean diameter of TST induration changed more significantly after inoculation with varicella vaccine, RR=6.071, 95%CI (1.667-22.116), P<0.05; After inoculation with varicella vaccine, the mean diameter of TST test did not change significantly from day 0 to day 195 with no statistical significance RR=3.474, 95%CI (0.333-36.240), P>0.05. Conclusions　Live attenuated varicella vaccine may temporarily affect the sensitivity of tuberculin skin test.

Objective To compare the differences in virulence-related factor aspartate protease,biofilm formation,and gene expression among clinical isolates of Candida parapsilosis(C.parapsilosis).Methods Gene sequencing and microsatellite typing(MT)method were adopted to identify C.parapsilosis isolated from patients with clinical fungal infection.The production of secreted aspartate protease and biofilm formation ability of each strain were de-tected,and the expression of biofilm formation related-genes BCR1,EFG1,and HWP1,as well as aspartate prote-ase virulence genes SAPP1,SAPP2,SAPP3 were compared among the strains.Results A total of 8 clinically iso-lated C.parapsilosis strains were collected,all of which were identified as genotype Ⅰ.Based on microsatellite ty-ping results,8 clinical strains were divided into 4 microsatellite types.G1,G2,and G3 strains isolated from the urine,peripherally inserted central catheters(PICC),and blood of patient A were of different subtypes.J1,J2,J3,J4,and J5 strains were of the same type,and isolated from blood specimens of patient B at different periods.All 8 clinical strains could form biofilm,and their biofilm formation ability was higher than that of the standard strain of C.parapsilosis(ATCC 22019).G1,G3 and J5 strains had strong biofilm formation ability,J1,J2,J3,and J4 strains had moderate biofilm formation ability,and G2 strain had weak biofilm formation ability.All of the eight clinical isolates secreted aspartate protease,and their in vitro expression levels of the enzyme were higher than that of the standard strain(ATCC 22019).G3,G1,and G2 strains showed low,moderate,and high in vitro enzyme expression respectively,with statistical differences(all P＜0.05).Enzyme expressed moderately in J1 and J5 strains,and highly in J2,J3,and J4 strains.Difference between moderate and high expressions was statistically significant(P＜0.05).The expression levels of biofilm formation genes BCR1,EFG1,and HWP1 in various strains isolated from patients A and B increased.In strains isolated from patient A,the expression level of EFG1 gene in G1 strain was higher than that in G2 strain(P＜0.05).There was no statistically significant difference in BCR1,EFG1,and HWP1 gene expression levels among strains isolated from patient B.The expression levels of as-partate protein genes(SAPP1,SAPP2,and SAPP3)in various strains isolated from patients A and B increased.The expression levels of SAPP1 and SAPP2 in strain G1 were higher than those in G2 and G3(both P＜0.05).There was no statistically significant difference in the expression levels of SAPP1,SAPP2,and SAPP3 genes in strains from patient B.Conclusion Clinical isolates of C.parapsilosis have higher biofilm formation and aspartate protease production abilities than standard strain.The expression of virulence factors varies among strains isolated from different specimens,while there is no significant difference in the expression of virulence factors among strains isolated at different periods.Patients may have been infected with different MT types of C.parapsilosis in multiple sites during the same period.