OBJECTIVE:To determine the content of glycyrrhetic acid in zhenkening capsules by RP-HPLC.METHODS:The separation was performed on Hypersil C 18,the mobile phase consisted of methanol-water-glacial acetic acid(87∶13∶2.5)with flow rate at 1.0ml/min and detection wavelength at 254nm,the column temperature was set at room temperature.RE-SULTS:The calibration cure of glycyrrhetic acide was linear in the concentration range of 10～120?g/ml(r=0.9999),the average recovery was 99.68%(RSD=0.49%).CONCLUSION:This method is simple,fast,accurate,and suitable for the determination of glycyrrhetic acid in zhenkening capsules.

Objective To investigate the curative effect of modified tracheal catheter in acute respiratory failure caused by central airway stenosis.Methods 16 cases inpatient with acute respiratory failure caused by central airway stenosis were involved.Found out the position and range of stenosis of central airway by X-ray and CT of chest and fiberbronchoscope,chose the suitable silicon suction tube and cut it to make a tracheal catheter,then guided the catheter through the stenosis by fiberbronchoscope to construct artificial airway.Results The dyspnea of all 16 cases of acute respiratory failure caused by central airway stenosis could by relieved in short time,the PaO_2 raised from(39?12)mm Hg to(72?10)mm Hg,SaO_2 raised from(75?13)% to(93?3)%,PaCO_2 dropped from(102?21)mm Hg to(62?13)mm Hg after therapy.The effective rate is 100%.There was no other serious complication except for 2 cases of little amount of bleeding in trachea.15 cases survived and one died of serious muhisystem organ failure.Conclusions The use of modified tracheal catheter in treatment of acute respiratory failure caused by central airway stenosis can relieve the acute dyspnea in short time,it also can dilate central airway,save the cost of tracheal balloon dilatation for the follow-up therapy.

Objective In the previous study completed in Korea, early three-dimensional conformal radiotherapy concurrent with chemotherapy in rectal cancer after radical surgery demonstrated a better prognosis compared with late radiotherapy. However, with the report of MOSAIC trial, the adjuvant chemotherapy regimen had transferred from 5-Fu alone to combined 5-Fu and Oxaliplatin. We need more evidence to clarify the best radiotherapy timing during the whole period of adjuvant therapy . Methods Patients who met the following criteria were accrued in this study: 18-70 years old, lower anterior resection,pathologically proven rectal adenocarcinoma, stage T3-4 and/or N+, no evidence of distant metastases and KPS≥70. Three dimensional conformal Radiotherapy was started at the fourth week after surgery, which included 45 Gy whole pelvic radiation following by 6-10 Gy tumor bed boost. Oxaliplatin of 50 mg/m2 weekly and Xeloda 625 mg/m2 twice a day, every week from d1-5 were used concurrent with radiotherapy.Toxicity was evaluated and graded by common toxicity critera version 3. 0. The study was designed as Simon two-phase design, in the first phase, a total of 15 patients were accrued, and if more than or equal to 9 patients had grade 3 toxicity, we had 85% power to confirm the toxicity caused by early radiotherapy more than 50%. Otherwise, another 15 patients of the second phase were accrued, we would have 85% power to confirm the high toxicity of more than 50% if 18 out of 30 patients had grade 3 toxicity. Results From July 2008 to December 2008, 15 patients were treated with early radiotherapy concurrent with combined chemotherapy, Grade 3 gastrointestinal toxicity occurred in 12 patients and Grade 3 hematologic toxicity occurred in 2 patients. According to Simon design, we had 85% power to confirm the toxicity caused by early radiotherapy more than 50%. Conclusions For locally advanced rectal cancer patients, whole pelvic radiotherapy concurrent with oxaliplatin and xeloda had severe toxicities. Further studies are needed to decrease toxieities.

OBJECTIVETo explore selection and efficacy assessment for membranous urethral trauma caused by pelvic fracture.

METHODSFrom June 2000 to August 2010, 72 patients with membranous urethral trauma caused by pelvic fracture were selected. There were 46 males and 26 females,ranging age from 26 to 62 years (averaged 35.2 years). The time from injury to hospitalization time was 1 to 3 hours. According to Tile pelvic fracture classification, there were 8 patients with type A, 45 patients with type B, 19 patients with type C. Thirty of the 35 patients with partial rupture of posterior urethral were treated by catheterization,5 patients treated by rupture anastomosis on the stage I combined with cystostomy; 25 of the 37 patients with complete rupture of posterior urethra were treated by early realignment, and 12 patients were treated by cystostomy. Urinary incontinence, impotence and urethrostenosis were evaluated.

RESULTSAll patients were followed up for 5 to 10 years (mean 7.7 years). Incidence of urethrostenosis, impotence and urinary incontinence in patients treated by cystostomy were significantly higher than rupture anastomosis on the stage I and early realignment (P < 0.05); while incidence in patients treated by catheterization was significantly lower than other groups (P < 0.05).

CONCLUSIONFor patients with partial rupture of posterior urethral, catheterization and rupture anastomosis on the stage I are preferred methods; while patients with complete rupture of posterior urethra, early realignment is a preferred method with advantages of simple operation and less complications.

Adult ; Female ; Fractures, Bone ; complications ; Humans ; Male ; Middle Aged ; Pelvic Bones ; injuries ; Retrospective Studies ; Urethra ; injuries ; surgery

OBJECTIVETo detect the expression of human telomerase reverse transcriptase (hTERT) protein and mRNA in bile duct carcinomas and the adjacent tissues and to elucidate its role in bile duct carcinogenesis.

METHODSThe expression of hTERT protein and hTERT mRNA in the formalin-fixed paraffin-embedded specimens of 71 cases of bile duct cancers and 39 cases of adjacent tissues was detected by streptavidin-peroxidase immunostaining and in situ hybridization. The correlation was analysed statistically between the expression of hTERT protein and mRNA and clinicopathological parameters bile duct carcinomas.

RESULTSThe positive rate of hTERT protein expression and mRNA expression in malignant specimens was 78.9% (56/71) and 67.6% (48/71), while that in the adjacent tissues was 35.9% (14/39) and 23.1% (9/39), respectively. All the positive signals were found in the hyperplastic biliary epithelia. No significant correlation was established between hTERT expression and clinicopathological parameters.

CONCLUSIONhTERT gene transcription and protein expression is most likely involved in the proliferation and malignant transformation of bile epithelia and the malignant progression of bile duct carcinomas. The detection of hTERT expression may serve elucidating the carcinogenesis of bile duct.

Adult ; Aged ; Aged, 80 and over ; Bile Duct Neoplasms ; enzymology ; pathology ; DNA-Binding Proteins ; Female ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; RNA, Messenger ; analysis ; Telomerase ; analysis ; genetics

OBJECTIVETo investigate the effect of Shenfu injection (SF) in postoperative recovery after abdominal surgery.

METHOD150 patients were randomly divided into control group (75) and SF group (75). The efficacy were evaluated with the time of passage of gas by anus, information of wound healing, blood routine, blood coagulaton function, liver function. Changes recovery factor, immune index and hemorheological index were detected too.

RESULTThe time of passage of gas by anus in SF group was significantly shorter than that in control group. Blood routine, blood coagulaton function, liver function showed no significant difference in the two group of preoperative and postoperative. Whole blood viscosity, blood reduced viscosity and plasma fibrinogen viscosity in SF group were significantly lower than that in control group after operation. IgG and IgA in SF group was significantly higher than that in control group after operation. IgG and CD4+/CD8+ in control group was significantly higher after operation than that in before operation. Among tissue damage plerosis correlation factor, the blood levels of superoxide dismutase (SOD) in SF group and control group is significantly lower than that in preoperation (P < 0.05), SOD in SF group was significantly higher than that in control group after operation. The blood levels of malondialdehyde (MDA) in SF group and control group is significantly higher than that in preoperation (P < 0.05). MDA in SF group was significantly lower than that in control group after operation. Whole blood viscosity, blood reduced viscosity and plasma fibrinogen viscosity in control group after operation were significantly higher than that before operation.

CONCLUSIONSF can stimulate the immune system and reduce the blood viscosity. It is contribute to the patients' rehabilitation.

Aconitum ; chemistry ; Adult ; Aged ; Antigens, CD ; blood ; Blood Viscosity ; drug effects ; Cholecystectomy ; Drug Combinations ; Drugs, Chinese Herbal ; administration & dosage ; therapeutic use ; Female ; Hepatectomy ; methods ; Humans ; Infusions, Intravenous ; Male ; Malondialdehyde ; blood ; Middle Aged ; Panax ; chemistry ; Phytotherapy ; Plants, Medicinal ; chemistry ; Postoperative Care ; Recovery of Function ; drug effects ; Superoxide Dismutase ; blood

OBJECTIVETo study the durability of expanded polytetrafluoroethylene artificial heart valve (ePTFE AHV).

METHODSSix ePTFE AHVs were tested for 400 million times against accelerated fatigue using TH-2200 artificial heart valve exosomatic accelerated fatigue instrument. Hydromechanical parameters of fore-and-aft accelerated fatigue test of the 6 AHVs were obtained by TH-1200 artificial heart valve exosomatic pulsatile stream instrument.

RESULTS AND CONCLUSIONThe mean gradient pressure spanning the valve and the effective orific area of ePTFE AHVs did not undergo significant changes after fore-and-aft the fatigue test, but the regurgitation volume and regurgitation rate of ePTFE AHVs were reduced after the accelerated fatigue test, suggesting good durability of ePTFE AHV.

Biocompatible Materials ; chemistry ; Heart Valve Prosthesis ; standards ; Materials Testing ; methods ; Polytetrafluoroethylene ; chemistry ; Tensile Strength

OBJECTIVETo analyze the causes of initial erroneous diagnosis of pulmonary embolism (PE) to improve the diagnostic efficiency.

METHODSThe clinical data of 63 patients with a definite diagnosis of PE were retrospectively analyzed. According to the initial diagnosis, the patients were divided into definite diagnosis group (Group A, 23 cases) and misdiagnosis group (group B, 40 cases). The risk factors, initial symptoms, time of definite diagnosis, Wells scores, revised Geneva scores, and findings in chest X-ray and ECGs after onset and before the definite diagnosis were compared between the two groups.

RESULTSIn group A, recent operations, malignancy, long-term bedridden state, PE history and deep vein thrombosis (DVT) symptom were more commonly seen than in group B, and the patients in group B were more likely to have hypertension, smoking, diabetes mellitus and lower limb varicose veins. The patients in group B had significantly lower Wells scores and revised Geneva scores than those in group A [2.50 (5.00) vs 6.00 (6.00), u=-3.296, P<0.001; 5.50 (4.75) vs 12.00 (9.00), u=-3.187, P<0.001, respectively]. In group B, chest examination in 22 of the 40 cases (55%) reported pulmonary infection, and among them, 15 were misdiagnosed as pneumonia. In groups A and B, SIQIIITIII/QIIITIII in ECG was found in 5 (21.7%) and 0 cases (0%), and normal ECG in 2 (8.7%) and 18 (45.0%) cases, respectively, showing significant difference between the two groups (P=0.010 and 0.003, respectively).

CONCLUSIONThe initial misdiagnosis of PE results mainly from the low awareness of some of the PE risk factors on the part of the physicians, atypical clinical manifestations and excessive dependence on chest films and ECGs.

Adult ; Aged ; Diagnostic Errors ; Electrocardiography ; Female ; Humans ; Male ; Middle Aged ; Pulmonary Embolism ; diagnosis ; diagnostic imaging ; etiology ; Radiography ; Retrospective Studies ; Risk Factors

OBJECTIVETo study the effects of Yanshu injection on the combined treatment in the advanced primary liver cancer.

METHODEighty-five cases of advanced primary liver cancer were treated with Yanshu injection combining with chemotherapy or only chemotherapy. The curative effects, pain genesic rate, one year survival rate, survival quality of life and cell immune functions were observed.

RESULTThe remission rate and one year survival rate of the trial group were 60.5% and 51.2%, respectively, and were significantly higher than those (45.2% and 40.5%) of the control group (P < 0.05). The pain relief rate of the trial group was significantly higher than that of the control group (P < 0.05). The improvement of the quality of life was higher than that of the contral group (P < 0.01). The ability of the T-cell subgroup and NK-cell of the trail group were significantly difference between pre-and post-treatment (P < 0.01 or 0.05); however, that of the control group was no obviously change.

CONCLUSIONYanshu injection combination with chemotherapy can raise the curative effect, one year survival rate and cellular immune function, reduce pain genesic rate and toxicity of chemotherapy, and improve the quality of life of the patients with advanced primary liver cancer, which is worthy to be recommended for clinical application.

Adult ; Aged ; Antineoplastic Agents, Phytogenic ; administration & dosage ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; administration & dosage ; isolation & purification ; therapeutic use ; Female ; Humans ; Injections, Intravenous ; Liver Neoplasms ; drug therapy ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; Phytotherapy ; Plants, Medicinal ; chemistry ; Quality of Life ; Sophora ; chemistry ; Survival Rate

Objective To explore the necessity of setting up the course on clinical healthcare-associated infection (HAI) and effectiveness of the case-based teaching method in medical higher education.Methods 198 students who underwent internship in a hospital between July 2015 and July 2016 were selected,according to whether they selected clinical HAI coures,they were divided into course selective group(n =107,adopted case-based teaching method) and unselective group(n =91),questionnaire survey on the knowledge and attitude of HAI was carried out.Results The average score on HAI in selective group was higher than that of unselective group([85.3 ± 1.6] vs [58.3 ± 1.8],t =111.72,P＜0.01).Before and after conducted case-based teaching method,21.49％ and 47.66％ of students actively studied respectively,difference was significant (x2 =16.195,P＜0.01).Conclusion It is necessary to carry out a systematic course on HAI,case-based teaching method can improve the learning enthusiasm of students.