OBJECTIVE:To establish a method for the simultaneous determination of narirutin,naringin,hesperiden and neo-hesperiden in Weisu granule. METHODS:UPLC was performed on the column of ACQUITY UPLC BEH C18 with mobile phase of acetonitrile-0.2% Phosphoric acid aqueous(gradient elution)at a flow rate of 0.40 ml/min,the detection wavelength was 284 nm, the column temperature was 30 ℃,and the injection volume was 1 μl. RESULTS:The linear range was 9.38-93.75 μg/ml for narirutin(r=0.999 7), 32.25-322.50 μg/ml for naringin(r=0.999 7), 11.25-112.50 μg/ml for hesperiden(r=0.999 9) and 11.88-118.75 μg/ml for neohesperidin(r=0.999 8);limits of quantitation were 20 ng,18 ng,18 ng and 18 ng,the limits of detec-tion were 6 ng,5 ng ,5 ng and 5 ng,respectively;RSDs of precision,stability and reproducibility tests were lower than 2.0%;re-coveries were 96.24%-103.12%(RSD=2.45%,n=6),98.43%-102.10%(RSD=1.42%,n=6),96.10%-101.41%(RSD=2.07%,n=6)and 95.57%-99.06%(RSD=1.44%,n=6),respectively. CONCLUSIONS:The method is rapid and efficient,and suitable for the simultaneous determination of narirutin,naringin,hesperiden and neohesperiden in Weisu granule.

Objective To investigate the relationship between the coagulation system status and the pulmonary hemorrhage in children with severe hand,foot and mouth disease(HFMD)and approach the clinical significance of early detection of coagulation function. Methods By prospective case design method,89 cases with HFMD admitted to Department of Critical Care Medicine of Hebei Provincial Children Hospital from July 2010 to July 2012 were enrolled. The children were divided into severe group(46 cases)and critical group(43 cases)according to the severity of disease,and the children in critical group were subdivided into survivor group(26 cases)and non-survivor group (17 cases). Forty-four healthy children with the same age and in the same period were served as healthy control group. The blood of children was collected immediately after admission for determination of blood routine, prothrombin time(PT),thrombin time(TT),activated partial thrombin time(APTT),fibrinogen(Fg),and D-dimer (DD). Results There were no significant differences in PT,TT,APTT and Fg among severe group,critical group and health control group(all P>0.05). The blood platelets count(PLT)in severe group and critical group was significantly lower than that in health control group(×109/L:245±130,237±156 vs. 389±120),while the DD was significantly higher than that in healthy control group(mg/L:0.34±0.67,0.41±0.08 vs. 0.24±0.13),and the DD in critical group was obviously higher than that in severe group(all P<0.05). The mortality rate in critical group was 39.5%,and there were no significant differences in PT,APTT,Fg,TT and PLT between survivor group and non-survivor group(all P>0.05),but the DD in non-survivor group was significantly lower than that in survivor group(mg/L:0.60±0.09 vs. 0.12±0.09,P<0.05). Conclusions In children with severe or critical HFMD, the coagulation factor and blood platelet were in a state of mobilization,mild consumption state with the existence of fibrinolytic inhibition,but without systemic bleeding tendency,therefore it is in a compensatory stage of disseminated intravascular coagulation(DIC),not the mechanism of pulmonary hemorrhage. The monitor of DD has its clinical significance in evaluations of the disease situation and its prognosis.

Objective To explore the learning curve of robotic-assisted kidney transplantation(RAKT).Methods The clinical data of 96 consecutive RAKT patients performed by the same surgical team were retrospectively analyzed.The arterial anastomosis time,venous anastomosis time,ureteral anastomosis time,hospital stay,and blood loss were selected as evaluation indicators.The learning curve of RAKT was analyzed using the cumulative sum(CUSUM),and the curve was divided into the learning improvement stage and the proficient mastery stage according to the learning curve.The learning curve was verified by comparing the general data and surgical data of patients in different learning stages,and the clinical efficacy of each stage was analyzed.Results The optimal fitting equation of the learning curve reached its peak at the 33rd case,which was the minimum number of surgeries required to master RAKT.There was no statistically significant difference in age,gender,dialysis type,previous abdominal surgery history,number of donor renal arteries,and preoperative serum creatinine between the learning improvement group and the proficient mastery group(all P>0.05).Compared with the learning improvement stage,the body mass index(BMI)was higher,and the number of right donor kidney was increased compared to the left donor kidney in the proficient mastery stage(both P<0.05).There were no significant differences in arterial anastomosis time,ureteral anastomosis time,postoperative serum creatinine,and complications between the two groups(all P>0.05).The iliac vessel dissection time,warm ischemia time,venous anastomosis time,blood loss,and hospital stay in the proficient mastery stage were superior to those in the learning improvement stage,with statistically significant differences(all P<0.05).Conclusions RAKT requires at least 33 cases to cross the learning curve.There is no difference in complications and recovery of transplant renal function between the learning improvement stage and the proficient mastery stage.