Objective: To establish the quality control standard of Xiangshapingwei Pills (Rhizoma Atracylodis Pericarpium Citri Reticulatae Cortex Magnoliae Officinalis Radix Aucklandiae etc.)Methods: Rhizoma Atractylodis , Radix Auklandiae, Cortex Magnoliae Officinalis, Pericarpium Citri Reticulatae in Xingshapingwei Pills were identified by TLC. The content of hesperidin in Xiangshapingwei Pills was determined by RP HPLC with C 18 reversed phase column, mobile phase (methanol∶water∶acetic acid=30∶65∶5),detection wavelength at 283nm and flow rate 1.0mL?min -1 .Results: Hesperidin showed a good linear relationship at a rang of 0.8～4.0?g. r = 0.9993 . The average recovery was 96.7%, and RSD was 2.42%.Conclusion: The method is accurate and quick, and can be used for the quality control of Xiangshapingwei Pills.

OBJECTIVE To investigate the correlation between nasal obstruction score, Lund-Mackay score,congestion index and tissue remodeling degree of nasal mucosa in patients with chronic rhinosinusitis(CRS) and to study the role of diagnosing remodeling.METHODS Forty-three patients with CRS who underwent endoscopic surgery were studied.Congestion index of nasal mucosa was obtained by acoustic rhinometry.Nasal obstruction score was obtained by visual analogue scale.CT score was obtained by Lund-Mackay.The mucosa specimen of uncinate process from nasal cavity of the patients was used to evaluate the fibrosis degree.Statistical analysis was performed using SPSS11.5.RESULTS Nasal obstruction and Lund-Mackay score had no correlation with fibrosis degree of mucosa(r=0.77,P=0.40),whereas congestion index of nasal mucosa had a negative correlation with fibrosis degree of mucosa(r=-0.348, P=0.022).CONCLUSION Nasal congestion index can reflect the degree of remodeling in submucosal tissue.Nasal congestion index with obstruction symptoms and CT scan can be used to guide the CRS treatment strategies.

OBJECTIVE: To determine the inflammatory cells in the mucosa at the medial aspect of the normal uncinate process compared with that on the protected lateral aspect of the normal uncinate process. METHOD: The mucosa of 20 uncinate process from the nasal cavity of 17 patients with no evidence of sinus disease undergoing functional endoscopic sinus surgery were recruited for the study. The material was stained with HE, Chromotrope 2R, Alcian blue-periodic acid-schiff, Toluidine blue. Specimens were observed using an Olympus microscope. RESULT: The number of mast cells and goblet cells were found to be higher on the lateral aspect of the normal uncinate process than on the medial aspect. The number of plasma cells was obviously different from that of lymphocytes. We did not found any eosinophils on either sides of uncinate process. CONCLUSION There are differences in the number of mast cells and goblet cells between the mucosa at the medial aspect of the normal uncinate process and the mucosa at the protected lateral aspect of the normal uncinate process.
Adolescent ; Adult ; Ethmoid Sinus ; pathology ; Female ; Goblet Cells ; cytology ; pathology ; Humans ; Male ; Mast Cells ; cytology ; pathology ; Middle Aged ; Nasal Mucosa ; pathology ; Paranasal Sinuses ; pathology ; Young Adult

Objective To observe the effect of X-ray-guided placement of intestinal obstruction tube for treating malignant bowel obstruction(MBO)caused by gynecological malignant tumors.Methods Data of 60 patients with intestinal MBO after surgical operations of malignant gynecological tumors,including 30 cases underwent X-ray-guided intestinal obstruction tube placement(group A)and 30 cases underwent traditional nasogastric tube placement(group B),all followed by continuous gastrointestinal decompression were retrospectively analyzed.The remission of MBO symptoms,time of exhaust and defecation,so as diet recovery after treatment were compared between groups.The mean drainage volume within 24 h,tube retention time and treatment-related complications were recorded,and the survival of patients within 1 year after treatment were followed up.Results All 60 patients were successfully catheterized.The time of exhaust and defecation,oral feeding and tube retention time after catheterization in group A were shorter than those in group B(all P＜0.05),while the mean drainage volume within 24 h in group A was larger than that in group B(P＜0.05).No significant difference of relief rate of intestinal obstruction symptoms was found between groups(P=0.472).Minor nasal bleeding occurred in 8 cases,and oropharyngeal discomfort occurred in 4 cases in group A,while each in 5 cases in group B,all relieved without special treatments.No significant difference of treatment-related complication was observed between groups(P=0.361).One year after treatments,28 cases were followed up and 2 cases were lost in both groups,and no significant difference of survival rate was detected between group A(7/28,25.00%)and group B(5/28,17.86%)(P=0.745).Conclusion X-ray-guided placement of intestinal obstruction tube was safe and effective for treating MBO caused by malignant gynecological tumor.

Objective:To evaluate the clinical prognosis of patients with pseudomyxoma peritonei (PMP) after cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC).Methods:The clinical data of 42 patients with PMP after CRS combined with HIPEC in the Affiliated Haikou Hospital of Xiangya Medical College of Central South University from January 2012 to December 2018 was retrospectively analyzed. All patients underwent open surgery CRS combined with HIPEC, the operation condition and prognosis of patients were analyzed.Results:In 42 patients with PMP, the disenminated peritoneal adenomucinosis (DPAM) accounted for 61.9% (26/42), the peritoneal mucinous carcinomatosis (PMCA) accounted for 28.6% (12/42), and the borderline accounted for 9.5% (4/42). The incidence rate of major operative complications (grade Ⅲ-Ⅳ) after CRS combined with HIPEC was 21.4% (9/42). The logistic regression analysis showed that the previous surgery score ( OR = 35.765, 95% CI 2.746-43.986, P = 0.001) and completeness of CRS score ( OR = 23.865, 95% CI 1.345-347.876, P = 0.028) were independent factors influencing major postoperative complications in PMP patients. The overall survival time of 42 patients with PMP was (64.8±4.1) months, and the disease-free survival time was (54.0±4.9) months; the 3-year and 5-year overall survival rates were 80.8% and 65.9%, and the 3-year and 5-year disease-free survival rates were 59.5% and 54.6%, respectively. The difference in overall survival time of patients with different pathological subtypes was statistically significant ( P = 0.022). Conclusion:CRS combined with HIPEC is safe and effective for treatment of patients with PMP, and most of the patients have a good prognosis.

Uncovering the risk factors of pulmonary hypertension and its mechanisms is crucial for the prevention and treatment of the disease.In the current study,we showed that experimental periodontitis,which was established by ligation of molars followed by orally smearing subgingival plaques from patients with periodontitis,exacerbated hypoxia-induced pulmonary hypertension in mice.Mechanistically,periodontitis dysregulated the pulmonary microbiota by promoting ectopic colonization and enrichment of oral bacteria in the lungs,contributing to pulmonary infiltration of interferon gamma positive(IFNγ+)T cells and aggravating the progression of pulmonary hypertension.In addition,we identified Prevotella zoogleoformans as the critical periodontitis-associated bacterium driving the exacerbation of pulmonary hypertension by periodontitis,and the exacerbation was potently ameliorated by both cervical lymph node excision and IFNγ neutralizing antibodies.Our study suggests a proof of concept that the combined prevention and treatment of periodontitis and pulmonary hypertension are necessary.

Objective To investigate the safety and efficacy of transesophageal echocardiography assisted thoracoscopic left atrial appendage clipping in atrial fibrillation patients with high risk of stroke and bleeding.Methods Clinical data of 14 atrial fibrillation patients with high risk of stroke and bleeding from November 2021 to May 2023 was retrospectively analyzed.All the patients had suffered from cerebral infarction.The CHA2DS2-VASc score was 3-7(mean,5.0±1.4)and the HAS-BLED score was 3-4(mean,3.3±0.5).The thoracoscopic surgery was performed with two ports.The left atrial appendage clipping was performed by using a domestically produced E-Clip left atrial appendage closure system,assisted by transesophageal echocardiography.Results All the operations were successfully performed.The mean operation time was(39.6±7.7)min,the mean drainage volume after operation was(80.4±37.1)ml,and the drainage tube was removed at(26.0±2.5)h after operation.All the 14 patients were followed up for 3-21 months,with a median of 8 months.Complete closure of the left atrial appendage without residual leakage and no thrombosis in the left atrium were confirmed by transthoracic echocardiography.No new cerebral infarction or bleeding lesions in the brain was detected by CT scanning.The electrocardiogram showed that 2 patients converted to sinus rhythm and 12 patients still maintained atrial fibrillation rhythm.Conclusions Transesophageal echocardiography assisted thoracoscopic left atrial appendage clipping can completely closure left atrial appendage and avoid new onset of stroke in atrial fibrillation patients with high risk of stroke and bleeding.It can also play a role in electrical isolation of left atrial appendage so as to cure atrial fibrillation in few patients.