Objective To investigate the changes of electrolyte metabolism in patients undergoing moderate elective abdominal operation,and explore its relationship with postoperative complications.Methods The clinical data of 1117 inpatients (age ≥ 18 years) who had undergone moderate elective abdominal operation in the Department of General Surgery of Beijing Hospital from January 1,2011 to December 31,2011 were retrospectively analyzed.They received postoperative fasting for ≥ 3 days,and the preoperative liver function and renal function were normal.The perioperative electrolyte changes and clinical outcomes were recorded.For patients with normal preoperative electrolytes but abnormal postoperative electrolytes,its potential correlations with the postoperative infections and total complications were analyzed.Results The rates of abnormal postoperative electrolytes were as follows:potassium,24.1％ ; sodium,6.4％ ; chloride,27.6％ ; calcium,61.7％ ; magnesium,16.3％ ; and phosphorus,71％.The vast majority of ion levels were below the normal levels.The total complication rate was 19.7％ and the postoperative infection rate was 17.19％.Univariate logistic regression analysis showed that the postoperative total and infective complications were significantly associated with the increased (P =0.007) or decreased (P =0.007) serum potassium,the decreased serum sodium (P =0.016),the decreased serum phosphorus (P =0.004),and the decreased magnesium (P =0.049).Conclusions Electrolyte decrease is common after moderate elective abdominal operations.There is a certain correlation between postoperative electrolyte decrease and postoperative complications.Therefore,attention should be paid to maintain electrolyte balance during the perioperative period.

Objective To understand the intensity and characteristics of acute toxicity of esculentoside A on mice and measure relevant parameters and observe its diuresis effect on rat. Methods After intraperitoneal injection of different concentrations of esculentoside A to mice, toxic reactions were observed. Rats with water load were intraperitoneally injected with different doses of esculentoside A. Total urine volume in six consecutive hours after the injection was determined. Results The LD50 of esculentoside A calculated by Bliss method was 26. 19 mg · kg-1 , and the 95% confidence interval was 23. 11-29. 85 mg·kg-1 . The mortality and acute toxicity of esculentoside A appeared to be dose-dependent while the blank control group had no abnormal reaction. The urine volume was significantly different between high dose group and the negative control group. No significant difference in urine volume was found between middle and the negative control group, and between low dose group and the negative control group. Conclusion Esculentoside A is poisonous to mice when single dose was intraperitoneally injected, and high dose of esculentoside A has diuresis effect on rat.

This study was aimed to analyze changes of content and quantity of essential oil of processing drugs of Rhizome Atractylodes and to achieve the impact of pyrolysis characteristics for using excipients, in order to offer evi-dences for further research and its processing technology. Steam distillation was used to extract essential oil in the Rhizome Atractylodes. Infrared spectroscopy and gas chromatography were used in the qualitative and quantitative analysis on constituents of essential oil of processing products of Rhizome Atractylodes. Thermogravimetric analysis was used in the comparison of pyrolysis characteristics between Rhizome Atractylodes and its excipients. The results showed that the content of essential oil was declined after processing. However, after being processed, the content of atractylodin was increased at different degrees compared to crude product. The change of atractylodin showed differ-ent tendency in different processing drugs. The atractylodin content from high to low was in the order of products stir-baked to yellowish, products roasted by bran, products prepared with rice water, crude drug. At the temperature of more than 220oC, excipients had major impact for the pyrolysis characteristics of Rhizome Atractylodes. It was concluded that the essential oil declined, but atractylodin increased after Rhizome Atractylodes being processed. It also provided experimental basis for further research on processing technology, ormulation of quality standard and improvement of processing mechanism.

Abstract: The design space of the high shear wet granulation process was established and validated within the framework of quality by design (QbD). The system of microcrystalline cellulose-de-ioned water was used in this study. The median granule size and bulk density of granules were identified as critical quality attributes. Plackeet-Burmann experimental design was used to screen these factors as follows: dry mixing time, the impeller and chopper speed of dry mixing, water amount, water addition time, wet massing time, the impeller and chopper speed of wet massing and drying time. And the optimization was implemented with the central composite experimental design based on screened critical process parameters. The design space of the high shear wet granulation process was established based on the quadratic polynomial regression model. Since the P-values of both models were less than 0.05 and values of lack of fit were more than 0.1, the relationship between critical quality attributes and critical process parameters could be well described by the two models. The reliability of design space, illustrated by overlay plot, was improved with the addition of 95% confidence interval. For those granules whose process parameters were in the design space, the granule size could be controlled within 250 to 355 μm, and the bulk density could be controlled within a range of 0.4 to 0.6 g x cm(-3). The robustness and flexibility of the high shear wet granulation process have been enhanced via the establishment of the design space based on the QbD concept.

This study was aimed to find out the correlation between chemical component contents and physical prop-erties of tanshinone extract powders. The contents of cryptotanshinone and tanshinone IIA from 50 batches of tanshi-none extract powders were determined by HPLC. And the physical properties were determined by classical methods. The correlation analysis between component contents and physical properties were also investigated. The results showed that two sets of variables had good intraclass correlation, especially for the contents of cryptotanshinone and tanshinone IIA, among D10, D50, D90, there were relatively strong correlation between the bulk density and tapped density, between the Hausner ratio and compressibility index. The angle of repose had a certain correlation with the uniformity, Hausner ratio and compressibility index, but with no strong correlation. The correlation coefficient be-tween two sets was below 0.400, suggesting there was a not so good inter-group correlation. After the canonical cor-relation analysis, three pairs of canonical variables had significant correlations with correlation coefficients being 0.851, 0.674 and 0.565, respectively. It was concluded that there was a good intraclass correlation for each of physi-cal and/or chemical quality set, but the correlation between the two sets was bad. Canonical variables performed bet-ter inter-group correlation compared with original variables, indicating there was a certain correlation between chem-ical and physical quality attributes of tanshinone extract powders.

Objective To assess the application of preoperative prognostic nutritional index (PNI) in evaluation the surgical risk and long-term prognosis for elderly patients with gastric cancer.Methods The clinical data of 205 patients aged ≥ 75 years with gastric cancer undergoing radical resection from January 2004 to December 2016 were analyzed retrospectively.The PNI value was calculated by serum albumin (g/L) +5 x lymphocyte count (x 109/L).The receiver operating characteristic (ROC) curve and Youden's index was used to determine the value of PNI in surgical risk and prognosis of patients.Patients were divided into low PNI group and high PNI group based on the cut-off value,the clinicopathological characteristics,postoperative complications and long-term survival were compared between two groups.Results The average PNI value of 205 patients was 47.3 ± 5.5.When 44.9 was set as the cut-off value with the maximal Youden's index,the sensitivity and specificity of PNI were 0.86 and 0.47,respectively.There were statistically significant differences between the two groups of patients in age(t =-2.16,P =0.032),BMI (t =4.88,P =0.000),Charlson comorbidity score (x2 =7.77,P =0.005),gastric resection range (x2 =8.63,P =0.003),postoperative complications (x2 =9.46,P =0.002).The incidence of complications in the high PNI group was 24.8％ (33/133),which was lower than that in the low PNI group (45.8％,33/72;x2 =9.46,P =0.002).Multivariate logistic analysis showed that age (P =0.032),Charlson coplications scal (CCS) (P =0.042) and PNI ＜ 44.9 (P =0.027) were independent risk factors for postoperative complications;PNI ＜ 44.9 (P =0.001),gastrectomy (P =0.011),lymph node dissection (P =0.000),tumor differentiation (P =0.001) and TNM stage (P =0.000) were independent prognostic factors for elderly patients with gastric cancer.Conclusions Prognostic nutritional index is a valuable clinical marker in evaluation of surgical risk and prognosis for elderly patients with gastric cancer.

Objective To summarize our experience with surgical management of renal neoplasm involving inferoir veno cava.Methods We review the data of 115 patients,including 74 male patients and 41 female patients,with renal neoplasm involving venous system between March 1993 and December 2015.The mean age was 52 years old,ranging 22 to 77 years old.The tumor was found in right side in 77 cases and left side in 38 cases.There were 15 patients (13.0％) with renal vein thrombus,38 (33.1％) with infrahepatic thrombus,29 (25.2％) with low retrohepatic thrombus,20 (17.4％) with high retrohepatic thrombus,and 13 (11.3％) with supradiaphragmatic thrombus.The mean age was 52 years old,ranging 22 to 77 years old.The tumor was found in right side in 77 cases and left side in 38 cases.All patients accepted the radical nephrectomy.Primary outcomes were overall survival (OS),and cancer special survival (CSS) in patients with renal cell carcinoma (RCC) estimated by Kaplan-Meier method.Secondary outcome included operative and oncological features,past-operative complications and hospital mortality.Cox proportional hazard model was used to univariate and multivariate analysis for risk factor impacting on OS of RCC patients.Results Complete resections of renal neoplasm with tumor thrombus were achieved in 113 patients (98.3％),2 patients died intraoperatively due to the dropping of thrombus.Postoperative complication rate was 16.8％.Hospital mortality was 2.6％.Mean follow-up interval was 48 months.OS rates at 5-,and 10-year in RCC patients were 66.5％,and 61.8％,respectively.Metastasis was an independent risk factor affecting on OS (P =0.000).However,the level of thrombus was not an risk factor affecting the prognosis.Conclusions Radical resection of renal tumor and caval thrombus is an effective treatment for prolonging survival in patients with RCC extending into venous system.Retrohepatic caval tumor thrombus below or above the main hepatic vein should be dichotomized and managed respectively with diverse techniques.Metastatic rather than the level of thrombus was a risk factor impacting on RCC patient survival.

Objective:To evaluate the short-term efficacy of left colonic artery preservation in laparoscopic-assisted radical resection in elderly patients with rectal cancer.Methods:168 patients aged 65 and over who had undergonelaparoscopic-assisted radical resection of rectal cancer in the gastrointestinal surgery department of Beijing Hospital from December 2017 to December 2020 were retrospectively analyzed.According to different surgical methods, they were divided into the observation group with 90 subjects(the LCA group)and the control group with 78 subjects(the non-LCA group).Basic data, intraoperative, postoperative and clinicopathological data of the two groups were compared and analyzed.Results:There were no statistically significant differences between the two groups in operative time[(172.3±35.5)min vs.(155.5±28.7)min, t=2.182, P=0.103], intraoperative blood loss[(72.6±22.5)ml vs.(67.3±18.4)ml, t=1.473, P=0.128], number of group 253 lymph nodes dissected[(3.8±1.5) vs.(4.2±1.6), t=0.785, P=0.221], and total number of lymph nodes dissected[(14.1±4.3) vs.(15.8±5.0), t=1.652, P=0.113].There was no significant difference in the incidence of anastomotic hemorrhage[4.4%(4/90) vs.3.8%(3/78), χ2=1.182, P=0.133]and the incidence of urinary retention[4.4%(4/90) vs.6.4%(5/78), χ2=1.785, P=0.148].The time to first postoperative flatus[(52.4±23.2)h vs.(68.3±29.3)h, t=2.652, P=0.023]and length of postoperative hospital stay[(9.07±3.56)d vs.(10.68±4.94)d, t=2.785, P=0.017]in the LCA group were shorter than those in the non-LCA group.The incidences of anastomotic leakage in the LCA group and the non-LAC group were 2.2%(2/90)and 5.1%(4/78), respectively, and the difference was statistically significant( t=3.575, P=0.001). Conclusions:LCA preservation in laparoscopic-assisted radical resection of rectal cancer in elderly patients with rectal cancer is safe and feasible, reduces the incidence of anastomotic leakage, and shorten the time to first postoperative flatus and length of postoperative hospital stay.It has good practical clinical value.

In the field of dental aesthetics,digital aesthetic design plays a crucial role in helping dentists to predict treatment outcomes vis-ually,as well as in enhancing the consistency of knowledge and understanding of aesthetic goals between dentists and patients.It serves as the foundation for achieving ideal aesthetic effects.However,there is no clear standard for this digital process currently in China and abroad.Many dentists lack of systematic understanding of how to carry out digital aesthetic design for treatment.To establish standardized processes for dental aesthetic design and to improve the homogeneity of treatment outcomes,Chinese Society of Digital Dental Industry(CSD-DI)convened domestic experts in related field to compile this consensus.This article elaborates on the key aspects of digital aesthetic data collection,integration steps,and the digital aesthetic design process.It also formulates a decision tree for dental aesthetics at macro level and outlines corresponding workflows for various clinical scenarios,serving as a reference for clinicians.