OBJECTIVE:To optimize extraction technology of saponins from Paris polyphylla. METHODS:Using paris sapo-nin Ⅰ,paris saponin Ⅱand Paridis total saponin as dependent variables,using ethanol volume fraction,extraction time and sol-vent amount as independent variables,through multiple linear regression and binomial fitting,the extraction technology was opti-mized with response surface method and predicted. RESULTS:The optimized extraction technology of saponins from P. polyphylla was as follows as 10-fold of 80% ethanol,2 times reflux extraction,100 min each time. Under the extraction technology,the ex-traction rates of paris saponinⅠwere 85.4%,82.7% and 87.1%;those of paris saponinⅡwere 85.9%,81.3% and 83.6%;and those of Paridis total saponin were 89.5%,92.1% and 90.3%(all RSD<2.0%). Measured value was 0.964 9,predicted value was 0.986 0 and deviation rate was 2.14%. CONCLUSIONS:The central composite design-response surface method is simple and reliable for the optimization of extraction technology of saponins from P. polyphylla.

Objective To investigate the prognostic effects of continuous renal replacement therapy on multiple organ dysfunction complicated with acute kidney injury.Methods Fifty nine patients who were diagnosed with multiple organ dysfunction syndrome (MODS) complicated with acute kidney injury (AKI) and underwent continuous renal replacement therapy (CRRT) were selected and grouped according to the Kidney Disease Improving Global Outcomes (KDIGO) staging.Their clinical data before CRRT were collected.The patients were grouped according to the Intensive Care Unit (ICU) prognosis,namely death and survival.The differences between two groups were analyzed.The multinomial logistic regression analysis was performed to explore the prognostic factors.Results With the increase of KDIGO stage,the Acute Physiology And Chronic Health Evaluation Ⅱ (APACHEII) score,Sequential Organ Failure Assessment (SOFA) score,the need for vasoactive drugs,and the number of cases with oliguria and ICU mortality rates showed an increasing trend,and those differences were statistically significant (P ＜ 0.05).After multivariate analysis,KDIGO Ⅲ stage,the number of failed organs,oliguria,and the mean daily fluid balance were independent risk factors of death in patients who were diagnosed with MODS complicated with AKI and underwent CRRT.Conclusions The KDIGO classification plays an important role in predicting the prognosis of patients with MODS complicated with AKI in need of CRRT.The number of failed organs,oliguria,and the mean daily fluid balance are also the risk factors for prognosis.

ObjectiveTo explore the value of virtual touch tissue quantification (VTQ) in evaluating Lauren classification of advanced gastric carcinoma.MethodsForty-one patients with gastric cancer proved by endoscopic biopsy performed preoperative VTQ examination,and the findings were compared with postoperative pathologic results via hematoxylin -eosin and Alcian Blue-Periodic Acid Schiff (AB-PAS) staining.ResultsIn 41 patients,26 cases were diagnosed as diffuse type and 15 cases as intestinal type by pathology after operation.The shear wave velocity(SWV) of diffuse type was higher than that of intestinal type [(1.72± 0.83)m/s vs (1.05± 0.66)m/s,t =2.819,P=0.008] measured by virtual touch tissue quantification (VTQ).According to the area under the ROC curve,the cut- off value of SWV in gastric cancer tissues for assessing the diffuse type was 1.045 m/s with a sensitivity of 80.8％ and specificity of 73.3 ％ respectively.ConclusionsVTQ could be considered as a promising method to distinguish the Lauren classification in patients with advanced gastric carcinoma.

Abstract The processs of female Osteoporosis and its prevention by Physical activity were simulated using anisotropic bone remodelling model with mechanostat combining with finite element method. The results show that bone mass declines slowly at the beginning, bone loss accelerates in postmenopause and bone mass declines 25. 84%-28.63% at the age of 60 and 38.50%-40.44% at the age of 80. Bone mass increases 3.05%-10.26% by an increase of 10%-20% in physical activity. The above results are consistent with clinical observations,which proves that declination of mechanical usage is the primary factor leading to osteoporosis, menopause quickens the process of female osteoporosis, physical activity can decelerate it.
Aged ; Biomechanical Phenomena ; Bone Remodeling ; Computer Simulation ; Exercise ; physiology ; Female ; Humans ; Middle Aged ; Models, Biological ; Osteoporosis, Postmenopausal ; prevention & control

At present, the numerical model of bone remodeling is inadequate to copy the physiological process of bone remodeling. According to the physiological mechanism of bone remodeling and the anisotropy of bone mechanics properties, an anisotropic bone modeling model with mechanostat was developed, and then was applied to a study on the remodeling evolution of 2D squareplate model. Good results were obtained. The model can be used in the study of implant, osteoporosis and other bone diseases.
Anisotropy ; Biomechanical Phenomena ; Bone Remodeling ; physiology ; Bone and Bones ; physiology ; Models, Biological ; Osteoporosis ; physiopathology

Objective:To characterize the histopathological subtypes and their clinicopathological parameters of gender and onset age by common, rare and sparse primary esophageal malignant tumors (PEMT).Methods:A total of 272 437 patients with PEMT were enrolled in this study, and all of the patients were received radical surgery. The clinicopathological information of the patients was obtained from the database established by the State Key Laboratory of Esophageal Cancer Prevention & Treatment from September 1973 to December 2020, which included the clinical treatment, pathological diagnosis and follow-up information of esophagus and gastric cardia cancers. All patients were diagnosed and classified by the criteria of esophageal tumor histopathological diagnosis and classification (2019) of the World Health Organization (WHO). The esophageal tumors, which were not included in the WHO classification, were analyzed separately according to the postoperative pathological diagnosis. The χ 2 test was performed by the SPSS 25.0 software on count data, and the test standard α=0.05. Results:A total of 32 histopathological types were identified in the enrolled PEMT patients, of which 10 subtypes were not included in the WHO classification. According to the frequency, PEMT were divided into common (esophageal squamous cell carcinoma, ESCC, accounting for 97.1%), rare (esophageal adenocarcinoma, EAC, accounting for 2.3%) and sparse (mainly esophageal small cell carcinoma, malignant melanoma, etc., accounting for 0.6%). All the common, rare, and sparse types occurred predominantly in male patients, and the gender difference of rare type was most significant (EAC, male∶ female, 2.67∶1), followed with common type (ESCC, male∶ female, 1.78∶1) and sparse type (male∶ female, 1.71∶1). The common type (ESCC) mainly occurred in the middle thoracic segment (65.2%), while the rare type (EAC) mainly occurred in the lower thoracic segment (56.8%). Among the sparse type, malignant melanoma and malignant fibrous histiocytoma were both predominantly located in the lower thoracic segment (51.7%, 66.7%), and the others were mainly in the middle thoracic segment.Conclusion:ESCC is the most common type among the 32 histopathological types of PEMT, followed by EAC as the rare type, and esophageal small cell carcinoma and malignant melanoma as the major sparse type, and all of which are mainly occur in male patients. The common type of ESCC mainly occur in the middle thoracic segment, while the rare type of EAC mainly in the lower thoracic segment. The mainly sparse type of malignant melanoma and malignant fibrous histiocytoma predominately occur in the lower thoracic segment, and the remaining sparse types mainly occur in the middle thoracic segment.

Objective: To explore whether early oral feeding after total laryngectomy is safe and effective by evaluating the incidence of pharyngocutaneous fistula (PCF) and the hospital duration. Methods: A retrospective cohort study was conducted, including 52 patients underwent total laryngectomy, plus partial tongue base resection (n=2), partial pharyngectomy (n=1), or pedicle flap (n=2) between January 2012 and October 2017. Patients who had a history of preoperative radiotherapy, chemotherapy or chemoradiotherapy, previous surgery for larynx or pharynx and who had severe complications were excluded. Early oral feeding started between 48 h and 72 h postoperatively, while delayed oral feeding started within postoperative day 8-10. The incidences of PCF in two groups were compared to evaluate whether PCF and early oral feeding was related. Multi-variables analysis was conducted to evaluate risk factors for PCF. Results: PCF rate was 19.2% among all patients, 11.1% in patients with early oral feeding and 23.5% in patients with delayed oral feeding. No significant statistically difference in PCF rate was found between two groups (χ²=0.506, P=0.477). Multi-variables analysis showed that oral feeding time (early or delayed) was not a independent risk factor of PCF (Two classification response variable Logistic regression, P=0.200, OR=0.242, 95%CI[0.028-2.118]). But low preoperative albumin level was observed as an independent risk factor for PCF (P=0.039, OR=0.848, 95% CI [0.726-0.992]). A negative correlation was observed between preoperative albumin level and PCF. And also there was not a significant difference in hospital duration between patients with early oral feeding and delayed oral feeding(U=268, P=0.464). Conclusion For patients total laryngectomy with no previous history of radiotherapy, chemotherapy, chemoradiotherapy, early oral feeding after surgery is safe and effective.

Objective: To investigate the value of secondary cervical lymph node dissection in papillary thyroid carcinoma (PTC). Methods: PTC patients with recurrence re-operated in a previously dissected area at our hospital during 2000-2016 were included in this analysis. Patients were divided according to the operative interval of 6 months. The level and number of lymph node metastasis and the number of lymph node dissection were analyzed to calculate the ratio of lymph node metastasis. Results: A total of 336 PTC patients received 360 side lateral cervical lymph nodes dissection. The ratio of recurrence in unilateral lateral neck is 92.9%(312/336). The ratio of recurrence in multiple levels (more than two regions) were 47.5% (171/360). The recurrence ratio of level Ⅱ, Ⅲ, Ⅳ and Ⅴ were 55.6%(200/360), 44.2%(159/360), 59.7%(215/360) and 10.3%(37/360), respectively. Lymph node metastases were inclined to level Ⅱ (33.6%) and Ⅳ (35.8%). The mean number of lymph node dissection and metastasis in the group of operative interval ≤ 6 months was 26.56 per case and 4.37 per case, respectively. The mean number of lymph node dissection and metastasis in the group of operative interval >6 months was 16.80 per case and 3.20 per case, respectively. The number of lymph node dissection and metastasis between these two groups were significantly different (P=0.001, P<0.001). Conclusions Lymph node metastasis of PTC patients with secondary cervical lymph node dissection are inclined to level Ⅱ and level Ⅳ. Moreover, multi-level metastasis is not rare. Level Ⅱ and level Ⅳ require more attention in the first operation. Most of the patients undergo reoperation because of residual lymph nodes from the previous treatment. Normalization and completeness of the initial dissection are particularly important to PTC patients.