Traditional medicine (herb medicine) began to prevail again over last two decades, and it is about 70% of the world population taking herb medicine as supplement or alternative medicine according to a recent survey. The consumption of herb medicine increased exponentially in Canada, Australia and Europe during last 10 years. Since concomitant administration of herbal and western medicine has become a trend, it requires paying close attention to the problem. Herb-drug interactions have been extensively investigated worldwide, and there is an increasing concern about the clinical herb-drug interaction. In this review we introduced the current progress in the herb-drug interactions including evidence-based clinical studies and establishment of levels of evidence for herb-drug interaction; and in the related mechanisms including the induction and inhibition of metabolic enzymes, inhibition and induction of transport and efflux proteins, alteration of gastrointestinal functions, and alteration in renal elimination. We also analyzed both the achievements and the challenges faced in the concomitant administration of traditional Chinese medicine and western medicine.

Objective To study the immobilization effect and keep the accurate treating position of Body-Fix (R) device in the patients with vertebral metastatic tumor treated by hypofractionated intensitymodulated radiotherapy.Methods From October 2008 to February 2010,six nasopharyngeal carcinoma patients with 10 treated lesion with vertebral metastasis who were treated by hypofractionated intensitymodulated radiotherapy and immobilized by the Body-Fix (R) device were enrolled in this study.Three sets cone beam CT images were taken and recorded when patient was underway the initial setup,position correction and after radiation delivery.Comparing these images with the planning CT images to get the setup errors and the intrafractional position shifting,and the immobilization effect of Body-Fix (R) device was analyzed.Results In the upper,middle and lower sections of the vertebrae,the intrafractional setup errors in the left-right direction were (-0.6±0.5) mm,(-0.1 ±1.0) mm,(0.0±0.4) mm,with in the superior-inferior direction (1.0 ± 1.4) mm,(4.8 ± 5.7) mm,(0.0 ± 0.3) mm and in the anterior-posterior direction (1.2 ± 5.2) mm,(-0.3 ± 0.3) mm,(0.0 ± 0.5) mm,respectively.Conclusions With Body-Fix (R) device,the intrafractional setup errors can be minimized within 2 mm which make the accurate spinal radiosurgery technique possible.

The study is to establish an HPLC method using fluorescence detector for the determination of doxazosin enantiomers and investigate their chiral inversion in vitro and in vivo. Ultron ES-OVM was taken as the chiral chromatographic column, and the column temperature was 30 degrees C. Isocratic elution using a mobile phase of phosphate buffer-acetonitrile (85 : 15, v/v) at a flow rate of 0.8 mL x min(-1) was done. The fluorescence detection was set at lambda(Ex) = 255 nm and lambda(Em) = 385 nm. Prazosin was used as the internal standard. (-) Doxazosin or (+) doxazosin added into rat plasma in vitro was determined after incubating in 37 degrees C water bath for 2, 5 and 10 days. (-) Doxazosin or (+) doxazosin was administered orally to the rats for one months. Plasma samples were taken at 8 h after the last administration. A good linear relationship was achieved when the concentration of doxazosin enantiomers was within the range of 4 - 2 000 ng x mL(-1). The average recovery for (-) doxazosin was 99.5% with RSD 3.6%, and for (+) doxazosin was 99.3% with RSD 4.3%. Chiral inversion was observed neither in vitro nor in vivo studies. The method is selective, accurate and reproducible, which is suitable for the detection of doxazosin enantiomers in rat plasma. The in vitro and in vivo studies indicate that chiral inversion occurs uneasily between (-) doxazosin and (+) doxazosin in the rat.

Objective To evaluate the diagnostic value of procalcitionin (PCT ) in infectious diseases .Methods Levels of PCT , C reaction protein (CRP) and white blood cells (WBC) were detected and compared among 103 cases of bacterial infection ,77 ca‐ses of viral infections and 60 cases of non‐infected patients .Results PCT level of most bacterial infection patients was higher than 0 .5 ng/mL ,and that of viral infection patients was less or equal to 0 .5 ng/mL .Proportion of bacterial infection patients with differ‐ent PCT level was different with that of viral infection patients (P<0 .05) .PCT ,CRP and WBC levels in bacterial infection patients were higher than viral infection patients and non‐infected patients (P<0 .05) .Positive rates of PCT ,CRP and WBC in bacterial in‐fection patients were higher than viral infection patients and non‐infected patients (P<0 .05) .Conclusion PCT might be with high diagnostic sensitivity and specificity to infectious diseases ,with important diagnostic value .

Objective To study the correlation of fingerprint chromatograms of Cinnamomi Ramulus formula granules, decoction pieces and water decoction by HPLC; To investigate the difference of main chemical constituents among different forms. Methods The Diamonsil C18 column (4.6 mm × 250 mm, 5 μm) was used with mobile phase of acetonitrile and 0.1% phosphoric acid at the flow rate of 1.0 mL/min, with detection wave of 280 nm and temperature of 30 ℃. The detection of 10 batches of Cinnamomi Ramulus formula granules, 10 batches of decoction pieces and 10 batches of water decoction were established respectively. Results Totally 12 peaks in the HPLC fingerprint chromatogram from 10 batches of formula granules could be tracked in the water decoction; 10 peaks in the HPLC fingerprint chromatogram could be tracked in the decoction pieces. Three components, such as protocatechuic acid, coumarin and cinnamic acid were verified. Conclusion The main chemical components of Cinnamomi Ramulus formula granules and water decoction are basically the same, and the common component contents have similar proportion.

Objective:To explore the effects of repetitive transcranial magnetic stimulation on balance function in stroke patients.Methods:A total of 238 patients randomized to a rTMS group and a control group by using the random number table at the ratio of 1∶1. Patients in the rTMS group were treated with low-frequency rTMS delivered to the contralateral M1 area, while those in the control group were treated with sham rTMS. The intervention was administered 5 times a week for 4 weeks. Both groups were also treated with conventional physical therapies in addition to rTMS. At one day before the intervention, two days and six weeks after the intervention, Fugl-Meyer Balance Scale, Berg Balance Scale and Modified Barthel index were employed to evaluate the functional outcome of all the patients.Results:After intervention, the scores of Fugl-Meyer Balance Scale, Berg Balance Scale and Modified Barthel index in both groups were significantly improved, and the rTMS group improved significantly more than control group ( P<0.05). When compare to the control group, the rTMS group improved to a significantly greater extent with regard to all the outcomes measures p after intervention and at follow-up ( P<0.05). Conclusion:rTMS is beneficial to the recovery of balance function in patients with stroke.

Objective:To explore the relationship between the positive thyroid peroxidase antibody (TPOAb) in early pregnancy and the adverse maternal and infant outcomes.Methods:A retrospective analysis was conducted on the clinical data of 168 TPOAb positive pregnant women who underwent early prenatal testing in Family Planning Endocrinology Department of Shanxi Children’s Hospital from Jun. 2020 to Dec. 2022. They were divided into group A (104 cases with normal thyroid function and TPOAb positive) and group B (64 cases with hypothyroidism and TPOAb positive) based on their thyroid function. Another 150 pregnant women with negative TPOAb during early prenatal testing during the same period were selected as the control group. Follow up was from the first prenatal examination to 6 weeks after delivery, the adverse pregnancy outcomes of three groups of pregnant women and fetuses were recorded, and chi square test for inter group comparison was used.Results:There were statistically significant differences in the incidence of adverse outcomes such as diabetes, premature rupture of membranes and cesarean section among the three groups ( P values were 0.028, 0.003 and 0.006, respectively). The incidence of premature rupture of membranes in group A was significantly higher than that in the control group ( P=0.003). The incidences of pregnancy diabetes, premature rupture of membranes and cesarean section in group B were significantly higher than those of the control group ( P=0.008, 0.003, 0.001, respectively). The incidence of cesarean section in group B was significantly higher than group A ( P=0.0461). There was no statistically significant difference in the incidence of adverse outcomes such as gestational hypertension, preeclampsia, abnormal amniotic fluid, placental abruption, miscarriage, difficult labor, and stillbirth among the three groups of pregnant women ( P values of 0.433, 0.137, 0.231, 0.825, 0.138, 0.356, and 0.933, respectively). The incidence rates of premature birth, intrauterine distress, fetal growth restriction, and pathological jaundice were compared among the three groups of fetuses, and the differences were statistically significant ( P<0.001, 0.008, 0.038, respectively). The incidence of intrauterine distress and pathological jaundice in group A was significantly higher than control group ( P<0.001, 0.028, respectively), while the incidence of premature birth, intrauterine distress, fetal growth restriction, and pathological jaundice in group B was significantly higher than the control group ( P<0.010, <0.000, 0.001, 0.014, respectively) . Conclusions:TPOAb positive in early pregnancy can increase the incidence of adverse maternal and infant outcomes such as premature rupture of membranes, preterm delivery, intrauterine distress, pathological jaundice, etc. Early screening of thyroid function and TPOAb and intervention will help reduce adverse maternal and infant outcomes.

Objective     To investigate the current status of constipation during postoperative hospitalization and the factors associated with moderate to severe constipation at discharge in lung cancer patients. Methods     Lung cancer patients who underwent surgery in 6 tertiary hospitals in Sichuan Province from November 2017 to January 2020 were enrolled. The MD Anderson Symptom Scale-Lung Cancer Module was used to collect postoperative constipation scores. Unconditional logistic stepwise regression was used to analyze the related influencing factors for moderate to severe constipation on the day of discharge. Results     Finally 337 patients were collected. There were 171 males and 166 females, with an average age of 55.0±10.3 years. Constipation scores of lung cancer patients increased from postoperative day 1 to day 3, and showed a decreasing trend from day 3 to day 7. Moderate to severe constipation was present in 68 (20.2%) patients at discharge. The postoperative hospital stay (OR=0.743, P<0.001) and the dose of morphine used during postoperative hospitalization (OR=1.002, P=0.015) were influencing factors for moderate to severe constipation at discharge in lung cancer patients. Conclusion    Lung cancer patients have the most severe constipation on postoperative day 3. Moderate to severe constipation at discharge is associated with the postoperative hospital stay and the dose of morphine used during postoperative hospitalization.