OBJECTIVE:To establish a method for the simultaneous determination of gallic acid,rhein and emodin in Com-pound xiaozhi suppository. METHODS:HPLC was performed on the column of Kromasil C18 with mobile phase of 0.5% phosphor-ic acid-Acetonitrile solution(gradient elution)at a flow rate of 1.0 ml/min,the detection wavelength was 273 nm for gallic acid and 254 nm for rhein and emodin,the column temperature was 28 ℃,and the injection volume was 20 μl. RESULTS:The linear range was 0.296 4-14.82 μg/ml for gallic acid(r=0.999 6),0.215 0-10.75 μg/ml for rhein(r=0.999 9)and 0.307 2-15.36 μg/ml for emo-din(r=0.999 9);RSDs of precision,stability and reroducibility tests were lower than 3.0%;recoveries were 95.1%-97.2%(RSD=0.64%,n=6),95.4%-97.2%(RSD=0.42%,n=6) and 96.5%-99.4%(RSD=1.10%,n=6),respectively. CONCLU-SIONS:The method is simple and accurate,and can be used for the contents determination of gallic acid,rhein and emodin in Compound xiaozhi suppository.

Objective To observe the effect of hyperbaric oxygen (HBO) combined with borneol on the permeability of the blood-brain barrier to sodium valproate in rats.Methods Fifty-six male,healthy Sprague Dawley rats were randomly divided into a control group which received an intraperitoneal injection of sodium valproate (0.1 g/kg),an HBO-1 group to which HBO was administered 0.5 hours before an equivalent injection of sodium valproate,an HBO-2 group where the HBO and sodium valproate were administered together,an HBO-3 group which received HBO 0.5 hours after the injection,a low dosage borneol group (L-borneol) which received 0.125 g/kg of borneol by oral perfusion 0.5 hours before an injection of sodium valproate (0.1 g/kg),a high dosage borneol group which received 0.25 g/kg of borneol 0.5 hours before an injection of sodium valproate (0.1 g/kg) and a combined group which received the HBO-3 group's treatment supplemented with the borneol dose of the L-borneol group.There were 8 rats in each group.Blood and cerebrospinal fluid (CSF) were collected 1.5 h after the sodium valproate injection and the concentrations of sodium valproate were measured by high performance liquid chromatography.Results Compared with the control group,the CSF concentrations of sodium valproate in the HBO-2 and HBO-3 groups had increased significantly more (to 97.43 ± 12.09 mg/L and 100.10 ± 13.54 mg/L respectively).The ratios of the CSF to plasma (C/P) concentrations had also increased significantly more.The CSF concentration of sodium valproate in the H-borneol group (91.09 ± 9.45 mg/L) and the C/P ratio (0.577 ± 0.051) had increased significantly more than in the control group.Compared with the L-borneol group,there were significantly greater increases in the HBO-3 group and the combined group in the concentration of sodium valproate in the rats' CSF.Compared with the HBO-3 group,the average concentration of sodium valproate in the CSF of the combined group (112.43 ± 11.52 mg/L) and the C/P ratio (0.698 ±0.058) had increased significantly more.There was no significant difference among the groups in the plasma concentrations of sodium valproate.Conclusions HBO can increase the permeability of the blood-brain barrier to sodium valproate,at least in rats.Combining HBO with a low dose of borneol has an additional effect.

Objective To analyze clinical pathologic characteristics of patients with primary biliary cirrhosis autoimmune hepatitis overlap syndrome (PBC AIH OS),the incidence of extrahepatic autoimmune disease,malignant tumor and the abdominal lymph node enlargement.Methods From January 2000 to January 2012,the clinical data of 49 patients with PBC AIH OS were retrospectively analyzed,which included general information,clinical manifestations,biochemical parameters,immunological parameters,liver histopathological features,the incidence of extrahepatic autoimmune disease and malignant tumor,imaging findings and the efficacy.Results Among 49 PBC-AIH OS patients,the percentage of patients between 51 and 60 years old was 59.2％ (29/49),and the mean age of onset was (57.2±8.9) years old.Female was 83.7％ (41/49).The percentage of jaundice and pruritus in the main symptoms of initial visit was 42.9％ (21/49).The serum level of alanine aminotransferase (ALT),aspartate transaminase (AST),alkaline phosphatase (ALP),γ-glutamyl transpeptadase (GGT) and total bilirubin (TBil) of 49 patients all increased.Among 31 patients who accepted IgA,IgG and IgM level test,the level of IgM increased in 58.1％ (18/31) of patients,and the level of IgG increased in 61.3％ (19/31) of patients.Ninety-eight percent of patients were antinuclear antibody (ANA) positive,6.1 ％ (3/49) were anti-smooth muscle antibody (SMA) positive,89.8％ (44/49) of patients were anti mitochondrial antibody (AMA) and or AMA-M2 positive.All patients had interface hepatitis.Forty-nine percent (24/49) of patients had both histological features of autoimmune hepatitis (AIH) and primary biliray cirrhosis (PBC).After being treated with ursodeoxycholic acid (UDCA) and immunosuppressant,the percentage of remission,incomplete response and failure was 65.3％ (32/49),26.5％ (13/49) and 8.2％ (4/49),respectively.After remission,five of six patients with medicine withdrawal relapsed.Among 49 patients,40.8％ (20/49) with extrahepatic autoimmune disease and the percentage of Sjogren's syndrome,autoimmune thyroid disease,interstitial pneumonia,systemic lupus erythematosus,psoriasis,sarcoidosis and membranous nephropathy was 16.3％ (8/49),12.2％ (6/49),4.1％ (2/49),2.0％ (1/49),2.0％ (1/49),2.0％ (1/49) and 2.0％ (1/49),respectively.Among 49 patients,14.3％ (7/49) with malignant tumor and the percentage of endometrial cancer,breast cancer,thyroid cancer and lymphoma was 4.1％ (2/49),4.1％ (2/49),4.1％ (2/49) and 2.0％ (1/ 49).Among 49 patients,abdominal ultrasound showed abnormality in 93.9％ (46/49) of patients.Abdominal lymph nodes enlargement was found in 91.8％ (45/49) of patients.Conclusions Autoimmune disease and malignant tumor should be screened when patients with PBC-AIH OS were assessed.Abdominal lymph nodes enlargement found by imaging examination may have guiding significance to the diagnosis.

Objective: To develop an HPLC method for the simultaneous determination of paeoniflorin , liquiritin, baicalin and costunolide in Fuke Yangkun pills , and optimize the extraction technology by response surface methodology ( RSM).Methods: The separation of targeted compounds were performed on a Kromasil C 18 column (250 mm ×4.6 mm, 5 μm).The mobile phase consisted of acetonitrile (A) and 0.2%phosphoric acid (B) with gradient elution at a flow rate of 1.0 ml min-1.The detection wavelength was set at 230, 276, 280 and 225 nm, respectively.The column temperature was 28℃.Using the contents of the four components as the indices, the extraction process was optimized by a response surface method with methanol concentration , solid-liquid ratio and ex-traction time as the influencing factors .Results: The linear range of paeoniflorin , liquiritin, baicalin and costunolide was 1.616-161.600, 0.432-43.180, 2.045-204.500 and 0.518-51.840 μg ml-1, respectively.The average recovery (n=9) was 98.3%, 99.6%, 97.9%and 98.1%, respectively.The optimum conditions of extraction process were as follows:the methanol concentration was 64%, the solid-liquid ratio was 1 ∶51, and the extraction time was 25 min.Conclusion: The response surface methodology is convenient and highly predictive in optimizing the extraction process of the four effective components in Fuke Yangkun pills .The devel-oped content determination method is simple and accurate , which can be used for the quality control of Fuke Yangkun pills .

Objective To explore the security and the short term efficacy of VIABAHN stents in the treatment of branching area lesions in lower extremity arterial diseases. Methods The data of 16 patients (11 male and 5 female, aged 59.0 to 81.0 with median of 71.6) with lower extremity arterial occlusive disease from November 2014 to June 2015 were analyzed retrospectively. All lesions were located around the branching area of the lower extremity artery (3 cases in the internal iliac artery orifice, 6 cases in the deep femoral artery orifice and 7 cases in the vascular net around the knee). The short?term effects on these patients in the follow-up period, such as the success rate of surgical technique, the improvement of symptoms and the incidence of complications were summarized. Results Revascularization was technically successful in all 16 patients, and ischemic symptoms relieved significantly after the operation. The ABI were 0.36±0.12 before and 0.89±0.10 after the operation. The patients were followed up for 3 to 9 months (median 5.5 months). All the patients were achieved limb salvage and no complication occurred. Conclusions VIABAHN stent is safe and effective for the treatment of lower extremity arterial occlusive disease. The branches around the lesion can be covered with VIABAHN stents.

Objective To evaluate the safety and efficacy of mechanical thrombectomy in treating in-stent restenosis of lower extremity arteriosclerosis obliterans. Methods From May 2015 to Sep 2016, the clinical data of 9 cases of lower extremity arteriosclerosis obliterans who were with in-stent restenosis(3 were stent graft)were retrospectively collected, and of which 7 were males and 2 were females with a mean age of (75.4 ± 6.3)years old. All the cases were treated by mechanical thrombectomy of Rotarex catheter. All the patients were diagnosed via low-extremity artery CTA, and treated by means of the Rotarex catheter, combined with angioplasty and stent if necessary. All patients received antiplatelet therapy. Doppler ultrasonography was taken during the followed-up. Results All the 9 cases were successed in technology, without complications in hospital. All patients received Rotarex mechanical thrombectomy. Six of which used balloon and 1 stent implanted. The ABI increased from 0.29 ± 0.07 to 0.88 ± 0.07 after treatment, the difference was statistically significant(t=28.875,P<0.05). All the patients were followed up for 3—18 (median time, 11.5)months. No death and symptoms recurrence appeared during the follow-up. Conclusions Mechanical thrombectomy using Rotarex catheter is a safe and effective treatment for in-stent restenosis in lower extremity arterial diseases.

Objective To investigate the treatment of diabetes mellitus complicated acute necrotizing sinusitis .Methods By way of reviewing the clinical procedures of 2 patients with diabetes mellitus complicated acute necrotizing sinusitis .Results In perioper-ative period ,by means of glycemic control ,anti-infection ,and emergency surgery to remove the necrotic tissue in nasal sinuses and open the sinuses ,one of the patients discharged from hospital after 8 days .He has been followed up for more than 4 years without recurrence ,and is still in follow-up .Due to complicating renal failure and ascites ,the another patient gave up treatment and dis-charged on the third postoperative day ,and died on the same day .Conclusion Glycemic control ,homeostasis ,surgical removal of necrotic tissue and anti-infection treatment in perioperative period as soon as possible ,is the key to a successful treatment .

OBJECTIVE: To assess the long-term clinical efficacy of endoscopic surgery of primary sinonasal malignant neoplasms and find out the potential postoperative prognostic factors. METHOD: Forty-three clinical cases of primary sinonasal malignant neoplasms treated under endoscopy were analyzed retrospectively. RESULT: Fifteen patients died. The 1-year, 2-year, 3-year and 5-year survival rates were 83. 7% (36/43), 74. 4% (32/43), 69. 8% (30/43) and 65. 1% (28/43), respectively. Kaplan-Meier single-variable analysis showed that gender, T grade, TNM stage and pathological types of olfactory neuroblastoma were statistically significant prognostic factors (P< 0. 05). COX Pro-Portional hazard models showed that TNM stage was an independent prognostic factors. CONCLUSION Endoscopic surgery for primary sinonasal malignant neoplasms is a safe and effective minimally invasive surgical treatment, and it is an important supplement to the traditional surgery. Gender, T grade, TNM stage and pathological types of olfactory neuroblastoma might be significant prognostic factors.
Endoscopy ; Esthesioneuroblastoma, Olfactory ; surgery ; Humans ; Nasal Cavity ; pathology ; surgery ; Nose Neoplasms ; surgery ; Proportional Hazards Models ; Retrospective Studies ; Survival Rate ; Treatment Outcome

OBJECTIVE To understand the present situation of hand hygiene execution rate among clinical medical personnel,and discuss a series of scientific,reasonable and practical hand hygiene intervention methods,in order to elevate the hand hygiene execution rate among medical personnel.METHODS Using the self-designed questionoaires in combination with observation on hand hygiene process and investigation of hand hygiene knowledge level among medical personnel in various departments of different levels of hospitals to assess the hand hygiene execution rate.RESULTS The investigation indicated 76.00% medical personnel have had hand hygienic knowledge training,and referred in the stipulation health drafts,the hand hygiene execution rate was 50.00-70.00%.The hand health execution rate before contact with patients was 59.82%,and after contacts with patients was 77.97%;among department the hand hygiene execution rate before contact with patients was highest in the department of pediatrics(82.78%),the lowest was in emergency department(11.11%),after contact with patients the highest was department of infectiong(100.00%),and the larest was in the internal medicine department(39.93%).CONCLUSIONS Medical personnel's hand hygiene consciousness is still weak,with lacked hand hygiene related knowledge,it is necessary to summarize a set of reasonable effective intervention plans to elevate the hand hygiene execution rate,reduce the hospital infection percentage,and lower the patient pain and the economic loss.

Objective To investigate the image features of congenital pyriform sinus fistula (CPSF). Methods We retrospectively analyzed the clinical features and preoperative images of 80 patients with confirmed diagnosis of CPSF by surgical and pathological outcome in Guangdong general hospital from January 2007 to December 2014. At least one of the following imaging examinations were performed for all the patients, including Barium swallow X-ray (BSX), CT and MRI. Among them, 63 patients were examined with BSX, while 42 patients underwent plain and enhanced CT scans, wherein 40 of them were exanimated shortly after BSX. Thirty-two patients underwent plain and enhanced MRI scans. Patients were divided into two groups according to their age, young age group (≤14 years old) and older age group (>14 years old). Furthermore, they were also grouped based on inflammatory or quiescent stage clinically. The images of BSX, CT, and MRI from the patients were analyzed and the positive diagnostic rates (PDR) between groups were compared by using χ2 tests. Results For the patients examined with BSX, sinuses in 35 of 63 were depicted from pyriform and fistulas in 9 of 63 were depicted from the pyriform. The overall PDR of BSX was 74.6%(47/63),wherein 46.2%(12/26)in young age group , 94.6%(35/37)in older age group, 52.9%(9/17) in inflammatory stage group ,and 82.6%(38/46)in quiescent stage group. The inter-group differences were statistically significant (χ2 were 18.911 and 5.766,both P<0.05). The PDR of CPSF with CT was 85.7%(36/42), MRI was 84.4%(27/32), BSX+CT was 87.5%(35/40). The courses of fistula or sinus were showed on CT and MRI. The presence of air bubbles at the inferomedial edge of cricothyroid joints or around the upper lobe of the thyroid gland, the changes of the morphology of thyroid grand as well as the inflammatory change along the fistula region were detected much clearly on CT and MRI. There was no statistical difference between CT and MRI groups(P>0.05).Conclusions BSX could be a screening method for suspected cases of CPSF in quiescent stage. However, the PDR could be affected by many factors (age and inflammation). CT and MRI could provide valuable information for diagnosis. An examination combined BSX and CT is preferred to improve the positive detective rate of CPSF.