Objective To discuss the specific role of association rules in the compatibility of herbs and the relationship between herbs and symptoms by analyzing ancient analogous prescriptions Zhizichi Decoction with SQL Server software.Methods The prescriptions which contain Gardenia and Semen Sojae Preparatum were searched in the database of “Ancient Prescriptions for Epidemic Disease”, and they were imported to software with the standardized data of their symptoms and ingredients, then the proper association rules were found. The laws between parameter setting and rule generation were searched through parameter adjustment.Results Many laws of the drug compatibility and relationship between herbs and symptoms were obtained effectively in data mining by adjusting the parameters:The support setting was good for finding common used drug compatibility, and the confidence was good for finding specific drug compatibility and relationship between herbs and symptoms;the item set which had high frequency, sometimes made the rule’s importance low.Conclusion The laws of compatibility of herbs and the relationship between herbs and symptoms for data mining of analogous prescriptions are discovered by analyzing the support, confidence and importance of the association-rules and the clinical magnificence between symptoms and herbs.

Objective To investigate toxicity and teratogenic effect of Microula seed oil on embryo of rat.Methods 150 mature Wistar rats (100 females, 50 males) were selected with female∶ male = 2∶1 cage match. During the daily morning examination the sperm was discovered in the vagina as the zero day for conception.100 pregnant rats were randomly divided into 5 groups (n=20 in each group): treatment group (included 3 groups: to give Microula seed oil 2.5 g /kg, 5.0 g /kg, 10.0 g /kg body weight, ig, respectively), cyclophosphamide group(7 mg/ kg body weight, sc) and the edible oil group (to give dose, such as volume as Microula seed oil, ig). From the 7th day of pregnancy, the treatment group, the edible oil group were given intervention once a day for 10 days. From the 11th day of pregnancy cyclophosphamide group was given cyclophosphamide as intervention once a day, for 3 days. On the 20th day the pregnant rats were killed.Results The body weight of pregnant rats and the rate of live births were significantly higher in the Microula seed oil dose group than in the cyclophosphamide group (P<0.01), stillbirth rate and birth rate of absorption was significantly lower in the Microula seed oil dose group than in the cyclophosphamide group (P<0.01), and no significant difference from the edible oil group (P> 0.05); the fetal rat, body weight, body length, tail length in all groups of Microula seed oil was no significant difference from the edible oil group (P> 0.05). There was no malformation in appearance, viscera, bones in the treatment group and the edible oil group while there were 112 fetal rats with deformity in 140 in the cyclophosphamide group.Conclusion Microula seed oil at doses of 2.5 g /kg, 5.0 g /kg, 10.0 g /kg body weight had no significant role in the toxicity and teratogenicity on embryos of pregnant rats.

Objective: To explore the relationship between procalcitonin (PCT), C-reactive protein (CRP) and blood glucose (BG) levels and postoperative pancreatic fistula (POPF) in non-diabetic patients after pancreaticoduodenectomy (PD), and evaluate the clinical value of early multi-indicators combined prediction of pancreatic fistula. Methods: The clinical data of 68 non-diabetic patients who underwent PD surgery from April 2016 to June 2018 in the First Affiliated Hospital of Harbin Medical University were retrospectively analyzed, including 42 males and 26 females, with average age of 58 years, age range from 26 to 80 years. According to the diagnostic criteria of POPF, the patients were divided into the pancreatic fistula group (n=17) and the non-pancreatic fistula group (n=51). The surgical related indicators, health economic indicators and PCT, CRP, and BG levels on preoperative and postoperative day 1, 3 and 5(POD1, POD3, POD5) were compared between two groups. Multivariate logistic regression analysis was used to screen out independent risk factors associated with POPF, and a weighted predictive model (wScore M) for predicting pancreatic fistula in non-diabetic patients was established by combining independent risk factors. The receiver operating characteristic (ROC) curves of each independent risk factor and prediction model were plotted to determine the cutoff value, area under the ROC curve (AUC), sensitivity, specificity, positive predictive value, negative predictive value, and individual risk factors were compared. And the predictive value of the multi-indicator combined prediction model. Results: Univariate analysis showed that the pathological types of the tumor, the tumor size, the blood glucose level of POD3, the PCT level of POD1, POD3, POD5 and the CRP level of POD3, POD5 were statistically different (P<0.05). Multivariate analysis showed that PCT (P=0.004), CRP (P=0.031), and BG (P=0.005) levels of POD3 were independent risk factors of POPF. The AUC of the ROC were 0.967, 0.692, and 0.698, respectively. The sensitivity were 0.588, 0.706, and 0.647, respectively. The specificities were 0.863, 0.686, and 0.765, respectively. The positive predictive values were 52.9%, 70.6%, and 64.7%, respectively. The negative predictive values were 88.2%, 70.6%, and 76.5%; the AUC of the wScore M ROC curve was 0.877, the sensitivity was 0.706, the specificity was 0.863, the positive predictive value was 70.6%, and the negative predictive value was 86.3%. Compared with the non-pancreatic fistula group, the patients of the pancreatic fistula group with pancreatic fistula complications had prolonged hospitalization time and increased the total hospitalization cost, which were statistically different (P=0.039, 0.010). Conclusion PCT, CRP and BG are independent risk factors for POPF, and early combined prediction of multiple indicators (POD3)has good predictive value, which has significant clinical reference for optimal and effective interventions at early stage.

Objective: To investigate the prognostic factors related to the severity of acute pancreatitis and to establish the multiple predictor models of severe acute pancreatitis(SAP) in elderly patients. Methods: Clinical data of 146 consecutive elderly patients who met the inclusion criteria between January 2014 and May 2017 at Department of Pancreatic and Biliary Surgery, the First Affiliated Hospital of Harbin Medical University were retrospectively collected and analyzed, wherein 88 cases were mild acute pancreatitis, 29 cases were moderately severe acute pancreatitis and 29 cases were SAP. The patients data were subjected to univariate analysis and multiple classified Logistic regression analysis for independent prognostic factors of the severity of acute pancreatitis in elderly patients. Unweighted predictive score(unwScore) and weighted predictive score(wScore)for SAP in elderly patients were established according which the receiver-operating characteristic(ROC) curves of independent prognostic factors and predictor models were produced. The cutoff values of independeut prognostic factors and predictor models were determined. The area under the curve, the sensitivity, the specificity, the positive predictive value and the negative predictive value to verify the predictive efficiency of the independent prognostic factors and predictor models were calculated. Results: Procalcitonin(PCT)(Z=10.564, P=0.000), blood urea nitrogen(BUN)(Z=22.231, P=0.003), serum creatinine(Scr)(Z=14.151, P=0.030), serum calcium(Z=34.979, P=0.032) and pleural effusion(χ²=28.463, P=0.015) were independent prognostic factors of the severity of acute pancreatitis by univariate analysis and multiple classified Logistic regression analysis in elderly patients. Respectively, the area under the curve of PCT, BUN, Scr, serum calcium and pleural effusion were 0.908, 0.737, 0.701, 0.753, 0.712, the sensitivity were 0.828, 0.621, 0.552, 0.690, 0.517, the specificity were 0.915, 0.786, 0.846, 0.966, 0.906, the positive predictive value were 70.6%, 41.9%, 47.1%, 83.3%, 57.7%, the negative predictive value were 95.5%, 89.3%, 88.4%, 92.6%, 88.3%. Respectively, the area under the curve of unwScore and wScore were 0.915 and 0.953, the sensitivity were 0.759 and 0.931, the specificity were 0.889 and 0.915, the positive predictive value were 62.9% and 73.0%, the negative predictive value were 93.7% and 98.2%. Conclusions PCT, BUN, Scr, serum calcium and pleural effusion were independent prognostic factors of the severity of acute pancreatitis in elderly patients. The multiple predictor models of SAP in elderly patients have a good predictive efficiency, which may provide valuable clinical reference for prediction and treatment.

Objective To examine short-term outcomes and long-term survival of elderly patients (aged over 80 years) with colorectal cancer who received laparoscopic versus open surgery. Methods A total of 313 patients over 80 years old with colorectal cancer who underwent radical surgery were included.According to the surgical method, all patients were divided into open-surgery group (n=143) and laparoscopic surgery group (n=170).Baseline data were balanced between the two groups by using propensity score matching.Kaplan-Meier was used to draw the survival curve, and survival was compared by Log rank tests.Cox proportional risk model was used to analyze the effects of all factors on overall survival (OS) and disease-free survival (DFS). Results After matching, 93 patients were included in each group.The mean intraoperative blood loss, the incidence of overall postoperative complications and gradeⅠ-Ⅱ complications in the laparoscopic surgery group were significantly lower than those in the open surgery group (all P < 0.05).The time to first flatus, the time to oral feeding, and postoperative hospital stays in the laparoscopic surgery group were significantly shorter than those in the open surgery group (all P < 0.05).The mean number of lymph-node dissection was also significantly higher in the laparoscopic surgery group than in the open surgery group (P=0.030).Patients in both groups had similar 5-year OS (P=0.594) and DFS (P=0.295).Multivariate Cox prognostic analysis showed that CEA level > 5 ng/ml, pathological TNM stage Ⅲ, and perineural invasion were independent risk factors for poor OS and DFS. Conclusion Compared with open surgery, laparoscopic surgery can provide better short-term advantages and similar long-term outcomes for colorectal cancer patients over 80 years of age.

Objective: To examine the association of hyperglycemia and postoperative complications in non-diabetic patients underwent pancreaticoduodenectomy(PD). Methods: The clinical data of 209 non-diabetic patients who underwent PD from January 2012 to June 2018 at Department of Pancreatic and Biliary Surgery, the First Affiliated Hospital of Harbin Medical University and met the inclusion criteria were retrospectively analyzed. According to the diagnostic criteria of postoperative hyperglycemia, the patients were divided into postoperative hyperglycemia group (167 cases, 79.9%) and control group(42 cases, 20.1%). The propensity score matching(PSM) method was used to eliminate the difference between groups(caliper value=0.02; 38 cases in control group including 30 males and 8 females with age of 59.0 years; 38 cases in postoperative hyperglycemia group including 32 males and 6 females with age of 61.0 years; 37 cases of pancreatic head carcinoma, 30 cases of periampullary carcinoma and 9 cases of benign diseases). A comparative analysis was applied for preoperative data, surgical related indicators and postoperative complication rates.The receiver operating characteristic(ROC) curve was used to calculate the area under the curve(AUC) of blood glucose values on postoperative day 1,3 and 5(POD1, POD3, POD5), to determine the high-risk blood glucose cutoff value of complications and to evaluate its sensitivity and specificity for the prediction of postoperative complications. Results: Univariate analysis showed that the differences in gender, body mass index, preoperative blood glucose, and serum urea nitrogen levels were statistically significant before PSM.There was no significant difference in the preoperative data between the two groups after PSM. Compared with the control group, the incidence of postoperative pancreatic fistula (31.6% vs. 5.3%), abdominal infection(29.0% vs. 7.9%) and Clavien-Dindo Ⅲ-Ⅴ complications(31.6% vs.7.9%) were statistically different(χ²=7.092, P=0.008; χ²=4.290, P=0.038; χ²=5.316, P=0.021), respectively. According to the AUC on POD3, the blood glucose value≥8.860 mmol/L was an independent risk factor for pancreatic fistula with sensitivity of 58.3% and specificity of 76.9%, the blood glucose value ≥9.130 mmol/L was an independent risk factor for abdominal infection with sensitivity of 54.5% and specificity of 81.5% and the blood glucose value ≥7.685 mmol/L was independent risk factor of Clavien-Dindo Ⅲ-Ⅴcomplications with sensitivity of 75.0% and specificity of 57.7%. Conclusions Postoperative hyperglycemia in non-diabetic patients is associated with postoperative pancreatic fistula, abdominal infection, and Clavien-Dindo Ⅲ-Ⅴ complications.According to the early postoperative blood glucose value, the occurrence of postoperative pancreatic fistula, abdominal infection and Clavien-Dindo Ⅲ-Ⅴ complications can be effectively predicted.

A rich diversity of wild medicinal plant resources is distributed in China, but the breeding of new plant varieties of Chinese medicinal plants started late and the breeding level is relatively weak. Chinese medicinal plant resources are the foundation for new varieties breeding, and the plant variety rights(PVP) are of great significance for the protection and development of germplasm resources. However, most Chinese medicinal plants do not have a distinctness, uniformity, and stability(DUS) testing guideline. The Ministry of Agriculture and Rural Affairs has put 191 plant species(genera) on protection lists, of which only 30 are medicinal species(genera). At the same time, only 29 of 293 species(genera) plants in the Protection List of New Plant Varieties of the People's Republic of China(Forest and Grass) belong to Chinese medicinal plants. The number of PVP applications and authorization of Chinese medicinal plants is rare, and the composition of variety is unreasonable. Up to now, 29 species(genera) of DUS test guidelines for Chinese medicinal plants have been developed. Some basic problems in the breeding of new varieties of Chinese medicinal plants have appeared, such as the small number of new varieties and insufficient utilization of Chinese medicinal plant resources. This paper reviewed the current situation of breeding of new varieties of Chinese medicinal plants and the research progress of DUS test guidelines in China and discussed the application of biotechnology in the field of Chinese medicinal plant breeding and the existing problems in DUS testing. This paper guides the further application of DUS to protect and utilize the germplasm resources of Chinese medicinal plants.
Agriculture ; Biotechnology ; Plant Breeding ; Plants, Medicinal/genetics*

Objective To investigate the predictive value of PCT for postoperative pancreatic fistula (POPF) in advance.Methods Clinical data of 62 consecutive patients who underwent pancreaticoduodenectomy(PD) and 19 consecutive patients who underwent distal pancreatectomy (DP) between Apr 2016 and Apr 2017 in the First Affiliated Hospital of Harbin Medical University and met the inclusion criteria were retrospectively collected and analyzed.Patients with PD and DP were divided into pancreatic fistula group (12 cases,3 cases),and non-pancreatic fistula group (50 cases,16 case).The PCT,CRP and WBC count levels of preoperative and postoperative day 1,3,5 (POD1,POD3,POD5) were compared between two groups.The data were subjected to independent sample t-test,Mann-Whitney rank sum test,x2 test or Fisher exact test.Receiver operating characteristic (ROC) curve was drawn and area under curve (AUC) was calculated to determine the cutoff value,sensitivity and specificity.Results For PD and DP patients,there were no significant difference on age,gender,BMI,diabetes,obstructive jaundice,preoperative laboratory test,operation time,intraoperative blood loss,tumor type between the two groups,which were comparable.For PD patients,postoperative hyperglycemia rate,postoperative ICU admission rate and total hospital stay of pancreatic fistula group were significantly higher than those of non-pancreatic fistula group (P =0.011,P =0.023,P ＜0.001).The PCT levels of POD1,POD3 and POD5 of pancreatic fistula group were significantly higher than those of non-pancreatic fistula group (P ＜ 0.001,P =0.010,P =0.002).PCT of POD1 had the highest sensitivity (100％) and specificity (80％) and PCT ＞0.76 μg/L was the risk factor for POPF.For DP patients,the PCT levels of POD1,POD3 and POD5 had the same predictive value for pancreatic fistula.Conclusion PCT has early predictive value for POPF of PD patients.

Objective To evaluate the early predictive and diagnostic value of procalcitonin (PCT) in abdominal infection after pancreatoduodenectomy(PD).Methods The clinical data of 62 patients with PD in the First Affiliated Hospital of Harbin Medical University from April 2016 to April 2017 were retrospectively analyzed.The general data and postoperative conditions of the patients were recorded.Serum PCT,C-reactive protein (CRP) levels and WBC counts were measured before and 1,3,and 5 days after surgery.According to the postoperative abdominal infection,the patients were divided into abdominal infection group (n =10) and control group(n =52).The area under the ROC curve (AUC) was calculated by plotting the receiver operating characteristic (ROC) curve,and the cut-off value was determined to compare the sensitivity and specificity of the two groups of patients.Results There were no significant difference between two groups on age,gender,BMI,diabetes mellitus,preoperative laboratory indicators,anesthetic time,operation time,intraoperative bleeding and blood transfusion,surgical procedures and Braun anastomosis,which were comparable.The incidence of postoperative hyperglycemia,surgical incision infection,pancreatic fistula,biliary fistula,mortality,postoperative hospital stay and total medical costs of abdominal infection group were significantly higher than those of control group (P ＜ 0.05).There were no significant differences on PCT,CRP,and WBC between the two groups before surgery.The PCT level of the abdominal infection group was significantly higher than that of the control group at the 1st postoperative day and the difference was statistically significant (P ＜0.05).The sensitivity of predicting abdominal infection was 90％ and the specificity was 75％,which was significantly higher than those of CRP and WBC.There were no significant differences on the sensitivity and specificity of PCT,CRP and WBC for postoperative abdominal infection at 3 and 5 days after surgery,but the sensitivity of the combined diagnosis was as high as 100％ and 90％,significantly higher than 3 indicators alone,respectively.Conclusions Serum PCT level may predict in advance or diagnose early abdominal infection after PD.The combination of PCT,CRP and WBC might be more valuable for the diagnosis of abdominal infection after PD.

Objective To investigate the risk factors of death and to establish an early multi-index predictive model for mortality moderately of severe acute pancreatitis (MSAP) and severe acute pancreatitis (SAP) in elderly patients.Methods Clinical data of 58 digible elderly patients of MSAP and SAP between January 2014 and May 2017 in First Affiliated Hospital of Harbin Medical University were analyzed retrospectively,including 18 cases (31.0％) in the death group and 40 cases in the control group (69.0％).Univariate analysis and logistic regression analysis were used to screen out the independent risk factors related to death,combined with these independent risk factors,the unweighted predictive model (unwScore) and weighted predictive model (wScore) for mortality were established.The receiver-operating characteristic (ROC) curves of independent risk factors and predictive models were drawn to determine the cut-off value,to calculate the area under the curve (AUC),sensitivity,specificity,positive predictive value and negative predictive value and to observe the clinical predictive effectiveness.Student's t-test was used to analyze continuous variables that complied with a normal distribution expressed as ((x) ± s).Mann-Whitney U test was used to analyze abnormally distributed variables expressed as median (quartile range) [M(P25,P75)].chi-square test or Fisher's exact test was used to analyze categorical data expressed by rate (％).Univariate analysis was used to screen out data with statistically significant difference,and then Logistic regression analysis was performed to determine independent predictors.Results Univariate analysis showed that there were statistically significant differences in pro-calcitonin,serum albumin (ALB),serum calcium,D-dimers,mean arterial pressure,pleural effusion and peritoneal effusion between the two groups (P ＜0.05);multivariate analysis showed that ALB,pleural effusion and peritoneal effusion were independent risk factors for mortality of MSAP,SAP in early patients,which AUC were 0.815,0.678,0.696,sensitivity were 0.611,0.556,0.667,specificity were 0.825,0.800,0.725,the positive predictive values were 61.1％,55.6％,52.2％,and the negative predictive values were 82.5％,80.0％,89.9％,respectively.The AUC of unwScore and wScore were 0.852 and 0.863,the sensitivity were 0.667 and 0.778,the specificity were O.875 and 0.800,the positive predictive values were 70.6％ and 63.6％,and the negative predictive values were 85.4％ and 88.9％,respectively.Conclusion ALB,pleural effusion and peritoneal effusion were independent risk factors for mortality of MSAP,SAP in elderly patients.The multi-index predictive model had good clinical predictive effectiveness,which could provide clinical references for the treatment of MSAP and SAP in elderly patients.