Objective:To study the effects of Naoling tablet on Aristolochia acid A from Aristolochia fangchi,preliminary explore the deintoxication of Aristolochia fangchi.Methods:Absorption value of Aristolochhia aicd A was determined by HPLC after Aristolochi fangchi decocted with Naoling tablet,the change of content of Aristolochia acid A was observed .Results:the content of Aristolochia acid A from Aristolochia fangchi was markedly decreased after Naoling tablet was added.Conclusion:Naoling tablet can markedly decreased the content of Aristolochhia aicd A from Aristolochia fangchi.

Objective To study the effects of Ziyin Bushen Pill on Aristolochia acid A in Aristolochia fangchi,and preliminary study on reducing poisonous effects of Ziyin Bushen Pill to Aristolochia fangchi.Methods Absorption of Aristolochhia acid A in the mingled decoction of Aristolochia fangchi and Ziyin Bushen Pill by HPLC,and the change of Aristolochia acid A was observed.Results Aristolochia acid A content of Aristolochia fangchi was markedly decreased after Ziyin Bushen Pill was added.Conclusion Ziyin Bushen Pill can markedly decreased Aristolochhia acid A content of Aristolochia fangchi.

Objective:To analyze the characteristics of local histological damage in patients with Mycobacterium abscessus infection caused by facial drug injection, and propose a treatment. Methods:The patients of Mycobacterium abscessus infection caused by facial injection of unknown drugs ( "osteolytic needles" ) admitted to Shaanxi Provincial People’s Hospital from September 2021 to June 2022 were analyzed retrospectively. Secretions were collected from the infected site for smear examination before surgery, and perform ultrasound, CT, MRI, and other related examinations. Surgical debridement was performed on the infected site under the assistance of endoscope and the guidance of B-ultrasound. During the operation, the infection was demonstrated to affect the facial superficial musculoaponeurotic system, even the deep muscle and bone tissue. The necrotic and degenerative tissue was completely removed and then the secretion was sent to bacterial culture and drug susceptible test, and the resected tissue was sent to pathological examination for HE staining. After debridement, the wound was not sutured. The vacuum sealing drainage (VSD) technique was used to treat the wound. The cavity was irrigated with 50 ml of normal saline+ 100 000 U of amikacin, and the wound was sutured after the wound was completely healthy and the secretion culture was negative. Drug treatment: first, according to the results of secretion smear examination (positive acid-fast bacteria), empirically apply cefoxitin or amikacin injection. After the infection was confirmed by bacterial culture, oral clarithromycin and minocycline were added, and bicyclol tablets were orally administered to protect liver function. Intravenous drip of cefoxitin or amikacin injection during hospitalization according to the results of drug susceptible test. After discharge, clarithromycin or minocycline and bicyclol tablets were used for 3-6 months, and the blood routine test and liver and kidney functions were examined every 2 weeks. Regular outpatient re-examination was carried out to observe whether there is a recurrence of infection and the recovery of facial appearance in the wound. Results:A total of 10 patients were included, including 1 male and 9 females, aged 19-28 years, with an average age of 25.3 years. The clinical manifestations were local redness and swelling in the zygomatic, buccal, periocular, or anterior temporal regions, low skin temperature, skin ulceration, purulent secretions, and palpable induration. CT and MRI results showed varying degrees of swelling and fluid accumulation in facial soft tissues, as well as locally structural and bone destruction. The results of secretion culture showed all patients were infected with Mycobacterium abscessus. Drug susceptible test results: sensitive to minocycline, cefoxitin, amikacin. HE staining showed exudative, proliferative and necrotic lesions, chronic suppurative inflammation and mixed granuloma lesions. Ten patients were hospitalized for 12-28 days, and their facial infections were well controlled. The wound healing was good. After 6 months of follow-up, there was no recurrence of facial infections and their appearance was generally normal. Conclusion:The local tissue damage caused by facial injection of unknown drug Mycobacterium abscessus infection is characterized as multiple layers, multiple sinuses, and bone destruction. Based on external debridement during treatment, drugs that are sensitive to Mycobacterium abscessus and have relatively small adverse reactions can be selected based on drug susceptible test results. Adherence to long-term and standardized treatment can achieve good results.

Objective:To analyze the characteristics of local histological damage in patients with Mycobacterium abscessus infection caused by facial drug injection, and propose a treatment. Methods:The patients of Mycobacterium abscessus infection caused by facial injection of unknown drugs ( "osteolytic needles" ) admitted to Shaanxi Provincial People’s Hospital from September 2021 to June 2022 were analyzed retrospectively. Secretions were collected from the infected site for smear examination before surgery, and perform ultrasound, CT, MRI, and other related examinations. Surgical debridement was performed on the infected site under the assistance of endoscope and the guidance of B-ultrasound. During the operation, the infection was demonstrated to affect the facial superficial musculoaponeurotic system, even the deep muscle and bone tissue. The necrotic and degenerative tissue was completely removed and then the secretion was sent to bacterial culture and drug susceptible test, and the resected tissue was sent to pathological examination for HE staining. After debridement, the wound was not sutured. The vacuum sealing drainage (VSD) technique was used to treat the wound. The cavity was irrigated with 50 ml of normal saline+ 100 000 U of amikacin, and the wound was sutured after the wound was completely healthy and the secretion culture was negative. Drug treatment: first, according to the results of secretion smear examination (positive acid-fast bacteria), empirically apply cefoxitin or amikacin injection. After the infection was confirmed by bacterial culture, oral clarithromycin and minocycline were added, and bicyclol tablets were orally administered to protect liver function. Intravenous drip of cefoxitin or amikacin injection during hospitalization according to the results of drug susceptible test. After discharge, clarithromycin or minocycline and bicyclol tablets were used for 3-6 months, and the blood routine test and liver and kidney functions were examined every 2 weeks. Regular outpatient re-examination was carried out to observe whether there is a recurrence of infection and the recovery of facial appearance in the wound. Results:A total of 10 patients were included, including 1 male and 9 females, aged 19-28 years, with an average age of 25.3 years. The clinical manifestations were local redness and swelling in the zygomatic, buccal, periocular, or anterior temporal regions, low skin temperature, skin ulceration, purulent secretions, and palpable induration. CT and MRI results showed varying degrees of swelling and fluid accumulation in facial soft tissues, as well as locally structural and bone destruction. The results of secretion culture showed all patients were infected with Mycobacterium abscessus. Drug susceptible test results: sensitive to minocycline, cefoxitin, amikacin. HE staining showed exudative, proliferative and necrotic lesions, chronic suppurative inflammation and mixed granuloma lesions. Ten patients were hospitalized for 12-28 days, and their facial infections were well controlled. The wound healing was good. After 6 months of follow-up, there was no recurrence of facial infections and their appearance was generally normal. Conclusion:The local tissue damage caused by facial injection of unknown drug Mycobacterium abscessus infection is characterized as multiple layers, multiple sinuses, and bone destruction. Based on external debridement during treatment, drugs that are sensitive to Mycobacterium abscessus and have relatively small adverse reactions can be selected based on drug susceptible test results. Adherence to long-term and standardized treatment can achieve good results.