Objective To establish the HPLC determination method of chlorogenic acid for developing the quality standard of Yinqiao Jiedu Oral Liquid.Methods HPLC method was performed on an E.Merck LiChrospher 100RP-18 column(250 mm? 4 mm,5 ? m).The mobile phase consisted of acetonitrle and o.4 % phosphoric acid(10:100).The flow rate was 1.0 mL/min,column temperature was 30 ℃,and the detection wavelength was 327 nm.Results Chlorogenic acid was linear at the range of 0.12～ 0.63 ? g(r=0.999 6),the average recovery was 96.68 %,and RSD was 1.56 % .Conclusion This method is accurate,reliable,reproducible,and can provide evidence for the quality control of Yinqiao Jiedu Oral Liquid.

Objective To explore the three criteria of Ranson,CT severity index (CTSI) and the bedside index of severity in acute pancreatitis (BISAP) in assessment of severity and prognosis of acute pancreatitis.Methods A total of 503 diagnosed acute pancreatitis patients from January 2008 to April 2011 were studied retrospectively,including 356 mild acute pancreatitis (MAP) cases and 147 severe acute pancreatitis (SAP) cases.The differences of the three criteria of Rason,CTSI and BISAP in assessment of severity and prognosis of acute pancreatitis were compared with receiver operating characteristic (ROC) curve.The SAP group was divided into no organ failure group and organ failure group,and the predictive value of the three criteria in acute pancreatitis with organ failure was compared.Results There was significant differences between MAP group and SAP group with Rason,CTSI and BISAP score (x2 =236.88、126.24 and 101.27,P＜0.01).The sensitivity (97.3％) and AUC value (0.93) of Ranson criterion was highest.In no organ failure group and organ failure group of 147 SAP patients,there was significant difference between Ranson criterion and BISAP criterion (x2 =17.67 and 26.12,P＜0.01),both sensitivity were 100％,the specificity were 96％ and 85％ respectively,and the area under ROC curve (AUC) value of BISAP criterion (0.8) was the highest.In illness improved group and deteriorated group,the difference of score between Ranson criterion and BISAP criterion was significant (x2 ＝ 9.53 and 10.19,P＜0.05),and the AUC value of BISAP criterion (0.74) was the highest.Conclusions All three criteria can be used to determine the severity of acute pancreatitis.In predicting the risk of SAP with organ failure and prognosis,BISAP criterion is better than Ranson criterion.BISAP criterion is simple and easy to practice,which provides an important rule for evaluating the clinical condition of acute pancreatitis.

Fetal cystic lymphangioma is a developmental anomaly of the lymphatic system, which can occur in any part of the body, but most commonly in the neck and armpit. A case of fetal cystic lymphangioma located at the chest wall under the right armpit with a size of 21 mm×18 mm×16 mm is reported here. The mass was initially diagnosed by routine ultrasound examination at 21 gestational weeks. After the diagnosis, ultrasound was repeated every 4 weeks till 37 +4 gestational weeks. Over this period, the mass increased progressively to 101 mm×110 mm×95 mm. Ultrasound-guided intrauterine fetal cystic mass puncture and aspiration was performed 38 +4 weekss, and Bleomycin was injected into the cyst after operation and on day 42 after birth. During a follow-up to 10 months after birth, no obvious cystic mass was found at the right axillary chest wall of the child.

Objective: To study the effects of Rhizoma Polygoni Cuspidati on expression of transforming growth factor beta 1(TGF-?1) in rats with pulmonary fibrosis induced by bleomycin.Method: 120 male SD rats were randomly divided into five groups: the control group(n=30),the bleomycin(BLM) model group(n=30),the Rhizoma Polygoni Cuspidati prophylactic group(n=30),the 7 th day treatment group(n=20) and the 28 th day treatment group(n=10).The rat models of pulmonary fibrosis were established by intratracheal injection of bleomycin, while the control group was given with normal saline instead.The Rhizoma Polygoni Cuspidati prophylactic group received intragastric administration with 4ml?kg-1?d-1 Rhizoma Polygoni Cuspidati 2 days before setting up models.The 7 th day treatment group and the 28 th day treatment group received the treatment on the seventh day and the twenty-eighth days after establishing models respectively.The other two groups received saline instead.On the 3rd,7th,14th,28th,42th and 56th day after instillation of bleomycin,lung samples were obtained and the content of hydroxyproline in lung tissue homogenate was detected to judge the degree of fibrosis and the therapeutic efficacy.At the same time the express of TGF-?1mRNA and TGF-?1 protein was examined by RT-PCR and immunohistochemical method.Results: Compared with the model group,the content of hydroxyproline in the Rhizoma Polygoni Cuspidati prophylactic group and the 7th day treatment group decreased significantly(P

Objective To improve the training system of the combined education mode between professional master degree students of clinical medicine and resident standardization training (RST) in Zhe-jiang province, and improve the professional quality of medical graduate students. Methods A question-naire was designed through literature review and expert interview, and the data of 77 clinical training post-graduates were collected, and the effect of the training was evaluated by taking the reaction level, learning level, behavior level and achievement level of Ke's evaluation as the breakthrough point. Statistical analysis was performed by SPSS 20.0, and the mean score was used as the standard deviation. The scores were compared with t test, and the scores of multiple groups were made variance analysis. Results The RST attitude value in reaction layer was 9.26±1.08, RST content value was 29.29±4.36, RST teacher enthusiasm value was 11.13±2.17, RST experience value was 17.38±3.10, which indicated that residents' overall satisfaction to RST was high, but the satisfaction on teachers, evaluation and compensation was relatively low;The grade difference before and after RST in learning layer was statistically significant (P<0.05), indicating that before and after RST the grades were obviously improved, and the sense of belonging is high. The behave layer showed the residents' behavior changed obviously before and after RST (P<0.05), and their abilities in various aspects such as ward round and dealing with common diseases were largely improved;The result layer showed 77 graduate students had no medical accident and complaint , and all of them passed the annual assessment and participated in the research projects. Conclusion In general, RST graduate students are relatively satisfied with the plan, content and methods of the training, on the other hand, there are problems such as the absence of timely information feedback, teachers' poor enthusiasm, lack of effective competition mechanism, etc. Kirkpatrick Model made a comprehensive and objective eval-uation on graduate students RST from a overall perspective, and it can be introduced into the effectiveness evaluation for graduate students RST.

In order to explore the role of connective tissue growth factor (CTGF) in the pathogenesis of renal tubulointerstitial fibrosis, 48 Wistar rats were randomly divided into sham-operated and unilateral ureteral obstruction (UUO) group. On the postoperative day 1, 3, 7 and 14, the rats were killed and the kidneys were removed. The renal tubulointerstitial injury index was evaluated according to the MASSON staining. The mRNA levels of CTGF, transforming growth factor-β1(TGF-β1), collagen Ⅰ (col Ⅰ ), and plasminogen activator inhibitor-1 (PAI-1) were detected using reverse transcriptional-polymerase chain reaction (RT-PCR). Immunohistochemistry was performed to evaluate the protein expression of the above factors, and the relations among them were analyzed. Quantitative expression of CTGF protein in the kidneys was also assessed using Western blot. The results showed that TGF-β1 mRNA level was increased at first day after UUO, followed by a marked elevation of CTGF mRNA level, which began to increase 3 days after UUO (P＜0.01). With the progression of the disease, the mRNA expression of CTGF, col Ⅰ and PAI-1 was increased progressively. Immunohistochemistry revealed that the CTGF protein expression was significantly increased in fibrotic areas and tubular epithelial cells 3 days after UUO. On the post-UUO day 7, the protein level of CTGF was positively related to the renal tubulointerstitial injury index (r =0.62, P＜0.01), the expression of TGF-β1 (r=0.85, P＜0.01), col Ⅰ (r=0.78, P＜0.01),and PAI-1(r=0.76, P＜0.01). Upon Western blot analysis, CTGF protein expression began to increase 3 days after UUO, and appeared progressively throughout the time course (P＜0. 01, as compared with sham-operated group). It is concluded that CTGF can be induced by TGF-β and mediate various profibrotic actions of this cytokine, such as increasing extracellular matrix (ECM)synthesis and decreasing ECM degradation. The increased expression of CTGF may play a crucial role in the development and progression of tubulointerstitial fibrosis.

Objective:To construct a risk prediction model for unplanned readmission of patients undergoing cardiac resynchronization therapy (CRT) and verify the performance of the model.Methods:Using convenience sampling, patients who underwent CRT at the Department of Cardiovascular of the First Affiliated Hospital of Zhengzhou University from July 2017 to July 2020 were selected as the modeling group ( n=279) and the internal validation group ( n=120). CRT patients admitted to the Department of Cardiovascular of the First Affiliated Hospital of Zhengzhou University from August 2021 to August 2022 due to the same or related diseases were selected as the external validation group ( n=86). Multivariate Logistic regression was used to explore the influencing factors of unplanned readmission of CRT patients and establish the prediction model. The fitting effect and discrimination of the model were evaluated through the Hosmer-Lemeshow test and receiver operating characteristic (ROC) curve. The nomogram was established based on R-4.1.2 and Rstudio software. Results:The multivariate Logistic regression analysis showed that creatinine, left atrial diameter, pulmonary artery systolic pressure, New York Heart Association (NYHA) classification, and body mass index (BMI) were risk factors for unplanned readmission in CRT patients, with statistically significant differences ( P<0.05). The prediction model formula was: P=1/{1+exp[- (0.792×creatinine+1.408×left atrial inner diameter+0.887×pulmonary artery systolic pressure+0.769×NYHA classification-0.970×BMI-2.266) ]}. The area under the ROC curve was 0.874, the maximum value of the Jordan index was 0.636, the optimal threshold was 0.256, the sensitivity was 0.826, and the specificity was 0.810. The accuracy of internal validation and external validation was 90.00% and 90.70%, respectively. Conclusions:The constructed prediction model for unplanned readmission of CRT patients has good predictive performance, and the visualized nomogram improves the practical performance of the model. It helps medical and nursing staff identify high-risk groups of unplanned readmission of CRT patients in the early stage and provides a basis for formulating nursing strategies for different risk groups.