Objective: To establish a quantitative analysis of multi-components by single marker (QAMS) method for the determination of ten components in Xuefu Zhuyu Pills (XZP), which are paeoniflorin, ferulic acid, amygdalin, liquiritin, catalpol, β-ecdysone, hydroxysafflor yellow A, naringin, neohesperidin, and saikosaponin A, and to examine the feasibilities of the method for quality control of XZP. Methods: Using XZP as the research object, paeoniflorin was chosen as the internal reference substance by correction methods. The relative correlation factors (f) of ferulic acid, amygdalin, liquiritin, catalpol, β-ecdysone, hydroxysafflor yellow A, naringin, neohesperidin, and saikosaponin A to paeoniflorin were established. The contents of ten components in 16 batches of samples were determined by the external standard method and QAMS, and the measured values of the external standard method were compared with the calculated results of correction factor in order to test the accuracy of established method. The results were compared with the methods finally. Results: The f value of ferulic acid, amygdalin, liquiritin, catalpol, β-ecdysone, hydroxysafflor yellow A, naringin, neohesperidin, and saikosaponin A to paeoniflorin were 2.22, 1.73, 0.56, 3.55, 2.03, 2.31, 1.03, 1.68, and 1.13, respectively; There was no significant difference between the calculated value and the measured value of f by correction method. The contents of nine batches of catalpol, amygdalin, saikosaponin A, ferulic acid, naringin, neohesperidin, liquiritin, β-ecdysone, hydroxysafflor yellow A, and paeoniflorin were 0.47-0.72, 0.63-0.94, 0.37-0.74, 0.11-0.33, 1.15-1.37, 0.64-0.84, 1.47-1.88, 0.38-0.62, 0.17-0.34, and 1.16-1.48 mg/g, respectively. Conclusion: The QAMS method is feasible and credible, and could be used to determine and control the multiple components in XZP.

Objective: To develop a high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) method for the simultaneous determination of eight components (puerarin, tanshinone IIA, stibene glucoside, paeoniflorin, ginsenoside Re, ginsenoside Rg1, calycosin-7-glucoside, and baicalin) in Shenwu Jiannao Capsules (SJC). Methods: Chromatographic column: YMC-Triart C18, mobile phase: methanol-water (including 0.2% formic acid), and gradient elution, flow rate: 0.6 mL/min, column temperature: 40℃. MS condition: electrospray ionization (ESI) and multiple reaction monitoring (MRM) were adopted, the detected peak areas of ion pairs were used for quantitative determination. Results: There was a good linearity between the absorption peak area and the concentration for puerarin, tanshinone IIA, stibene glucoside, paeoniflorin, ginsenoside Re, ginsenoside Rg1, calycosin-7- glucoside, and baicalin in the ranges of 20.31-20 310, 25.66-25 660, 20.45-20 450, 50.79-50 790, 50.57-50 570, 50.38-50 380, 10.32-10 320, and 25.74-25 740 ng/mL, respectively (r ≥ 0.999 0). The precision was good and RSD was less than 2.0%. The repeatability was good and RSD was less than 2.0%. The stability was good in 24 h. The average recoveries were ranged from 97.98% to 102.48% (RSD ≤ 1.6%). The contents of puerarin, tanshinone IIA, stibene glucoside, paeoniflorin, ginsenoside Re, ginsenoside Rg1, calycosin-7-glucoside, and baicalin in six batches of samples were in the ranges of 1.843-1.860, 1.618-1.629, 2.116-2.129, 2.537-2.547, 0.034-0.041, 0.048-0.055, 0.551-0.564, and 2.333-2.346 mg/g, respectively. Conclusion: The method is rapid, simple, repeatable, and can be used to determine the multi components in different batches of SJC simultaneously.

Objective To evaluate the effect of surgical management of primary venous reflux disease in lower extremity. Methods Literatures about the surgical management of venous reflux disease in lower extremity were collected and reviewed. Results In patients with primary venous reflux disease,comprehensive surgical management of concomitant superficial,deep and perforating veins might greatly improve the clinical effect.Conclusion Comprehensive surgical management will be the direction of surgical management of primary venous reflux disease in lower extremity.

Brachiocephalic Trunk ; Fistula/surgery* ; Humans ; Trachea ; Tracheostomy

Objective: To investigate the related factors and treatments of delayed cerebrospinal fluid rhinorrhea (CFR) after invasive pituitary adenoma (IPA) surgery. Methods: One hundred and forty-two patients with IPA treated in Tianjin Huanhu Hospital from January 2014 to January 2019 were analyzed retrospectively, including 62 males and 80 females, aging from 38 to 67 years. The clinical data of patients before and after operation were collected. All patients with postoperative CFR underwent endoscopic CFR repair. During the operation, residual or recurrent pituitary adenomas were resected, the dura around the leak was enlarged and the necrotic tissue was removed. For those who still had fluid leakage after repair, the necrotic tissue was cleaned up, the leakage was filled and reinforced under endoscopy. Endoscopic rhinorrhea repair was performed if necessary. The cerebrospinal fluid leak was repaired with multi-layer materials. The related risk factors of delayed CFR after operation were analyzed. SPSS 19.0 software was used for statistical analysis. Results: Among the 142 patients in this group, 64 cases underwent total tumor resection and 78 cases underwent non-total tumor resection. They were followed up for 6 to 72 months. Thirty-one cases had delayed CFR, with an incidence of 21.83%, and occurred between 1 and 5 years postoperatively, with an average of 2.4 years. All 31 patients with delayed CFR underwent endoscopic CFR repair. The nasal endoscopy was rechecked at 2 weeks, 1 month, 3 months and 6 months after operation. Twenty-eight patients were repaired successfully after 1 operation, while 2 patients after 2 operations and 1 patient after 3 operations. These patients were followed up for 6 to 60 months, and no CFR occurred again. Univariate analysis showed that the degree of tumor resection, recurrence, size, texture, postoperative radiotherapy and operator experience were the risk factors of delayed CFR (all P<0.05). Multivariate analysis showed that the degree of tumor resection and recurrence were the highest independent risk factors for postoperative CFR, and tumor size, texture, postoperative radiotherapy and operator experience were the independent risk factors in this study. Conclusions: Delayed CFR after IPA is related to the degree of tumor resection, recurrence, size, texture, postoperative radiotherapy and the operator experience. It is necessary to completely remove the tumor under endoscope, to expand resection of the dura and necrotic tissue around the leak, to repair the defect with multi-layer materials, to follow-up closely and to repair timely after operation.
Adenoma/surgery* ; Adult ; Aged ; Cerebrospinal Fluid Leak ; Cerebrospinal Fluid Rhinorrhea/surgery* ; Female ; Humans ; Male ; Middle Aged ; Pituitary Neoplasms/surgery* ; Retrospective Studies

Objective: To indicate the clinical features of endoscopic transnasal resection of epidural cholesteatoma at paracentral skull base and to analyze its efficacy. Methods: The total excision rate, postoperative complications and postoperative curative effect of 7 patients (4 males and 3 females, aging from 32 to 63 years old) who underwent middle skull base surgery for epidural cholesteatoma resection under transnasal endoscope at Tianjin Huanhu Hospital between August 2017 and August 2020 were retrospectively reviewed. All patients were followed up for 6 to 36 months. The postoperative MRI, clinical symptoms and recurrence were reviewed. Descriptive statistical methods were used for analysis. Results: Among the 7 patients, there were total resection (complete resection of cyst contents and capsule) in 4 patients, near-total resection (complete resection of cyst contents, incomplete resection of cyst capsule) in 1 patient, and subtotal resection (incomplete resection of cyst contents and capsule) in 2 patients. The clinical symptoms of all patients were improved postoperatively with 1 patient who had no clinical symptoms. One case had postoperative cerebrospinal fluid rhinorrhea, which was cured after lumbar drainage and nasal iodoform gauge packing. Up to now, 7 patients (including patients with partial resection) had no recurrence. Conclusion: Endoscopic transnasal approaches may be effectively used for resection of epidural cholesteatoma in the paracentral skull base in carefully selected cases.
Adult ; Cholesteatoma ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Retrospective Studies ; Skull Base/surgery*

OBJECTIVETo Analyze the influence factors on the complications of percutaneous dilational tracheotomy.

METHODSBetween August 2008 and February 2014, there were 3 450 patients with the indications of tracheotomy accepted percutaneous dilational tracheostomy, mainly using percutaneous dilational and percutaneous guide wire forceps in these cases. Statistical analysis was performed by SPSS 19.0 software on postoperative complications, the possible influence factors including age, gender, etiology, preoperative hypoxia, obesity, preoperative pulmonary infection, state of consciousness, operation method, operation doctor and whether with tracheal intubation.

RESULTSAmong 3 450 patients, there were 164 cases with intraoperative or postoperative complications, including postoperative bleeding in 74 cases (2.14%), subcutaneous emphysema in 54 cases (1.57%), wound infection in 16 cases (0.46%), pneumothorax in 6 cases (0.17%), mediastinal emphysema in 5 cases (0.14%), operation failed and change to conventional incision in 4 cases (0.12%), tracheoesophageal fistula in 2 cases (0.06%), death in 3 cases(0.09%).Obesity, etiology, preoperative hypoxia, preoperative pulmonary infection, state of consciousness and operation method were the main influence factors, with significant statistical difference (χ(2) value was 0.010, 0.000, 0.002, 0.000, 0.000, 0.000, all P < 0.05). Gender, age, operation doctor and whether there was the endotracheal intubation were not the main influence factors. There was no significant statistical difference (P > 0.05).

CONCLUSIONAlthough percutaneous dilational tracheostomy is safe, but the complications can also happen. In order to reduce the complications, it is need to pay attention to the factors of obesity, etiology, preoperative hypoxia, preoperative pulmonary infection, state of consciousness and operation method.

Humans ; Intubation, Intratracheal ; Postoperative Complications ; epidemiology ; Subcutaneous Emphysema ; Surgical Instruments ; Tracheoesophageal Fistula ; Tracheostomy ; Tracheotomy ; methods ; statistics & numerical data

Objective: To analyze the activation of brain regions associated with olfactory in patients with mild cognitive impairment (MCI) by olfactory functional magnetic resonance imaging (fMRI). Methods: Twenty six patients with MCI were compared with twenty six controls in the dementia center of Tianjin HuanHu hospital in terms of olfactory function T&T testing, the differences between the activation of the whole brain and region of interest associated with olfactory (bilateral primary olfactory cortex(POC), bilateral hippocampus, bilateral orbital frontal gyrus) by olfactory stimulator using event correlation design for olfactory fMRI scanning. To analyze the correlation between the number of activator in POC and the threshold of olfactory discriminate as well as the severity of cognitive impairment.SPSS 19.0 software was used for the statistical analysis. Results: T&T olfactory testing revealed that MCI patients had higher scores than controls (3.57±1.29 (±s) vs 1.02±0.35, t=4.372, P<0.05). The activation range of whole brain in MCI patients was less than controls (pleasant odor (po) 147.36±21.45 vs 323.11±39.76, unpleasant odor (upo) 201.86±24.93 vs 447.73±57.22, t_po=4.241, t_upo=5.365, both P<0.05). The activation range of whole brain in inhaling unpleasant odor was more than pleasant odor in controls (447.73±57.22 vs 323.11±39.76, t=3.936, P<0.05). The number of activator in ROI_awo in MCI patients was less than controls (pleasant odor (po) 51.0[8.0, 109.0](M[P₂₅, P₇₅]) vs 135.0[21.0, 321.5], unpleasant odor (upo) 65.0[6.0, 158.0]vs 205.0[36.5, 491.0], Z_po=-2.199, Z_upo=-2.216, both P<0.05). The number of activator in POC in MCI patients was less than controls (pleasant odor (po) 19.0[4.0, 35.5]vs 46.0[9.0, 118.5], unpleasant odor (upo) 26.0[2.0, 51.0]vs 79.0[17.5, 189.0], Z_po=-1.898, Z_upo=-2.167, both P<0.05). The number of activator in POC was negatively correlated with olfactory discriminate threshold in MCI patients (r_po=-0.415, r_upo=-0.409, both P<0.05). The number of activator in POC was positively correlated with MoCA in MCI patients (r_po=0.289, r_upo=0.296, both P<0.05). Conclusion Olfactory fMRI can objectively assess the olfactory function in MCI, it is a imaging indicator with neuropsychological tests for detection in MCI, the number of activator in POC can reflect the severity of MCI.

OBJECTIVETo analyze the correlation between olfactory bulb(OB) volume with depth of olfactory sulcus (OS) and olfactory function in patients with idiopathic olfactory loss (IOL).

METHODSForty patients with IOL and forty normal controls were compared in terms of olfactory function T&T testing and magnetic resonance imaging (MRI, observation of OB volume and depth of OS). T&T testing and MRI were performed again after a year in 40 IOL patients, the results were compared with the first time.

RESULTSOB volume of left side in IOL patients was (30.31 ± 4.07) mm(3), right side was (30.82 ± 4.14) mm(3), average OB volume was (30.53 ± 4.10) mm(3); OB volume of left side in normal controls was (49.56 ± 7.19) mm(3), right side was (49.84 ± 7.25) mm(3), average OB volume was (49.73 ± 7.21) mm(3). OB volume was lower in IOL patients as compared to controls (t value were 8.122, 8.274, 8.231, all P < 0.01). OS depth study revealed no statistical different between IOL patients and controls (t value were 0.998, 1.017, 1.001, all P > 0.05). Olfactory discriminate threshold was negatively correlated with OB volume in IOL patients (r = -0.53, P < 0.05). There was no correlation with the depth of OS (r = -0.19, P > 0.05). Among 40 IOL patients, when followed-up, 12 showed increased in OB volume and olfactory function after a year, but no statistical difference was found with the first time (t value were 0.831, 0.864, 0.826, all P > 0.05). The other 28 patients showed no significant changes of OB volume and olfactory function.

CONCLUSIONSThe OB volume was lower in IOL patients as compared to normal controls. The depth of OS showed no significant changes in IOL patients. The OB volume was correlated with olfactory function. The depth of OS did not correlated with the olfactory function. Some IOL patients showed increased OB volume and improved olfactory function with the development of the disease.

Humans ; Magnetic Resonance Imaging ; Olfaction Disorders ; diagnosis ; Olfactory Bulb ; anatomy & histology ; Prefrontal Cortex ; anatomy & histology ; Smell

OBJECTIVETo evaluate the effectiveness of transsphenoidal endoscopic endonasal approach for the resection of Rathke cleft cysts (RCC).

METHODSThirty-five pathologically diagnosed RCCs were resected throuth transsphenoidal endoscopic endonasal approach at the HuanHu hospital between January 2000 and December 2011. The clinical data were retrospectively analysed. There were 12 male and 23 female. The average age was 45.7 years and the average disease course was 4.6 years. The typical clinical manifestations included headache (26 cases), visual interference (11 cases) and pituitary dysfunction (8 cases). The postoperative symptoms and follow-up results were recorded.

RESULTSAll of the patients underwent complete removal of the cyst contents, complete removal of the cyst wall in 20, fenestration and aspiration of the RCC with partial excision of the cyst wall in 15. The mean cyst volume was (1145.3 ± 12.1) mm(3) [range (121 - 4586) mm(3)]. One patient had cerebrospinal fluid leak, which was repaired using artificial dura mate of brain and gelatin sponge intraoperatively. No postoperative complications were found. Follow-up time ranged from half a year to 11 years. Headache resolved in 100% (26/26), visual interference resolved in 90.9% (10/11), pituitary dysfunction resolved in 62.5% (5/8). No patient recurred.

CONCLUSIONIt is concluded that the transsphenoidal endoscopic endonasal approach is microinvasive, safe and effective in the treatment of RCC.

Adolescent ; Adult ; Aged ; Central Nervous System Cysts ; surgery ; Endoscopy ; methods ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Young Adult