Objective To establish the quality standard for Xiaozhong Tablets (Radix Angelicae Sinensis, Pheretima, etc.). Methods TLC was performed to Radix Angelicae Sinensis, Pheretima, Ursolic acid. The content of Aconitine was identified by TLC. HPLC was used to determine Strychnine content. Results The characteristic for identification by TLC was distinct and hightly specific. The quantification method of Strychnine had the linear range of 0.52～1.56 ?g (r =0.9998). The average recovery was 99.9% (RSD=1.77%, n =5). Conclusion The methods of identification and quantification were accurate, realizable and reproducible. It can be used effectively for the quality control of Xiaozhong Tablets.

A sensitive determination method for sulfur mustard ( HD ) metabolites thiodiglycol ( TDG ) in rabbit urine was established and validated using isotope dilution negative ion chemical ionization ( NICI) gas chromatography-mass spectrometry ( GC-MS ) , in which deuterated thiodiglycol ( TDG-d8 ) was used as internal standard. Two solid-phase extraction ( SPE) steps were established and optimized in order to reduce the interfering backgrounds, one was used to extract thiodiglycol ( TDG ) from urine with self-assemblied Florisil SPE cartridges, another cleaning treatment of the by-products after pentafluorobenzoyl chloride (PFBZ) derivatization. The results showed that the limits of detection quantitation of this method were 0. 1 and 0. 3 μg/L, respectively. The exposure time-response relationship and exposure dose-response relationship of TDG in rabbit urine were studied after rabbit skin exposure to sulfur mustard (HD, 0. 02-0. 15 LD50). The TDG levels in the rabbit urine increased rapidly during the first day after application and then decreased over time for all dosage groups. A secondary release was also noted for the high-dose group, and the duration of high TDG excretion levels was correlated positively with the HD dosage levels. We thus concluded that abnormally high levels of TDG in urine could be used as a clear diagnostic indicator of HD exposure.

Objective To evaluate the clinical effects of ultrasound-guided internal jugular vein catheterization in long axis plane,short axis plane and oblique axis plane,in order to identify the opti-mal axis plane for this procedure.Methods One hundred and eighty patients (male 94 cases,female 86 cases,aged 34-82 years)requiring ultrasound-guided internal jugular vein catheterization were in-cluded in this study.They were randomly divided into three groups (n =60 each),long axis group, short axis group and oblique axis group,with 60 cases in each group.The details of catheterization in-cluding the time accessing into vein,the time finishing cannulation,needle redirecting times,number of skin points of puncture,puncture successful rate and complications in the three groups were recor-ded.Results Compared with long axis plane and short axis plane,the oblique axis plane was associat-ed with decreased time for venous access and cannulation.The oblique axis plane also needed less changes of needle direction.The complication of arterial puncture in the oblique axis plane group was significantly lower than long axis plane group and short axis plane group(P <0.05).The number of skin puncture points were similar between the three groups.Conclusion The oblique plane can provide a safe and more effective route to perform the IJV catheterization with minimal risk for carotid artery puncture,which demonstrates the practical superiority over the classic short axis plane and long axis plane for critically ill patients.

Objective: To observe the pathological response in tumor tissues and the vascular endothelial growth factor (VEGF) changes in serum of patients with esophageal carcinoma receiving radiotherapy or concurrent chemoradiotherapy, and to investigate the relationship between these two factors and the prognosis of these patients. Methods: A total of eighty-nine patients with esophageal carcinoma treating with radiotherapy or concurrent chemo-radiotherapy were prospective included. Gastroscopy and biopsy were performed at 4 week of radiotherapy to assess pathologicalresponse. VEGF serum levels were measured by double antibody sandwich avidin-biotin ELISA prior to, at 4 week of, and 1 week after radiotherapy. The relationship between pathological response in tumor tissues and VEGF serum changes and the prognosis of the patients were analyzed. The survival curve and survival rate were respectively drawn and calculated by the Kaplan-Meier method, and the Log-rank test was used for survival analysis. Multivariate Cox proportional hazard model was used to analyze the prognostic factors. Results: Pathological responses were classified into two degrees: Non-CR responses (22 cases), and CR responses (67 cases). The 1-, 3- and 5-year OS rates in CR group and non-CR group were 77.6%, 46.3%, 35.2% (median OS: 30.0 months, 95%CI 14.3-45.6 months) and 50.0%, 0.0%, 0.0% (median OS: 11.4 months, 95%CI 4.2-18.6 months), respectively, showing that the OS in CR group were significantly higher than that in non-CR group (P<0.001). Meanwhile, the 1-, 3- and 5-year PFS rates in CR group and non-group were 69.7%, 40.9%, 34.3% (median PFS: 21.7 months, 95%CI 13.1-30.3 months) and 36.4%, 0.0%, 0.0% (median PFS: 7.4 months, 95%CI 2.1-12.4 months), respectively, showing that the PFS in CR group was significantly higher than that in non-CR group (P<0.001). VEGF serum changes were classified into three degrees: increased group (16 cases), stable group (43 cases) and decreased group (30 cases). The 1-, 3- and 5-year OS rates in VEGF increased group were 50.0%, 18.8%, 12.5% (median OS: 9.2 months, 95%CI 2.2-17.9 months), respectively, while the 1-, 3- and 5-year OS rates in VEGF stable group were 67.4%, 30.2%, 19.9% (median OS: 19.9 months, 95%CI 14.9-24.9 months), respectively, and the 1-, 3- and 5-year OS rates in VEGF-decreased group were 86.7%, 50.0%, 42.9% (median OS: 28.7 months, 95%CI 5.4-51.2 months), respectively, showing that the OS in VEGF-decreased group was significantly the highest among the three groups (P<0.05). The 1-, 3- and 5-year PFS rates in VEGF-increased group were 43.8%, 12.5%, 0 (median PFS: 8.0 months, 95%CI 2.5-15.9 months), respectively, while the 1-, 3- and 5-year PFS rates in VEGF stable group were 57.1%, 26.2%, 20.8% (median PFS: 15.5 months, 95%CI 10.7-20.4 months), respectively, and the 1-, 3- and 5-year PFS rates in VEGF decreased group were 76.7%, 46.7%, 39.7% (median PFS: 20.1 months, 95%CI 2.4-40.1 months), respectively, showing that the PFS in VEGF decreased group was significantly the highest among the three groups (P=0.013). Conclusions: Pathological response and VEGF changing trend during radiotherapy were both closely related to prognosis of patients with esophageal carcinoma. Trial registration This clinical trial was registered in the United States Trial, ID: NCT01551641

Objective To observe the pathological response in the tumor tissue and the changes of serum level of vascular endothelial growth factor ( VEGF) in esophageal cancer patients receiving concurrent chemoradiotherapy, in order to study the impacts of these two factors on the prognosis of patients. Methods One hundred pathologically confirmed esophageal cancer patients were treated with radiotherapy including 72 patients with concurrent chemoradiotherapy. After 4 weeks, gastroscopy was performed to collect tumor biopsies for examination of pathological changes. The responses to radiotherapy were classified into three degrees: mild, moderate and intensive. Moreover, serum samples were collected from the patients prior to, at the fourth week during radiotherapy, and one week after radiotherapy, and serum VEGF level was determined. The changes of serum VEGF were classified as increased, unchanged and decreased. Serum samples from 30 healthy subjects were collected and represented as VEGF healthy control. Results Among the eighty?nine patients evaluable, the 1? and 3?year overall survival ( OS) rates were 70.8% and 33.3%, respectively;1?year and 3?year progression?free survival ( PFS) rates were 61.8% and 28.2%, respectively;and 1?year and 3?year local control ( LC) rates were 76.9% and 50.0%, respectively. The 1?year OS rates in the patients with mild, moderate and intensive pathological responses were 50. 0%, 76. 9% and 78. 0%, respectively. The 1?year OS rate in the mild response group was significantly lower than that in the intensive response group ( P<0.05) . The 1?year and 3?year PFS rates in the three groups were 36.4%, 73.1%, 68.3%, and 0. 0%, 40.0% and 38. 9%, respectively, showing that the rate in the mild response group was significantly lower than that in the moderate and intensive response groups ( P<0.05 for both) . The PFS rate in the mild response group was significantly lower than that in the moderate and intensive response groups ( P<0.05 for both) . Moreover, the 1?year local control ( LC) rates in the three groups were 52.9%, 83.3%and 83.8%, and the three?year LC rates were 0. 0%, 64. 3% and 64. 0%, respectively, showing that the lowest LC rates in the mild response group were significantly lower than that in the moderate and intensive response groups (P<0.05 for both). The average serum VEGF levels in the patients prior to, during and after radiotherapy were (109.6±33.7) ng/L, (101.2±24.3) ng/L and (99.5±22.9) ng/L, respectively, all significantly higher than that in the healthy subjects [(79.6±39.2) ng/L, P<0.05 for both]. The level of serum VEGF was decreased during and after radiotherapy compared with that before radiotherapy ( F=6.124, P=0.004). The 1?year OS rates in the VEGF?increased, unchanged and decreased groups were 50.0%, 67.4% and 86.7%, respectively, and the 3?year OS rates in these three groups were 15. 4%, 27. 0% and 50.0%, respectively. The OS rates in the increased group were significantly lower than that in the VEGF?decreased group (P<0.05). Moreover, the 3?year PFS rates in the three groups were 7.7%, 21.6% and 46.4%, respectively, and the rate in the VEGF?increased group was significantly lower than that in the VEGF?decreased group ( P<0.05) . The multi?variate analysis showed that TNM stage, pathological response and serum VEGF were independent factors affecting the survival in the non?surgical patients with esophageal cancer (P<0.05 for all). Conclusions Tumor tissue pathological response and variation of serum VEGF level in response to chemoradiotherapy can be used to predict the efficacy of chemoradiotherapy in non?surgical patients with esophageal cancer. Hence, monitoring the pathological response and VEGF changes during the course of therapy is of utmost importance to evaluate and perform an individualized therapy in clinical practice.

Objective To observe the pathological response in the tumor tissue and the changes of serum level of vascular endothelial growth factor ( VEGF) in esophageal cancer patients receiving concurrent chemoradiotherapy, in order to study the impacts of these two factors on the prognosis of patients. Methods One hundred pathologically confirmed esophageal cancer patients were treated with radiotherapy including 72 patients with concurrent chemoradiotherapy. After 4 weeks, gastroscopy was performed to collect tumor biopsies for examination of pathological changes. The responses to radiotherapy were classified into three degrees: mild, moderate and intensive. Moreover, serum samples were collected from the patients prior to, at the fourth week during radiotherapy, and one week after radiotherapy, and serum VEGF level was determined. The changes of serum VEGF were classified as increased, unchanged and decreased. Serum samples from 30 healthy subjects were collected and represented as VEGF healthy control. Results Among the eighty?nine patients evaluable, the 1? and 3?year overall survival ( OS) rates were 70.8% and 33.3%, respectively;1?year and 3?year progression?free survival ( PFS) rates were 61.8% and 28.2%, respectively;and 1?year and 3?year local control ( LC) rates were 76.9% and 50.0%, respectively. The 1?year OS rates in the patients with mild, moderate and intensive pathological responses were 50. 0%, 76. 9% and 78. 0%, respectively. The 1?year OS rate in the mild response group was significantly lower than that in the intensive response group ( P<0.05) . The 1?year and 3?year PFS rates in the three groups were 36.4%, 73.1%, 68.3%, and 0. 0%, 40.0% and 38. 9%, respectively, showing that the rate in the mild response group was significantly lower than that in the moderate and intensive response groups ( P<0.05 for both) . The PFS rate in the mild response group was significantly lower than that in the moderate and intensive response groups ( P<0.05 for both) . Moreover, the 1?year local control ( LC) rates in the three groups were 52.9%, 83.3%and 83.8%, and the three?year LC rates were 0. 0%, 64. 3% and 64. 0%, respectively, showing that the lowest LC rates in the mild response group were significantly lower than that in the moderate and intensive response groups (P<0.05 for both). The average serum VEGF levels in the patients prior to, during and after radiotherapy were (109.6±33.7) ng/L, (101.2±24.3) ng/L and (99.5±22.9) ng/L, respectively, all significantly higher than that in the healthy subjects [(79.6±39.2) ng/L, P<0.05 for both]. The level of serum VEGF was decreased during and after radiotherapy compared with that before radiotherapy ( F=6.124, P=0.004). The 1?year OS rates in the VEGF?increased, unchanged and decreased groups were 50.0%, 67.4% and 86.7%, respectively, and the 3?year OS rates in these three groups were 15. 4%, 27. 0% and 50.0%, respectively. The OS rates in the increased group were significantly lower than that in the VEGF?decreased group (P<0.05). Moreover, the 3?year PFS rates in the three groups were 7.7%, 21.6% and 46.4%, respectively, and the rate in the VEGF?increased group was significantly lower than that in the VEGF?decreased group ( P<0.05) . The multi?variate analysis showed that TNM stage, pathological response and serum VEGF were independent factors affecting the survival in the non?surgical patients with esophageal cancer (P<0.05 for all). Conclusions Tumor tissue pathological response and variation of serum VEGF level in response to chemoradiotherapy can be used to predict the efficacy of chemoradiotherapy in non?surgical patients with esophageal cancer. Hence, monitoring the pathological response and VEGF changes during the course of therapy is of utmost importance to evaluate and perform an individualized therapy in clinical practice.

Objective: To investigate the adverse events and efficacy in cervical cancer patients receiving intensity modulated radiationtherapy (IMRT) plusbrachytherapy with or without chemotherapy, and to indentify the factors that may affect the prognosis. Methods: In this retrospective analysis, we analyzed the clinical and follow-up data of the 422 cervical cancer patients, who received IMRT plus brachytherapy with or without chemotherapy.Among these patients, 353 cases received concurrent chemoradiotherapy and the other 69 cases received radiotherapy alone. Kaplan-Meier method was utilized to calculate the overall survival (OS) rates. Log-rank-test and Cox regression were performed to executing the univariate and multivariate analysis of the OS, respectively. Results: The rate of complete response (CR) in the patients receiving concurrent chemoradiotherapy was significantly higher than that of the patients who received single radiotherapy (77.6% vs. 65.2%, χ²=4.812, P<0.05). The 1-, 3-, and 5-year OS rates were 93.4%, 79.4%, and 65.0%, respectively. Univariate analysis showed that age, Federation International of Gynecology and Obstetr(FIGO)2009 staging, lymph node metastasis, pathological type, chemotherapy experiences concurrent with radiotherapy, short-term efficiency, and sequential chemotherapy could affect the OS (χ²=6.375-613.123, P<0.05). Multivariate analysis showed that FIGO staging, lymph node metastasis, pathological type, chemotherapy experiences concurrent with radiotherapy, and the short-term efficacy were the independent determinants for the prognosis (χ²=3.930-42.994, P<0.05). For patients with positive pelvic lymph node, there were no statistical differences in the para-aortic lymph node (PALN) metastasis whether undergoing prophylactic extended field irradiation of the PALN or not(PALN metastasis rates: 6.1% vs. 16.8%, P>0.05). The OS for the patients receiving prophylactic extended field irradiation of the PALN was higher than that of patients without prophylactic radiation (χ²=3.953, P<0.05). Conclusions Cervical cancer patients receiving IMRT plus brachytherapy with or without chemotherapy had achieved promising prognosis. Prophylactic extended field irradiation of the PALN contributed to the improved OS in the patients with pelvic lymph node metastasis. FIGO staging, pathology type, lymph node metastasis, radiotherapy concurrent with chemotherapy or not, and short-term efficiency were independent factors for the prognosis.