Objective: To optimize the extraction process of Yunpitongbian decoction.Methods: With the extraction yield and the contents of hesperidin and atractylenolide Ⅲ as the comprehensive evaluation indices, and based on the results of single factor tests, Box-Behnken response surface methodology was used to optimize the extraction process with the extraction duration, extraction times and liquid-solid ratio as the independent variables.Results: The optimum processing conditions were as follows: extracted three times with 15-fold amount of solvent and extraction time of 66 min.The measured value of comprehensive score was 1.198 40, which was close to the predicted value of 1.204 78.Conclusion: The optimized extraction process of Yunpitongbian decoction is simple and feasible with good predictability.

Objective To evaluate the value of PET-CT in patients with breast cancer and to determine if the PET-CT can provide additional information to predict early response to neoadjuvant chemotherapy (NAC).Methods NAC was given to 20 patients with breast cancer confirmed by biopsy puncture from September 2009 to March 2012.The PET-CT was carried out for all patients before NAC.TEC program with three weeks for one cycle was selected.After 6 days of the first cycle,the PET-CT was performed again.The changes of standard uptake value before and after the first cycle were compared.At the same time hand palpation was selected to detect the changes in tumor size before and after the first cycle of NAC.The changes of the standard uptake value and in tumor size need to refer to the pathology Miller & Payne classification methods to evaluate the efficacy of the NAC.Results The SUV were (7.51±1.76) Bq/ml and (4.98±1.61) Bq/ml before and after chemotherapy (t =7.916,P ＜ 0.05) the maximum tumor diameters were (9.62±4.38) cm and (8.89±4.08) cm before and after NAC (t =2.154,P＞ 0.05).SUV had highly correlated with pathological MP classification (r =0.725,P =0.000); while for the tumor size there was no significant change (r =0.026,P =0.824).Conclusion PET-CT can predict the efficacy earlier and is more accurate than clinical efficacy standard for the NAC.

Adult acquired aortic disease such as aortic dissection,aortic aneurysm,is common,and the treatment is complicated.Furthermore,the specific molecular etiology of this kind of disease is unknown.MicroRNA,which is a short peptide molecule,to some extent,participated in almost every aspect of biological functions.This paper aims to review the role of microRNA in molecular etiology of adult acquired aortic disease.

Objective To investigate the pathogenesis,diagnosis,treatment and prognosis of aort-oesophageal fistula(AEF).Methods Retropective analysis was performed on 6 patients presenting with AEF between January 2002 and December 2014,and relative literature was reviewed on its pathogenesis,di-agnosis,prognosis and treatment.Results Five men and 1 woman with a mean age of 49 (range,27-71 years)were recruited to the study.One case of AEF was caused by esophageal foreign body,2 cases were caused by aneurysm while the other 3 patients presented AEF after aortic surgery.All 6 patients showed he-matemesis,among whom 3 presented sentinel hemorrhage,1 presented exsanguination after sentinel hemor-rhage,2 presented sudden exsanguination.Among 4 patients with sentinel hemorrhage,2 accompanied with chest pain,1 with dysphagia and 1 with fever.Two patients had a history of hypertension.Diagnostic rate was nearly 100% by gastroscopy or CT/CTA.Four patients died from hemorrhagic shock and 2 patients re-covered from surgery.Conclusion AEF should be seriously considered for patients with a history of hyper-tension,aortic disease or esophageal foreign body presenting sentinel hemorrhage,chest pain,dysphagia,fa-tal exsanguination followed by symptom-free interval.Prompt examinations and aggressive surgery are of great significance for survival.

An analysis of the time pattern of outpatients visits to our hospital from 1997 to 2000 led to the discovery of the variation pattern of each outpatient departments workload. This discovery has enabled the managers of the hospital to rationally deploy the manpower and material resources of various departments, make full use of limited resources, readjust the working hours and shifts of different kinds of staff, and work out a flexible system of working hours which is more scientific and more convenient to patients. Implementation of such a system has ensured that prompt delivery of medical service is accessible to patients even at the peak of visiting hours. Hence the reduction of patients time of waiting and the provision of a scientific guarantee for establishing a quality, efficient, low consumption and fast outpatient service system, meeting the medical needs of patients to the maximum and enhancing work efficiency.

Objective To summarize surgical treatment of Takayasu arteritis,and analysis the drug treatment effect during the perioperative period.Methods Retrospective analysis 46 patients with Takayasu's arteritis disease and received cardiovascular surgery between January 2010 to December 2015,in Anzhen Hospital.By collecting their clinical characteristics,preoperative drug therapy,surgical treatment,pathological examination results to analyze operation conditions,effect of drugs and preoperative conditions.Results The perioperative mortality rate was 2.2％ and the complication rate was 23.9％ in 46 patients.There were 34 patients with symptomatic relief in the perioperative period,11 patients didn't take hormone drugs before operation.There were 11 cases of complications during the perioperative period,of which 7 patients were in active stage and 10 patients had not been used before operation.Conclusion The surgical treatment of patients with Takayasu's arteritis disease can effectively improve symptoms.The patients in Takayasu's arteritis active stage will affect the outcome of the surgery.Rational use of hormone drugs before surgery,can effectively control the patient's condition,improve the rate of remission of symptoms,and effectively reduce the incidence of perioperative complications.

ObjectiveTo explore the surgical techniques and clinical experiences in treating thoracoabdominal aorta dissecting aneurysm following Sun's procedure.MethodsFrom June 2009 to May 2011,thoracoabdominal aorta replacement was performed in thirteen patients with thoracoabdominal aorta dissecting aneurysm following Sun's procedure in Beijing Anzhen Hospital.Among which,eleven were male,and two were female with a mean age 39.3 years (28 -58 years).All cases were Stanford A aortic dissection,and were underwent Sun's Procedure.The pathogeny of the dissection,ten were Marfan's syndrome,and three were hypertension.Thoracoabdominal aorta dissecting aneurysms were all Crawford type Ⅱ,with the diameter( 5.78 ± 1.00 )cm (4.0 -8.0 cm).All the procedures were performed through combined thoracoabdominal incision via the retroperitoneal approach.And thoracoabdominal aorta was replaced by a tetrafurcate graft with short-time interval circulatory arrest.24 - 30 mm tetrafurcate grafts were selected in all patients.The main graft of the tetrafurcate graft was anastomosed to the elephant truck stent graft.Visceral arteries were joined into a patch and were anastomosed to the other end of the main graft.T6 to T12 intercostal arteries were reconstructed by an 8 mm sidearm.Another 8 mm sidearm was anastomosed to the left renal artery.Both 10 mm sidearms were anastomosed to iliac arteries.Among which,seven were underwent by profound hypothermia with circulatory arrest,and six were underwent off pump with normal temperature.ResultsNo early death.Twelve patients were cured and discharged from hospital.Seven patients were underwent profound hypothermia with circulatory arrest.Among which,one patient had paraplegia,sepsis,pseudomembranous colitis,respiratory failure,and died on 102-day after operation.Another one patient had neurological dysfunction and was cured after six-day's dehydrated treatment.The UFCT showed that the tetrafurcate graft was unobstructed,no distortion,no pseudoaneurysms in all patients.The branch to intercostal arteries was obstructed in three cases,but there were no spinal cord ischemia complications.The mean duration of follow-up was (9.6 ±2.1 ) months (range,1 -24 months),with a follow-up rate of 100％.All the tetrafurcate graft were very well,no obstruction,no distortion and no pseudoaneurysms.There were no cerebral,spiral cord and abdominal viscera ischemia complications in all patients.ConclusionThoracoabdominal aorta replacement after Sun's procedure is simple,and it is helpful to reduce complications.Following Sun's procedure,using tetrafurcate graft with short-time interval circulatory arrest and off pump technique in thoracoabdominal aorta replacement is simple,and it is helpful to reduce complications.

Respiratory infectious disease has become ahead of all the children′s diseases, with the trend of continuously increasing global incidence, antimicrobial resistance and simultaneous infection with multiple pathogens. Diagnosis of this disease is mainly based on clinical symptoms and pathogenic detection. However, there are some differences in clinical manifestations, progression and prognosis between pediatric patients and adults, which prompting clinical diagnosis mainly depending on clinical laboratory test. Therefore, fast, convenient and accurate methods are urgently needed to clarify the type of infectious pathogen and carry out differentiated treatment, and reduce the burden on families and public health-care systems in schools. This article aims to elaborate the laboratory methods of children′s respiratory infectious diseases and explore the opportunities and challenges, which can provide ideas for prevention, early screening and diagnosis, prognosis and treatment monitoring.

Objective To explore the application of perioperative nursing of trinity management mode with preoperative room-operating room-post-anesthesia room in operation department.Methods Preoperative room and post-anesthesia room were made up perianesthesia unit, together with the operation unit, set up the operation suite.Each unit has nursing policies, operation standards, nursing routine, working process and job description and evaluation separately.Results After the application of perioperative nursing of trinity management mode, 28 operation rooms with surgical operation quantity 25 553 million per year, with surgical operation quantity 103 per day, averaged surgery waiting time was 31 minutes, and operation room occupancy in day was 10.01 hours.The average awakening time of patients was ( 10 ±3 ) minutes, average time of intravenous drug delivery was (5.0 ±0.4) minutes, and 10 minutes per surgery was saved.Conclusions The application of trinity of perioperative nursing management mode in operation department is meet to the standards of international hospital, and ensure medical and nursing safety.

Respiratory infectious disease has become ahead of all the children′s diseases, with the trend of continuously increasing global incidence, antimicrobial resistance and simultaneous infection with multiple pathogens. Diagnosis of this disease is mainly based on clinical symptoms and pathogenic detection. However, there are some differences in clinical manifestations, progression and prognosis between pediatric patients and adults, which prompting clinical diagnosis mainly depending on clinical laboratory test. Therefore, fast, convenient and accurate methods are urgently needed to clarify the type of infectious pathogen and carry out differentiated treatment, and reduce the burden on families and public health-care systems in schools. This article aims to elaborate the laboratory methods of children′s respiratory infectious diseases and explore the opportunities and challenges, which can provide ideas for prevention, early screening and diagnosis, prognosis and treatment monitoring.