The HPLC fingerprint differences ofRadix Platycodonis from different origins were studied to provide references for their quality control and production. The total platycodins were purified by DB101 macroporous resin. HPLC-ELSD fingerprints of the total platycodins for 39 batches ofRadix Platycodonis samples from 9 provinces were performed on an Agilent HC-C8 column (4.6 mm x 250 mm, 5μm) with gradient elution. The mobile phase was acetonitrile-0.5% acetic acid. The injection volume was 6μL. The flow rate was 0.5 mL·min-1. The temperature of drift tube was set at 90℃. And the gas flow (N2) was set at 1.2 mL·min-1. The results showed that there were large differences in the quality ofRadix Platycodonis from different origins with the common fingerprints of 6 batches of samples fromChifeng in Inner Mongolia as references. The quality ofRadix Platycodonis was closely related to the seeds, the ecological environment, the way of drying and storing and so on. It was concluded that it was important to strengthen the provenance base construction, standardization of the seeds, reasonable formulation of the regionalization, and standardization of the production processing for the cultivation and production ofRadix Platycodonis.

This study was aimed to compare the expectorant and antitussive actions ofPlatycodon grandilforum from different production areas in order to provide references for its cultivation and production. The antitussive activities ofP. grandilforum water extract from different areas were investigated through testing the cough times induced by ammonium hydroxide in mice. And the expectorant activities were studied by testing the amount of tracheal phenolsulfonphthalein excretion in mice. The results showed that the minimum effective dose ofP. grandiflorum fromChifeng of Inner Mongolia was 0.2 g·kg-1. Under this dosage,P. grandiflorum fromChifeng of Inner Mongolia can significantly reduce the cough frequency in mice (P < 0.01), and significantly prolong the cough incubation period in mice (P < 0.01).P. grandiflorum fromSichuan province,Shangzhou ofShaanxi province andChongqing can significantly decrease the cough frequency in mice (P < 0.05). P. grandiflorum from Sichuan province,Shangzhou ofShaanxi province andChifeng of Inner Mongolia can significantly increase the phenolsulfonphthalein excretion quantity in mice (P < 0.05). It was concluded thatP. grandilforum was effective for relieving cough and removing sputum. The effect ofP. grandilforum fromChifeng of Inner Mongolia was obviously stronger than that from other areas.

Objective To summarize the diagnosis and surgical treatment of mesenteric cyst in children.Methods The clinical records of mesenteric cyst cases from January 2011 to December 2015 were reviewed retrospectively.The diagnosis and treatment options were analyzed, and the prognosis of laparoscopic surgery and laparotomy was compared.Results The main clinical symptoms included abdominal mass, abdominal pain, and abdominal distension.Abdominal ultrasound and/or CT scan were the diagnostic tools in all cases.Traditional laparotomy was performed in 14 cases, while laparoscopy in 7 cases (1 case switched to laparotomy).2 cases had emergency surgery due to acute abdomen, laparotomy and laparoscopy in each case.Simple cyst resections were completed in 14 cases, of which 2 cases with a small amount of residual in the mesenteric root.Intestinal resection and anastomosis were required in other 7 cases.The average time of hospital stay for laparotomy group was 12 days, and 10.14 days for laparoscopy group.There was no significant difference.All patients were discharged without postoperative complications.With 1-4 years follow-up, there was no recurrence.Conclusion The operation for mesenteric cysts depends on the relationship between the cyst and the adjacent bowel or organs, and the overall outcome is favorable.The selective use of laparoscopy will benefit more children.

OBJECTIVETo establish a method of comprehensive chemical pattern recognition of plantain seed via HPLC fingerprint, principal component analysis (PCA) and cluster analysis.

METHODThe chromatographic separation was performed on a C18 column (4.6 mm x 250 mm, 5 microm). The mobile phase was a mixture of acetonitrile-0.5% acetic acid aqueous solution in gradient elution. The HPLC fingerprint of ethyl acetate fraction of 24 batches Plantaginis Semen from different habits and varieties was set up and 10 common peaks were obtained.

RESULTThe result of the principal component analysis (PCA) and cluster analysis is similar but there is disparity between them.

CONCLUSIONThe method could be used for the quality control and comprehensive evaluation of Plantaginis Semen.

OBJECTIVE: To evaluate therapeutic efficacy and safety of allopurinol versus (vs.) TCM prescription for gout in the treatment of gout, and to provide evidence-based reference for clinical treatment of gout. METHODS: Retrieved from PubMed, Embase, Medline, The Cochrane library, Chinese Journal Full-text Database (CJFD), China Scientific Journal Database (CSJD) and Wanfang database, randomized controlled trials (RCTs) about therapeutic efficacy (total response rate, level of uric acid) and safety (the occurrence of ADR) of TCM prescription for gout alone or combined with allopuinol (trial group) vs. allopurinol (control group) in the treatment of gout were collected. After data extraction of clinical studies meeting inclusion criteria, Cochrane system evaluator manual 5. 1. 0 was used to evaluate the quality of included studies, and Meta-analysis was conducted by using Rev Man 5. 3 statistical software. RESULTS: A total of 20 RCTs were included, involving 1 961 patients. Results of Meta-analysis showed that total response rate of trial group was significantly higher than that of control group [OR=2. 29, 95％ CI(1. 84, 2. 84), P<0. 001], uric acid level was significantly lower control group [MD= -27. 99,95％ CI(-33. 04, -22. 93),P<0. 001],with statistical significance. The incidence of ADR in trial group was significantly lower than control group, with statistical significance (P<0. 05). CONCLUSIONS: Therapeutic efficacy and safety of TCM prescription are better than those of allopuinol for gout.

Objective To study the effects of monomers in Lagotis brachystachya Maxim including quercetin,echinacoside,and apigenin on the p38MAPK/JNK,TLR4/MyD88/NF-κB,and NLRP3 signaling through establishing a rat model of chronic alcoholic liver injury combined with gouty arthritis,and to explore the mechanism of the above-mentioned monomers in the treatment of chronic alcoholic liver injury combined with gouty arthritis.Methods Eighty rats were randomly divided into normal group,model group,bifendate group(100 mg·kg-1),colchicine group(0.3 mg·kg-1),and different dose groups of quercetin(50,25 mg·kg-1),echinacoside(50,25 mg·kg-1),and apigenin(50,25 mg·kg-1).The rats were administered at a dose of 10 mL·kg-1 per day in the morning and administered with 56-degree Red Star Erguotou at a dose of 4 mL·kg-1 in the afternoon,with gradual increasement of 2 mL·kg-1 per week until a final dose of 10 mL·kg-1.The rats were continuously fed by gavage for 8 weeks.Gouty arthritis model was induced at the 53th day of alcohol-based feeding.Toe volume was measured at difference time.At the end of the 8th week,blood was collected after the last administration.Serum alanine aminotransferase(ALT),aspartate aminotransferase(AST),alkaline phosphatase(ALP)levels,total cholesterol(TC)and triglycerides(TG)were measured.Enzyme-Linked Immunosorbent Assay(ELISA)was used to detect interleukin-1β(IL-1β)in rat serum.Western Blot was used to detect the expression of p38 mitogen-activated protein kinase(p38MAPK),phosphorylated p38MAPK(p-p38MAPK),c-Jun N-terminal kinase(JNK),phosphorylated JNK(p-JNK),Toll-like receptor 4(TLR4),myeloid differentiation factor 88(MyD88),nuclear factor-κB(NF-κB),phosphorylated NF-κB(p-NF-κB),and NOD-like receptor protein domain containing 3(NLRP3)in liver and synovial tissues.Results Compared with the normal group,the toe swelling degree in the model group was significantly increased at difference time(P＜0.05,P＜0.01).The levels of ALT,AST,ALP,TC,TG,and IL-1β in serum were significantly increased(P＜0.01).The protein expression levels of p-p38MAPK,p-JNK,MyD88,p-NF-κB,TLR4,and NLRP3 in liver and synovial tissues were all increased to varying degrees(P＜0.01).Compared with the model group,the toe swelling degree in all treatment groups significantly decreased after 24 hours(P＜0.01).The levels of ALT and TC in the bifendate group and different dose groups of monomers decreased to varying degrees(P＜0.05,P＜0.01).Except for the low dose group of echinacoside,the levels of AST and ALP in other treatment groups decreased to varying degrees(P＜0.01).Except for the high dose group of quercetin,the levels of TG in other treatment groups decreased to varying degrees(P＜0.01).The protein expression levels of p-p38MAPK,p-JNK,MyD88,p-NF-κB,TLR4,and NLRP3 in liver and synovial tissues of rats in all treatment groups were down-regulated(P＜0.05,P＜0.01).Conclusion The monomers in Lagotis brachystachya Maxim show certain therapeutic effects of treating different diseases with same treatment on the rat model of chronic alcoholic liver injury combined with gouty arthritis,and their therapeutic effects may be mediated through p38MAPK/JNK,TLR4/MyD88/NF-κB,and NLRP3 signaling pathways.

Objective To summarize the etiology,diagnosis and treatment of three cases of duodenal perforation. Methods The data of 3 cases of children with duodenal perforation in our hospital from September 14,2016 to June 20,2017 were retrospectively analyzed. The causes,clinical features and treatment of children's duodenal perforation were summarized. Results A total of 2 males and 1 females aged 2 years,3 years and 5 years were included in the 3 cases. All 3 cases had fever history of upper respiratory tract infection before onset. Acute abdominal pain occurred after oral administration of ibuprofen several times,and all the abdominal plain films prompted pneumoperitoneum. Three cases of perforation sites were duodenal anterior wall,diameter were 0. 5-1 cm. Two cases of small amount of pneumoperitoneum were explored and repaired the duodenal perforation by 3D laparoscopic,1 case underwent laparotomy to repair the duodenal perforation due to a large number of liquid pneumoperitoneum and severe shock. Repair of 3 cases were covered with omentum. Three cases were all cured without anastomotic fistula, ulcer, adhesive intestinal obstruction or other complications. Followed-up in the department of gastroenterology,3 cases had no Helico-bacter pylori infection. Conclusion Repeatedly oral administration of ibuprofen can cause duodenal perfora-tion in children in the short term. Once the digestive tract perforation confirmed,emergency surgical explora-tion is needed. Laparoscopic repair of duodenum perforation is safe and effective and may have a faster recov-ery. We can choose exploratory laparotomy if conditions are not allowed.

Objective: To discuss the affect of glycosylated hemoglobin (HbA1c) level for the onset of nonalcoholic fatty liver disease (NAFLD) in cohort population. Methods: An epidemiological survey of the relationship between HbA1c and NAFLD conducted in 2012 was based at cohort baseline, and three follow-up sessions conducted in 2013, 2014 and 2015. In total 2 811 subjects were included in the study after exclusion of NAFLD patients at baseline and those who lost their lives due to relocation, and death. The Cox proportional hazard model was used to analyze the relationship between glycosylated hemoglobin and other risk factors of NAFLD. Continuous variables were compared using the t-test or the Mann-Whitney test. χ ²-test was used for the measurement of categorical data. Results: A total of 2 811 subjects with mean age of 59 (58.2±9.8) years old, including 1 664 males and 1 147 females. Age, waist circumference, body mass index, systolic blood pressure, γ-glutamyltransferase and fasting blood glucose level of HbA1c abnormal group were higher than normal group. The incidence of NAFLD in the abnormal HbA1c level group (25.4%) was higher than normal group (14.9 %), and diastolic blood pressure, high-density lipoprotein cholesterol was lower than normal group and the differences were statistically significant. During the three follow-up intervals, there were 440 new cases of NAFLD, consisting 285 males and 155 females with cumulative incidence of 15.7% (440/2 811). Multivariate Cox regression analysis showed that patients with elevated HbA1c had a higher risk of developing NAFLD (HR 1.796; 95% CI 1.335~2.418; P < 0.01), and the increased HbA1c level after adjustment for gender, age, and metabolic syndrome-related factors remained an independent risk factors for NAFLD (HR 1.580; 95.0% CI 1.161-2.152; P < 0.01). Conclusion An elevated HbA1c levels have a positive predictive value for the onset of NAFLD.