Simultaneous determination of nine kinds of active components in Hugan Agent by RP-HPLC / 中草药

Objective: To establish an RP-HPLC method for simultaneous determining the contents of nine kinds of components in Hugan Agent such as loganin, paeonflorin, scuteuarin, baicalin, baicalein, deoxyschizandrin, schisandrin, schizandrin C, and ursolic acid, and to provide the quality guarantee for it. Methods: Agilent Zorbax SB-C18 (150 mm×4.6 mm, 5 μm) column was used. Acetonitrile and 0.1% phosphoric acid water-solution were used as mobile phase of gradient elution, and the volume flow was at 1.0 mL/min; Ultraviolent determination wavelength was 236, 280, and 210 nm; Column temperature was at 30℃, and injection volume was 5 μL. Results: The lowest detection limit in loganin, paeonflorin, scuteuarin, baicalin, baicalein, deoxyschizandrin, schisandrin, schizandrin C, and ursolic acid respectively was 12.0, 2.60, 5.75, 9.75, 14.39, 19.06, 14.90, 15.63, and 16.08 ng; The linear range was 583.33-18.229, 916.67-28.65, 541.67-16.93, 416.67-13.02, 500.00-15.63, 458.33-14.32, 625.00-19.53, 458.33-14.32, and 1 000.00-31.25 mg/L, respectively; The average recovery in Hugan Agent was 103.51%, 104.19%, 95.16%, 96.71%, 105.61%, 96.12%, 97.09%, 96.87%, and 105.90%, respectively; The repeatability RSD was 1.39%, 1.41%, 1.87%, 1.91%, 1.79%, 1.45%, 1.32%, 1.71%, and 1.49%, respectively; The stability RSD was 1.36%, 1.22%, 1.87%, 1.91%, 1.93%, 1.56%, 1.39%, 1.78%, and 1.61%, respectively. 6 batche of Hugan Agent contained the average quality of loganin, ursolic acid, paeonflorin, scuteuarin, baicalin, baicalein deoxyschizandrin, schisandrin, and schizandrin respectively was 216.5-222.5, 40.8-42.8, 125.4-136.3, 144.0-147.3, 1640.8-1947.3, 497.5-515.0, 15.0-17.3, 33.6-36.0, and 3.0-3.9 mg/L. Conclusion: The method is believable for determining the concent of loganin, paeonflorin, scuteuarin, baicalin, baicalein, deoxyschizandrin, schisandrin, schizandrin C, and ursolic acid in Hugan Agent with its simplicity, sensibility, repeatability, and better recovery rate.

Identification and Treatment of the Early Form of Neurogenic Pulmonary Edema in Emergency Room / 中国医学科学院学报

<p><b>OBJECTIVE</b>To improve the management of the early neurogenic pulmonary edema(NPE)in patients with non-traumatic cerebral hemorrhage.</p><p><b>METHODS</b>Totally 140 eligible patients with non-traumatic cerebral hemorrhage who were treated in the emergency department of our hospital from October 2008 to October 2014 were divided into two groups:NPE group(n=25)and non-NPE group(n=115). The clinical data were analyzed and compared.</p><p><b>RESULTS</b>Although the mean arterial pressure was similar between these two groups,the median pH and the bicarbonate ion(HCO(3)(-))were significantly lower in the NPE group than in the non-NPE group(pH:7.32 vs.7.39,P=0.002;HCO(3)(-),20.6 mmol/L vs.22.7 mmol/L,P=0.01). Multivariate regression analysis indicated that younger age and higher glucose level were significantly correlated with the early onset of NPE in the NPE group than in the non-NPE group(age:50.1 years vs.65.1 years,P=0.0008;glucose,15.4 mmol/L vs.10.78 mmol/L,P=0.001).There were only 3 patients in all with non-traumatic cerebral hemorrhage happened the fulminant NPE in 1 hour. Within 24 hours after patients visited the emergency room,the condition was improved in 20 of 25 patients in the NPE group. However,5 patients died,among whom 3 patients with fulminant NPE(onset within 1 hour)died due to acute respiratory distress syndrome and complicated with multiple organ failure,and 2 died of cerebral hernia.</p><p><b>CONCLUSIONS</b>NPE is a rare and severe complication in patients with non traumatic cerebral hemorrhage. The possibility of NPE should be considered in relatively young patients with higher glucose and lower blood pH value. Timely prevention and treatment can improve the outcomes.</p>

Identification of a novel pathogenic mutation in PDHA1 gene for pyruvate dehydrogenase complex deficiency / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the molecular genetic mechanism and genetic diagnosis of pyruvate dehydrogenase complex deficiency (PHD), and to provide a basis for genetic counseling and prenatal genetic diagnosis of PHD.</p><p><b>METHODS</b>Polymerase chain reaction (PCR) was performed to amplify the 11 exons and exon junction of the PDHA1 gene from a child who was diagnosed with PHD based on clinical characteristics and laboratory examination results. The PCR products were sequenced to determine the mutation. An analysis of amino acid conservation and prediction of protein secondary and tertiary structure were performed using bioinformatic approaches to identify the pathogenicity of the novel mutation.</p><p><b>RESULTS</b>One novel duplication mutation, c.1111_1158dup48bp, was found in the exon 11 of the PDHA1 gene of the patient. No c.1111_1158dup48bp mutation was detected in the sequencing results from 50 normal controls. The results of protein secondary and tertiary structure prediction showed that the novel mutation c.1111 _1158dup48bp led to the duplication of 16 amino acids residues, serine371 to phenylalanine386, which induced a substantial change in protein secondary and tertiary structure. The conformational change was not detected in the normal controls.</p><p><b>CONCLUSIONS</b>The novel duplication mutation c.1111_1158dup48bp in the PDHA1 gene is not due to gene polymorphisms but a possible novel pathogenic mutation for PHD.</p>

Determination of notoginsenoside R1, ginsenoside Rg1, Rb1, and scutellarin in Baogan Pill by RP-HPLC / 中草药

Objective: To establish an RP-HPLC method for determining the mass concentration of notoginsenoside R1, ginsenoside Rg1, Rb1, and scutellarin in Baogan Pill, and to provide the quality guarantee for Baogan Pill. Methods: Agilent Zorbax SB-C18 (150 mm×46 mm, 5 μm) column were used. Acetonitrile and 0.1% phosphoric acid water-solution were used as mobile phase of gradient elution, the volume flow was at 1.0 mL/min; Ultraviolent determination wavelength was 203 nm; Column temperature was at 30℃, and injection volume was 5 μL. Results: The lowest detection limit in notoginsenoside R1 was 0.287 mg/L, the linear range was 4.427-141.668 mg/L; The lowest detection limit in ginsenoside Rg1 was 0.182 mg/L, the linear range was 6.055-193.75 mg/L; The lowest detection limit in ginsenoside Rb1 was 0.182 mg/L, the linear range was 3.255-104.167 mg/L; The lowest detection limit in scutellarin was 0.305 mg/L, the linear range was 5.729-183.333 mg/L. The average recovery of notoginsenoside R1, ginsenoside Rg1, Rb1 and scutellarin in Baogan Pill respectively were 101.76%, 99.66%, 99.43%, and 101.26%; The precision RSD values respectively were 1.81%, 1.79%, 1.39%, and 1.51%; The repeatability RSD values respectively were 1.71%, 1.86%, 0.97%, and 1.63%; The stability RSD values respectively were 1.62%, 1.25%, 1.10%, and 1.41%. The average amounts of notoginsenoside R1, ginsenoside Rg1, Rb1, and scutellarin in the selected samples per pill respectively were 4.303, 31.729, 20.776, and 1.071 μg. Conclusion: The method is believable for determining the mass concentration of R1, Rg1, Rb1, and scutellarin with its simplicity, sensibility, repeatability, and better recovery rate.

Determination of deoxyschizandrin, schisandrin b, schisandrin c, and ursolic acid in Baogan Pill by RP-HPLC / 中草药

Objective: To establish an RP-HPLC method for determining the contents of deoxyschizandrin, schisandrin b, schisandrin c, and ursolic acid in Baogan Pill, and to provide the quality guarantee for Baogan Pill. Methods: Agilent Zorbax SB-C18 (150 mm × 46 mm, 5 μm) column was used. Acetonitrile and 0.1% phosphoric acid water solution was used as mobile phase, the volume flow was at 1.0 mL/min; Ultraviolent wavelength was 210 nm; Column temperature was at 30℃, and injection volume was 10 μL. Results: The lowest detection limits in deoxyschizandrin, schisandrin b, schisandrin c, and ursolic acid respectively were 0.016, 0.019, 0.020, and 0.025 mg/L, the linear ranges respectively were 3.906-250.000, 5.323-340.000, 3.225-205.000, and 5.323-340.000 mg/L. The average recoveries of deoxyschizandrin, schisandrin b, schisandrin c, and ursolic acid in Baogan Pill respectively were 100.79%, 101.09%, 101.26%, and 101.16%; The precision RSD values were 1.76%, 1.69%, 1.80%, and 1.86%, respectively; The repeatability RSD values were 1.77%, 1.66% 1.49% and 1.56%, respectively; The stability RSD values were 1.61%, 1.39%, 1.60%, and 1.56%, respectively. The average amounts of deoxyschizandrin, schisandrin b, schisandrin c, and ursolic acid in the selected samples per pill were 0.444, 1.066, 0.3125, 1.068μg, respectively. Conclusion: The method is believable for determining the contents of deoxyschizandrin, schisandrin b, schisandrin c, and ursolic acid with good simplicity, sensibility, repeatability, and recovery rate.

Effect of inflammatory factors on cell proliferation and apoptosis in insulin-like grown factor 1-slienced human coronary artery smooth muscle cells / 中国医学科学院学报

<p><b>OBJECTIVE</b>To study the effect of inflammatory factors on cell proliferation and apoptosis in insulin-like grown factor 1 (IGF1)-slienced human coronary artery smooth muscle cells (hCASMCs).</p><p><b>METHODS</b>We silenced the expression of IGF1 in hCASMCs using the lentivirus-mediated RNA interference technology. Blank control group and negative control group were set using the hCASMCs without the infection of a virus vector and the hCASMCs with the infection of a negative control virus vector, respectively. After the treatment of these cells with both tumor necrosis factor-α 50 ng/ml and interleukin-1β 40 ng/ml, the concentration of IGF1 in cell-culture medium was detected by enzyme-linked immunosorbent assay, and the proliferation and apoptosis were evaluated by MTT assay and flow cytometry.</p><p><b>RESULTS</b>After the simulation with inflammatory factors, the concentration of IGF1 in the supernatant fluid of cultured IGF1-slienced hCASMCs was significantly lower than those in the blank control group and negative control group [(426.35±120.96) vs. (1 030.69±54.69) and (992.82±26.90)pg/ml, P=0.000). The proliferation of IGF1-slienced hCASMCs was substantially much less than the two control groups (0.302±0.011 vs. 0.401±0.028 and 0.302±0.011, F=37.628, P=0.000), and the apoptosis rate of IGF1-slienced hCASMCs was significant increased compared with the other two groups [(10.57±0.99)% vs. (0.19±0.13)% and (1.31±0.30)%, P=0.001].</p><p><b>CONCLUSION</b>Inflammatory factors can inhibit the cell proliferation and promote apoptosis after the knock-down of IGF1 in hCASMCs.</p>

Determination of oxalate in human plasma and urine by RP-HPLC / 中草药

Objective: To establish a method of reversal phase-high performance liquid chromatography (RP-HPLC) for determining the mass concentration of oxalate in human plasma and urine and to monitor the variation of mass concentration of oxalate in the patients with primary hyperoxaluria (PH) before and after combined liver-kidney transplantation. Methods: Agilent XDBC18 (150 mm × 4.6 mm, 5 μm) column and Agilent Zorbax extend-C18 (12.5 mm × 4.6 mm, 5 μm) guard column were used. Methyl alcohol and aqueous solution containing 0.1 mol/L ammoniom acetate (15∶85) were used as mobile phase. The flow rate was at 1.2 mL/min, ultraviolent determination wavelength was 314 nm, column temperature was at 26.3 ℃, and injection volume was 50 μL. o-phenylenediamine was used as derivating agent, reacted with oxalate in human plasma and urine so as to obtain the compound with better ultraviolet absorption-2, 3-dyhydroxy quinoxaline. Results: The detection limit in human plasma was 0.3 mg/L, the linear range was 1.953-125 mg/L, the average recovery was 94.89%, and its RSD was 4.1%; The detection limit in urine was 0.5 mg/L, the linear range was 1.953-125 mg/L, the average recovery was 94.31%, and its RSD was 3.2%. Conclusion: The method is believable for determining the mass concentration of oxalate with its simplicity, sensibility, repeatability, and better recovery rate.

Efficacy evaluation on knee osteoarthritis treated with acupuncture: non-randomized concurrent control trial / 中国针灸

<p><b>OBJECTIVE</b>To evaluate the clinical efficacy and efficacy sustainable time of acupuncture in knee osteoarthritis (KOA).</p><p><b>METHODS</b>The non-randomized concurrent control trial was adopted. One hundred and ninety-three cases of KOA were divided into an immediate acupuncture group (group A, 97 cases) and a delayed acupunc-weeks at the end of treatment. In group B, the same acupuncture therapy was applied after waiting 4 weeks. The acupoints in the two groups were Liangqiu (ST 34), Dubi (ST 35), Zusanli (ST 36), Yanglingquan (GB 34), Yinlingquan (SP 9), Xuehai (SP 10), Xiyan (EX-LE 4), Xiyangguan (GB 33). WOMAC (Western Ontario and McMasters Universities Osteoarthritis) was used for the assessment of the primary index and VAS (visual analogue scale) was for the secondary index. The evaluation was accomplished by the patients at the beginning of trial, on the 4th and 8th weeks. In each group, 72 patients finished the trial and the data of the lost cases were included in the final data analysis.</p><p><b>RESULTS</b>In the 4th week of trial, WOMAC score was (25. 8+/-22.0) in group A difference (P<0. 001). VAS scorewas (31. 8+/-24. and was (43.8+/-22.2) in group B, indicating the significant 6) in group A and was (56. 6 +/-25. 8) in group B, indicating very significant difference (P<0. 001). In the 8th week, the efficacy was reduced slightly in the follow-up of group A, but it was improved apparently as compared Acupuncture relieves joint pain and improves joint function obviously.by th patiĩeffr,a Mtaetfti-?an tf ri-with that before treatment.</p><p><b>CONCLUSION</b>Acupuncture relieves joint pain and improves joint function obviously.The effect of acupuncture is still sustainable in 4 weeks after terminating the treatment.</p>

Lung cancer associated paraneoplastic limbic encephalitis: an analysis of 7 cases / 中华外科杂志

<p><b>OBJECTIVE</b>To analyze the clinical features, diagnosis and treatment of lung cancer associated paraneoplastic limbic encephalitis (PLE).</p><p><b>METHODS</b>The clinical data of 7 cases of patients with lung cancer associated PLE out of 8927 patients of lung cancer from January 2000 to May 2010 was analyzed retrospectively. All the patients were male, aging from 41 to 54 years with a mean of 48 years. The data including history, physical examination, laboratory tests, diagnosis, treatment and follow-up were collected and analyzed.</p><p><b>RESULTS</b>All the 7 patients had smoking history. All 7 patients had varying short-term memory loss, 6 had epilepsy, 4 had different degrees of mental disorders, and 2 had syndrome of inappropriate secretion of antidiuretic hormone. Malignancies were screened and detected by chest X-ray or CT scan, while the pathological diagnoses were obtained through biopsy or transbronchial needle aspiration through electronic bronchoscope (5/7), biopsy of supraclavicular lymph nodes (1/7) and open pulmonary lobectomy (1/7). The pathological diagnosis included small cell lung cancer in 6 cases, adenocarcinoma of lung in 1 case. During the follow-up, 1 patient was lost, and the mean time of follow-up of the remaining 6 patients was about 11.5 months (ranged from 4 to 21 months). Four patients received early immunosuppressive treatment in terms of corticosteroids, only slight relief of neurological symptoms was seen in 2 patients. However, after chemotherapy (6/6), radiation (3/6), or surgical removal of the tumor (1/6), complete remission (3/6, with negative anti-Hu antibody) or partial remission (3/6, 2 of whom with positive anti-Hu antibody) of neurological symptoms were observed. Till October 2010, 3 patients with poorer tumor stag died ( survival were 4, 10, and 14 months respectively), while the other 3 patients with negative anti-Hu antibody and relative better tumor stag were still in the follow-up (the period were 5, 15, and 21 months).</p><p><b>CONCLUSIONS</b>PLE is a rare disease. In comparison with immunosuppressive therapy, chemotherapy, radiation or surgical removal of the tumor could provide better remission of the neurological symptoms. Positive serum anti-Hu antibody, poorer tumor stag, and together with poorer response to treatments seem to indicate a poorer prognosis.</p>

Influence of intensive insulin therapy on vascular endothelial growth factor in patients with severe trauma / 华中科技大学学报（医学）（英德文版）

The influence of early-stage intensive insulin therapy on the plasma levels of vascular endothelial growth factor (VEGF) and the related parameters in patients with severe trauma and the clinical implication were investigated. Sixty-four cases of severe trauma (injury severity score ≥20) with stress hyperglycemia (blood glucose >9 mmol/L) were randomly divided into intensive insulin therapy group and conventional therapy group. ELISA method, radioimmunoassay and density gradient gradation one-step process were used to determine plasma VEGF, endothelin-1 (ET-1), and the number of circulating endothelial cells (CECs) at the day of 0, 2, 3, 5 and 7 after admission. Simultaneously, the changes of CRP concentration in plasma were monitored to evaluate inflammatory response. The results showed that plasma levels of observational indexes in patients receiving early-stage intensive insulin therapy were all significantly lower than those in conventional therapy groups 2, 3, 5 and 7 days after admission [for VEGF (ng/L), 122.2±23.8 vs. 135.9±26.5, 109.6±27.3 vs. 129.0±18.4, 88.7±18.2 vs. 102.6±27.3, 54.2±26.4 vs. 85.7±35.2, P<0.05, 0.01, 0.05, 0.05 respectively; for ET-1 (ng/L), 162.8±23.5 vs. 173.7±13.2, 128.6±17.5 vs. 148.8±22.4, 96.5±14.8 vs. 125.7±14.8, 90.7±16.9 vs. 104.9±22.5, P<0.05, 0.01, 0.01, 0.01 respectively; for CRP (mg/L), 23.2±13.8 vs. 31.9±16.5, 13.6±17.3 vs. 23.5±18.4, 8.7±10.2 vs. 15.6±13.3, 5.2±9.4 vs. 10.7±11.2, all P<0.05; for CECs (/0.9 μL), 10.9±5.6 vs. 13.9±6.2, 8.5±4.9 vs. 11.3±5.3, 6.3±6.4 vs. 9.4±5.7, 4.8±7.1 vs. 7.8±4.8, all P<0.05]. It was concluded that intensive insulin therapy could antagonize the endothelium injury after trauma and reduce inflammation response quickly, which was one of important mechanisms by which intensive insulin therapy improves the prognosis of trauma patients.

Influence of intensive insulin therapy on vascular endothelial growth factor in patients with severe trauma / 华中科技大学学报（医学）（英德文版）

The influence of early-stage intensive insulin therapy on the plasma levels of vascular endothelial growth factor (VEGF) and the related parameters in patients with severe trauma and the clinical implication were investigated. Sixty-four cases of severe trauma (injury severity score ≥20) with stress hyperglycemia (blood glucose >9 mmol/L) were randomly divided into intensive insulin therapy group and conventional therapy group. ELISA method, radioimmunoassay and density gradient gradation one-step process were used to determine plasma VEGF, endothelin-1 (ET-1), and the number of circulating endothelial cells (CECs) at the day of 0, 2, 3, 5 and 7 after admission. Simultaneously, the changes of CRP concentration in plasma were monitored to evaluate inflammatory response. The results showed that plasma levels of observational indexes in patients receiving early-stage intensive insulin therapy were all significantly lower than those in conventional therapy groups 2, 3, 5 and 7 days after admission [for VEGF (ng/L), 122.2±23.8 vs. 135.9±26.5, 109.6±27.3 vs. 129.0±18.4, 88.7±18.2 vs. 102.6±27.3, 54.2±26.4 vs. 85.7±35.2, P<0.05, 0.01, 0.05, 0.05 respectively; for ET-1 (ng/L), 162.8±23.5 vs. 173.7±13.2, 128.6±17.5 vs. 148.8±22.4, 96.5±14.8 vs. 125.7±14.8, 90.7±16.9 vs. 104.9±22.5, P<0.05, 0.01, 0.01, 0.01 respectively; for CRP (mg/L), 23.2±13.8 vs. 31.9±16.5, 13.6±17.3 vs. 23.5±18.4, 8.7±10.2 vs. 15.6±13.3, 5.2±9.4 vs. 10.7±11.2, all P<0.05; for CECs (/0.9 μL), 10.9±5.6 vs. 13.9±6.2, 8.5±4.9 vs. 11.3±5.3, 6.3±6.4 vs. 9.4±5.7, 4.8±7.1 vs. 7.8±4.8, all P<0.05]. It was concluded that intensive insulin therapy could antagonize the endothelium injury after trauma and reduce inflammation response quickly, which was one of important mechanisms by which intensive insulin therapy improves the prognosis of trauma patients.

Differences of clinical trails on domestic and international treatment of knee osteoarthritis with acupuncture / 中国针灸

Literatures on knee osteoarthritis treated by acupuncture both in China and abroad published in the mainstay periodicals in recent 10 years were selected, and analyses were done in the following aspects: (1) Randomization, (2) Control group, (3) Sample size, (4) Intervention measurements, (5) Intervention periods, (6) Evaluation on therapeutic effects, (7) Follow-up assessment, (8) Adverse effects, (9) Ratio of the lost case. The result indicates that differences can still be found on the trial designation in China and abroad. The domestic research design should be more comprehensively and strictly.

A preliminary study about the apoptostic mechanism of RNA targeting basic fibroblast growth factor in glioma U251 cells / 中华外科杂志

<p><b>OBJECTIVE</b>To preliminarily investigate the mechanism of small interfering RNA (siRNA) induced apoptosis in glioma U251 cells by silencing basic fibroblast growth factor (bFGF).</p><p><b>METHODS</b>U251 cells were divided into the normal control group, the mock group and experiment group, the mock and experiment group were transfected with mock vector (Ad-null) and the recombinant adenovirus carrying bFGF-siRNA (Ad-bFGF-siRNA) respectively at a multiplicity of infection (MOI) of 100. After 72 hours, the expression of related proteins was revealed by the method of Western blot. Mitochondrial transmembrane potential (ΔΨm) was measured with flow cytometry and confocal microscopy, Groups were compared using single factor analysis of variance (One-way ANOVA).</p><p><b>RESULTS</b>After U251 cells were transfected with bFGF-siRNA, the results of Western blot showed that after 72 hours of transfection the bFGF protein in the experiment group decreased obviously, meanwhile Cytochrome C, Caspase-3 and Bax showed increased expression while in the Bcl-xl and Bcl-2 proteins decreased expression. The proportion of high mitochondrial membrane potential of cells by flow cytometry, the experimental group was 74.4% ± 4.7% decreased significantly compared with the control group 92.1% ± 2.5%, the mock group 90.9% ± 1.8% (F = 28.805, P < 0.05); laser scanning confocal microscopy results showed that the red fluorescence and green fluorescence ratio of the experimental group was 0.83 ± 0.12 decreased significantly compared with 1.36 ± 0.40 of the control group and 1.32 ± 0.35 of the mock group(F = 7.920, P < 0.05).</p><p><b>CONCLUSION</b>siRNA targeting bFGF induced U251 cell apoptosis may be achieved through the mitochondrial pathway.</p>

Wolman disease with novel mutation of LIPA gene in a Chinese infant / 中华儿科杂志

<p><b>OBJECTIVE</b>To explore the clinical characteristics of Wolman disease and diagnostic methods using enzymatic and molecular analysis.</p><p><b>METHOD</b>Lysosomal acid lipase activity was measured using 4-methylumbelliferyl oleate in the leukocytes of an infant suspected of Wolman disease and LIPA gene mutational analysis was performed by PCR and direct sequencing in the proband and his parents. After the diagnosis was confirmed, the clinical, biochemical, radiological and histopathological findings in this case of Wolman disease were retrospectively reviewed.</p><p><b>RESULT</b>The sixteen-day-old boy was failing to thrive with progressive vomiting, abdominal distention and hepatosplenomegaly. Abdominal X-ray revealed adrenal calcifications which were confirmed on abdominal CT scan. Xanthomatosis were observed on enlarged liver, spleen and lymph nodes during abdominal surgery. Liver and lymph node biopsy showed foamy histiocytes. The lysosomal acid lipase activity in leukocytes was 3.5 nmol/(mg·h) [control 35.5 - 105.8 nmol/(mg·h)]. Serum chitotriosidase activity was 315.8 nmol/(ml·h) [control 0 - 53 nmol/(ml·h)]. The patient was homozygote for a novel insert mutation allele c.318 ins T, p. Phe106fsX4 in exon 4 on LIPA gene. His both parents were carriers of the mutation.</p><p><b>CONCLUSION</b>The clinical features of Wolman disease include early onset of vomiting, abdominal distention, growth failure, hepatosplenomegaly and bilateral adrenal calcification after birth. A plain abdominal X-ray film should be taken to check for the typical pattern of adrenal calcification in suspected cases of Wolman disease. The enzymatic and molecular analyses of lysosomal acid lipase can confirm the diagnosis of Wolman disease.</p>

Evolution and prognosis of the acute flaccid paralysis associated with enterovirus 71 infection evaluated through a clinical and magnetic resonance imaging follow-up study / 中华儿科杂志

<p><b>OBJECTIVE</b>To explore the development and prognosis of the acute flaccid paralysis (AFP) associated with enterovirus 71 (EV71) infection through clinical follow-up study for clinical and magnetic resonance imaging (MRI) features based on the research progress of virology and pathology.</p><p><b>METHOD</b>Sixteen children with HFMD associated with AFP in hospital from May 1, 2011 to August 31, 2011 were investigated and the patients received intensive rehabilitation training. The 16 cases were divided into two groups (the recovery or the sequela) by if the muscle strength recovered to level 4 after intensive rehabilitation. The MRI findings of 15 children were analyzed and among them, 6 patients were reexamined after one month. The clinical markers were compared between groups including course of disease, WBC, WBC in cerebrospinal fluid (CSF), ventilator support, therapy, the worst muscle strength, the initial tendon reflex, the muscle atrophy, and multi-limb paralysis. The data were analyzed by t test and χ2 test with SPSS10.0.</p><p><b>RESULT</b>All the 16 children were infected with enterovirus 71 (EV71). The myodynamia of 7 children were level 0, 4 children had serious upper limbs paralysis. The neck muscle in 3 cases and the brain stem motor ruckus in 4 cases were involved. The ankle clonus of non-completely paralyzed limbs in 14 cases occurred during rehabilitation. Eight children had the better prognosis, the other 8 children had sequela. 0 level muscle strength (0 case vs. 7 cases, χ2=12.4), the initial tendon reflex (2 cases vs. 8 cases, χ2=9.6), obvious muscle atrophy (0 case vs. 8 cases, χ2=16), were significantly different in the children with the recovery when compared to the sequela (P<0.01). The severe upper limbs paralysis had the worse prognosis than the severe lower limbs paralysis. MR imaging showed signs of spinal nerve root inflammation and the bilateral hyperintense lesions, symmetrical in the posterior portions of the medulla, pons, and asymmetrical in the ventral horns of cervical spinal cord. Signal enhancement occurred only in the early MRI examination.</p><p><b>CONCLUSION</b>In the evolution of AFP due to EV71 infection, the upper motor neuron damage is common, the prognosis is related with the severity of early paralysis and neuron damage. MR imaging is helpful to understand the pathological mechanism of AFP.</p>

Efficacy observation of knee osteoarthritis treated with acupuncture / 中国针灸

<p><b>OBJECTIVE</b>To evaluate the clinical efficacy of the conventional acupuncture on knee osteoarthritis (KOA).</p><p><b>METHODS</b>Seventy-three cases of KOA were treated with the conventional acupuncture therapy at Liang-qiu (ST 34), Dubi (ST 35), Zusanli (ST 36), Yanglingquan (GB 34), Yinlingquan (SP 9), etc. The conventional acupuncture therapy lasted for 4 weeks (at least 3 treatments and less than 5 times each week). At the end of treatment, the follow-up visit lasted for 4 weeks. The Western Ontario and McMaster Universities osteoarthritis index (WOMAC) and the visual analogue scale (VAS) were adopted for the efficacy assessments of the patients.</p><p><b>RESULTS</b>Of 73 cases, 49 cases accomplished the trial. The data of the lost cases were included in the final data analysis. At the end of 4-week treatment and the follow-up visit, every score in VAS and WOMAC was decreased The conventional acupuncture therapy reduces the joint pain for apparently (P < 0.001, P < 0.05).</p><p><b>CONCLUSION</b>the patients with KOA and improves the joint function. The 4-week follow-up visit indicates that the efficacy of acupuncture is still sustained.</p>

Mucopolysaccharidosis VII: report of a case and review of the literature / 中华儿科杂志

<p><b>OBJECTIVE</b>To investigate the clinical characteristics and diagnosis of mucopolysaccharidosis VII.</p><p><b>METHOD</b>The clinical and biochemical features of an infant with mucopolysaccharidosis VII confirmed by enzyme assay were analyzed.</p><p><b>RESULT</b>The 2 month-old male infant showed hydrops fetalis, mental retardation, coarse face, corneal clouding, hepatosplenomegaly, hernias, Alder-Reilly granules in the leucocytes and decreased platelet (32 × 10(9)/L). The biochemical markers showed urinary glycosaminoglycans (GAG) (532.8 mg/L, controls < 70.0 mg/L). The ratio of GAG/creatinine was 161.3 (controls: 26.2 ± 11.7). Serum chitotriosidase activity was 315.8 nmol/(ml·h) [control < 53 nmol/(ml·h)]. Beta-glucuronidase activity was deficient in isolated leukocytes.</p><p><b>CONCLUSION</b>Severe form of mucopolysaccharidosis VII exhibited characteristics of hydrops fetalis, hepatosplenomegaly, coarse face, thrombocytopenia and Alder-Reilly granules in the leucocytes. The measurements of GAG in urinary and beta glucuronidase in leucocytes are critical to diagnosis and deferential diagnosis.</p>

Surgical treatment of intralobar pulmonary sequestration / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To evaluate the clinical features, diagnosis, treatment, and outcome of intralobar pulmonary sequestration (ILS).</p><p><b>METHODS</b>Patients who were diagnosed with ILS in our hospital between January 1988 and January 2009 were retrospectively reviewed. We recorded the clinical symptoms, imaging findings, operative technique, complications, and outcome of these patients.</p><p><b>RESULTS</b>Forty-seven patients (25 men and 22 women) with an average age of 32.3 years were enrolled. Forty-two patients had symptoms including cough and hemoptysis. Chest X-ray, computed tomography (CT), magnetic resonance imaging (MRI), and angiography were performed. Thoracotomy was performed in 45 patients, while thoracoscopy was performed in 2 patients. Lobectomy was the most common treatment procedure. Massive bleeding developed in 2 patients due to injury of aberrant supplying artery intraoperatively, 1 patient had atrial fibrillation, 1 patient had thrombosis of upper extremity postoperatively. All patients were confirmed the diagnosis pathologically, 4 accompanied with bronchogenic cyst, 15 with bronchiectasis, 8 with infection, 2 with aspergilloma, and 1 with carcinoid. No late complications occurred.</p><p><b>CONCLUSIONS</b>ILS is rare, surgery is recommended because some patients may have potential severe complications. Contrast enhanced CT and three-dimensional reconstruction is the best diagnostic method. Both thoracotomy and thoracoscopy are appropriate for the selected candidates.</p>

Anti-glioma effect of combination of bFGF-siRNA and Vpr in nude mice / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To study the anti-glioma effect of recombinant adenovirus mediated combined gene therapy of bFGF-siRNA and HIV1-Vpr in vivo.</p><p><b>METHODS</b>Mouse glioma model was established by injecting 5 × 10(6) LN229 cells into BALB/c-nu nude mice. 30 nude mice were randomly divided into 5 groups: the negative control group, mock group, bFGF-siRNA group, Vpr group and combined therapy group, which at regular intervals were injected with PBS, rAd5-null, rAd5-bFGF-siRNA, rAd5-Vpr, rAd5-bFGF-siRNA plus rAd5-Vpr, respectively. The tumor volume was recorded every third day to draw a growth curve. After four weeks treatment, the mice were killed and specimens were taken. HE, immunohistochemical and TUNEL staining were performed to observe the cell morphology, detect the changes of relevant target proteins and cell apoptosis, respectively. Also the ultrastructural changes were observed by electron microscopy.</p><p><b>RESULTS</b>The tumor growth inhibition rates were 36.9%, 37.2% and 58.6% in the bFGF-siRNA group, Vpr group and combined therapy group, respectively, and the combined therapy group showed the most significant effect (P < 0.05). Also the results of HE, immunohistochemical and TUNEL staining revealed that the combined therapy group had the best effects on proliferation inhibition and apoptosis induced in glioma cells (P < 0.05). The most significant ultrastructural changes were observed in the combined therapy group.</p><p><b>CONCLUSION</b>The combined gene therapy of bFGF-siRNA with Vpr shows a prominent and synergistic anti-glioma effect compared with that of mono-gene therapy in nude mice.</p>

Primary malignant tumor of the appendix: clinicopathological analysis of 22 cases / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To investigate the clinicopathological and immunohistochemical features of primary malignant tumor of the appendix.</p><p><b>METHODS</b>The clinical data were reviewed; and histopathological and immunohistochemical features were analyzed in 22 cases with primary malignant tumor of the appendix.</p><p><b>RESULT</b>In 22 cases of primary malignant tumor of the appendix, 19 cases were carcinoid and 3 were adenocarcinoma. Immunohistochemistry showed that the carcinoid was positively reacted to the neuroendocrine markers, and the adenocarcinoma was negatively reacted to the neuroendocrine markers.</p><p><b>CONCLUSION</b>Immunohistochemistry is useful in diagnosis of primary malignant tumor of the appendix, a rare type of cancer.</p>