Lu Dangshen, a traditional authentic medicinal material of Codonopsis Radix is mainly produced in Shangdang (Changzhi) area of Shanxi Province. Baitiao Dangshen is mainly produced in Gansu Province. Codonopsis Radix contains many kinds of components such as phenylpropanoids, polyalkynes, alkaloids, terpenes, fatty acids, flavonoids, and so on. At present, the effect of producing areas on its chemical compositions has not been systematically studied. This study analyzed the differences of metabolites among Codonopsis pilosula from different producing areas by UPLC-HRMS. PCA, OPLS-DA coupled with Thermo mzcloud online and local databases were used to compare the overall differences of metabolites among Codonopsis pilosula from different producing areas, and the chemical constituents were identified to further screen and find out the different metabolites and analyze the metabolic pathways by information retrieval in HMDB, PubChem, Chemspider and KEGG databases. The results showed that 72 differential metabolites were identified in this study. There were 15 kinds of up-regulated and 57 kinds of down-regulated metabolites of Lu Dangshen compared with Baitiao Dangshen. The top 30 metabolic pathways were analyzed by KEGG enrichment, and the most important metabolic pathways were phenylpropanoid biosynthesis, which was demonstrated that phenylpropanoid biosynthesis pathway and related intermediate metabolites could be used as the characteristics of distinguishing Lu Dangshen from different habitats of Codonopsis pilosula. The present study provided a basis for analyzing the influence of producing areas on the chemical components of Codonopsis pilosula and reasonably evaluating the quality of Codonopsis Radix, and also provided a new idea for expounding the authenticity of Lu Dangshen.

OBJECTIVETo investigate the cost-effectiveness of fish oil in patients undergoing major surgery and those with systemic inflammatory response syndrome(SIRS).

METHODSA retrospective study was conducted in patients undergoing major surgery and those with SIRS on admission in the Zhongshan Hospital from January 2008 to December 2011. Fish oil group was enrolled and matched to control group by 1:2 for gender, age, diagnosis, and surgical procedure. There were 220 pairs of patients who were not admitted to ICU, 102 pairs of patients admitted to ICU, and 66 pairs of patients with SIRS. The clinical outcomes and costs were measured and cost-effectiveness analyses were conducted.

RESULTSThe clinical outcomes and costs showed no significant difference between the fish oil group and the control group in those patients who were not admitted to ICU(P>0.05). Fish oil fat emulsion supplementation significantly reduced the length of total hospital stay, postoperative hospital stay, ICU stay, re-operation rate, infection rates, perioperative mortality in patients admitted to ICU and those with SIRS(P<0.05). The cost-effectiveness ratio of non-reoperation rate, non-infection rate, and survival rate were lower in those patients receiving fish oil fat emulsion as compared with those without fish oil administration. Fish oil fat emulsion supplementation could reduce cost-effectiveness ratios of non-reoperation rate, non-infection rate and survival rate by 105 RMB, 160 RMB, and 89 RMB respectively in major surgical patients who admitted to ICU, and by 670 RMB, 280 RMB, and 220 RMB respectively in SIRS patients.

CONCLUSIONSAddition of fish oil fat emulsion to clinical nutrition may have positive effects on critically ill patients. It seems that the effects of fish oil fat are strongly related to the severity of patient's underlying disease. Fish oil fat emulsion supplementation shows acceptable cost-effectiveness ratio and pharmacoeconomic value.

Aged ; Cost-Benefit Analysis ; Fat Emulsions, Intravenous ; economics ; therapeutic use ; Female ; Fish Oils ; economics ; therapeutic use ; Humans ; Male ; Middle Aged ; Parenteral Nutrition ; economics ; methods ; Postoperative Care ; Retrospective Studies ; Surgical Procedures, Operative ; Systemic Inflammatory Response Syndrome ; therapy

ObjectiveTo analyze therapeutic effects of conservative treatment and the causes of malunion of intertrochanteric fracture in elderly patients, and try to find the way to deal with the problems. MethodsFifteen cases aged 75 to 101 years with intertroehanterie fracture treated conservatively were included.Their average age was 88.8 years.All fractures were classified according to Evens-Jensen.Because of the medical complication or other reasons, they were conservatively treated by methods of traction, wearing shoes et al. X-ray examination was taken at regular time and their final functions were assessed. ResultsTwo cases were died 1-3 months after admission, and the fractures were only partially healed. The remaining thirteen cases got complete healing. Among the fifteen cases, the deformity did not happen in 4 cases of IA without fixation and 1 case of IIB with bone traction. All others got the deformity of varus, shorting and external rotation in different degree, which interfered the lower extremity motor function. ConclusionsThe fracture position not kept and fixed satisfactorily during treatment would lead to more joint deformity and deteriorated hip joint function for the displaced intertroehanterie fractures in elderly patients.

From air bacteria capable of decomposing creatinine, three single independent strains K9510、K9511 and K9512 have been isolated. The highest creatinine amidohydrolase (EC 3. 5. 2. 10; creatininase) producing strain K9510 was screened out. The strain K9510 was identified as Pseudomonas sp. The results of culture condition for creatininase formation by strain K9510 were obtained as follows: creatinine and creatine were found to be the effective inducers for enzyme formation; the solution of mixed metallic salts could stimulate cell growth and enzyme formation. The suitable medium for creatininase formation was consisted of 0. 9% creatinine、0. 15% yeast extract、 0. 09% malt extract、0. 05% NH4Cl and some amount of the solution of mixed metallic salts at pH5 5. When the bacterium was grown in 250mL conic flask containing 50mL of the medium mentioned above on the rotary shaker(250r/min) at 35℃ for 33 h, about 50 u creatininase was obtained.

A white-rot fungi Rigidoporus sp.W-1 which could produce laccase was isolated. The fermentation conditions in shaking flasks were investigated. The optimal carbon source was wheat bran and (NH 4) 2SO 4 was the optimal nitrogen source. The components of the medium were optimized by orthogonal experiment. When W-1 was cultured under the optimum conditions, the activity of laccase could get to 7.1U/mL in 7 days.A great amount of crude laccase could be obtained by adding fresh medium to the 7 days old mycelium.

Aim To establish a model of the vascular endothelial cell (VEC) injury in SDrats.Methods SD rats were randomly divided into the control and the modelgroups. The model rats were injected with adrenaline diluted to 2. 5 times 0. 05 mg?100 g-1 (tid) for 5 d continously. From the 4th d, they were irritated for 5 min in the0℃ cold-water in the middle between adrenaline injections.The control rats weregiven 0. 9% NS as above. At 6th d, blood samples were taken from carotid arteries ofthe rats and the CEC counts, t - PA、PAI activities, 6-keto-PGF1? concentrations andthe platelet aggregation rate(max) were detected respectively. Results In the modelgroup, as compared with those in the control group, t - PA activity and 6-keto-PGF1?concentration decreased significantly(P

Objective To compare the effect of ultrasound-guided Mammotome minimally invasive operation and traditional surgery in treating benign breast tumor.Methods Eighty patients with benign breast tumor admitted to People's Hospital of Beijing Daxing District from October 2015 to April 2016 were randomly divided into group A and group B.Patients in group A accepted ultrasound-guided Mammotome minimally invasive operation (n =40),while patients in Group B accepted traditional surgery (n =40).Operation time,incision length,blood loss,patient satisfaction,postoperative pain,and the occurrence rates of complications were compared between the two groups.Results All the tumors in two groups were removed.Patients in group A had shorter operation time (10.4 ± 1.0) min,less blood loss (4.1 ± 0.5) ml,smaller length of incision (0.34 ± 0.04) cm (P ＜ 0.05 or P ＜ 0.01);also had less occurrence of complication (P ＜ 0.05);and patients in group A had better patient's satisfaction (95％) (P ＜ 0.01).Conclusions Ultrasound-guided Mammotome minimally invasive operation is helpful to shorten operation time and incision length,and reduce blood loss,also improve satisfaction.It is valuable for application and popularization in primary hospital.

OBJECTIVETo evaluate the therapeutic effect of Danning Tablet (DNT) on patients with non-alcoholic fatty liver (NAFL) of damp-heat Syndrome type.

METHODSMulti-center randomized double-blinded positive medicine parallel controlled method was adopted. One hundred and two patients were treated with DNT and 33 patients treated with Ursodeoxycholic acid (UDCA) as control. Indexes including body mass index (MBI), principal symptom, liver function, blood lipids, iconographic parameters and comprehensive efficacy were measured before and after treatment in the two groups respectively.

RESULTSDNT and UDCA had the effect in improving BMI, distress in hepatic region, fatigue, anorexia, liver function, blood lipids and iconographic parameters, etc. DNT showed effects in improving BMI and distress in hepatic region better than those of UDCA. Histological examination also showed that DNT had good therapeutic effect.

CONCLUSIONDNT is an effective medicine for NAFL patients of damp-heat Syndrome type, and its efficacy is better than that of UDCA.

Adult ; Diagnosis, Differential ; Double-Blind Method ; Drugs, Chinese Herbal ; therapeutic use ; Fatty Liver ; classification ; drug therapy ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Phytotherapy ; Tablets ; Treatment Outcome

Background Erythropoietin (EPO) has a protective effect on retinal neurons in many retinal diseases,but regarding the effect of EPO on apoptosis of retinal photoreceptor cells in retinal detachment (RD) is uncompletely clear.Objective This study was to investigate the protective effect of endogenous EPO on photoreceptors in a rat model of RD and explore its possible mechanism.Methods Seventy-two Sprague- Dawley (SD) rats were randomly assigned to control group,RD group,RD+PBS group,RD+erythropoietin soluble receptor (EPOsR) 2, 20, 200ng groups with 12 rats for each group.1.4% hyaluronic acid was slowly injected into the subretinal space to induce RD in rats,and PBS or 2,20 or 200ng EPOsR was then injected into the vitreous space.On day 3 after RD,apoptotic photoreceptors were detected using transferase-mediated dUTP nickend labeling (TUNEL),and caspase-3 activity was assessed by Western-blot and immunofluorescence staining.On day 14 after RD,retinal histopathologic examination was carried out and outer nuclear layer (ONL) thickness was measured under the light microscope.The use of animals complied with the Statement of Association for Research in Vision and Ophthalmology. Results Apoptotic photoreceptors were seen in ONL of rats of the RD group.Apoptotic photoreceptors were gradually increased with the elevation of EPOsR dose in the vitreous cavity.Western blot and immunofluorescence consistently showed that the gray scale of caspase-3 activity was 0.15±0.04,0.49±0.03,0.50±0.07,0.63±0.03,0.69±0.04 and 0.83±0.04 in the normal group,RD group,RD +PBS group,RD+EPOsR 2,20,200ng groups respectively with statistically significant differences (F=76.016;P=0.000),and caspase-3 activity was considerably stronger in the RD+EPOsR 200ng group than the other groups (P＜0.01).On day 14 after RD,the ONL thicknesses in the normal control group,RD group,RD+PBS group,RD+EPOsR 2,20,200ng groups were (47.39±3.39)μm,(33.96±3.54)μm,(31.83±5.21)μm,(31.40±2.63)μm,(24.99±2.06)μm and (19.30±3.71)μm,showing significant differences among these groups (F=44.733,P=0.000).ONL thicknesses the groups treated with different doses of EPOsR were markedly thinner than that of the RD group and RD +PBS group (P＜0.01).Conclusion EPOsR induces apoptosis of retinal cells and enhances the activity of caspase-3 in a dose-dependent manner.Endogenous EPO can protect photoreceptors against anoxia-mediated damage in RD eyes through decreasing caspase-3 activity and inhibiting apoptosis.

Objective To improve the level of early detection and treatment of pyonephrosis. Methods This study included 41 cases(17 men and 24 women;mean age,49 years)of pyonephrosis.A variety of examinations,including urinary analysis,blood analysis,kidney nuclear medicine scan,ultrasonog- raphy,intravenous urography(IVU),and CT were used for the early diagnosis of pyonephrosis.Pereutaneous nephrostomy(PCN)drainage was done for the interim management of pyonephrosis,then phase 2 operation was performed in 28 cases.The double-J tube was placed in ureter by ureteroscope for drainage,and then phase 2 operation was done in 2 cases.Emergency operation was done in 10 cases.The remaining 1 case un- derwent ESWL after anti-infective therapy.Results Definite diagnosis of pyonephrosis before operation was made by invasive examinations in 31 cases(75.6%),and by percutaneous drainage in 4 cases;the other 6 cases were detected during operation.Only 6 cases(14.6%)underwent nephrectomy;the other 35 cases (85.4%)underwent kidney-sparing operation.Follow-up of 3 months to 9 years was available in 37 cases. No nephrectomy was needed in 33 cases with spared kidney.Serum creatinine was normal in the 4 cases un- dergoing nephrectomy.Conclusions The key to the treatment of pyonephrosis by kidney-sparing surgery is early diagnosis,timely drainage and relief of obstruction.Ultrasonography plays an important role in the early diagnosis of pyonephrosis,and CT has a high sensibility in the diagnosis.Pereutaneons nephrolithotomy (PCNL)secondary to drainage through pereutaneous nephrostomy was beneficial to the patients with kidney stones or upper ureter stones.