Clinical characteristics and prognostic characterization of endometrial carcinoma: a comparative analysis of molecular typing protocols.

BACKGROUND: Endometrial carcinoma (EC) is one of the most common gynecological malignancies in China and globally, accounting for the fourth-prevalent cancer in women. Although numerous studies have confirmed prognostic value of The Cancer Genome Atlas (TCGA) molecular subgroups, it is unclear how they are combined with histological features. The main objective of this study was to compare ProMisE and TCGA classification for the rapid and accurate prediction of prognosis within EC patients, together with the provision of a revised strategy for individualized diagnosis and treatment of patients. METHODS: Within this study, 70 patients with EC from Beijing Tsinghua Changgeng Hospital (affiliated to Tsinghua University) were retrospectively examined between July 2015 and December 2021. Samples were processed for determination of clinical markers, together with ProMisE and TCGA classification. RESULTS: Comparative analysis across four TCGA types (POLE, Low-CN, High-CN, and MSI-H) and age, was statistically significant (χ²= 7.000, p = 0.029). There was no significant difference observed among the four TCGA types and FIGO stage, vascular invasion and depth of invasion, or lymph node metastasis and tumor area. There was no significant association between the expression of Vimentin, Ki-67, PTEN, MSH2, PAX-8, ß-catenin, CD10, ER, PR, P16, MLH1, and PMS2 with the four TCGA types. In addition, p63 expression (χ²= 11.09, p = 0.029) and p53 expression (χ²= 11.585, p = 0.005) were statistically significant. Numerous models demonstrated that patients with POLE mutations and low-CN had higher progression free survival (PFS) and overall survival (OS), whereas those with high-CN had lowest values. The log-rank test revealed that the survival rate of PR-positive and ER-positive patients was significantly higher (p < 0.001). CONCLUSION: Overall, these results can be of additional benefit for clinical applications, in comparison to the ProMisE classification method. In addition, PR, ER, vascular infiltration, hyperlipidemia and atherosclerosis were found to be the key factors affecting EC prognosis.

Research progress of GBA1 variation and Parkinson′s disease / 中华神经科杂志

GBA1 is one of the common risk genes of Parkinson′s disease (PD), which encodes glucocerebrosidase. It is difficult to distinguish PD patients with heterozygous variants of GBA1 ( GBA1-PD) from idiopathic Parkinson′s disease patients, but GBA1-PD tends to progress faster, be more severe, and be more likely to be associated with cognitive impairment and other non-motor symptoms. The pathological mechanism of the increased risk of PD in GBA1 heterozygous variant carriers may be related to autophagy-lysosome dysfunction and mitochondrial dysfunction. Targeted therapy for GBA1 is expected to become a new direction of precision therapy for PD. In this article, the epidemiology and clinical features of GBA1-PD, the possible pathogenesis of GBA1 variation, and the therapeutic strategies for GBA1-PD were elaborated.

Self-assembling SARS-CoV-2 nanoparticle vaccines targeting the S protein induces protective immunity in mice

The spike (S), a homotrimer glycoprotein, is the most important antigen target in the research and development of SARS-CoV-2 vaccine. There is no doubt that fully simulating the advanced structure of this homotrimer in the subunit vaccine development strategy is the most likely way to improve the immune protective effect of the vaccine. In this study, the preparation strategies of S protein receptor-binding domain (RBD) trimer, S1 region trimer, and ectodomain (ECD) trimer nanoparticles were designed based on ferritin nanoparticle self-assembly technology. The Bombyx mori baculovirus expression system was used to prepare these three nanoparticle vaccines with high expression levels in the silkworm. The immune results of mice show that the nanoparticle vaccine prepared by this strategy can not only induce an immune response by subcutaneous administration but also effective by oral administration. Given the stability of these ferritin-based nanoparticles vaccine, easy-to-use and low-cost oral immunization strategy can make up for the vaccination blind areas caused by the shortage of ultralow-temperature equipment and medical resources in underdeveloped areas. And the oral vaccine is also a very potential candidate to cut off the spread of SARS-CoV-2 in domestic and farmed animals, especially in stray and wild animals.

Impact of thymosin α1 as an immunomodulatory therapy on long-term survival of non-small cell lung cancer patients after R0 resection: a propensity score-matched analysis / 中华医学杂志(英文版)

BACKGROUND@#There is limited information about thymosin α1 (Tα1) as adjuvant immunomodulatory therapy, either used alone or combined with other treatments, in patients with non-small cell lung cancer (NSCLC). This study aimed to evaluate the effect of adjuvant Tα1 treatment on long-term survival in margin-free (R0)-resected stage IA-IIIA NSCLC patients.@*METHODS@#A total of 5746 patients with pathologic stage IA-IIIA NSCLC who underwent R0 resection were included. The patients were divided into the Tα1 group and the control group according to whether they received Tα1 or not. A propensity score matching (PSM) analysis was performed to reduce bias, resulting in 1027 pairs of patients.@*RESULTS@#After PSM, the baseline clinicopathological characteristics were similar between the two groups. The 5-year disease-free survival (DFS) and overall survival (OS) rates were significantly higher in the Tα1 group compared with the control group. The multivariable analysis showed that Tα1 treatment was independently associated with an improved prognosis. A longer duration of Tα1 treatment was associated with improved OS and DFS. The subgroup analyses showed that Tα1 therapy could improve the DFS and/or OS in all subgroups of age, sex, Charlson Comorbidity Index (CCI), smoking status, and pathological tumor-node-metastasis (TNM) stage, especially for patients with non-squamous cell NSCLC and without targeted therapy.@*CONCLUSION@#Tα1 as adjuvant immunomodulatory therapy can significantly improve DFS and OS in patients with NSCLC after R0 resection, except for patients with squamous cell carcinoma and those receiving targeted therapy. The duration of Tα1 treatment is recommended to be >24 months.

Influence of high-density lipoprotein cholesterol on the prognosis of patients with alcohol-related hepatocellular carcinoma after radical treatment / 临床肝胆病杂志

ObjectiveTo investigate the association of high-density lipoprotein cholesterol (HDL-C) with the prognosis of patients with alcohol-related hepatocellular carcinoma (HCC) after radical treatment. MethodsA retrospective analysis was performed for the clinical data of 43 patients with alcohol-related HCC who were admitted to The Fifth Medical Center of Chinese PLA General Hospital and underwent radical treatment from January 2008 to July 2015, and according to HDL-C level, the patients were divided into normal group with 26 patients and abnormal group with 17 patients. The two groups were compared in terms of basic information, laboratory markers, imaging indices, Barcelona Clinic Liver Cancer tumor stage, and Child-Pugh class of liver function. The t-test test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups. The Kaplan-Meier method was used to plot survival curves and the log-rank test was used for comparison between groups. Univariate and multivariate Cox proportional hazards models were used to analyze independent risk factors for prognosis. ResultsThere was a significant difference in prealbumin between the two groups (162.38±60.86 mg/L vs 120.06±64.08 mg/L, t=2.184, P=0.035). Number of tumors (hazard ratio ［HR］=2.839, 95%confidence interval ［CI］: 1.120~7.200,P=0.028), tumor size (HR=2.634, 95%CI: 1.062~6.529,P=0037), and HDL-C level (HR=2.400, 95%CI: 1.040~5.537,P=0.040) were independent risk factors for the overall survival of patients with alcohol-related HCC. There were significant differences in 1-, 3-, and 5-year cumulative survival rates between the normal group and the abnormal group (88.5%/72.4%/55.7% vs 70.6%/43.7%/17.5%, χ2=5.881, P=0.015). ConclusionThe reduction in HDL-C level might indicate poor prognosis of patients with alcohol-related HCC.

Research progress of new vaccine adjuvants / 生物工程学报

In recent years, the development of new vaccines such as nucleic acid vaccines, genetically engineered vaccines, and synthetic peptide vaccines has achieved rapid development. However, compared with traditional inactivated or live vaccines, these vaccines often have problems such as poor immunogenicity. Therefore, an adjuvant is needed to enhance its effect, and adjuvants have proven to be a key component in vaccines. There are many types of adjuvants, while currently no unified standard for the classification. At present, the most commonly used adjuvants are Aluminum adjuvant and Freund's adjuvant, but new generation vaccines will probably need new generation adjuvants. Thus, this review aims to showcase the current status of immune adjuvants, with the focus on immunomodulatory molecular adjuvant, antigen delivery adjuvant and compound adjuvant. This review provides new insights for the development of novel vaccine adjuvants.

Activation of FXR receptor reduces damage of ET-1 on H9C2 cardiomyocytes by activating AMPK signaling pathway.

BACKGROUND: To investigate the effect of Farnesoid X receptor (FXR) on oxidative stress injury of H9C2 cardiomyocytes induced by endothelin-1 (ET-1), and to explore the possible mechanism. METHODS: H9C2 cardiomyocytes were treated with ET-1 at concentrations of 10-8, 10-7 and 10-6 mmol/L for 12, 24, 36, and 48 h, respectively. At the same time, oxidative stress injury models were established. After the oxidative stress injury model was established, GW4064 (FXR agonist), siRNA-FXR (the virus interfered with FXR expression) and FXR empty virus were treated for 48 h. CCK-8 method was used to observe the survival rate of cardiomyocytes. Biochemical kit method was used to detect Creatine Kinase (CK) contents, CAT and mitochondrial activity. Western blot was used to detect the protein expression of SOD1, AMPK and p-AMPK. And real-time PCR was used to detect GPX1 mRNA, GPX3 mRNA, Sirt1 mRNA, PGC-1α mRNA expression levels. RESULTS: At the concentrations of 10-8, 10-7 and 10-6 mmol/L, ET-1 could induce the decrease of mitochondrial complex I and III activity, and increase of CK content in H9C2 cardiomyocytes. Moreover, with the increase of ET-1 concentration and the extension of culture time, the oxidative stress damage of cardiomyocytes became more serious. After ET-1 intervention, the expressions of p-AMPK protein, Sirt1 mRNA and PGC-1α mRNA were decreased. The 2 µmol/L GW4064 could effectively improve the oxidative stress induced by ET-1, and compared with the ET-1 group, the survival rate of H9C2 cardiomyocytes increased obviously. In addition, the CK content was decreased. On the contrary, the mitochondrial complex I and III, and CAT activity increased significantly, and the expressions of SOD1 and p-AMPK protein, Sirt1 mRNA and PGC-1α mRNA increased obviously. However, siRNA-FXR can partially block the improvement effect of FXR agonist on cardiomyocytes injury. CONCLUSIONS: Activation of FXR receptor may reduce the damage of ET-1 on H9C2 cardiomyocytes by activating AMPK signaling pathway.

Epithelioid hemangioendothelioma of the sternum.

Epithelioid hemangioendothelioma (EHE) is a rare vascular tumor composed of dendritic and endothelial cells, and accounts for less than 1% of all vascular tumors. The tumor may arise from any location in the body, but it has a predilection for veins of the extremities, the liver, bone, and skin. Herein, we report a case of a 43-year-old man who presented with a chest mass accompanied by chest pain. Computed tomography (CT) scan of the chest showed a 3 cm × 2 cm sternal mass in the chest wall. We performed tumor resection and reconstruction of the chest wall. EHE was confirmed via postoperative pathology. The patient underwent postoperative adjuvant radiotherapy, and no evidence of tumor recurrence was discovered during the one-year follow up.

Empirical study on satisfaction of physical health education in primary schools of Ganjiang New District / 中国学校卫生

Objective@#To understand the status of physical health education in primary schools in Ganjiang New District, and to provide a reference for physical health education for educational managers.@*Methods@#Based on the client satisfaction index and national documents, satisfaction questionnaire survey was administered among parents of 789 primary school students from 5 school in Ganjiang New Area.Sixteen indicators including physical monitoring and hours of physical education.@*Results@#Modrate satisfaction level towards physical health education found among parents ranging from "4" to "3". The highest score for "sports teacher level" was 4.13 and the lowest score for "multimedia education" was 3.00. The average value of "sports teacher training locations" was 4.08, which was higher than the "overall satisfaction" score of 3.67; the average value of "school sports activities" was 3.58, which was lower than "overall satisfaction". The five-dimensional sample has good independence and there was no multicollinearity; the coefficient of influence of "Physical health of students" was 0.15(P<0.05).@*Conclusion@#Parents satisfaction with the management of physical health education in the five primary schools is generally good, but they are dissatisfied with the lack of physical education teachers venues and teaching hours. It is recommended that parents correct the "five education concept" to improve health education, balance the strengths and weaknesses of school education to make up for shortcomings, and strengthen the home school society co-education mechanism to improve the physical health of primary school students in Ganjiang New District.

Antidiastole Value of Three-dimensional Ultrasonography and Power Doppler between Uterine Parenchyma Lumps and Endometrial Cancer: A Retrospective Study.

Sometimes endometrial polyps, submucosal myomas, and endometrial cancer show similar findings under ultrasonography. The aim of this study was to assess the antidiastole value of blood flow parameters using three-dimensional (3D) power Doppler ultrasonography angiography (PDA) between endometrial cancer and uterine parenchyma lumps. The data of the blood flow indices in 3D-PDA including the vascularization index (VI), flow index (FI), and vascularization flow index (VFI) in 40 patients with endometrial cancer and 41 patients with uterine parenchyma lumps (endometrial polyps and submucosal myomas) were retrospectively analysed and compared utilizing Virtual Organ Computer-aided AnaLysis (VOCAL) software. The results showed that all the blood flow parameters (VI, FI, VFI) were significantly higher in women with endometrial cancer than in those with uterine parenchyma lumps (P<0.001). The area under the curve of ROC of VI, FI, and VFI was 0.98, 0.84, and 0.97, respectively. Thus, the best predictor of endometrial carcinoma was VI with a sensitivity of 97.0% and a specificity of 91.0%. The optimal cutoff value of VI was 4.06%. Our data demonstrated that all of the blood flow signal parameters (including VI, FI, and VFI) in 3D power Doppler ultrasonography had significant antidiastole values between endometrial cancer and uterine parenchyma lumps to assist clinicians in properly diagnosing patients.

Construction and application of immunization information system based on children cases collected by vaccination clinic clients in Shandong Province, China / 中华预防医学杂志

Construction and application of immunization information system is an important part of health information, which is very useful to improve the quality, efficiency and safety of vaccination. The background, system architecture, functions and applications, working conditions and characteristics of Shandong province Immunization Information System (IIS) are introduced in this article. It is expected to provide experiences for the development of immunization information system of other provinces.

Efficacy of ultrasound-guided modified anterior approach to sciatic nerve block for orthopedic sur-gery with general anesthesia / 中华麻醉学杂志

Objective To evaluate the efficacy of ultrasound-guided modified anterior approach to sciatic nerve block ( SNB) for orthopedic surgery with general anesthesia. Methods Ninety American So-ciety of Anesthesiology physical status Ⅰ or Ⅱpatients of both sexes, aged 18-64 yr, weighing 19-28 kg∕m2 , scheduled for elective knee joint or distal orthopedic surgery, were divided into 3 groups ( n=30 each) using a random number table method: modified anterior approach ( the puncture needle was almost perpendicular to the ultrasound beam) group, anterior approach group and posterior approach group. SNB ( injecting 0. 5％ ropivacaine 20 ml) combined with femoral nerve block ( injecting 0. 5％ ropivacaine 15-20 ml) was performed under ultrasound guidance. Surgery was completed under combination of the laryngeal mask and combined intravenous-inhalational anesthesia. When the respiratory rate ≥20 beats∕min and∕or the increase in heart rate was more than 20％ of the baseline value, sufentanil 1μg∕time was intravenously injected. When visual analog scale ( VAS) score ≥4 within 24 h after surgery, celecoxib capsules 0. 2 g was taken orally for analgesia. The depth of sciatic nerve, needling depth, sharpness score of needle ima-ging under ultrasound, and operation time and duration of SNB were recorded. VAS scores at rest and dur-ing activity were recorded at 6, 8, 10, 12 and 24 h after surgery. The amount of sufentanil consumed dur-ing surgery and use of celecoxib capsules within 24 h after surgery were recorded. The development of ad-verse reactions such as hematoma at the puncture site, nausea and vomiting was also recorded after surgery. Results Compared with posterior approach group, the depth of sciatic nerve and needling depth were sig-nificantly increased, the operation time of SNB was prolonged, the duration of SNB was shortened, the in-traoperative consumption of sufentanil was increased, VAS scores at rest and during activity were increased at 10 h after surgery, and the sharpness score of needle imaging was increased in modified anterior approach and anterior approach groups (P<0. 05). Compared with anterior approach group, the sharpness score of needle imaging was significantly increased, and VAS scores during activity were decreased at 24 h after sur-gery in modified anterior approach group ( P<0. 05) . There was no significant difference in the requirement for celecoxib capsules within 24 h after surgery or occurrence of adverse reactions among the three groups ( P>0. 05) . Conclusion Although ultrasound-guided modified anterior approach to SNB provides compara-ble efficacy with anterior approach to SNB and is not as good as posterior approach to SNB when used for or-thopedic surgery with general anesthesia, modified anterior approach to SNB is easy to operate, with clear images under ultrasound.

CT and MRI features of synovial sarcoma / 实用放射学杂志

Objective To analyze and evaluate the CT and MRI features of synovial sarcoma (SS).Methods Clinical and imaging data of 25 cases with SS confirmed by pathology were retrospectively analyzed.1 5 cases with CT scan,including 1 1 contrastGenhanced CT scan,and 1 2 cases with MRI scan,including 8 contrastGenhanced MRI scan.Results Among 25 cases,1 8 were located in the lower extremities,2 in the upper extremities and in the chest wall respectively,1 case in the lung parenchyma,mediastinum and spine respectively.1 8 cases were deep seated,while 1 9 cases were lobulated.On CT image,most of the lesions were isodense or hypodense to muscle,while 3 cases presented peripheral calcification,and 9 cases showed progressive enhancement.On MRI,10 cases were isointense or slight hypointense on T1 WI,while 9 cases presented hyperintense or slight hyperintense on T2 WI.9 cases showed cystic change (7 of them located in the periphery),and 8 cases showed short T1 signal.3 cases demonstrated "fluidGfluid levels",and 9 cases exhibited hypointense septa.7 cases revealed "triple sign"on T2 WI and 7 cases showed obviously heterogenous enhancement.Conclusion Synovial sarcomas are mostly located in the lower extremities,with clear margins,peripheral cystic changes,intramural hemorrhage,"triple sign"on T2 WI and progressive enhancement.

Efficacy of thunder-fire moxibustion combined with external applicaion of powder for mild and moderate knee osteoarthritis / 中国针灸

OBJECTIVE@#To compare the therapeutic effect between thunder-fire moxibustion combined with external applicaion of powder and thunder-fire moxibustion alone for mild and moderate knee osteoarthritis.@*METHODS@#A total of 70 patients with mild and moderate knee osteoarthritis were randomly divided into an observation group and a control group, 35 cases in each group. In the observation group, thunder-fire moxibustion combined with external applicaion of powder were applied, Thunder-fire moxibustion was applied at Xuehai (SP 10), Liangqiu (ST 34), Neixiyan (EX-LE 4), Yanglingquan (GB 34) and point, external applicaion of powder was given to the affected knee after the treatment of thunder-fire moxibustion. Simple thunder-fire moxibustion was given in the control group. All patients in the two groups were treated once a day, 7 days as one course and the consecutive 4 courses were required, with an interval of 1 day between courses. Before and after treatment, the visual analogue scale (VAS) score and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score were used to assessed knee pain, stiffness and physical function in the two groups. In addition, the efficacy was evaluated.@*RESULTS@#Compared before treatment, the VAS scores, total scores of WOMAC, pain scores, stiffness scores and physical function scores were reduced after treatment in the two groups (<0.01), and the scores in the observation group were significantly lower than those in the control group (<0.01, <0.05). The total effective rate was 97.0% (32/33) in the observation group, which was superior to 91.2% (31/34) in the control group (<0.05).@*CONCLUSION@#Thunder-fire moxibustion combined with external applicaion of powder are superior to simple thunder-fire moxibustion in improving the symptoms and delaying the development of the disease for mild and moderate knee osteoarthritis.

Development and Characterization of A Linear Matrix-assisted Laser Desorption Ionization Mass Spectrometer / 分析化学

Matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) is an important analytical technique for biological macromolecules,such as proteins,peptides and nucleic acid, especially in the field of microbial identification. Based on previous study,a linear MALDI-TOF MS has been designed and assembled for biological applications. The instrument comprises a vacuum system,a vacuum fast sample introduction system, an optical system, a time-of-flight mass analyzer, an ion source, a data acquisition system and an electric control system. The ion source adopts two-stage source acceleration,delayed extraction and dynamic pulse focusing technology. The time-of-flight distance of field-free drift region is about 1 meter. The optical system adopts a solid laser with adjustable frequency of 1-2000 Hz and spots of 20-100 μm. The angle of incidence laser is controlled at 5 degrees. A series of experiments are carried out to further evaluate the instrument performances. It can not only analyze the samples more than 199 kDa, but also achieve isotope resolution at 1000-3000 Da and up to 900(FWHM) at 5000-17000 Da. The minimum detectable concentration of gramicidin is 10 amol/μL, absolute sensitivity can reach up to 2. 56 amol. Independent detection of saliva samples from different targets shows that the instrument has high reproducibility. We identified Escherichia Coli and Shigella spp,which are two common bacteria but difficult to be differentiated by mass spectrometry,showing its potential identification for clinical microorganism. In a summary,this instrument can play a role on clinical examination in the near future.

Characteristics and influencing factors analysis of depressive symptoms among only-child-lost-persons / 重庆医学

Objective To explore the characteristics and influencing factors of depressive symptoms among the only-child-lost persons.Methods A total of 841 only-child-lost persons and 674 controls conforming to entering group condition were selected.The difference of SDS score between the two groups and the demographic characteristics distribution differences of depression severity in only-child-lost persons were compared and the influencing factors were analyzed.Results The SDS score had statistical difference between the only-child-lost persons group and control group(P＜0.05),and was correlated to the only-child-lost years and no physical disease;the proportion of mild to moderate depression in the only-child-lost persons of the low cultural level,somatic diseases and middle income level groups was significantly higher than that in the other groups;the only-child-lost persons with low income level,age≤60 years old and high educational level had a higher proportion of severe depression;the Logistic regression analysis showed that the educational level had a significant influence on the depression onset among the only-child-lost persons,the difference was statistically significant(P＜0.05).Conclusion The characteristics of depressive symptoms among the only-child-lost persons are related to their demographic characteristics.

Imaging features and pathological basis of seminoma / 实用放射学杂志

Objective To analyze the imaging findings and pathological basis of seminoma and improve the understanding and diagnostic accuracy.Methods The imaging findings of seminoma in 67 patients proved by histopathology were analyzed retrospectively.The tumor location,size,contour,periphery,density or signal and contrast enhancement patterns were evaluated,and these were compared with the pathological results.Results All of the 67 cases were male.46 cases were located in testicular,10 cases in the pelvic cavity,6 cases in the peritoneal and retroperitoneal,4 cases in the mediastinum,1 case in the brain.On non-enhanced CT,testicular lesions appeared to be nodular or lobular masses with clear margin.Some cases showed cystic-solid masses.And the solid component was located in the edge of the lesion,and the irregular necrosis areas of low density was located in the center.Fat and calcification component were not found in the mass.After contrast administration,the masses showed heterogeneous enhancement.The thickened and tortuous testicular arteries were seen in 11 cases in arterial phase,and thickened and twisted testicular veins were seen in 9 cases in the venous phase.The imaging findings of the mass at the other location were without features.Conclusion Testicular seminoma has significant characteristics,thickened testicular arteries and/or draining veins on enhanced CT can help the diagnosis.Imaging features of extragonadal primary seminoma are not characteristic.Combined with clinical history and signs,it is possible to improve the diagnostiic accuracy of seminoma.

Catastrophic antiphospholipid syndrome during pregnancy: a case report and literature review / 中华围产医学杂志

ObjectiveTo summarize the diagnosis, management and prognosis of catastrophic antiphospholipid syndrome (CAPS) in pregnant and postpartum women through a case report and literature review.MethodsThe reported case was a gravida who had a history of antiphospholipid syndrome and was admitted to the Peking University First Hospital in July 2017 due to CAPS in the second trimester. She was fully recovered and discharged after effective management. Clinical data was collected and analyzed. Relevant literatures regarding the diagnosis, treatment and prognosis of pregnancy-related CAPS were reviewed. Results(1) Case report: The patient had taken warfarin after the diagnosis of antiphospholipid syndrome but stopped the medication six months before conception. She was admitted at 22 weeks of gestation due to severe upper abdominal pain accompanied by nausea and vomiting and diagnosed with CAPS based on severe low platelet count and remarkably elevated liver enzymes. After a series of treatment, including anticoagulation, glucocorticoid, plasma exchange and cesarean section, the patient became stable and was fully recovered. (2) Literature review: After searching all published literatures, 13 relevant literatures which including 35 patients were finally reviewed. It is found that CAPS was a rare and life-threatening condition with rapid progression and the mortality rate was 6/14 during gestation and 9％ (2/21) after delivery. Anticoagulation, glucocorticoid, plasma exchange and immunoglobulin were the first-line treatment. Termination of pregnancy was required once CAPS was diagnosed.ConclusionsCAPS is a rare but life-threatening disease. Early diagnosis and timely termination of pregnancy are crucial for gravidas with CAPS.

Efficacy of flupentixol and melitracen in optimizing conventional treatment for postherpetic neural-gia / 中华麻醉学杂志

Objective To evaluate the efficacy of flupentixol and melitracen in optimizing conven-tional treatment for postherpetic neuralgia. Methods Seventy patients of both sexes with thoracolumbar postherpetic neuralgia, were divided into 2 groups ( n＝35 each) according to the registration order: pa-tients with odd number were included in control group ( group C) and patients with even number were in-cluded in flupentixol-melitracen group (group D). Patients in group C received conventional treatment: an-ti-epileptic drugs, analgesia with opioids, neurotrophy, paravertebral nerve block and physical therapy. Flupentixol-melitracen 10. 5 mg was taken orally based on the conventional treatment in group D. The time for treatment was recorded. The severity of pain was assessed by using the numeric rating scale, and anxiety and depression were evaluated using the Hospital Anxiety and Depression Scale before treatment and on 3rd and 7th days after treatment. The development of flupenthixol and melitracen-related adverse reactions was recorded during treatment in group D. Results Compared with group C, the numeric rating scale and Hos-pital Anxiety and Depression Scale scores were significantly decreased on 3rd and 7th days after treatment, and the time for treatment was shortened in group D (P＜0. 05). No flupenthixol-and melitracen-related ad-verse reactions were found in group D. Conclusion Flupentixol-melitracen can optimize the conventional therapeutic effect for postherpetic neuralgia.

Simultaneous Determination of 3 Components in Xiaoer Huadu Powder by HPLC / 中国药房

OBJECTIVE:To establish a method for simultaneous determination of paeoniflorin,berberine hydrochloride and ammonium glycyrrhizinate in Xiaoer huadu powder.METHODS:HPLC method was adopted.The separation was performed on Waters SunFireTM-C18 column with mobile phase consisted of acetonitrile-0.1％ phosphoric acid (gradient elution) at the flow rate of 1.0 mL/min.The detection wavelength was set at 238 nm,and column temperature was 25 ℃.The sample size was 10 μL.RESULTS:The linear ranges of paeoniflorin,berberine hydrochloride and ammonium glycyrrhizinate were 8.808-88.08 μg/mL(r=0.999 8),1.778-17.78 μg/mL(r=0.999 6),2.533-25.33 μg/mL(r=0.999 9),respectively.LOQ were 4.404,0.889,2.533 μg/mL;LOD were 1.101,0.445,1.267 μg/mL.RSDs of precision,stability and reproducibility tests were all lower than 2％.The recoveries were 95.08％-99.61％ (RSD=1.77％,n =9),96.93％-99.94％ (RSD=0.92％,n=9),98.33％-102.05％ (RSD=1.27％,n=9).CONCLUSIONS:The method is simple,accurate and reproducible,and can be used for simultaneous determination of paeoniflorin,berberine hydrochloride and ammonium glycyrrhizinate in Xiaoer huadu powder.