Objective: To develop an HPLC method for the simultaneous determination of 3 anthraquinones components in Knoxia valerianoides.Methods: The separation was performed on a Waters Xbridge C18column(250 mm×4.6 mm,5 μm), the mobile phase A was 0.05% phosphoric acid, and acetonitrile served as the mobile phase B, and the analysis was with gradient elution;the flow rate was 1.0 ml·min-1;the detection wavelength was 280 nm;the column temperature was 30℃.Results: The linearity of lucidin, 3-hydroxymorindone and knoxiadin was 0.147-29.400 μg·ml-1 (r=0.999 6), 0.126-25.200μg·ml-1 (r=0.999 9) and 0.135-27.000μg·ml-1 (r=0.999 5), and the average recovery was 98.50%(RSD=1.20%), 98.72%(RSD=0.73%) and 101.10%(RSD=1.12%)(n=6), respectively.Conclusion: The developed method for the simultaneous determination of 3 components can be used to control the quality of Yunnan Knoxia valerianoides.

Objective To study the relationship between thyroid hormone level and 24h urine protein quanti-tation in patients with severe preeclampsia. Methods From August 2015 to October 2017,180 patients with severe preeclampsia who were treated in the Third People's Hospital of Qingdao were selected. The level of thyroid-stimula-ting hormone ( TSH) was detected by chemiluminescence particles immune method. According to the test results,the patients were divided into normal group (n=110,TSH=0. 3-3. 3mU/L) and hypothyroidism group (n=70,TSH>3. 3mU/L). Another 240 healthy pregnant women who admitted in the Third People's Hospital of Qingdao during the same period were selected as control group. The TSH,free triiodothyronine (FT3),free thyroxine (FT4) levels and 24h urine protein quantitation were compared among the three groups. The correlation between the level of thyroid hormone and 24h urine protein quantitation,the results of thyroid autoantibody in patients with severe preeclampsia were analyzed.Results The FT4,FT3 levels in the normal group were (11.92±2.54)pmol/L,(5.22 ±1.25)pmol/L, respectively,which in the hypothyroidism group were (9. 02 ± 1. 09) pmol/L,(3. 92 ± 1. 57) pmol/L,respectively, which were all lower than those in the control group (t=6. 657,16. 758,13. 221,18. 245,all P<0. 05),which in the hypothyroidism group were lower than those in the normal group (t=9. 031,6. 149,all P<0. 05). The TSH,24h urine protein quantitation levels in the normal group were (2. 56 ± 0. 86) mU/L,(66. 51 ± 18. 52) mg,respectively, which in the hypothyroidism group were (5. 87 ± 3. 02) mU/L,(79. 14 ± 12. 58) mg,respectively,which were all higher than those in the control group(t=2. 330,7. 197,16. 417,13. 335,all P<0. 05),which in the hypothyroidism group were higher than those in the normal group (t=10. 883,5. 014,all P<0. 05). There was positive correlation between serum TSH and 24h urine protein quantitation in patients with severe preeclampsia (r=0. 254,P=0. 001). There was negative correlation between FT4 and 24h urine protein quantitation (r= -0. 182,P=0. 025). There was no correlation between serum FT3 and 24h urine protein quantitation (r= -0. 080,P=0. 330). The positive rates of TPO Ab,TG Ab were 12. 86％,18. 57％ in hypothyroidism group,there were no statistically significant differences compared with 10. 91％,14. 55％ in the normal group (χ2 =0. 158,0. 513;P=0. 691,0. 474). Conclusion There is correlation between thyroid hormone levels and 24h urine protein quantitation in patients with severe preeclampsia. It has great significance for clinical treatment of severe preeclampsia by detecting the level of thyroid hormone.

OBJECTIVETo investigate the safety, feasibility and long-term outcomes of laparoscopic complete mesocolic excision for the transverse colon cancer.

METHODSClinical data of 61 patients who underwent laparoscopic complete mesocolic excision for transverse colon cancer (transverse group) in our department from January 2011 to January 2014 were retrospectively analyzed, which were compared with those of 155 patients undergoing laparoscopic complete mesocolic excision for ascending colon cancer (ascending group) and 230 patients undergoing laparoscopic complete mesocolic excision for sigmoid colon cancer (sigmoid group). Differences in operative details, postoperative recovery, postoperative complications and long-term survival among 3 groups were evaluated.

RESULTSNo significant differences in the baseline information were found among 3 groups(all P>0.05). The average operative time was significantly longer in transverse group as compared to ascending group and sigmoid group [(192.1±58.7) min vs. (172.2±54.7) min and (169.1±53.6) min]( P<0.05), while the blood loss [(89.7±63.6) ml, (86.3±66.3) ml, (82.6±61.5) ml], conversion rate [3.3%(2/61), 2.6%(4/155), 2.2%(5/230)], number of harvested lymph node (13.0±4.7, 14.4±6.5, 13.4±5.6), time to flatus [(2.7±1.1) d, (2.6±1.1) d, (2.5±1.0) d], time to liquid diet [(3.0±1.7) d, (2.8±1.5) d, (2.7±1.4) d], incidence of postoperative complication(6.6%, 9.0%, 11.7%), and hospital stay [(11.6±5.8) d, (10.7±5.8) d, (10.6±5.7) d] among 3 groups were not significantly different (all P>0.05). A total of 436 patients received postoperative follow-up of median 36 (5 to 67) months. The overall 5-year survival rate was 73.1%, 73.7% and 74.8%, and the 5-year disease-free survival rate was 71.5%, 71.1% and 72.7% in transverse, ascending and sigmoid colon cancer groups respectively, whose differences were not significant among 3 groups (all P>0.05).

CONCLUSIONLaparoscopic complete mesocolic excision for transverse colon cancer is safe and feasible with slightly longer operation time, and has quite good long-term oncologic efficacy.

Colectomy ; methods ; Colon, Ascending ; surgery ; Colon, Sigmoid ; surgery ; Colon, Transverse ; surgery ; Colonic Neoplasms ; surgery ; Comparative Effectiveness Research ; Disease-Free Survival ; Humans ; Laparoscopy ; methods ; Length of Stay ; Lymph Node Excision ; Lymph Nodes ; Mesocolon ; surgery ; Operative Time ; Postoperative Complications ; Postoperative Period ; Retrospective Studies ; Survival Rate ; Treatment Outcome

Objective To evaluate the efficacy and safety of transthoracic echocardiography (TTE) guided by transcatheter closure of patent ductus arteriosus (PDA) through the femoral artery.Methods From February 2016 to December 2017,53 patients with simple PDA were selected,the funnel type in 30 cases,cast type in 23 cases.All patients were guided by TTE and transcatheter closure of PDA through the femoral artery.The femoral artery was guided by TTE by establishing the orbit of the femoral artery-catheter-pulmonary artery to the right ventricle.The right ventricular septal defect was placed under the femoral artery approach,and the therapeutic effect was evaluated by echocardiography after occlusion.The outpatient visits were made at 1,3,and 6 months after operation.Results PDA closure was successfully completed under TTE guidance in 53 patients.In one adult PDA,the ultrasonic diagnosis of the inner diameter of the catheter was incorrect due to the image quality,which resulted in the replacement of the occluded device several times,but the occlusion was successful.The operative time was (30 ± 10)min.And the back diameter of the transcatheter closure device was (12 ± 6) mm and the murmur of the transmission sheath disappeared.There was no shunt between the main pulmonary artery and the main pulmonary artery,and the length of hospitalization was 3-4 days.No shunt signal was found at 1,3 and 6 months follow-up.Left atrial diameter (LAD) [(25.8 ± 6.1) mm vs (30.6 ± 8.4) mm] and left ventricular end diastolic diameter (LVEDD) [(38.5 ±9.1)mm vs (45.2 ± 11.5)mm],were decreased significantly (P ＜0.05).Conclusions It is safe and effective to block PDA by using femoral artery approach under the guidance of TTE,which avoids the damage of X-ray and contrast agent,and its prospect of clinical application is promising.

Osteonecrosis of the femoral head (ONFH) is one of the common and difficult-to-treat orthopedic diseases caused by a variety of factors that lead to abnormal blood flow to the femoral head, which in turn leads to deformation and collapse of the femoral head and eventually results in severe hip joint dysfunction. The key to the treatment is early diagnosis and correct treatment according to the stage classification and active prevention of further aggravation of ONFH aiming to delay or avoid hip replacement surgery in young and middle-aged patients. At present, there are various non-surgical and surgical hip-preserving modalities for early ONFH, designed to slow down the progression of the disease, prevent the femoral head from collapsing and stop the mild collapse. In recent years, with the emergence and development of bone reconstruction biomaterials, artificial bone reconstruction after scraping of ONFH lesions has shown great potential in the treatment of early ONFH. The authors review the research progress in hip-preserving modalities for early ONFH in young and middle-aged patients from non-surgical and surgical perspectives, hoping to provide a reference for clinical treatment of early ONFH.

Objective    To investigate the clinical efficacy and application value of percutaneous interventional treatment for structural heart diseases under guidance of ultrasound. Methods    The clinical data of 1 010 patients with structural heart diseases treated by transcutaneous ultrasound-guided occlusion in our hospital from December 2, 2015 to December 31, 2019 were retrospectively reviewed, including 360 males and 650 females, aged 1-50 years. There were 692 patients of atrial septal defect (603 with central type, 9 combined with arterial catheter, 80 with ethmoid type), 116 patent foramen ovale, 25 ventricular septal defects (3 combined with atrial septal defect), 132 patent ductus arteriosus, 32 pulmonary valve stenosis (3 combined with atrial defect), 1 main pulmonary artery window, and 3 aneurysm rupture of aortic sinus. All patients were diagnosed by transthoracic echocardiography (TTE) before operation. Treatment was accomplished intraoperatively through TTE or transesophageal echocardiography (TEE) via the femoral artery or femoral vein. After operation, echocardiography, electrocardiogram and chest radiograph were reexamined. Results    Satisfactory results were obtained in 1 005 patients, and 1 patient failed to seal the ventricular defect and was repaired under direct vision, occluder detachment occurred in 5 patients after operation (3 patients of atrial septal defects underwent thoracotomy for Amplatzer device and were repaired, 1 patient of atrial septal defects was closed after removing Amplatzer device, 1 patient of patent ductus arteriosus underwent thoracotomy for Amplatzer device and was sutured), mild pulmonary valve regurgitation occurred after balloon dilation in 2 patients with pulmonary stenosis, a small amount  of residual shunt was found in 2 patients with ventricular defect, which disappeared after 3 months of follow-up, and 1 patient of right bundle branch block occurred and disappeared after 1 week. After follow-up of 1-24 months, 3 patients of ethmoidal atrial septal defect were reexamined with mild shunt. The occluder was in good position and the pressure difference of pulmonary valve was significantly reduced. There was no complication such as hemolysis, arrhythmia, embolism or rupture of chordae tendinae. Conclusion    Percutaneous transfemoral artery and vein guided by TTE or TEE is safe and effective, with little trauma, no radiation or contrast agent damage, and has significant clinical efficacy and application values.

Objective    To evaluate the efficacy and safety of transcatheter closure of patent ductus arteriosus (PDA) with transthoracic echocardiography (TTE). Methods    From February 2016 to November 2018, 98 patients of pure PDA were selected, including 43 patients of funnel type and 55 patients of tube type. There were 38 males and 60 females at age of 2-48 (9.8±10.4) years. All patients underwent TTE-guided retrograde closure of the PDA through the femoral artery to establish a femoral-abdominal aorta-thoracic aorta-ductus arteriosus-aorta-right ventricle trajectory.Under the guidance of TTE, a suitable closure umbrella was placed through the femoral artery. One month, 3 months, 6 months, 12 months after the surgery, the patients received out-patient clinical follow-up. Results    Ninety eight patients were successfully occluded by TTE. The occluder was replaced many times in an adult PDA patient, but finally it was successfully plugged. The operation time was 33.2±5.8 min. The lumbar diameter was 12±6 mm. And the postoperative murmur disappeared. Ultrasound showed no shunt between the aorta and the pulmonary artery, and the postoperative hospital stay was 3-4 days. No shunt signal was found in 1, 3, 6, 12 months follow-up. Left atrial anteroposterior diameter (25.8±6.1 mm vs. 30.6±8.4 mm) and left ventricular end diastolic diameter (38.5±9.1 mm vs. 45.2±11.5 mm) were significantly smaller (P < 0.05). Conclusion    TTE-guided transcatheter closure of PDA via femoral artery is a safe and effective method to avoid the damage of X-ray and contrast medium. The prospect of clinical application is good.

Objective    To analyze the efficacy and safety of percutaneous balloon pulmonary valvuloplasty (PBPV) for pulmonary valve stenosis guided by ultrasound. Methods    From March 2016 to July 2019, 32 patients with pulmonary valve stenosis were treated in our hospital. There were 19 males and 13 females with an average age of 1-12 (6.2±3.1) years and weight of 7-45 (22.7±9.2) kg. The clinical efficacy of PBPV guided by transthoracic echocardiography (TTE) was evaluated. Results    The transvalvular pressure gradient (PG) of the patients before PBPV was 65.4±11.9 mm Hg. All patients successfully received PBPV under TTE guidance. The PG was 19.7±4.0 mm Hg immediately after operation, which was significantly decreased (P<0.001). All patients survived without any serious complications. The PG values at 3 months, 6 months and 12 months after operation were 18.4±4.0 mm Hg, 16.4±3.9 mm Hg, 15.2±3.3 mm Hg, respectively, which were significantly lower than that before the operation (P<0.001). Conclusion    PBPV guided by echocardiography is safe and effective in the treatment of pulmonary valve stenosis with low complications rate.

Objective    To investigate the effectiveness and safety of esophageal ultrasound-guided percutaneous femoral artery closure of ventricular septal defect (VSD). Methods    The clinical data of 24 patients with congenital VSD in our hospital from March 2017 to December 2019 were retrospectively analyzed, including 6 males and 18 females, with a median age of 12 (3-42) years, weight of 32 (12-91) kg, and VSD diameter of 4 (3-7) mm. There were 3 patients with VSD combined with atrial septal defect. Results    Twenty-four patients successfully underwent interventional closure of percutaneous femoral artery under esophageal ultrasound guidance, and the position and shape of the occluders were good. The operation time was 45 (39-54) min, and the waist size of the occluders was 7 (5-12) mm. Among the patients, 14 patients used symmetric ventricular occlusion devices, 8 patients used asymmetric ventricular occlusion devices, and 2 patients used ventricular occlusion muscle occluders. Small amount of residual shunt occurred in 2 patients after the operation and it disappeared 3 months after the operation. One patient with right bundle branch block, which disappeared after 1 week of observation. There were no complications such as occluder closure, pericardial effusion or valve regurgitation during the perioperative period. During the follow-up period [3-18 (9.25±5.04) months], no serious complication occurred. Conclusion    Transesophageal ultrasound-guided transfemoral artery occlusion for VSD is simple and safe, and it avoids the damage of radiation and contrast medium. It has advantages over traditional percutaneous interventional occlusion therapy.

Objective    To compare the surgical results of ultrasound-guided percutaneous antegrade or retrograde therapy in the treatment of patent ductus arteriosus. Methods    The clinical data of 166 patients (44 males and 122 females) who underwent transthoracic echocardiography guided closure of patent ductus arteriosus in Xinjiang Cardiovascular and Cerebrovascular Disease Hospital from February 2016 to August 2020 were retrospectively analyzed, and the patients were divided into two groups: an antegrade group (n=60) and a retrograde group (n=106). The operation time, success rate, bed rest time, postoperative complications and surgical safety were compared between the two groups. Results    The immediate success rate of the two groups was 100.0%. Compared with the retrograde group, the antegrade group had shorter time of bed rest and hospital stay, but longer operation time. In the retrograde group, there were 2 patients of complications, including occlusive device falling off to pulmonary artery 12 hours after the operation in 1 patient, and false arterial tumor in 1 patient. Both groups were followed up for 3-18 months, and there was no death in the whole group. Conclusion    It is safe and effective to block patent ductus arteriosus under the guidance of transthoracic echocardiography. Although the operation process of anterior occlusion of patent ductus arteriosus is slightly complex and the operation time is long, the indication is wide, and the bed rest time is short. Therefore it can be used as the first choice for patent ductus arteriosus occlusion.