Objective: To propose updates and amendments for the nitroglycerin tablets quality in the Chinese pharmacopoeia 2020 due to the failure of effective separation of 4 known impurities and nonseparation of free nitrate ion and excipients.
Methods: Related substances were analyzed using gradient elution by HPLC, and free nitrate ion was determined on SAX column by different HPLC method.
Results: Using the improved method to test the related substances and free nitrate ion of nitroglycerin tablets,the content of the maximum individual impurity were not more than 0.5%, the total content was not more than 2.4% and the content of free nitrate ion was not more than 6.3%.
Conclusion: The improved method is accurate and feasible. It provided a reference for the updates and amendments of the quality standard of nitroglycerin tablets in the Chinese Pharmacopoeia 2020.

Background:MicroRNAs ( miRNAs ) is a class of small non-coding RNAs that regulate gene expression at posttranscriptional level. They are considered to play a critical role in the tumorigenesis and development of various tumors. Aims:To identify the recurrence-specific miRNAs in peripheral blood of patients with recurrent colorectal adenoma by miRNA array for providing sensitive and specific molecular markers for recurrence prediction. Methods:Fifty colorectal adenoma patients who had undergone polypectomy by colonoscopy were re-examined from Aug. 2012 to Sep. 2013. Four recurrent and four non-recurrent patients were selected and miRNA array was used to detect the expression profiles of miRNAs in peripheral blood samples. Differentially expressed miRNAs were identified between recurrent and non-recurrent patients. Real-time PCR was applied to verify the differentially expressed miRNAs identified by microarray. Results:Seven up-regulatedmiRNAs(hp hsa-miR-548ai,hsa-miR-4446-3p,hsa-miR-139-3p,hsa-miR-27a-5p,hsa-miR-10a,hsa-miR-23a and hsa-miR-486-3p)and 4 down-regulated miRNAs( hsa-miR-124,hsa-miR-3613-5p,hsa-miR-495 and hsa-miR-485-5p)were identified by microarray between recurrent and non-recurrent patients. Among them,seven miRNAs were validated by real-time PCR as consistent with microarray. Conclusions:Some differentially expressed miRNAs may be involved in the recurrence of colorectal adenoma,which gives clues for further investigation on recurrence predictors.

Objective: To establish the quality standard for Tiaolitongbao I capsules.Methods: The components including Astragalus , Atractylodes, Finger citron and Radix aucklandiae were identified by TLC.Emodin, the effective component of Polygonum cuspidatum , was determined by HPLC.Results: The characteristic spots in TLC were clear without any interference.The linear range of emodin was 4.25-68.00 μg·ml-1 (r =0.999 9).The average recovery was 95.22% ,and RSD was 1.47% (n =6).Conclusion: The methods used for the identification and quantification are sensitive, simple and accurate, which can be used for the quality control of Tiaolitongbao I capsules.

Objective To study the long-term efficacy of bladder pressure expansion and perfusion therapy by bladder hydraulic expansion with alkalify lidocaine,heparin,dexamethasone for the treatment of ketamine correlation cystitis Methods From January 2008 to September 2011,the data from 19 male and 3 female patients,who were diagnosed as ketamine-associated cystitis was retrospectively analyzed.The mean age was (26 ± 5)years old.All patients accepted bladder pressure expansion under the spinal and epidural anesthesia.After expansion,the silicon three-channel catheters were left in those patients.2％ lidocaine (20 ml) and 5％ bicarbonate (10 ml) was perfused into the bladder.Meanwhile,the heparin (2.5 U) and dexamethasone (10 mg) were added into the solution,as well.After perfusion,the catheter was clamped until the patient could not tolerate.The perfusion was performed three times every day for 5 days.The volume of urine was recorded each time.The OABSS score,urine volume,maximum urine flow rate,day and night urination frequency were followed within 5 years.And the data was compared with those preoperative and postoperative 1 week,1 month,3 months,6 months.Results 22 patients accepted the procedure successfully.No complications,such as fever or bladder rupture,occurred.At the end of 5 years,the bladder volume daily urinating frequency,night urinating frequency,maximal flow rate,OABSS score were (238.3 ± 37.3) ml,9.2 ± 2.3,2.1-± 1.3,(18.2 ± 8.3) ml/s,4.4-± 2.4,respectively.Compared to the one week and one month after the operation,those results have significant difference (P ＜ 0.01).Compared to the 3 months after the procedure,the bladder volume has significant difference [(238.3-± 37.3) ml vs.(158.3-± 18.3) ml,P ＜ 0.01].No significant differences were noticed in those items 6 months after the procedure (P ＞ 0.05).Conclusion The long-term efficacy of bladder pressure expansion with alkaline lidocaine,heparin and dexamethasone the anesthesia in the treatment of ketamine associated cystitis is good.The outcome is stable,and no obvious complications.

Objective To investigate the difference of expression profiling of plasma miRNAs (microRNA) between the patients with small artery occlusive stroke (SAO) and the healthy subjects.Methods Eight patients with SAO classified by TOAST were selected and 8 healthy subjects were used as a control group.High-throughput sequencing technology was used to detect the expression profiling of plasma miRNAs.The differentially expressed miRNAs were screened.Real-time fluorescent quantitative polymerase chain reaction was used to validate the results,and the target gene prediction and bioinformatics analysis were performed.Results The miRNA difference analysis showed that the expression profilings of miRNA-127,miRNA-99b-5p,miRNA-320,and other 19 miRNAs in the SAO group were significantly upregulated compared with those in the control group (all P＜0.01),while miRNA-451a and other 5 miRNAs in the SAO group were significantly downregulated compared with those in the control group (all P ＜0.01).The validated results of miRNA-127,miRNA-99b-5p,miRNA-320,and miRNA-451a with real-time fluorescent quantitative polymerase chain reaction were consistent with those of the high-throughput sequencing.Bioinformatics analysis showed that the miRNA-regulated target genes expressed differentially were mainly correlated with cell proliferation,adhesion,phylogenetic development,macromolecule metabolism,and other biological functions.Conclusions There are significant differences in the expression profiling of plasma miRNAs between the patients with SAO and the healthy subjects,suggesting that miRNAs may play a regulatory role via target genes in pathogenesis of SAO.

OBJECTIVETo evaluate clinical efficacy of electroacupuncture at Changqiang (GV 1) and Chengshan (BL 57) 30 min before surgery on postoperative pain and discomforts in patients with mixed hemorrhoids.

METHODSOne hundred and twenty cases of mixed hemorrhoids who received Milligan-Morgan operation were randomly divided into an electroacupuncture group, a sham electroacupuncture group and a blank group, 40 cases in each one. At the same time of basic treatment, the electroacupuncture was applied at Changqiang (GV 1) and Chengshan (BL 57) 30 min before surgery in the electroacupuncture group, while shallow needling without electrical stimulation at sham acupoint (1 cm next to acupoint) was applied 30 min before surgery in the sham electroacupuncture group, while no treatment was given before the surgery in the blank group. The total dose of painkillers in the first 24 h after operation, the number of cases who received additional anesthetic in the operation, the self-score of most severity pain in the first 24 h after operation and sleeping time in the night of surgery were observed.

RESULTSThe differences of the numbers of cases who received additional anesthetic in the operation had no statistical significance among the three groups (all P > 0.05), but compared with the sham electroacupuncture group and blank group, the total dose of painkillers in the first 24 h after operation was reduced in the electroacupuncture group [(2.43 +/- 1.08) tablets vs (3.23 +/- 1.33) tablets, (3.10 +/- 1.22) tablets], and the score of most severity pain was also decreased (6.65 +/- 1.00 vs 7.48 +/- 0.96, 7.25 +/- 1.19), besides, the sleeping time in the night of surgery was increased [(220.63 +/- 85.50) min vs (162.00 +/- 92.69) min, (151.50 +/- 80.01) min, all P < 0.05].

CONCLUSIONThe electroacupuncture at Changqiang (GV 1) and Chengshan (BL 57) 30 min before surgery has effects of preemptive analgesia on postoperative pain for patients with mixed hemorrhoids.

Acupuncture Points ; Adult ; Aged ; Electroacupuncture ; Female ; Hemorrhoids ; surgery ; Humans ; Male ; Middle Aged ; Pain, Postoperative ; therapy ; Young Adult

We presented a new method for vessel segmentation and vascular structure recognition for coronary angiographic images. During vessel segmentation, a new vessel function was proposed to attain vessel feature map. Then the region growing algorithm was implemented with an automatic selection of seed point, extraction of main vessel branch, and vessel detail repairing. In the algorithm of vascular structure recognition, a fuzzy operator was used, which can detect the structures of vascular segments, bifurcations, crosses, and tips. The experimental results indicated that there was about 5 percent larger vessel region which was extracted by the proposed segmentation method than that by the simple region growing algorithm, and several thinner vessels were resumed from the lower gray region. The results also indicated that the fuzzy operator could correctly infer the simulative and real vessel structure with 100% and 90.59% correctness rate on the average, respectively.
Algorithms ; Coronary Angiography ; Humans ; Radiographic Image Enhancement ; methods ; X-Rays

OBJECTIVETo evaluate the therapeutic effect on pain in the dressing change after perianal abscess surgery treated with warm suspending moxibustion at Changqiang (GV 1).

METHODSOne hundred and sixty patients were randomized into a moxibustion group and a far-infrared therapy group, 80 cases in each one. In the moxibustion group, the warm suspending moxibustion at Changqiang (GV 1) was applied. In the far-infrared therapy group, the infrared ray was radiated at Changqiang (GV 1). The treatment started in 10 min after dressing change in the two groups. Totally, 8 treatments were required. The time requirement being equal to or less than 2 score in the assessment face scale (AFS), the case number of pain relief in 10 min after treatment and the intention of the two therapies after everyday dressing change were observed in the patients of the two groups.

RESULTSIn the moxibustion group, the time of pain relief was shorter than that of the far-infrared therapy group [(11.5 +/- 3.9) min vs (17.8 +/- 3.8) min on the 1st day; (9.4 +/- 3.6) min vs (15.2 +/- 4.3) min on the 2nd day; (7.8 +/- 2.7) min vs (14.3 +/- 3.2) min on the 3rd day; (6.4 +/- 3.3) min vs (10.5 +/- 2.9) min on the 4th day; (5.9 +/- 2.9) min vs (11.2 +/- 1.9) min on the 5th day; (5.3 +/- 2.2) min vs (8.8 +/- 2.3) min on the 6th day; (5.4 +/- 1.8) min vs (9.2 +/- 2.1) min on the 7th day; (5.1 +/- 1.4) min vs (9.5 +/- 2.6) min on the 8th day, all P < 0.05]. The case numbers of pain relief in 10 min after treatment were 74 cases, 75 cases, 77 cases and 78 cases from the 1st to the 4th day separately in the moxibustion group, which were much more than 63 cases, 65 cases, 68 cases and 69 cases in the far-infrared therapy group (all P < 0.05). The treatment intention scores in the moxibustion group were better than those in the far-infrared therapy group (all P < 0.05).

CONCLUSIONThe warm suspending moxibustion at Changqiang (GV 1) relieves pain rapidly in the dressing change of much more patients after perianal abscess surgery in much shorter time as compared with the far-infrared therapy. Moreover, the patients have more expectation to be treated with moxibustion therapy.

Abscess ; surgery ; Adolescent ; Adult ; Aged ; Anus Diseases ; surgery ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; Pain, Postoperative ; therapy ; Young Adult

Bronchopulmonary Sequestration ; classification ; pathology ; surgery ; Humans ; Infant ; Lung ; diagnostic imaging ; Male ; Radiography ; Respiratory System Abnormalities ; diagnosis ; surgery

Objective To investigate the way of pacemaker implantation in 127 elderly patients over 80 years old to reduce postoperative complications and improve the life quality. Methods One hundred and twenty-seven patients over 80 years old had the dual chamber pacing in 95 cases(74. 8%, including tri-chamber pacing) and the single ventricular pacing in 32 cases (25. 2%). Cephalic veins were used primarily in all patients with modified methods. The safe fixation of pacing leads were emphasized not only in the heart but also in the site of pacemaker pocket. The pacemaker package was made prior to the leads insertion in order to have enough time for stopping bleeding. It was necessary for some cases with diffused bleeding to use electric coagulation. All patients were told to get out of bed in the operating day or the day after procedure. Results Cephalic vein was well exposed. The successful rates of implanting pacing leads directly through cephalic vein were 92. 0% and 81. 5% in the single chamber and dual chamber patients, respectively. The overall complications observed in 5 cases(3. 9%) were pocket hematoma formation in 3 cases (2. 4%), cardiac tamponade in 1 case (0.8%), and disconnection of pacemaker with lead in 1 case (0.8%). There were no hemothorax, infection and lead dislodgement. Conclusions Insertion of pacing lead through cephalic vein is important, especially for the advanced aged patients. This operation can decrease the complications of subclavian vein puncture. Leads dislodgement are mainly due to the inadequate skill of operator, not to the patient s early activity out of bed. Appropriate way for stopping bleeding is the key to protect the patients from pacemaker pocket effusion and hemotama.