Objective To investigate the value of Xueshuangtong combined with radiofrequency thermocoagulation in the treatment of lumbar degenerative lumbar pain.MethodsFrom January 1, 2014 to December 30, 2015, 60 patients with lumbar degenerative low back pain admitted in Jiashan Traditional Chinese Medicine Hospital.All of them were randomly divided into observation group and control group, and each with 30 cases.All patients received radiofrequency thermocoagulation, while the observation group received Xueshuantong for further treatment.All of the patients were assessed by the international Pain Association recommended the use of visual analogue scale (VAS) and McGill pain questionnaire (SF-MPQ) and CRP when treatment before starting and after 1, 3, 7, 14, 30 and 90d of the treatment.ResultsThere were no significant differences between the two groups in VAS, SF-MPQ and CRP before treatment (P<0.05).However, when compared with the control group, patients in the observation group got significantly lower levels of VAS at 1, 3, 7 and 14d after the operation;significantly lower levels of SF-MPQ at 1, 3, 7, 14 and 30d after the operation;and significantly lower levels of CRP at 14, 30 and 90d after the operation (P<0.05).And we found no serious complications occurred in the two groups.ConclusionThe Xueshuantong combined with radiofrequency thermocoagulation treatment of lumbar facet joint is a safe, effective and inexpensive for the low back pain which caused by lumbar degeneration.

Objective To explore ways for the supervision of department directors. Methods Job responsibility agreements with department directors were signed and a series of assessment standards were established. Results The methods adopted were standardized, individualized and easy to use. Conclusion Job responsibility agreements with department directors and a standard assessment system are currently effective measures for the supervision of department directors.

OBJECTIVE:To establish an analytical method for the determination of prednisolone and prednisolone-hemisuccinate in biological media METHODS:Using RP-HPLC,biological media were extracted with a mixture of n-pentane and methyl tert-butyl ether(2∶3) The mobile phase consisted of acetonitrile and trisodium citrate buffer (33∶67) The sample was eluted on C18 column and detected at 254nm RESULTS:The extraction recoveries of two drugs were over 80% and the RSDs of within-day and day-to-day were below 3% CONCLUSION:The method is simple,rapid,sensitive,accurate and good enough to be applied to the pharmacokinetic study of new preparation of prednisolone and can also be applied to other similar glucocorticoids

Objective To investigate the effects of different doses of 1 ,25(OH)2D3 on rat Thy‐1 nephritis mesangial cell ap‐optosis .Methods 120 clean SD rats were divided into the blank control group(group A) and the experimental group .The experi‐mental group was re‐divided into the nephritis group(group B) ,0 .25μg 1 ,25(OH)2D3 intervention group(group C) and 0 .50μg 1 , 25(OH)2D3 group(group D) ,30 cases in each group .The group C and D were performed the medication intervention after success‐fully constructing the model .6 rats were randomly killed in each group on 1 ,3 ,7 ,14 ,21 d after intervention .The renal tissues were taken for determining the renal pathological injury classification after hematoxylin and eosin staining and PAS staining .The expres‐sion of Caspase‐3 in the renal tissues was detected by the immunohistochemistry method ,and the glomerular cell apoptosis was de‐tected by TUNEL .Results The immunohistochemistry results showed that compared with the group A ,the Caspase‐3 expression in the group B was increased (P<0 .05);compared with the group B ,the Caspase‐3 expression in the group C and D was increased , but there was no statistical differences between them (P> 0 .05);the Caspase‐3 expression in the group D was highest ,but the difference was not statistically significant compared with the group C .The TUNEL results showed that compared with the group A ,the apoptotic glomerular cells in the group B were increase obviously (P<0 .05) ,which was gradually enhanced over time ;com‐pared with the group B ,the apoptotic glomerular cells in the group C and D were increased significantly (P<0 .05) ,reaching a peak on 3 d ,then decreasing gradually on 7 ,14 d and tending to be normal on 21 d(P<0 .05);the comparison between the group C and D showed that the apoptotic cells in the group D were increased significantly ,but the difference between these two group ,was not statistically significant(P>0 .05) .Conclusion 1 ,25(OH)2D3 has the effect for inducing glomerular mesangial cell apoptosis in rat , which participates in the regulation of Caspase‐3 ,induces glomerular mesangial cell apoptosis ,promotes the recovery of nephritis and could delay the progression of renal disease .

Objective To investigate the influence of discontinuance of methimazole (MMI) and propylthiouracil (PTU) on 24 h radioactive iodine uptake(RAIU) in normal rats.Methods A total of 66 female SD rats were randomly divided into 3 groups by simple random sampling method.MMI group (30 rats) received MMI with a dose of 0.6 mg·ml-1·d-1 orally for 2 weeks, PTU group (30 rats) received PTU with a dose of 6 mg·ml-1·d-1 orally for 2 weeks.At 1, 3, 5, 7 and 9 d after MMI or PTU was discontinued, 6 rats were sacrificed to measure 24 h RAIU respectively.The control group (6 rats) received normal saline with a dose of 1 ml/d orally for 2 weeks, and then they were sacrificed to measure 24 h RAIU too.Data were analyzed with two-sample t test or t′ test.Results Thyroid 24 h RAIU in normal rats was (14.6±4.3)%.The 24 h RAIU on 1, 3, 5, 7 and 9 d was (4.6±0.7)%, (24.2±7.2)%, (13.1±2.9)%, (14.1±2.6)%, (16.1±3.7)% respectively after MMI withdrawal.The 24 h RAIU was significantly lower than that in control group at day 1 (t′=5.55, P<0.01), higher at day 3 (t=-2.83, P<0.05), and returned to the normal level at day 5, 7, 9 (t=0.68, 0.24,-0.67, all P>0.05).The 24 h RAIU on 1, 3, 5, 7 and 9 d was (1.9±0.8)%, (3.3±1.2)%, (7.7±2.4)%, (29.0±4.0)%, (17.1±4.8)% respectively after PTU withdrawal.It was lower than that in control group (t=7.01, 6.10, 3.40, all P<0.05) at day 1, 3, 5, and higher at day 7 (t=-5.97, P<0.01).The 24 h RAIU of 9 d showed no difference when compared with that in control group (t=-0.95, P>0.05).Conclusions MMI and PTU can inhibit the iodine uptake of thyroid, the 24 h RAIU returns to normal level at day 5 after withdrawal of MMI and at day 9 after withdrawal of PTU in euthyroid rats.

OBJECTIVE:To determine the content of ?-schizandrin,one of the effective ingredients,in Shuangjia Wuling capsules METHODS:The RP-HPLC method was performed with YWG C18 column(4 6mm?250mm) The mobile phase consisted of methanol-water(72∶28) The detecting wavelength was 254nm RESULTS:The calibration curve for ?-schizandrin was linear in the range of 0 0 207～0 4 130mg/ml(r=0 9 999) The average recovery was 97 68% with RSD=1 85% CONCLUSION:The method is simple,rapid and reliable for quality control of the capsules

Objective To study the clinical application of laparoscope combined with gastroscope surgery in patients with gastric stromal tumor. Methods The clinical data of 50 patients with gastric stromal tumor were retrospectively analyzed. Among them 20 cases were treated with traditional laparotomy (laparotomy group), and 30 cases were treated with laparoscope combined with gastroscope surgery (combination group). The intraoperative bleeding, operation time, postoperative recovery time, postoperative hospitalization time and complications were compared between 2 groups. Results One case in combination group received open surgery (3.33%, 1/30), mainly because of obesity, and tumor rupture occurred in 1 case during operation. All specimens of the 2 groups had no tumor residue. There were no statistical differences in tumor diameter and operation time between 2 groups (P>0.05); the intraoperative bleeding, postoperative recovery time and postoperative hospitalization time in combination group were significantly lower than those in laparotomy group:(26.33 ± 14.21) ml vs. (42.57 ± 15.67) ml, (37.96 ± 8.80) h vs. (60.14 ± 13.41) h and (6.42 ± 2.80) d vs. (12.04 ± 4.69) d, and there were statistical differences (P<0.05). The 2 groups had no death, stomach bleeding, anastomotic stenosis and anastomotic leakage. The laparotomy group had postoperative incision fat liquefaction in 3 cases and incision infection in 2 cases, and the combination group had pulmonary infection in 1 case. All were cured after symptomatic treatment. Conclusions Laparoscope combined with gastroscope surgery in the treatment of gastric stromal tumors has a short operation time, less blood loss, faster postoperative gastrointestinal function recovery, shorter hospitalization time, and no major complications. It is a more ideal and minimally invasive surgery.

Objective:To evaluate the diagnostic performance of probe-based confocal laser endomicroscopy (pCLE) for indeterminate biliary strictures.Methods:Twelve patients with indeterminate biliary strictures who underwent pCLE and brush cytology from April 1, 2013 to December 30, 2016 were enrolled. Clinical data, the results of endoscopic retrograde cholangiopancreatography, pCLE examination and brush cytology were collected. Compared with post-operative pathology and follow-up over 12 months, sensitivity, specificity, positive predictive value(PPV), negative predictive value(NPV), and accuracy of pCLE and brush cytology of the diagnosis of malignant biliary strictures were analyzed.Results:The final diagnosis were 9 malignant and 3 benign. The sensitivity, specificity, PPV, NPV and accuracy of brush cytology were 3/9, 3/3, 3/3, 3/9 and 50.0%(6/12), respectively. The corresponding indicators of pCLE were 9/9, 2/3, 9/10, 2/2, and 91.7%(11/12), respectively.Conclusion:pCLE can be used for differential diagnosis of indeterminate biliary stricture.

Objective: To search for the best condition of microwave assisted extraction(MAE) for the flavonoids in Radix glycyrrliza and to compare with traditional boiling water extraction(WE). Methods: MAE and BWE were adopted, and its proper experimental conditions were examined and optimized by means of uniform design. The flavonoids in Radix glucyrrliza were determined by spectrophotometry. Results: Appropriate MAE conditions included extraction time of 1min, ethanol concentration of 38%, liquid/solid ratios of 8∶1(ml/g) and the power of microwave oven of 288W, the recovery of flavonoids from Radix glycyrrliza with MAE(24.6mg/g) was higher than BWE (11.4mg/g). Conclusion: Compared with traditional boiling water extraction(BWE), the experiment results demonstrated higher extracting rate and shorter extracting time. It indicated that MAE was more suitable to extraction of the flavonoids.

Objective To study the efficacy and safety of endobiliary radiofrequency ablation (RFA) with stent placement in treatment of unresectable extrahepatic cholangiocarcinoma (EHCC).Methods The patients with unresectable EHCC in Hangzhou First People's Hospital between October 2013 and January 2015 were enrolled in a prospective, randomized, single-blind cohort study, and were assigned randomly into two groups: RFA+stent group and stent-only group.The jaundice fade time, stent patency period, overall survival rate, and postoperative adverse events were analyzed between two groups.Results Among 59 patients with non-resectable EHCC, 28 were divided into RFA+stent group, and 31 were in stent-only group.There was no statistical difference in preoperative serum total bilirubin between the two groups.Mean serum bilirubin decrease time was significantly lower in the RFA+stent group than that in the stent-only group[17.9 d(7-22 d) VS 29.9 d(10-55 d),P=0.03].The biliary patency period in RFA+stent group was significantly longer than that of stent-only group (8.9 months VS 4.5 months, P=0.02).The mean survival time in RFA+stent group was significantly longer than that of stent-only group[13.3 months(6.2-16.5 months) VS 8.6 months(4.5-11.7 months), P=0.000).Incidence of postoperative adverse events showed no statistical difference between the two groups(P=0.727).Conclusion RFA with stent placement is effective and safe as a palliative measure in the treatment of non-resectable EHCC, and it can significantly shorten the jaundice fade time, prolong the biliary patency period and overall survival, while without increase of the incidence of adverse events.