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AIM: To establish a method of simultaneously determining ginsenoside Rg1,ginsenoside Re and ginsenoside Rb1 in Tangniaole Granule (Radix Trichosanthis, Rhizoma Dioscoreae, Radix et Rhizoma Ginseng Rubra, Rhizoma Anemarrhenae, Radix Astragali, etc.). METHODS: Three components: ginsenoside Rg1, ginsenoside Re and ginsenoside Rb1 in Tangniaole Granule were determined simultaneously by HPLC, using a Diamonsil C_ 18 ( 4.6 mm?250 mm, 5 ?m), acetonitrile-water as a mobile phase. The detection wavelength was at 203 nm. RESULTS: The relationship among the concentrations and the peak areas of ginsenoside Rg1, ginsenoside Re and ginsenoside Rb1 were linear respectively. The RSD of precision, stability, repeatability and recovery were all less than 3%. CONCLUSION: The method is simultaneous determination for three components in Tangniaole Granule, and can be applied to the quality control of Tangniaole Granule.

Objective To observe the effect ropivacaine mesylate combined with sufentanil on walking epidural laboranalgesia.Methods 360 puerperae who accepted 0.12％ ropivacaine mesylate combined with sufentanil (0.5 μg/ml) epidural analgesia were analgesic group;at the same time and under the similar conditions,the 356 cases of puerprtae unused analgesic were control group.With visual analogue scale(VAS) assessing the uterine contraction pain and improved Bromage scale assessing lower limb movement block,recording the analgesic effect,every labor time,delivery mode,and the condition of postpartum hemorrhage,fetal distress and neonatal Apgar score in every group.Results Labor pain of pain group significant relief,the active period shorten and the vaginal eutocia percentage were higher than those in the control group; Labor time of the secend and the third stage,vaginal birth rate and oxytocin utilization rate had no differences between the two groups.Conclusion The effect of epidural block labor analgesia on 0.12％ ropivacaine mesylate combined with sufentanil is obvious and security.There is no motor nerve block and do not affect the stage of labor and neonatal.It still can reduce the rate of cesarean section and improve maternal satisfaction.

Objective To investigate the effects of enhanced recovery after surgery (ERAS) combined with laparoscopic common bile duct exploration (LCBDE) in elderly patients with choledocholithiasis.Methods From Jan 2015 to Dec 2016,in the control group 40 patients received conventional perioperative management and 40 patients in the ERAS group followed the ERAS protocol.The operative details and outcomes were compared in the two groups.Results No perioperative death occurred during the study period.There was no statistically significant difference between the two groups in operative time and intraoperative blood loss (t =1.04,0.88,P ＞0.05).Patients in ERAS group showed significantl shorter time of gastrointestinal tract peristalsis,off-bed,postoperative infusion,food intake,and abdominal drainage tube removal,as well as reduced weight loss,length of hospital stay and total cost than those in the control group (P ＜ 0.05).There were no significant difference of preoperative CRP and PCT,IL-6 in the 2 groups (t =1.18,0.44,1.49,P ＞ 0.05),However,the CRP and PCT,IL-6 levels in ERAS group were significantly lower than those in control group at postoperative days 1,4,7 (P ＜ 0.05).Furthermore,postoperative complications developed in 3 (7.5％),and 12 (30.0％) respectively (x2 =6.47,P ＜ 0.05).Conclusions Minimally invasive surgery combined with ERAS is safe and cost-effective approach for elderly patients of choledocholithiasis.

Objective To investigate the role of human umbilical cord mesenchymal stem cell-derived extracellular vesicle (hUC-MSC-EV) in the regeneration of fibrotic liver. Methods C57BL/6 mice were randomly divided into the 70% normal liver resection group (Oil+PHx group), 70% liver fibrosis resection group (CCl₄+PHx group) and 70% liver fibrosis resection+mesenchymal stem cell-derived extracellular vesicle (MSC-EV) treatment group (CCl₄+PHx+MSC-EV group), with 8 mice in each group. LX-2 cell lines were assigned into the phosphate buffer solution (PBS) group, transforming growth factor (TGF)-β group and TGF-β+MSC-EV group. The serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) in mice after partial liver resection were detected in each group. The expression levels of liver fibrosis and proliferation-related parameters were analyzed in each group. The messenger RNA (mRNA) expression levels of epidermal growth factor (EGF), fibroblast growth factor (FGF), vascular endothelial growth factor (VEGF) and hepatocyte growth factor (HGF) in LX-2 cells were detected in each group, and their effects on HGF expression in mouse liver were observed. Results Compared with the Oil+PHx group, the serum levels of AST, ALT and LDH were up-regulated, and the degree of fibrosis was more severe, the positive area of Sirius red and α-smooth muscle actin (α-SMA) staining was larger, and the expression level of α-SMA protein was up-regulated in the CCl₄+PHx group. Compared with the CCl₄+PHx group, the serum levels of AST, ALT and LDH were decreased, the degree of fibrosis was slighter, the positive area of Sirius red and α-SMA staining was decreased, and the expression level of α-SMA protein was down-regulated in the CCl₄+PHx+MSC-EV group, and the differences were statistically significant (all P < 0.05). Compared with the Oil+PHx group, the protein expression levels of Ki67 and proliferating cell nuclear antigen (PCNA) were lower in the CCl₄+PHx group. Compared with the CCl₄+PHx group, the protein expression levels of Ki67 and PCNA were increased in the CCl₄+PHx+MSC-EV group, and the differences were statistically significant (all P < 0.05). Compared with the PBS group, the expression level of CollagenⅠ mRNA in LX-2 cells was increased, the expression level of α-SMA protein was up-regulated and the expression level of HGF protein was decreased in the TGF-β group. Compared with the TGF-β group, the expression level of CollagenⅠ mRNA in LX-2 cells was decreased, the expression levels of HGF mRNA and protein were increased, and the expression level of α-SMA protein was decreased in the TGF-β+MSC-EV group, the differences were statistically significant (all P < 0.05). The expression level of HGF protein in the CCl₄+PHx group was lower than that in the Oil+PHx group, whereas the difference was not statistically significant (P > 0.05). The expression level of HGF protein in the CCl₄+PHx+MSC-EV group was higher than that in the CCl₄+PHx group, and the difference was statistically significant (P < 0.05). Conclusions The regenerative capacity of fibrotic liver is weaker than that of normal liver. hUC-MSC-EV may alleviate liver fibrosis and improve liver regeneration by promoting HGF secretion from actived hepatic stellate cells and effectively enhancing the regenerative capacity of fibrotic liver.

Head and neck squamous cell carcinoma (HNSCC) is one of the most common human cancers; however, its outcome of pharmacotherapy is always very limited. Herein, we performed a batch query in the connectivity map (cMap) based on bioinformatics, queried out 35 compounds with therapeutic potential, and screened out parbendazole as a most promising compound, which had an excellent inhibitory effect on the proliferation of HNSCC cell lines. In addition, tubulin was identified as a primary target of parbendazole, and the direct binding between them was further verified. Parbendazole was further proved as an effective tubulin polymerization inhibitor, which can block the cell cycle, cause apoptosis and prevent cell migration, and it exhibited reasonable therapeutic effect and low toxicity in the in vivo and in vitro anti-tumor evaluation. Our study repositioned an anthelmintic parbendazole to treat HNSCC, which revealed a therapeutic utility and provided a new treatment option for human cancers.