Quality standard research of pieces of Chinese crude drugs is the important content of research of Chinese medicine processing, and it is also the key point of the whole standardization system of Chinese medicine. Although we have set up a preliminary quality standard system of pieces of Chinese crude drugs, it still under a low level. During the research of quality standard of pieces of Chinese crude drugs, we still face some problems, such as how to set up a more comprehensive, scientific, and reasonable quality standard. In this paper, we proposed some advices that we should pay more attention to traditional processing theories, processing mechanisms and effective substances during research of quality standard research of pieces of Chinese crude drugs.

【Objective】 To establish a practical and feasible blood management (PBM) model for clinical liver transplant patients, so as to optimize the perioperative blood usage and improve patient prognosis and survival rate. 【Methods】 Led by the Medical Department, a questionnaire survey Establishment and Implementation of a Blood Management Model for Organ Transplant Patients on the importance of establishing a PBM model for liver transplant patients in clinical practice was conducted among 71 staff from relevant departments such as the Anesthesiology Department, Hepatobiliary Department, Blood Transfusion Department, and ICU Medical Department. After statistical analysis, the important items of PBM for liver transplant patients were determined, and a (trial) plan was organized by the Medical Department and training was conducted by Blood Transfusion Department for medical staff training from departments as Anesthesiology, Hepatobiliary and Pancreatology, and ICU; PBM measures for liver transplant patients before, during and after surgery were determined by the Anesthesiology Department, Hepatobiliary and Pancreatic Department, and ICU; PBM was fully implemented in the experimental group with liver transplant patients in our hospital in 2021 as subjects; 30 cases of liver transplantation performed in our hospital in 2020 were selected as the control group, and the general data, preoperative laboratory examination results, and preoperative, intraoperative, and postoperative blood transfusion of the two groups of patients were compared. 【Results】 Compared with the control group, the experimental group did not receive any blood component transfusion before surgery. Intraoperative blood transfusion volume of allogeneic components: red blood cells(U) were 12.75(8.75, 18.63) vs 15.25(8.38, 26.13)(P>0.05), apheresis platelet (treatment volume) was 0(0, 2) vs 1(0, 4.25)(P>0.05), plasma(U) was 2 300(1 550, 3 763) vs 3 650(2 075, 5 400)(P<0.05); cryoprecipitate(U) was 0(0, 10) vs 10(0, 30)(P<0.05); Postoperative blood transfusion volume of allogeneic components were as follows: red blood cells(U) 8.00(3.38, 12.88) vs 11.25(4.75, 19.63)(P>0.05), platelets were not transfused, plasma(U) was 0(0, 0) vs 0(0, 600)(P>0.05), and cryoprecipitates were not transfused. 【Conclusion】 The establishment of PBM model for liver transplant patients and the application of its management measures before, during and after transplantation significantly reduced the intraoperative blood transfusion volume and improved the prognosis of patients after transplantation.

Objective: To analyze the clinical phenotype and screen the genetic mutations of hereditary deafness in three deaf families to clarify their molecular biology etiology. Methods: From January 2019 to January 2020, three deaf children and family members were collected for medical history, physical examination, audiology evaluation, electrocardiogram and cardiac color Doppler ultrasound, temporal bone CT examination, and peripheral blood DNA was obtained for high-throughput sequencing of deafness genes. Sanger sequencing was performed to verify the variant sites among family members. The pathogenicity of the variants was evaluated according to the American College of Medical Genetics and Genomics. Results: The probands in the three families had deafness phenotypes. In family 1, proband had multiple lentigines, special facial features, growth retardation, pectus carinatum, abnormal skin elasticity, cryptorchidism and other manifestations. In family 2, proband had special facial features, growth retardation and abnormal heart, and the proband in family 3 had growth retardation and abnormal electrocardiogram. Genetic testing of three families detected three heterozygous mutations in the PTPN11 gene: c.1391G>C (p.Gly464Ala), c.1510A>G (p.Met504Val), c.1502G>A (p.Arg501Lys). All three sites were missense mutations, and the mutation sites were highly conserved among multiple homologous species. Based on clinical manifestations and genetic test results, proband 1 was diagnosed with multiple lentigines Noonan syndrome, and probands 2 and 3 were diagnosed with Noonan syndrome. Conclusion: Missense mutations in the PTPN11 gene may be the cause of the disease in the three deaf families. This study enriches the clinical phenotype and mutation spectrum of the PTPN11 gene in the Chinese population.
Deafness/genetics* ; Genetic Testing ; Hearing Loss/genetics* ; Humans ; Male ; Mutation ; Phenotype ; Protein Tyrosine Phosphatase, Non-Receptor Type 11/genetics*

OBJECTIVE: To establish an HPLC method for the determination of Paraquat in biological samples. METHODS: Paraquat in biological samples was extracted by C18 columns which were pre-treated with cetyl-trimethyl ammonium bromide (CTAB) and soudium dodecyl sulphate (SDS), and analysed by HPLC/DAD. RESULTS: The detection limit of the method was 1 ng x mL(-1), and the average recoveries were 81%-94%. CONCLUSION The method can be used to analysis of paraquat in biological samples.
Animals ; Chromatography, High Pressure Liquid/methods* ; Herbicides/chemistry* ; Liver/chemistry* ; Paraquat/analysis* ; Rabbits ; Sensitivity and Specificity ; Sodium Dodecyl Sulfate ; Solvents ; Swine

OBJECTIVETo compare frequencies of natural killer (NK) cell subsets and their surface expression of the NKG2D receptor in patients with primary biliary cirrhosis (PBC), and to determine the correlation between expression of MICA on monocytes and function-associated receptors on the NK cells of PBC patients.

METHODSTwenty patients with PBC and 18 healthy donors were included in the study. Peripheral blood samples anticoagulated with heparin were labeled with the following antibody combinations: anti-CD45/anti-CD14/anti-MICA, antiCD3/anti-CD56/anti-CD16/anti-NKG2D. Frequencies of MICA-positive monocytes, NK cell subsets, and NK cells with surface expression of NKG2D were measured with flow cytometry. Correlation of MICA expression on monocytes with NKG2D expreesion on NK cells was assessed through linear correlation and regression analysis.

RESULTSThe PBC patients had significantly lower percentages of NK cells than the healthy donors (6.8%+/-2.9% vs.16.4%+/-3.4%, P =0.000<0.05). In the PBC patients, the percentage of CD56-positive NK ceils was significantly higher than that of CD16-positive NK cells (4.2%+/-2.8% vs.1.4%+/-0.7%, P=0.003<0.05). The PBC patients also had significantly higher percentage of NKG2D surface expressing CD56-positive NK cells than the healthy donors (79.4%+/-10.2% vs.64.8%+/-10.7%, P=0.000<0.05). The PBC patients and healthy donors showed no statistically significant differences in percentages of NKG2D surface expressing CDl6-positive NK (70.1%+/-12.9% vs.61.1%+/-5.9%, P=0.078>0.05). MICA was seldom detected on normal monocytes (2.6%+/-1.9%), but present for 51.6%+/-16.2% of monoeytes from the PBC patients (P =0.000<0.05). There was a significant difference in frequency of CD14/MICA double-positive monocytes between the healthy donors and PBC patients. No correlation of MICA expression on monocytes with NKG2D expression on NK cells was found.

CONCLUSIONPBC patients have lower levels of NK cells in peripheral blood than their healthy counterparts. PBC patients also have higher levels of the CD56+ NK cell subset and cells with surface expression of the activated NKG2D receptor. It appears that PBC patients have a greater level of CD14+MICA+ peripheral blood mononuclear cells. NK cells may be affected by the PBC-related monocytes and participate in disease pathogenesis through immune regulation.

On November 17, 2013, the Second Affiliated Hospital of Kunming Medical University admitted a 23-year-old male patient with a high-temperature steel bar penetration injury from scrotum to buttocks who was transferred from another hospital. Expanded debridement, suture, and drainage of the perineum, right thigh, and right hip were performed as soon as possible after admission. A sputum suction tube was used as the guide mark for expanded debridement during the operation to ensure the accuracy of the direction and scope of expanded debridement. The incision was treated with vacuum sealing drainage (VSD) and full drainage. On the 20^th day after the operation (the 25^th day after admission), the unhealed wound was transplanted with split-thickness skin graft from the right thigh, and the drainage of the operation area and dressing change were strengthened. On the 53^rd day after injury, the patient was discharged after complete wound healing. This case suggests that VSD after early debridement is an effective means to treat high-temperature steel bar penetration injuries.
Adult ; Buttocks ; Debridement ; Drainage ; Humans ; Male ; Negative-Pressure Wound Therapy ; Scrotum/surgery* ; Skin Transplantation ; Steel ; Temperature ; Treatment Outcome ; Young Adult

Hepatitis B virus (HBV) infection is still a public problem that seriously threatens human health. Evaluation of liver fibrosis progression with an efficient noninvasive model is of great significance for condition assessment, disease management, and prognostic evaluation in patients with chronic HBV infection. This article reviews the noninvasive models commonly used in the diagnosis of liver fibrosis in recent years, summarizes the research background, methods, related studies, and advantages and disadvantages of these models, and analyzes the current research status and possible development trends of liver fibrosis assessment models. Recent studies have shown that although current models are not perfect for Chinese patients with chronic HBV infection as the main predisposing factor for liver fibrosis, the excellent performance of noninvasive models in liver fibrosis assessment provides a reference for the assessment of liver fibrosis in patients with chronic HBV infection and can replace liver biopsy to a certain extent.

【Objective】 To continuously improve the routine indoor quality and precision of TEG by applying Westgard multi-rule control method combined with Levey-Jennings quality control chart. 【Methods】 The parameters R, K, Angel and MA of TEG were monitored and analyzed in the laboratory for 12 consecutive months using the same batch of quality control products via Westgard multi-rule control method combined with Levey-Jennings quality control chart, and the mean(), standard deviation (SD) and coefficient of variation (CV%) were calculated to observe the control effect. 【Results】 We applied this quality control method to timely correct, analyze and improve the system errors in TEG indoor quality control.The CV% value of R, K, Angle and MA were 20.33%, 13%, 3.6% and 9.65%, respectively, during January to June 2019, but decreased to 9%, 3%, 1.28% and 5.35%, respectively, during July to December 2019. 【Conclusion】 The application of Westgard multi-rule control method and Levey-Jennings quality control chart in TEG indoor quality control test can improve the precision of TEG clinical test results.

【Objective】 To investigate the clinical efficacy and safety of low-dose rituximab combined with dexamethasone in the treatment of refractory ITP (RITP) in children. 【Methods】 A total of 31 RITP children, admitted to the Hematology Department of Kunming Children′s Hospital from January 2016 to December 2019 and agreed to receive low-dose rituximab (100 mg/ time, once a week, for 4 successive weeks) combined with dexamethasone (0.6 mg/kg, once a day, for 4 successive days) were enrolled and studied. Blood routine was monitored every other day during treatment, and adverse drug reactions were recorded. The influence of gender, disease course and age on prognosis was compared by χ² test. 【Results】 1) Among the 31 cases, 11 (35.5%) had platelets >100×10⁹/L after 4 weeks and had no recurrence in 6 months; 9 (29%) had platelets >30×10⁹/L but <100×10⁹/L and had no recurrence in 6 months; 11 (35.5%) showed no recovery of platelets, which were consistently lower than 30×10⁹/L. 2) Rituximab was used in 4 cases (12.9%), 1 case (3.2%) presented with severe drug-induced rashes; Headache, vomiting and elevated blood pressure occurred in 2 cases (6.4%). 1 case (3.2%) presented with laryngeal edema. 3) There was no difference in the total effective rate among different gender, age and disease course (P >0.05). 【Conclusion】 The total effective rate of low-dose rituximab combined with dexamethasone for children with refractory ITP in 6 months is 64.5%, and the adverse reactions are tolerable, so it can be used as a treatment option for children with refractory ITP.

Feature extraction methods and classifier selection are two critical steps in heart sound classification. To capture the pathological features of heart sound signals, this paper introduces a feature extraction method that combines mel-frequency cepstral coefficients (MFCC) and power spectral density (PSD). Unlike conventional classifiers, the adaptive neuro-fuzzy inference system (ANFIS) was chosen as the classifier for this study. In terms of experimental design, we compared different PSDs across various time intervals and frequency ranges, selecting the characteristics with the most effective classification outcomes. We compared four statistical properties, including mean PSD, standard deviation PSD, variance PSD, and median PSD. Through experimental comparisons, we found that combining the features of median PSD and MFCC with heart sound systolic period of 100-300 Hz yielded the best results. The accuracy, precision, sensitivity, specificity, and F1 score were determined to be 96.50%, 99.27%, 93.35%, 99.60%, and 96.35%, respectively. These results demonstrate the algorithm's significant potential for aiding in the diagnosis of congenital heart disease.
Humans ; Heart Sounds ; Neural Networks, Computer ; Algorithms ; Heart Defects, Congenital