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AIM: To examine the quality of Radix Astragali Injection from different manufacturers. METHODS: The HPLC-ELSD method for the determination of astragaloside Ⅳ in Radix Astragali Injection was established with hypersil ODS 2 C 18 column(250mm?4.6mm,5?m), column temperature at 40℃. The mobile phase was acetonitrile-water (36∶64) and flow rate was at 1.0mL?min -1. The evaporation light-scattering detector was used with its drift tube temperature at 100℃ and the gas flow rate: 3.0L?min -1. RESULTS: Within 2.4～12?g astragaioside Ⅳ had a good linearity. The average recovery was 101.6%, RSD=2.9%,n=5. By analyzing the samples of 10 batch of Radix Astragali Injection from 5 manufactuers, it showed there were significant difference in the contents of astragaloside Ⅳ. CONCLUSION: The method is simple and fast. The results are accurate and reproducible and can be used in the quality control of Radix Astragali Injection. The significant differences in the astragaloside content may influence clinical treatmem.

Objective To analyze the clinical and immunological manifestations of antiphospholipid syndrome(APS)in a cohort of 100 patients.Methods The clinical and serologic features of APS(Sapporo preliminary criteria)in 100 patients were analyzed retrospectively.Results The cohort consisted of 79 female patients and 21 male patients witb a mean age of 36?13 years at diagnosis.Primary APS was presented in 37% of patients;APS was secondary to systemic lupus erythematosus(SLE)in 46%,lupus-like syndrome in 14%. Eighty percent of the patients had thrombosis,43(54%)patients had venous thrombosis,18(22%)had arterial thrombosis,15(19%)had both arterial and venous thrombosis.4(5%)had thrombosis of microcirculation. Forty-two(52%)patients presented thrombosis at a single site,26(32%)at two sites,12(15%)at three or more sites.Forty-five(56%)patients experienced one thrombotic episode,20(25%)patients had only one re- currence,and 15(19%)had more thrombosis.The most common manifestations of thrombosis were deep vein thrombosis(36%),pulmonary embolism(30%)and stroke(26%),with heart,kidney,gastrointestinal tract and other organs involvements.Thirty-four(51%)female patients had spontaneous fetal losses including intrauter- ine fetus death and recurrent spontaneous abortion.Seventy-one(71%)patients developed thromboeytopenia. The presence of antieardiolipin antibody(ACL)was detected in 84 patients(84%).Among 90 patients with APS,alone ACL was detected in 38 patients(42%),both ACL and lupus anticoagulant(LA)were detected in 36(40%),LA alone in 16(18%).Patients with APS associated with SLE or lupus-like syndrome had higher frequency of arthritis,leukopenia,antinuclear antibodies(ANA)and low complement levels.Female patients had a higher frequency of leukopenia,ANA and ACL.Male patients had a higher prevalence of deep venous thrombosis in the lower limbs and LA.Conclusion APS is an autoimmune disorder characterized by recurrent arterial and venous thrombosis,fetal loss,or thrombocytopenia with the presence of ACL and/or LA.In APS secondary to with SLE,the patient's sex can modify the disease expression and define specific subsets of APS.

ObjectiveTo investigate the applicability and superiority of modified Seldinger technique (MST).MethodsTotally 108 patients receiving peripherally inserted central catheter (PICC) through vascular ultrasound combined with MST technology were enrolled as MST group and another 108 patients receiving PICC using traditional direct vision method as control group.The first puncture success rate,PICC succesa rate,catheterization time required,and early complication rate were compared between these two groups.ResultsThe first puncture success rate was 88.89％ in MST group and 72.22％ in control group (P=0.002) ; the catheterization success rate was 82.41％ in MST group and 57.41％ in control group ( P =0.000).In the MST group,there were two cases where the catheter within neck was ectopic ( P =0.003 ),two cases experienced bleeding at the puncture sites (P =0.017),three cases had phlebitis (P =0.001 ),and one case suffered from catheter blockage (P=0.010).In the eontrol group,the corresponding numbers were 13,10,18,and 9.However,the time required for PICC showed no significant difference between these two groups (P=0.685).In the MST group,15 cases were catheterized in less than 15 minutes,72 cases between 15 and 25 minutes,and 21 cases for more than 25 minutes.In the control group,12 cases were catheterized in less than 15 minutes,70 cases between 15 and 25 minutes,and 26 cases for more than 25 minutes.ConclusionPICC through MST can be more effective in positioning the targeting blood vessels,increasing the success rate of catheter insertion,reducing various tissue damages,and lowering potential complications.

To study the clinical skills training methods and formulate a training objective for pediatric long-year-program students, to let the students, through three years of training program, reach the clinical ability as a chief resident, with better laboratory research skills, teaching awareness and responsibility, and also with good comprehensive quality and excellent English, and finally become clinical talents with great potential and innovation, this report summarized our study results of training two terms of long-year-program pediatric graduates, who fully meeted the training objectives in the department's practice.

The hypoglycemic activity and its mechanism of Jatrorrhizine (Jat) were studied. The normal mice and alloxan-induced hyperglycemic mice were given with different doses of Jat. Blood glucose and liver glycogen levels were determined by spectrophotometry with glucose-oxidase and iodine reagents respectively. The levels of blood lactic acid (LC) and liver lactate dehydrogenase (LDH) activity were measured to explore the effect of Jat on anaerobic glycolysis. Succinate dehydrogenase (SDH) activity in liver was measured to evaluate the effect of Jat on aerobic glycolysis in liver. It was found that Jat (50 mg/kg, 100 mg/kg) could significantly decrease blood glucose level in a dose- and time-dependent manner in both normal and alloxan-diabetic mice, increase the activity of SDH, but had no significant effects on the LC level and LDH activity. Jat could significantly reduce the content of liver glycogen in normal mice. Moreover, Jat could inhibit the platelet aggregation in rabbits in vitro in a dose-effect relationship. It was concluded that Jat induced the pronounced decrease in blood glucose in normal and hyperglycemic mice. The hypoglycemic activity of Jat may be attributed to the enhancement of aerobic glycolysis.

Objective To investigate the efficacy and safety of surgical treatment for internal carotid artery atheromatous pseudo-occlusion (APO).Methods Clinical data of patients with carotid artery stenosis treated by carotid endarterectomy from Dec.,2011 to Jun.,2016 in Zhongshan Hospital Affiliated to Fudan University were analyzed retrospectively.Carotid endarterectomy were performed in 32 patients with pseudo-occlusion of the internal carotid artery (APO group).And 124 patients with traditional severe stenosis (70％-99％) served as control group.Perioperative major and minor complications,recurrence rate of ipsilateral ischemic stroke,restenosisrate and mortality in follow-up were compared between the two groups.Results Perioperative major complications:one patient (3.1 ％) developed myocardial infarction in the APO group,no ischemic stroke,cerebral hemorrhage and death cases;2 (1.4％) ischemic stroke cases,6 (4.2％) myocardial infarction cases and 1 (0.7％)death case was found in control group.Perioperative minor complications:1 (3.1％) incision bleeding case,2 (6.3％) pulmonary infection cases,2 (6.3％) cerebral hyperperfusion syndrome cases were found in APO group;3 (2.1％) incision bleeding cases,2 (1.4％) incision infection cases,4 (2.8％)pulmonary infection cases,2 (1.4％) cranial nerve injury cases,2 (1.4％) cerebral hyperperfusion syndrome cases were found in control group.Patients were followed up for 6-60 months,with mean follow-up period of (35.3 ± 17.5) months.During follow-up,1 (3.1％) ipsilateral ischemic stroke recurrence case,4 (12.5％) restenosis cases,and 3 (9.4％) death cases were found in the APO group.And 8 (5.6％) ipsilateral ischemic stroke recurrence cases,9 (6.3％) restenosis cases,8 (5.6％)death cases were found in control group.There were no significant differences in perioperative major and minor complications,recurrence rate of ipsilateral ischemic stroke,restenosis rate and mortality between the two groups.Conclusions Surgical treatment for atheromatous pseudo-occlusion of the internal carotid artery is safe and effective.Perioperative and follow-up results are satisfactory.

Objective To explore the effect of calreticulin (CRT) on cell proliferation and invasion of human hepatocellular carcinoma cell line SMMC-7721 and HepG2.Methods SMMC-7721 and HepG2 cells were transfected with small interfering RNA (siRNA).The transfection rate was detected by immunoflurescence and western blot.The cell proliferation,invasion and apoptosis of SMMC-7721 and HepG2 cells were determined by using cell counting kit-8 (CCK-8) assays,transwell assays and flow cytometry,respectively.The p-Akt and Akt levels were detected by western blot.Results The growth inhibition rate in the siRNA experimental group of SMMC-7721 and HepG2 cells for 24,36 and 48 h were (41.0 ±2.2) ％,(46.5 ±1.6)％,(59.7 ±2.2)％ and (36.8 ±2.7)％,(47.3 ± 1.8)％,(61.5 ±3.2)％,respectively.The apoptosis rate after down-regulating the expression of CRT in SMMC-7721 and HepG2 cells for 36h were (45.2 ± 9.1) ％ and (48.9 ± 8.0) ％,respectively.Compared with the blank group and the negative control group,the growth inhibition rate in the siRNA experimental group was lower (P ＜0.05),but the apoptosis rate was significantly higher (P ＜ 0.05).Transwell experiments confirmed that the numbers of invaded SMMC-7721 and HepG2 cells in the blank group and the negative control group and siRNA experimental group were (96.8±7.3),(95.6±5.4),(34.0±4.2) and (124.0 ±9.9),(121.6 ±7.0),(70.4±9.5),respectively,indicating that cell invasion in the siRNA experimental group was significantly suppressed (P ＜ 0.05).The expression of p-Akt was decreased (P ＜ 0.05) after down-regulating the expression of CRT for 36h.Conclusion CRT gene silencing by siRNA can inhibit the SMMC-7721 and HepG2 cell proliferation and invasion,but increase the cell apoptosis by regulating PI3K/Akt signal pathway.

Objective To observe the effects of different traditional Chinese medicine therapeutic methods on heart function and red cell volume distribution width (RDW) in patients with chronic heart failure (CHF). Methods A randomized, blinded and controlled study was conducted. One hundred and ninety patients with CHF accompanied by yang deficiency syndrome in Department of Cardiology of Chengdu Municipal First People's Hospital were divided into five contrast groups according to randomized envelope method:namely control group, warming yang group, nourishing yin group, activating blood group and combined warming yang and nourishing yin therapeutic group (combined group), each group being 38 cases. The patients not consistent with the criteria to enroll into the study and those lost contact were excluded from the study, thus the final total patients were 183 in number, including control 37, warming yang 36, nourishing yin 36, activating blood 37 and combined group 37 cases. All the cases were treated with routine medical therapy in accord to the guideline for CHF. In addition, placebo oral liquor was given to the control group, Wenyangjianxinling oral liquor (main ingredients:Aconiti Lateralis Radix Preparata, Astragali Radix, Chuanxiong Rhizoma, Epimedii Folium, Periplocae Cortex, Descurainiae Semen, Ginseng Radix et Rhizoma Rubra) was given to the warming yang group, Ophiopogonis Radix and Anemarrhenae Rhizoma oral liquor (main ingredients:Ophiopogonis Radix,Anemarrhenae Rhizoma) was taken by the nourishing yin group, Salviae Miltiorrhizae Radix and Chuanxiong Rhizoma oral liquor (main ingredients: Salviae Miltiorrhizae Radix, Chuanxiong Rhizoma) was administered by the activating blood group, and the main ingredients of oral liquors given to the warming yang and nourishing yin groups were assigned to the combined group, each group 10 mL, three times a day for one year. According to the prognosis, the patients were divided into survival group (168 cases) and death group (15 cases). The re-hospitalization situations such as aggravation of heart failure, acute myocardial infarction, angina, stroke, etc. were observed. The changes of hemoglobin (Hb) and RDW in the survival and death groups were investigated and compared between them. Results Compared with the control group, the rate of re-hospitalization was significantly decreased in the activating blood group [27.03% (10/37) vs. 54.05%(20/37), P<0.05];there were no statistical significant differences among all the other groups (all P>0.05). Before treatment, the levels of left ventricular ejection fraction (LVEF), fractional shortening (FS), the ratio of early to late ventricular filling velocities (E/A ratio) and E deceleration time (DT) showed no significant differences among five groups (all P>0.05). Compared with the control group at the same period, the LVEF, FS, E/A and DT were significantly increased in activating blood group and combined group after the treatment [LVEF: 0.453±0.131, 0.448±0.104 vs. 0.394±0.112, FS:(27.9±9.8)%, (27.0±11.5)%vs. (22.2±13.3)%, E/A:0.88±0.16, 0.92±0.20 vs. 0.75±0.27, DT (ms): 265.4±30.3, 251.4±37.5 vs. 225.7±35.4, all P < 0.05]. FS and DT were significantly increased in warming yang group after treatment [FS: (26.4±10.3)% vs. (19.7±7.4)%, DT: 242.0±38.7 vs. 216.3±50.9, both P < 0.05]. In the activating blood group, the level of RDW was elevated after treatment compared with that before treatment, but in the comparison with that in the control and nourishing yin groups, it was still obviously lower [(12.98±2.97)%vs. (14.37±2.52)%, (13.05±2.36)%, both P < 0.05]. The comparisons of Hb and RDW among other groups had no statistical significant differences (all P > 0.05). The level of Hb in death and survival groups also had no statistical significant difference (P > 0.05). The RDW of dead group was markedly higher than that of the survival group [(14.39±2.17)%vs. (13.02±2.08)%, P<0.05]. Conclusion The level of RDW is related to the prognosis of CHF patients, the level of RDW in death group is higher than that in survival group, and the activating blood circulation and removing blood stasis therapy can decrease the level of RDW, reduce the rate of re-hospitalization and improve the heart function in CHF patients.

Objective To study the efficacy and safety of tacalcitol combined with monochromatic excimer light (MEL) 308 nm vs MEL 308 nm monotherapy in treating vitiligo.Methods Thirty-eight pa- tients with vitiligo were enrolled in the single-blind clinical trial,using plabebo-treated lesions in the same patient as controls.Contralateral or nearby lesions were randomly selected to be treated by either tacalcitol or placebo.All lesions were treated weekly with MEL 308 nm,for a total of 12 sessions.Patients were ex- amined at monthly intervals.The mean number of sessions and the cumulative dosage for initial and excel- lent repigrnentation were calculated.Results Thirty-five patients were evaluated.The mean?SEM cumu- lative dose and number of MEL exposures for initial repigmentation,respectively,were 4.27?3.59 J/cm~2 and 4.89?3.16 on tacalcitol-treated site,5.36?4.12 J/cm~2 and 5.69?3.29 on placebo-treated site,re- spectively (both P＜0.05).For excellent repigrnentation,the cumulative dose and number of exposures were 7.72?5.64 J/cm~2 and 7.79?4.70 respectively on tacalcitol-treated site,and 8.18?4.87 J/cm~2 and 8.4?3.92 respectively on placebo-treated site (both P＞0.05).Treatment with tacalcitol resulted in a sig- nificantly higher percentage (71.4% vs 54.3%) of repigmentation than that with placebo.Conclusions Our results show that MEL 308 nm is safe and effective for the treatment of vitiligo.Additionally,concur- rent topical tacalcitol potentiates the efficacy of MEL 308 nm in the treatment of vitiligo;this combination achieves more rapid pigmentation with a lower total MEL dosage.