Objective: To investigate the hydrolysis conversion rate of alcohol amine-diterpene alkaloids from aconitum alkaloids, hydrolyze aconitum alkaloids reference substance, calculate the amount of alcohol amine-diterpene alkaloids in the hydrolysis solution by the hydrolysis conversion rate, which is used as the amount of alcohol amine-diterpene alkaloids reference substance, and establish a content determination method for aconine, hypaconitine and aconine in Aconiti radix cocta.Methods: Through controlling the hydrolysis conditions of aconitine, hypaconitine and mesaconitine, aconine, hypaconitine and aconine were obtained.The determination was performed on an Agilent ZORBAX Extend-C18 RRHT(2.1 mm×50 mm,1.8 μm) column with the mobile phase consisting of methanol(A)-water(B containing 0.1% formic acid and 2.5 mmol·L-1 ammonium acetate) with gradient elution by HPLC-QTOF-MS.The flow rate was 0.21 ml·min-1.The column temperature was 30 ℃.MS instrument was equipped with an ESI+ ion source.Results: Under the hydrolysis conditions of this study, the conversion rate of aconine from aconitine was 99.64%;the conversion rate of hypaconitine from hypaconine was 99.94%;the conversion rate of mesaconitine from mesaconine was 99.57%.The HPLC-QTOF-MS methodological investigation showed the 3 kinds of alcohol amine-diterpene alkaloids were with good linearity (r>0.999 1).The RSD of the precision, repeatability and stability tests were less than 5%.The average recoveries were within the range of 99.43%-100.10%.Conclusion: The validated method is simple, specific, reliable and reproducible.In the absence of reference substance, it can be used for the quality control of the herbs of Aconitum L.species.

Objective:To develop a method of quantitative analysis of multi-components by single marker( QAMS) for nine kinds of alkaloids in Xiaohuoluo pills. Methods: An HPLC-QTOF-MS method with an Agilent ZORBAX Extend-C18 RRHT(2. 1 mm × 50 mm,1. 8 μm) column was applied. The flow rate was 0. 21 ml·min-1 . The column temperature was 30 ℃. The mobile phase was methanol (A)-water (B;containing 0. 1％ formic acid and 2. 5 mmol·L-1 ammonium acetate) with gradient elution. The aconitine was used as the internal standard, and the relative correction factor ( RCFs) of hypaconitine, mesaconitine, benzoylaconine, benzoyl-hypaconine, benzoylmesaconine, aconine, hypaconine and mesaconine was respectively established, and the reproducibility inspection on the RCF was performed. The contents of the other 8 kinds of aconitum alkaloids were calculated according to the RCF. At the same time, an external standard method ( ESM) was performed for the content determination of the nine alkaloids. The results of the two methods were compared. The feasibility and accuracy of the QAMS method were verified. Results:Within a certain range,the RCF of hypacontine,mesacontine, benzoylaconine, benzoylhypaconine, benzoyl mesaconine, aconine, hypaconine and mesaconine to aconitine was 1. 736,1. 979,1. 0471,0. 9242,1. 2901,1. 3078,1. 2859,and 1. 0948,respectively. The QAMS method was established for determi-ning alkaloids. There were no significant differences between the results of the QAMS method and those of the external standard method ( ESM) . Conclusion:With the validation of methodology, the method established in our study can be used for the content determina-tion of aconitine, hypaconitine, mesaconitine, benzoylaconine, benzoylhypaconine, benzoylmesaconine, aconine, hypaconine and mesaconine in xiaohuoluo pills.

Objective:To investigate the effect of right stellate ganglion block (RSGB)-serratus anterior plane block (SAPB) combined with general anesthesia in thoracoscopic radical resection of lung cancer.Methods:A total of 90 patients who planned to undergo thoracoscopic radical resection of lung cancer in Xiangya Changde Hospital from March 2020 to September 2021 were prospectively selected and divided into 3 groups by random number table method: general anesthesia group (G group), (SAPB)+ general anesthesia group (SG group), RSGB+ SAPB+ general anesthesia group (RSG group), 30 cases in each group. The SG group received SAPB on the operative side before general anesthesia, and the RSG group received RSGB+ SAPB on the operative side before general anesthesia. After the blocking effect was determined, all patients were given general anesthesia in the same scheme according to their weight, and patients were given patient-controlled intravenous analgesia (PCIA) after surgery. The mean arterial pressure (MAP) and heart rate (HR) were recorded before anesthesia (T 0), before intubation (T 1), 1 min after intubation (T 2), 5 min after intubation (T 3), at extubation (T 4) and 5 min after extubation (T 5). The intraoperative dosage of remifentanil, incidence of nausea and vomiting (PONV) within 24 hours after surgery, number of additional PCIA within 24 hours, the Visual Analogue Scale (VAS) of static and dynamic pain, the Bruggrmann Comfort Scale (BCS) and Richard Campbell Sleep Questionnaire (RSCQ) 24 hours after surgery were recorded. Results:Compared with T 0, the MAP and HR in 3 groups were increased 1 min after intubation (T 2) and at extubation (T 4), but the increases in RSG group were significantly less than those in G and SG groups (all P<0.05). The remifentanil dosage, PONV incidence and PCIA supplemental times in SG and RSG groups were less than those in G group, and the BCS score and RSCQ score were higher than those in G group (all P<0.05); the BCS score and RSCQ score in RSG group were higher than those in SG group (all P<0.05). Conclusions:RSGB+ SAPB combined with general anesthesia in thoracoscopic radical resection of lung cancer has little circulation fluctuation, good postoperative analgesia effect, less adverse reactions and high comfort level.

Objective:To establish a GC method for the imultaneous determination of cinnamaldehyde, bornyl acetate, costunol-ide,dehydrocostus lactone,magnolol and honokiol in Dutong pills. Methods: The determination was performed on an HP-5 column (30 m ×0.32 mm,0.25 μm) with programmed temperature. The carrier gas was nitrogen with the flow rate of 2.0 ml·min-1. The injection volumn was 1 μl and the sample split ratio was 5:1. The inlet temperature was 280 ℃. The detector was a flame ionization detector with temperature at 300 ℃. Results:The linear ranges were 32.28-516.40 μg·ml-1for cinnamaldehyde(r=0.999 3), 27.06-433.00 μg·ml-1for bornyl acetate(r=0.999 2),25.65-410.40 μg·ml-1for costunolide(r=0.999 3),26.10-417.60 μg ·ml-1for dehydrocostus lactone(r=0.999 3),24.01-384.20 μg·ml-1for magnolol(r=0.999 0) and 18.32-293.10 μg·ml-1 for honokiol(r=0.999 4). The average recovery was 99.71%(RSD=0.67%),99.34%(RSD=1.18%),100.16%(RSD=0. 34%),100.40%(RSD=0.39%),99.32%(RSD=1.22%) and 99.58%(RSD=0.58%)(n=6),respectively. Conclusion:The method is simple,sensitive and accurate,can be used to supplement the insufficient quality control of Dutong pills.

Objective:To explore the effects of Baduanjin combined with resistance exercise in rural elderly.Methods:From May to September 2020, totally 80 aged people from 2 villages in Hebei province were selected by convenient sampling. Patients from one village were randomly included into an intervention group ( n=40) , and patients from the other village were included into a control group ( n=40) . Patients in the control group took daily activities and exercise, and received only health education, while patients in the intervention group practiced Baduanjin combined with resistance exercise in addition to daily activities. The Chinese version of Fried Frailty Phenotype Assessment Components, Time Up and Go Test (TUGT) , Five-Times Sit-to-Stand Test (FTSST) , and Pittsburgh Sleep Quality Index (PSQI) were used to evaluate the frailty, balance ability, lower limb muscle strength, and sleep quality of the two groups of rural elderly before and after the intervention. In this study, totally 80 questionnaires were distributed, and 78 valid questionnaires were recovered, accounting for an effective recovery rate of 97.5%. Results:The Chinese version of Fried Frailty Phenotype Assessment Components and PSQI scores of the rural elderly in the intervention group after the intervention were lower than those in the control group and before the intervention, and the differences were statistically significant ( P<0.05) . The TUGT and FTSST time of the rural elderly in the intervention group after the intervention were shorter than those in the control group and before the intervention, and the differences were statistically significant ( P<0.01) . Conclusions:Baduanjin combined with resistance exercise can delay the debilitating state of rural elderly, improve their lower limb muscle strength, balance ability and sleep quality, and enrich their exercise methods.

Objective:To construct a training program for the life care and caring abilities of home caregivers for the aged with cognitive impairment, so as to provide a basis for conducting training.Methods:From April to May 2021, a preliminary training program was developed through literature review and group discussion. From June to July 2021, purposive sampling was used to select 12 experts from Beijing city, Hebei and Hunan provinces to conduct two rounds of Delphi expert consultation, and finally a training program for life care and caring abilities of home caregivers for the aged with cognitive impairment was constructed.Results:The effective recovery rate of the questionnaire from two rounds of expert consultation was 100.00% (12/12). The authority coefficient of 12 experts was 0.891. The Kendall's W of the first, second, and third level indicators in the second round of consultation were 0.417, 0.205 and 0.200 respectively ( P<0.05). After the second round of consultation, the average value of each item's importance assignment was > 3.500, and the coefficient of variation was < 0.250. The final training program for the life care and caring abilities of home caregivers for the aged with cognitive impairment included 4 training modules, 11 training items, and 35 training content. Training forms included PPT teaching, video learning, case analysis, role playing, operational demonstrations, practical exercises, caregiver self-sharing, and other forms. Conclusions:The training program for life care and caring abilities of home caregivers for the aged with cognitive impairment has good scientific and practical significance, and can provide a basis for the training of home caregivers for the aged with cognitive impairment.

Objective To investigate the appropriate ratio of propofol and remifentanil in total in travenous anesthesia for adult fiberoptic bronchoscopy.Methods 122 cases of adult patients who were examined under total intravenous anesthesia (TIVA) with fiberoptic bronchoscopy in Xiangya hospital were randomly divided into three groups regarding the mixed proportion of propofol and remifentanil:group Ⅰ including 42 cases,group Ⅱ 41 cases,group Ⅲ 39 cases;the mixed proportion of propofol and remifentanil in group Ⅰ was 400 mg∶ 1 mg,in group Ⅱ was 1 000 mg∶ 1 mg,and in group Ⅲ was 2 000 mg∶ 1 mg,were given during TIVA.In the surgery,the bispectral index (BIS) values were sustained between 45 and 60 and we compared the changes of vital signs,airway resistance,the incidence of bucking and airway spasm before and after anesthesia.Results Compared with group Ⅱ,the airway resistance and the incidence of bucking and airway spasm in group Ⅰ both significantly increased and the blood pressure fluctuation in group Ⅲ was greater significantly (P ＜ 0.05).Conclusions The appropriate ratio of propofol and remifentanil is 1 000 mg∶ 1 mg with total intravenous anesthesia in fiberoptic bronchoscopy,which results a stable hemodynamics,lower airway resistance,and lower incidence of bucking and airway spasm.

Objective To study the unqualified items in the reported quality control tests of linear accelerators, analyze the issues in quality control tests, and propose the key points and development directions for accelerator quality control test in China. Methods A literature review was conducted using the CNKI database to analyze the qualified rates of test items and the issues in quality control tests. Results In the literature on the quality control tests of linear accelerators, except for a few provinces where the qualified rates of all test items were 100%, unqualified items were reported in most of the literature. There were unqualified items related to X-ray and electron beam in different reports. Error of dose indication was the unqualified item with the highest occurrence rate in X-ray test, and the item with the lowest qualified rates in X-ray and electron beam tests. The lowest qualified rate of X-ray dose indication error was 73.5% in 2016, and the lowest qualified rate of electron beam dose indication error was 46.2% in 2017. Conclusion Tests should be carried out strictly according to the items and intervals specified by the quality control test standards. Hospitals, radiation health technology service institutions, and health administrative departments should each fulfill their respective responsibilities, work together, and place emphasis on ensuring effective quality control tests of linear accelerators to further enhance the overall quality control standards for these devices.