AIM:To investigate the process parameters of adsorbing and separating the total flavones of Radix et Rhizoma glycyrrhiae and its assay. METHODS: Chalcone that flavanone in Licorice root was converted into in alkaline condition was adopted as index and niaringoside as control,through polyamide treatment,alkaline colorimetty was used to determine chalcone content. RESULTS: Under the condtion,namely, ratio of quantity of Licorice root to polyamide was 2:1,ratio of column diameter to column heighth was 1:7,70%ethanol used to eluate,flavone extract was up to 45%with 90%eluting yield.The recoveny of assaying was 98.17%(RSD=2.00%). CONCLUSION: The purification and assay of Licorice flavonoids are reliable and efficacious.

ObjectiveTo investigate the effects of sevoflurane anesthesia on aquaporin-9 (AQP-9) expression in brain tissue after focal cerebral ischemia-reperfusion (I/R) in rats.MethodsSeventy-five male SD rats weighing 230-270 g were randomly divided into 3 groups ( n =25 each):group sham operation (group S) ; group I/R and group sevoflurane anesthesia (group SE).All the animals were tracheally intubated under 2.0％ sevoflurane and mechanically ventilated.Anesthesia was maintained with fentanyl infusion at 25 μg· kg-1 · h-1 after a bolus of fentanyl 10 μg/kg and inhalation of 65％ N2O in O2 in groups S and I/R and with inhalation of 2％ sevoflurane in 35％ O2 in group SE.Focal cerebral ischemin was induced by occlusion of middle cerebral artery for 2 h using a nylon thread with rounded tip which was inserted into the right internal carotid artery and advanced cranially until resistance was met.The neurologic function was assessed and scored (0=no deficit,4 =unable to move,unconscious) and brain edema rate (volume of ischemic hemisphere-volume of contralateral hemisphere ÷volume of contralateral hemisphere × 100％ ) and expression of AQP-9 were determined at 6 h,1,2,3 and 5 d of reperfusion.ResultsFocal cerebral I/R significantly increased neurologic deficit scores,brain edema rate and AQP-9 expression in brain tissue in group I/R as compared with group S.Sevoflurane anesthesia significantly attenuated the I/R-induced increase in neurologic deficit scores and brain edema rate and further increased I/R-induced increase in AQP-9 expression in brain tissue.ConclusionSevoflurane anesthesia can reduce focal cerebral I/R injury by up-regulating the expression of AQP-9 in brain tissue.

AIM To establish the HPLC-ELSD fingerprints of oligosaccharide sites from mycelia of Hericium erinaceum solid cultures and Weilening Tablets.METHODS The analysis of aqueous extract from samples was performed on a 80 ℃ thermostatic Waters XBridge TM Amide column (4.6 mm × 150 mm,3.5 μm),with the mobile phase comprising of acetonitrile-0.2％ ammonium acetate flowing at 1 mL/min in a gradient elution manner.RESULTS There were eight and nine common peaks in two HPLC-ELSD fingerprints with the similarties of 0.994-0.966 and 0.990-0.997,respectively.Three of them were mannitol,lactose and trehalose,which showed good linear relationships within their own ranges (r ≥ 0.999 0),the average recoveries were 95.08％-104.82％ with the RSDs of 1.12％-2.90％.CONCLUSION This simple and accurate method can be used for the rapid quality control of mycelia of Hericium erinaceum solid cultures and Weilening Tablets.

The aim of the study is to investigate rat intestinal absorption behavior of three main active components, schisandrol A, schisandrin A and schisandrin B in Schisandra chinensis Baill extracts in intestine of rats. With phenol red as the indicator, in situ single pass intestinal perfusion (SPIP) model was used and the concentrations of three main active components in perfusion solution of different intestinal segments (duodenum, jejunum, ileum, and colon) were determined by HPLC in combination with diode array detection. The results showed that the absorption rate constant (Ka) and effective permeability values (Peff) of three main active components in Schisandra chinensis Baill extracts had significant difference (P < 0.05) at different concentrations of perfusion solution, the Ka and Peff first increased and then decreased with the increase of drug concentration, the middle concentration was higher than those of the other two concentrations. The saturate absorption phenomena were observed, and it suggested that the transport mechanisms of three main active components in vivo were similar to active transport or facilitated diffusion. Three active components can be well absorbed in all of the intestinal segments, while duodenum is the best absorption region. The Ka and Peff of three active components in jejunum and ileum had no significant difference (P > 0.05). The absorption of the three active components displayed significant difference (P < 0.05) at different intestinal segments of rats. Schisandrin A had the best absorption in duodenum. The Ka and Peff among three active components were sequenced as follows: schisandrin A > schisandrin B > schisandrol A in other intestinal segments, and there is significant difference (P < 0.05) between them.

Objective To explore risk factors in the mortality of casualties and to find a way to improve trauma emergency service. Method The possible factors likely related to the mortality of casualties were taken into account based on each stage of trauma emergency so as to find the independent risk factors by using univariate and multivariate analyses. Results A total of 3 659 casualties were enrolled in this study.Of them, 226 casualties died and the mortality rate was 6.18%. Following factors were related to mortality after univariate analysis: age, cause of trauma, injury severity score, Glasgow come scale come on the scene, professional emergency treatment on the scene, intubation in the ambulance, debridement and hemostasis in the ambulance, low blood pressure at admission, closed drainage of pleural cavity, emergency operation, CVP monitoring in ICU and mechanical ventilation in ICU. After multivariate analysis, six factors were independently related to the mortality of casualties as follows: Glasgow coma scale, injury severity score, mechanical ventilation, blood pressure at admission, age and professional emergency treatment on the scene. Conclusions It has a great significance to investigate the risk factors of mortality for casualties. Severity of trauma and age were independently associated with the outcomes of trauma. Besides, improving prehospital care and stabilizing the trauma patients in early phase can further decrease the mortality.

ObjectiveTo evaluate the trauma care effect and the value of trauma and injury severity score (TRISS) in prediction of the mortality by using TRISS to calculate the survival probability of trauma patients in five hospitals from Zhejiang province in 2009.MethodsA retrospective study was done on trauma patients (study group) firstly admitted to Emergency Department of five hospitals from Zhejiang province in 2009.The relevant information was collected,including demographic data,trauma types and injury causes.The TRISS score was obtained through calculating injury severity score (ISS) and revised trauma score (RTS) on admission into emergency department.With the major trauma outcome study (MTOS) as control group,M value,standardized Ws value and 95％ confidence interval (CI) were calculated to compare actual survival rate and anticipation survival rate.ResultsA total of 2 193 patients at mean age of 44.39 years were enrolled in the study,including 1 661 male patients (75.74％).Traffic accident injury was the most common,followed by fall injury.The mortality rate according to TRISS was 13.22％,but the actual mortality rate was 9.75％.For all the patients,M =0.80 indicated that the injury severity of the study group was significantly different from that of the control group.At the same time,Ws =2.15,95％ CI for Ws:1.54-2.77 showed that the actual survival rate of the study group was significantly higher than that of the control group.Besides,the survival rate of trauma patients in the affiliated hospitals and three hospitals at class A grade was significantly higher fian that of the control group,but there was no significant difference between three hospitals at class B grade and control group. ConclusionsTRISS overestimates the mortality of the study group,which is probably associated with the rapid development of traumatology and the old coefficients of TRISS.Setting up local trauma database and renewing coefficients of TRISS may improve the ability of TRISS in predicting mortality of the trauma patients.

Objective To compare the efficacies of total gastrectomy (TG) and proximal gastrectomy (PG) for patients with upper gastric cancer.Methods Databases including Medline,Cochrane Library,Web of Science,China National Knowledge Infrastructure,Wanfang database were searched to retrieve literatures on surgical treatment of upper gastric cancer which were published from January 1980 to October 2011.According to different surgical procedures,all the patients were divided into PG group and TG group.Meta analysis were performed by RevMan 5.1.Categorical variables were presented by odds ratio (OR) and 95％ confidence interval (95％CI).Results Thirteen literatures including 2622 patients with upper gastric cancer were retrieved.There were 1464 patients in the TG group and 1158 patients in the PG group.There was no significant difference in the 1-year survival rate between the 2 groups (OR =1.23,P ＞ 0.05).The 3-and 5-year survival rates of patients in the TG group were significantly higher than those of the PG group (OR =1.74,1.45,P ＜ 0.05).There were no significant difference in the 5-year survival rates of patients in TNM Ⅰ,Ⅱ,Ⅳ stages between the 2 groups (OR =0.94,1.31,2.03,P ＞ 0.05),while the 5-year survival rate of patients in TNM Ⅲ stage of TG group was significantly higher than PG group (OR =2.29,P ＜ 0.05) The overall recurrence rate of TG group was slightly lower than that of PG group,with no significant difference OR =0.44,P ＞ 0.05).The local recurrence rate of TG group was significantly lower than that of PG group (OR =0.29,P ＜ 0.05).There was no significant difference in the distal recurrence rate between the 2 groups (OR =0.60,P ＞ 0.05).Conclusions The medium and longterm efficacies of TG are superior than that of PG.The stage of cancer should be taken into account to determine the plan of individual treatment.

Objective To investigate the effects of special anticoagulation method of hybrid coronary revascularization procedure on postoperative bleeding and clinical outcomes.Methods One hundred and forty-one ASA Ⅱ or Ⅲ consecutive patients,aged 35-82 yr,weighing 45-105 kg,undergoing one-stop hybrid coronary revascularization procedure from June 2007 to January 2011 in Fuwai cardiovascular hospital were enrolled and served as Hybrid group.Using propensity score methodology,these patients were matched with another 141 patients who had undergone off-pump coronary artery bypass grafting (OPCAB group) during the same period,selecting from the surgical database.These ASAⅡ or Ⅲ 141 patients,aged 43-80 yr,weighing 47-110 kg,who underwent OPCAB,were served as control subjects.In group Hybrid,the left internal mammary artery was isolated and then 100-120 U/kg heparin was administrated to maintain activated clotting time between 250-300 s,and additional heparin was given if needed.Protamine 1 mg/kg was used to reverse the effect of heparin after anastomosis between left internal mammary artery and left anterior descending branch.Before stent implantation,6000-8000 U heparin and 300 mg clopidogrel were administrated.Activated clotting time was maintained between 200-250 s until the end of operation.Clopidogrel 75 mg/d was taken for at least 12 months after operation.The volume of postoperative chest tube drainage,mechanical ventilation time,length of stay in intensive care unit,postoperative transfusion of allogeneic blood,re-intubation,myocardial damage,acute kidney injury,atelectasis,hydrothorax and thromboembolism were recorded.Results No thromboembolism was observed within the stent during stay in hospital after operation in patients.The volume of chest tube drainage was significantly less,mechanical ventilation time and length of stay in intensive care unit were shorter,the incidence of atelectasis and hydrothorax and transfusion of allogeneic blood requirement were lower in Hybrid group than in OPCAB group (P ＜ 0.05).There was no significant difference in the incidences of re-intubation,myocardio damage,and acute kidney injury between the two groups (P ＞0.05).Conclusion Special anticoagulation method of hybrid coronary revascularization procedure does not increase postoperative bleeding and has a better clinical outcomes during the early period.

Objective To compare the setup errors between single-site and two-site image guidance in treating multiple metastases using Tomotherapy.Methods A total of 1 220 sets of megavoltage CT (MVCT) images from 50 multiple metastases patients were collected.The setup errors of two anatomic sites were determined by registration of MVCT images with planning images.Bland-Altman plot analysis was used to assess the coincidence of these two methods.Pearson correlation analysis was performed to evaluate the correlation of the setup errors determined by two sets of data and to analyze the deviation values of setup errors.Results The deviation values of setup errors more than 3 mm between two sites were 34％,46％ and 28％ in lateral (x),longitudinal (y),vertical (z) directions,respectively.The deviation values of setup errors more than 5 mm were 10％,16％ and 8％,respectively.The BlandAltman plot analysis showed that the 95％ agreement limits of agreement were (9.3,-10.6),(10.5,-11.7),(7.3,-6.9) mm in x,y,z directions,respectively,which were all out of 5 mm tolerance.The Pearson coefficient of correlation along all three directions was less than 0.05,and R2 was 0.074,0.475,and 0.178 in x,y,z directions,respectively.Conclusions To determine the setup errors for patients with multiple metastases,single-site image guidance method is not consistent,and the two site image guidance method would be recommended.

Aged, 80 and over ; Atrial Fibrillation ; complications ; Embolism ; complications ; Female ; Heart Atria ; pathology ; Heart Diseases ; complications ; Humans ; Myocardial Infarction ; etiology ; Thrombosis ; complications