Objective:To provide scientific basis for the quality control of Jiuwei Qianghuo granules by establishing an HPLC char-acteristic fingerprint. Methods:The HPLC analysis was performed on a Sunfire C18 chromatographic column (250 mm × 4. 6 mm, 5μm) , and the mobile phase was acetonitrile-0. 1% phosphoric acid with gradient elution at the flow rate of 1. 0 ml·min-1 . The de-tection wavelength was 270 nm and the temperature of column was 30℃. Results:The common pattern of HPLC characteristic chroma-tographic profile was established. There were 15 common peaks,and four of which were identified in the pattern. The similarities of 12 batches of Jiuwei Qianghuo granules was evaluated,and all of them were greater than 0. 90. Conclusion:The analysis method of HPLC characteristic chromatographic fingerprint is simple and reproducible, which can provide scientific basis for the identification and quali-ty evaluation of Jiuwei Qianghuo granules.

Objective To evaluate the clinical efficacy and safety of topical glucocorticoids combined with a moisturizer containing antimicrobial peptides in the treatment of persistent localized eczema. Methods A total of 60 patients with localized eczema were divided into 2 groups. Group 1 topically applied Fuqing gel (an antimicrobial dressing) and hydrocortisone butyrate cream twice a day for 2 weeks, and group 2 topically applied the vehicle of Fuqing gel and hydrocortisone butyrate cream twice a day for 2 weeks. Recovered patients were followed up once every 4 weeks for 12 weeks. Bacterial culture was performed for 5 patients with suspected local Staphylococcus. aureus infection, including 3 patients in group 1 and 2 in group 2, before and after the 2?week treatment. Therapeutic effects were evaluated and compared between the two groups. Results Compared with group 2, group 1 showed a signifi?cantly higher response rate after 1?week treatment(χ2 = 5.455, P < 0.05), but significantly lower eczema area and severity index(EASI)scores after 1? and 2?week treatment(both P < 0.05). Before the treatment, S. aureus was detected in all the 5 patients. After 2?week treatment, S. aureus was undetected in all the 3 patients in group 1, but was still detected in the other 2 patients in group 2. The treatment was rated as ineffective in none of 7 recovered patients in group 1 during the 12?week follow up, but in 2 of 5 recovered patients in group 2 at week 10. Conclusion Fuqing gel combined with glucocorticoid ointment is safe and effective for the treatment of localized eczema, and can be applied in clinic.

Objective:To evaluate the clinical efficacy and safety of topical hydrocortisone butyrate cream combined with a skin cream dressing in the treatment of mild to moderate atopic dermatitis (AD) .Methods:From July 2019 to June 2020, a randomized, open, controlled clinical study was conducted in Beijing Friendship Hospital, Capital Medical University. Sixty patients with mild to moderate AD were enrolled into this study, and randomly divided into 2 groups by using a random number table. The patients in test group topically applied a skin cream dressing (trade name FORENéE) followed by hydrocortisone butyrate cream, and those in control group topically applied the vehicle of the cream dressing followed by hydrocortisone butyrate cream. The treatment was carried out twice a day for 4 weeks. Visits were scheduled at baseline and after 2 and 4 weeks of treatment, efficacy was evaluated, and adverse reactions were recorded. Repeated measures analysis of variance and chi-square test were used to compare efficacy and safety between the 2 groups.Results:Before treatment, there was no significant difference in eczema area and severity index (EASI) , visual analogue scale (VAS) or investigator global assessment (IGA) scores between the 2 groups (all P < 0.05) . After 2 and 4 weeks of treatment, the response rate was significantly higher in the test group (86.67%[26/30], 93.33%[28/30], respectively) than in the control group (60.00%[18/30], 73.33%[22/30]; χ2=5.455, 4.320, respectively, both P < 0.05) . After 2 and 4 weeks of treatment, the remission rate of pruritus ( χ2=4.320, 4.022, respectively, both P < 0.05) and treatment success (IGA 0/1) rate ( χ2=6.667, 15.429, respectively, both P < 0.05) were significantly higher in the test group than in the control group. There was no drug-related adverse reactions in the 2 groups. Conclusion:Hydrocortisone butyrate cream combined with FORENéE skin cream dressing is safe and effective in the treatment of mild to moderate AD, and can be applied to clinical practice.

Objective To evaluate the efficacy of Qingpeng ointment for the treatment of asteatotic eczema and its effect on skin barrier function.Methods A self-controlled clinical study was performed.Totally,78 patients with asteatotic eczema symmetrically located on both lower extremities were enrolled into this study.The left and right lower extremities of these patients were treated with Qingpeng ointment (Qingpeng group) and hydrocortisone butyrate ointment (hydrocortisone butyrate group) respectively,twice a day for 4 consecutive weeks.At the end of treatment,therapeutic effect and skin barrier function were compared between the 2 groups.Results The response rate was significantly higher in the hydrocortisone butyrate group than in the Qingpeng group after 1-and 2-week treatment (week 1:58.97％ vs.39.74％,x2 =5.77,P ＜ 0.05;week 2:76.92％ vs.60.26％,x2 =5.03,P ＜ 0.05),but insignificantly different between the 2groups after 4-week treatment (80.77％ vs.87.18％,P ＞ 0.05).Compared with the hydrocortisone butyrate group,theQingpeng group showed significantly increased water content of the stratum corneum after 4-week treatment (P ＜ 0.05),and decreased transepidermal water loss after 2-and 4-week treatment (both P ＜ 0.05).Conclusion Qingpeng ointment is safe and effective for the treatment of asteatotic eczema with gradually increasing and stable effects,and also has a favoring effect on the restoration of skin barrier function.

Objective To estimate effects of Qingpeng ointment on skin barrier function,and to explore their potential mechanisms.Methods A total of 12 female volunteers with xerosis on the extensor surfaces of legs were enrolled into this study.All the volunteers were topically treated with Qingpeng ointment on the right leg (Qingpeng side) and its vehicle on the left leg (vehicle side) twice daily for 7 consecutive days.Skin barrier function-associated indexes including transepidermal water loss (TEWL) and the water content of the stratum corneum were measured before the treatment,after 3-and 7-day treatment separately.Thirty-six BALB/c female mice were randomly and equally divided into 6 groups:a blank control group receiving no induction or treatment,a model group induced by 2,4-dinitrofluorobenzene (DNFB) on the back for 5 consecutive weeks,3 Qingpeng groups and a vehicle group induced by DNFB on the back for 5 consecutive weeks followed by topical treatment with different concentrations (50％,75％,100％) of Qingpeng ointment or its vehicle twice a day for 2 consecutive weeks.At the end of treatment,skin appearance of mice was observed with naked eyes,skinfold thickness and TEWL were measured.Then,all the mice were sacrificed,and skin tissue specimens were resected from the back of mice followed by histopathologic examination and immunohistochemical staining for the detection of filaggrin (FLG),involucrin (IVL) and kallikrein 7 (KLK7) expressions in the epidermis.Results After start of treatment,both the Qingpeng side and vehicle side showed significantly decreased TEWL on day 3 (t =2.651,2.996,respectively,both P＜ 0.05) and 7 (t =3.615,3.586,respectively,both P＜ 0.05),but increased water content of the stratum corneum on day 3 (t=9.029,5.830,respectively,both P＜ 0.001) and 7 (t =13.842,11.299,respectively,both P ＜ 0.001) compared with those before the treatment.However,no significant differences were observed in TEWL or the water content of the stratum corneum between the Qingpeng side and vehicle side at any of the time points (all P ＞ 0.05).In addition,there were no marked differences in mouse skin appearance,skinfold thickness or histopathologic manifestations between the vehicle group and model group,while the manifestations of dermatitis were attenuated to different extents in the three Qingpeng groups compared with the model group.Both TEWL and KLK7 expression levels were significantly decreased in the vehicle group and three Qingpeng groups compared with the model group (all P ＜ 0.05),but similar between the vehicle and Qingpeng groups (all P ＞ 0.05).Conclusion The vehicle of Qingpeng ointment can improve skin barrier function.

Objective To investigate the effect and prevention of complications of selective posterior enlarged decompression and lateral mass screw fixation for multisegmental cervical spondylotic myelopathy with kyphosis.Methods From January 2008 to January 2011,43 patients with multisegmental cervical spondylotic myelopathy combined with kyphosis,aged from 42 to 74 years (average,59.6 years),underwent selective posterior enlarged decompression and lateral mass screw fixation.The JOA (Japanese Orthopaedic Association) scoring system and Neck Disability Index (NDI) were applied to evaluate the neurological function and axial neck/shoulder pain before and after surgery,respectively.The Ishihara method was employed to measure the cervical curvature index (CI).The expanding and shifting of the spinal cord was calculated in MRI.Results The decompression range was 3 to 5 segments (average,3.91±0.86 segments).All patients were followed up for 20 to 60 months (average,38 months).There were significant differences between preand post-operative JOA score (8.16±1.11 vs.14.31±1.33),CI (7.36％±9.69％ vs.15.30％±3.18％),anteroposterior diameter of the dural sac at the level of maximum stenosis in MRI [(2.92±1.49) mm vs.(6.10±0.89)mm],and NDI score (19.36±8.61 vs.4.90±2.46).The mean spinal cord posterior shift was (4.59±1.20) mm (range,2.97 to 6.68 mm).The complete bone graft fusion was achieved in all patients 3 to 6 months after surgery.No C5 nerve root palsy or instrument failure occurred.Conclusion The selective posterior enlarged decompression and lateral mass screw fixation is effective in treating multisegmental cervical spondylotic myelopathy with kyphosis,which can improve neurological function,recover and maintain the normal cervical curvature,and decrease the incidences of axial symptoms and C5 nerve root palsy

BACKGROUND:Restoring the stability of the spine has become the consensus of spinal surgery. The canaloplasty technology has been continuously improved, but how can we get the good clinical effect of the canaloplasty, and the price affordable, many domestic scholars have to try al kinds of the improved operation methods. OBJECTIVE:To evaluate the clinical application value of cannulated screws fixation in canaloplasty. METHODS:From February 2011 to February 2013, total y 24 patients with spinal disease treated by canaloplasty using cannulated screw were retrospectively analyzed, of which 12 cases of cervical stenosis, 2 cases of intraspinal tumor in thoracic and 10 cases of intraspinal tumor in lumbar. Al patients were fol owed up after treatment. Postoperative CT and MRI were done in al patients. Clinical symptoms and radiographic changes were observed after treatment. The Japanese Orthopaedic Association score and the spinal canal cross-sectional area measurement were conducted in the patients with cervical stenosis between the preoperation and postoperation. Visual analog scale score was evaluated in patients who have the tumor in the thoracolumbar spine between the preoperation and postoperation. RESULTS AND CONCLUSION:Al patients had no complications such as nerve or blood vessel damage. Al patients were fol owed up 12 to 24 months. Imaging evaluation showed that internal fixator was stable without the hol ow screw loss or displacement. The bone grafting in groove reached bone fusion. There was no occurrence of lamina col apse or“re-close of door”. The Japanese Orthopaedic Association score and spinal canal cross-sectional area of patients with cervical stenosis during the fol ow-up after 12 months of treatment were significantly superior to those in preoperation (P<0.01). After 12 months of treatment, Japanese Orthopaedic Association scores showed that the excel ent rate of classification assessment was 92%. During the fol ow-up after 12 months of treatment, the visual analog scale of patients with thoracolumbar tumor improved from (8.2±1.6) points before treatment to (2.3±1.3) points at the first year after discharge (P=0.004 2). These results suggest that the application of cannulated screws in the canaloplasty can not only enhance the stability of the rear pil ar, and can improve the healing rate of osteotomy, and has the characteristics of inexpensive, easy to operate, and repair effect is good.

Objective To ratiocinate the formula of relationship between opening size of laminoplasty and the increment of sagittal canal diameter following double-door cervical laminoplasty and to predict the increment of sagittal canal diameter and the cross sectional area of canal according to the opening size of laminoplasty.Methods Twenty patients (12 males and 8 females) with multilevel cervical spondylotic myelopathy had undergone double-door cervical laminoplasty (C3-C7 in 9 patients and C3-C6 in 11 patients,89 segments) in our institution between September 2010 and January 2013.The formula describing the relationship between the opening size of laminoplasty and the increment of sagittal diameter was deduced.The parameters of pre-and post-operative computed tomography scans of 20 patients who had undergone laminoplasty surgery were measured by picture archiving and communication system (PACS) software,and the increment of sagittal canal diameter and the cross sectional area of canal were predicted when the opening size of laminoplasty were 6 mm,8 mm,10 mm,12 mm,14 mm and 16 mm according to the formula.Results Increment of sagittal canal diameter and canal area respectively showed significant difference in the same segment laminoplasty.Increment of sagittal canal diameter between various groups in the same segment (C3-C6) showed significant difference.Increment of sagittal canal diameter between the opening size of 14 mm and 16 mm in C7 laminoplasty showed no significant difference.Increment of sagittal canal diameter was increased steadily following C3-C7 double-door laminoplasty with opening sizes of 6 mm,8 mm,10 mm,12 mm,14mm and 16mm,but the increasing trend in sagittal canal diameter diminished gradually.Conclusion Increment of sagittal canal diameter and canal area following C3-C7 laminoplasty can be accurately predicted according to the opening size of laminoplasty by this formula.The formula can help operator to perform double-door cervical laminoplasty based on accurate individual laminoplasty opening size,which prevents inadequate or excessive opening.

Objective To retrospectively analysis and compareabout Bryan artificial cervical disc arthroplasty with ante-rior cervical decompression and fusion (ACDF) on the clinical efficacy for“Skip”cervical spondylosis. Methods From February 2002 to May 2012, 49 cases were treated with Bryan artificial cervical disc arthroplasty (artificial cervical disc replacement surgery group, 18 cases) or anterior cervical decompression and fusion (ACDF group, 31 cases), 29 males and 20 females. Each case was evaluated at the moment of preoperatively, 3 months, 6 and 12 months and last follow-up after surgery by the Japanese Orthopedic Association (JOA), Neck Disability Index (NDI), Visual Analog Scale (VAS), Cervical sagittal curvature, the total cervical spine range of motion(ROM),middle segments of motion. MRI was also used to assess to adjacent segment disc degeneration, spinal cord compression and signal change situation. Results All patients were followed up for more than 24 months. The score of the JOA, NDI, VAS in the two groups of patients improved significantly after surgery than before surgery. In addition, the VAS score in last follow-up were significantly different between the two groups, but other index each time in the two groups showed no significant difference. In last follow-up, the result of artificial cervical disc arthroplasty group were better than ACDF group on the incidence of axial symptoms, the total cervical spine range of motion (ROM) and middle segments of motion. The incidence of axial symptoms in artificial cervical disc arthroplasty group were 11.1%,ACDF group were 45.2%. ROM in arti-ficial cervical disc arthroplasty group were 35.5°±5.9°,ACDF group were 24.5°±6.2°. Middle segments of motion in artificial cer-vical disc arthroplasty group were 7.3°±1.4°,ACDF group were 10.1°±1.6°. The above comparison of the datas were statistically different. There are two cases of adjacent segment degeneration in ACDF group without need to surgery. Conclusion Bryan artifi-cial cervical disc replacement surgery effectively retained the overall motion of the cervical spine, reduced the motion of middle segments, thus avoiding adjacent segment degeneration and the incidence of postoperative axial symptoms.

Objective To investigate the relationship between the cervical MR images and pathological changes, prognosis in patients with cervical spinal stenosis and cervical spondylotic myelopathy. Methods From Nov. 2006 to Nov. 2009, 286 patients with cervical spondylotic myelopathy were included through retrospective analysis. All patients were divided into two groups according to whether there was cervical stenosis, the grade of increased signal intensity (ISI) in spinal cord and the degree of spinal cord compression was evaluate in T2-weighted MR images of midian sagittal slices. JOA scale, duration of disease,Hoffmann sign, Babinski sign, sensory loss or hypoesthesia, and lower-extremity/upper-extremity hyperreflexia were recorded. Results The incidence rate of cervical spinal stenosis was 33.6% in patients with cervical spondylotic myelopathy. The study showed that the age was smaller (P＜ 0.001 ), preoperative JOA score was higher(P=0.0018), duration of disease was longer(P=0.009), and the recovery rate was lower(P＜ 0.001 )in cervical spinal canal narrowing group comparing with control group. There was no significant difference between the two groups in gender (x2=0.006,P=l.00). There was significant difference between two groups in the incidence of ISI in spinal cord through x2 test(x2=62.396,P＜ 0.001 ). Multivariate analysis indicated that the likelihood of the recovery rate of cervical myelopathy decreased with the presence of cervical spinal stenosis, duration of dieaase, number of neurological signs, age (R2=0.565). Conclusion Patients with congenitally narrow cervical spinal canal have to suffer severe spinal cord compression and high incidence of ISI in spinal cord. The duration of disease is long, and prognosis is poor.