Objective To compare the effects of different methods of honey sunburn on the contents of calycosin and formononetin in Hedysari Radix; To provide the basis for the establishment of the optimum processing technology. Methods By frying (traditional method), baking, and microwave methods put Hedysari Radix under honey sunburn. Agilent HC-C18 column (4.6 mm × 250 mm, 5 μm) was used; the mobile phase was acetonitrile-0.01% phosphoric acid solution, gradient elution (0–12 min, 30%–33% acetonitrile; 12–13 min, 31%–40% acetonitrile; 13–25 min, 40% acetonitrile) with velocity of 1.0 mL/min; detection wavelength was 248 nm;the column temperature was 30 ℃; sample volume was 10 μL. Results There was statistical significance in the contents of calycosin and formononetin of different methods of honey sunburn for Hedysari Radix. Among them, the contents of calycosin and formononetin in Hedysari Radix processed by honey roast were the highest, 7.9116 and 49.6996 μg/g, respectively; the contents of calycosin and formononetin in Hedysari Radix processed by traditional method were the lowest, 4.7767 and 37.2910 μg/g, respectively; the contents of calycosin and formononetin in raw Hedysari Radix and Hedysari Radix by honey microwave method were the same, 5.0802, 42.7989 μg/g, and 3.9839, 42.3145 μg/g, respectively. Conclusion Different honey sunburn methods for the contents of calycosin and formononetin in Hedysari Radix have certain effects, and honey roast method is the optimum method.

Objective To investigate the feasibility and therapeutic effect of stenting therapy by using modified Y-shaped self-expandable metal stent for the stenosis of gastroenteric stoma. Methods According to the particular anatomic structures and the pathological features of the narrowed gastroenteric stoma,the authors designed a modified Y-shaped self-expandable metal stent. Under the fluoroscopic guidance,implantation of modified Y-shaped self-expandable metal stent was performed in 5 patients with narrowed gastroenteric stoma. The technical safety and the clinical results were evaluated. Results The modified Y-shaped self-expandable metal stent was successfully implanted with one procedure in all five patients. After the implantation the symptoms such as nausea,vomiting,abdominal distension were promptly relieved,and the patients' living quality was markedly improved. Conclusion The stenting therapy with modified Y-shaped self-expandable metal stent can rapidly relieve the stenosis of gastroenteric stoma once for all. The technique is feasible and the short-term effect is reliable,therefore,it is worth popularizing this therapy in clinical practice.

Objective To investigate the optimal window width and window level for measuring the airway dimensions with spiral CT scan in Japanese white big-ear rabbits so as to lay the foundation for airway stenting in animal experiments. Methods Multi-slice spiral CT scanning of cervico-thoracic region was performed in 30 healthy adult Japanese white big-ear rabbits, the anteroposterior and transversal diameter of the thoracic trachea, the anteroposterior diameter of the right and left bronchus were measured with lung window, mediastinum window and special fat window separately. The revealing rate of the tracheal wall and the measuring results in different windows and levels were recorded and compared with the anatomical data. The differences of the relevant data were statistically analyzed. Results With lung window, the tracheal wall was well demonstrated, but the relevant data were smaller than that with mediastinum window. With mediastinum window, the data were bigger and the tracheal wall border appeared blurred. The results obtained with fat window were close to the actual anatomical data. Conclusion For accurately measuring the anteroposterior and transversal diameter of the thoracic trachea in Japanese white big-ear rabbits with multi-slice spiral CT scan, fat window should be adopted, which is helpful for the preparation of tracheal and bronchial stents.

BACKGROUND:Foreign studies have found that the magnesium alloy stent is safe and effective, but there are few studies on the degradation performance of magnesium alloy stents in China.OBJECTIVE:To investigate the degradation of degradable AZ31 magnesium alloy stent in the rabbit abdominal aorta and the effect of degradation process on vascularization.METHODS:Twenty-eight rabbits were enrolled, and the degradable AZ31 magnesium alloy stent was implanted into the rabbit abdominal aorta. Postoperative abdominal aortic X-ray examination and histological observation were done at 30, 60, 90, 120 days after implantation.RESULTS AND CONCLUSION:(1) X-ray examination: 30 days after implantation, the stent expanded completely with structural integrity; 60 days after implantation, the stent deformation, partial stent fracture, and lose of support were found; 90 days after implantation, only a small amount of support rod residues were found, and the majority of the stent was degraded; and 120 days after implantation, there was no support rod residual, and the stent was degraded completely. (2) Histological observation: 60 days after implantation, the number of residual support rods was less than that 30 days after implantation (P< 0.05), the number value at 90 days after implantation was lower than that at 30 and 60 days after implantation (P< 0.05), and the number value at 120 days after implantation was lower than that at 30, 60, 90 days after implantation (P < 0.05), indicating that the number of residual support rods was negatively correlated with post-implantation days. The time for complete stent degradation was 124.8 days. The intimal area at 90 days after implantation was higher than that at 30, 60, 120 days after implantation (P < 0.05), while the lumen area was smaler than that at 30, 60, 120 days after implantation (P < 0.05). There was no significant difference in the intimal area and lumen area at latter three time points after implantation. To conclude, the degradation of the degradable AZ31 magnesium alloy stent in the rabbit abdominal aorta can be completed within 124.8 days, and at 90 days after the stent is implanted, vascular intimal hyperplasia and lumen stenosis are most serious, and then gradualy reduced.

Twelve ASA Ⅳ or Ⅴ patients with severe airway stenosis, aged 34-87 yr, weighing 50-80 kg,were enrolled in the study. The guidewire and endotracheal tube were inserted through the oral cavity under the guidance of the method of interventional radiology. The expandor was then exchanged and the endotracheal tube was placed in the suitable position within the trachea along the expandor under X-ray guidance. Endotracheal intubation was technically successful in all patients, without serious complications in the process. The intubation time was 1-5 min.

Objective:To analyze the application effect of intelligent acceptance equipment for orthopedic medical equipment combined with medical device unique device identifier(UDI)code in the management of orthopedic medical devices.Methods:Based on the UDI code,the UDI application process of orthopedic medical devices was formulated,and all operations such as inspection and accurate billing of orthopedic medical devices were completed through the identification and comparison of intelligent acceptance equipment for orthopedic medical devices.A total of 8 317 orthopedic instruments used in orthopedic surgery in Wangjing Hospital of China Academy of Chinese Medical Sciences from September to December 2023 were selected.According to the different time of the implementation of intelligent acceptance equipment for orthopedic medical devices,the 4 072 orthopedic devices used from September to October 2023 was marked as before implementation and adopted the traditional management mode,the 4 245 orthopedic devices used from November 2023 to December 2023 were marked as before implementation and adopted the intelligent acceptance management mode.The management effect and incidence of adverse events were compared before and after the implementation of intelligent acceptance equipment for orthopedic medical devices.Results:The total effective rate of management after the implementation of intelligent acceptance equipment for orthopedic medical instruments was 98.78%,which was significantly higher than that before the implementation,the difference was statistically significant(x2=272.03,P<0.01).The total incidence of adverse events after the implementation of the intelligent acceptance equipment for orthopedic medical devices was 8.83%,which was significantly lower than that before the implementation,the difference was statistically significant(x2=281.38,P<0.01).Conclusion:The intelligent acceptance device combined with UDI code for orthopedic medical devices can achieve efficient distribution,accurate acceptance and billing,reduce the occurrence of adverse events,meet the requirements of the whole process traceability management of one thing and one code,and improve the management level orthopedic medical devices.

Objective To optimize the processing technology of honey baked Hedysari Radix, so as to provide the experimental basis for the quality control of Hedysari Radix processed products and standardization of the processing.Methods L9 (34) orthogonal design method was used, and the mean content of calycosin and formononetin which were detected by HPLC with gradient elution were taken as the comprehensive evaluation indexes, the processing technology was optimized.Results The optimum processing technology of honey baked Hedysari Radix was thickness of 3 cm at the temperature of 70 ℃ for 2.5 h.Conclusion Hedysari Radix baking processed products produced by the optimum technology met with the requirement of Chinese Pharmacopoeia (2015 Edition), which was simple, feasible, and repeatable.The method would provide evidence for further research on optimum processing technology and for standardiztion of industrial production.

Objective:To examine the role of the number of lymph nodes examined(NLNE) on the prognosis of patients with curatively resected gallbladder carcinoma(GBC).Methods:The clinicopathological data and prognosis of 401 patients with GBC who underwent radical surgery from six institutions of China from January 2013 to December 2017 were analyzed retrospectively. There were 153 males(38.2%) and 248 females(61.8%), with age of (62.0±10.5) years (range: 30-88 years). Fifty-three patients(22.2%) were accompanied by jaundice. All patients underwent radical resection+regional lymphadenectomy.R0 or R1 resection was confirmed by postoperative pathological examination.The different cut-off values of NLNE were determined by the X-tile software, the optimal cut-off values were identified by analyzing the relationship between different cut-off values of NLNE with survival rate. Kaplan-Meier method was used for survival analysis. Univariate and multivariate analysis were implemented respectively using the Log-rank test and Cox proportional hazard model.Results:Among the 401 patients enrolled, 135 cases (33.6%) had lymphatic metastasis, of which 98 cases were in N1 stage(24.4%) and 37 cases were in N2 stage(9.2%).A total of 2 794 NLNE were retrieved, with a median count of 6 (5).The median positive lymph nodes count was 0 (1), and the median positive lymph nodes ratio was 0 (IQR, 0-0.2). Since the 12 and 15 were determined as the cut-off values by X-tile, all patients were divided into three groups of 1-11, 12-15 and ≥16.The 3-year survival rate of the three groups was 45.2%, 74.5%, 12.0% respectively, with statistically significant difference between three groups (χ 2=10.94, P<0.01). The results of multivariate analysis showed that NLNE was an independent prognostic factor for overall survival ( P<0.05). Further analysis was performed specifically for subgroup of T stages. For T1b patients, the prognosis of the NLNE with 1-7 group was significantly better than that of the ≥8 group(χ 2=4.610, P<0.05). For T2 patients, the prognosis of the TLNE ≥7 group was significantly better than that of 1 -6 group (χ 2=4.287, P<0.05). For T3 and T4 patients, the prognosis of the TLNE with 12 - 15 group was significantly better than that of 1 -11 group (χ 2=5.007, P<0.01) and ≥16 group (χ 2=10.158, P<0.01). Conclusions:The NLNE is an independent factor affecting the prognosis of patients with GBC.For patients with stage T1b,8 lymph nodes should be retrieved; for patients with stage T2,extensive dissection of more than 6 lymph nodes can significantly improve the prognosis.For advanced patients (stages T3 and T4), extensive dissection with 12-15 lymph nodes is recommended. However, it fails to get more survival benefits by dissecting more than 16 lymph nodes.

Objective:To examine the role of the number of lymph nodes examined(NLNE) on the prognosis of patients with curatively resected gallbladder carcinoma(GBC).Methods:The clinicopathological data and prognosis of 401 patients with GBC who underwent radical surgery from six institutions of China from January 2013 to December 2017 were analyzed retrospectively. There were 153 males(38.2%) and 248 females(61.8%), with age of (62.0±10.5) years (range: 30-88 years). Fifty-three patients(22.2%) were accompanied by jaundice. All patients underwent radical resection+regional lymphadenectomy.R0 or R1 resection was confirmed by postoperative pathological examination.The different cut-off values of NLNE were determined by the X-tile software, the optimal cut-off values were identified by analyzing the relationship between different cut-off values of NLNE with survival rate. Kaplan-Meier method was used for survival analysis. Univariate and multivariate analysis were implemented respectively using the Log-rank test and Cox proportional hazard model.Results:Among the 401 patients enrolled, 135 cases (33.6%) had lymphatic metastasis, of which 98 cases were in N1 stage(24.4%) and 37 cases were in N2 stage(9.2%).A total of 2 794 NLNE were retrieved, with a median count of 6 (5).The median positive lymph nodes count was 0 (1), and the median positive lymph nodes ratio was 0 (IQR, 0-0.2). Since the 12 and 15 were determined as the cut-off values by X-tile, all patients were divided into three groups of 1-11, 12-15 and ≥16.The 3-year survival rate of the three groups was 45.2%, 74.5%, 12.0% respectively, with statistically significant difference between three groups (χ 2=10.94, P<0.01). The results of multivariate analysis showed that NLNE was an independent prognostic factor for overall survival ( P<0.05). Further analysis was performed specifically for subgroup of T stages. For T1b patients, the prognosis of the NLNE with 1-7 group was significantly better than that of the ≥8 group(χ 2=4.610, P<0.05). For T2 patients, the prognosis of the TLNE ≥7 group was significantly better than that of 1 -6 group (χ 2=4.287, P<0.05). For T3 and T4 patients, the prognosis of the TLNE with 12 - 15 group was significantly better than that of 1 -11 group (χ 2=5.007, P<0.01) and ≥16 group (χ 2=10.158, P<0.01). Conclusions:The NLNE is an independent factor affecting the prognosis of patients with GBC.For patients with stage T1b,8 lymph nodes should be retrieved; for patients with stage T2,extensive dissection of more than 6 lymph nodes can significantly improve the prognosis.For advanced patients (stages T3 and T4), extensive dissection with 12-15 lymph nodes is recommended. However, it fails to get more survival benefits by dissecting more than 16 lymph nodes.