OBJECTIVE:To establish the quality standard for Embelia laeta. METHODS:TLC was adopted for the qualitative identification. HPLC was adopted for the content determination of embelin:the column was Waters C18 with mobile phase consisted of methanol-5%methanoic acid(90∶10,V/V)at a flow rate of 0.9 ml/min,the detection wavelength was 288 nm,the column tem-perature was 40 ℃,nd the injection volume was 10 μl. RESULTS:The TLC of E. laeta showed clear spots and good separation. The linear range of embelin was 4.012-40.12 μg/ml(r=0.999 4);RSDs of precision,stability and reproducibility tests were lower than 2%;recovery was 96.54%-99.57%(RSD=1.20%,n=6). CONCLUSIONS:The established standard can be used for the quality control of E. laeta.

Objective:To systematically evaluate the effectiveness and safety of intra-articular in-jection of mesenchymal stem cells (MSCs) and hyaluronic acid (HA) in the treatment of knee osteoarthritis.Methods:The relevant literatures published in both English and Chinese were systematically searched in PubMed, Embase, Wanfang database, China Knowledge Network (CNKI), SinoMed database and other data-bases from inception to May 2020. Two researchers independently extracted data and evaluated the included literature. Risk assessment of literature bias was carried out. RevMan 5.3 software was used for Meta analysis, and the combined sensitivity were calculated.Results:Finally, 13 references were included, including a total of 726 patients with knee osteoarthritis. Meta-analysis results showed that compared with the HA group, the Western Ontario and McMaster University Osteopathic Index Total Score (WOMAC) [ MD=-10.92, 95% CI (-16.87, -4.96), P<0.01], the visual analogue scale (VAS) score [ MD=-1.70, 95% CI(-2.44, -0.95), P<0.01], and the knee joint Lequesne index score of MSCs group all decreased significantly [ MD=-13.78, 95% CI (-15.03,-12.52), P<0.01]. Furthermore, there was no significant difference in the incidence of adverse events (AEs) between the two groups [ RR=1.11, 95% CI(0.90, 1.37), P=0.33]. However, American Knee Association Score (AKS score) [ MD=-10.15, 95% CI(-22.33, 2.03), P=0.10] and whole-organ magnetic resonance imaging score (WORMS) [ MD=-3.93, 95% CI(-11.60, 3.75), P=0.32] were not statistically significant ( P>0.05). Conclusion:Compared with intra-articular injection of HA, intra-articular injection of MSCs can significantly improve the symptoms and dysfunction, and has favorable clinical tolerability and safety, suggesting that MSCs is expected to bea new treatment for knee osteoarthritis.

Objective To observe the clinical efficacy of butylphthalide soft capsules for treatment of acute cerebral infarction and its effect on the neurological function and inflammatory reaction of patients.Methods A total of 100 patients with acute cerebral infarction in the First Hospital of Zhangjiakou City and the Third Hospital Affiliated to Hebei North University from January 2016 to October 2016 were selected and divided into control group (n =50) and treatment group (n =50) according to the treatment protocols.The patients in the control group were given anti-platelet aggregation,statins,and other routine treatment;based on this,the patients in treatment group were orally administrated with butylphthalide soft capsules.The elbow venous blood of patients in the two groups was collected and the C reactive protein(CRP),interleukin-6 (IL-6) levels,the platelet aggregation rate were detected.The change of National Institute of Health stroke scale(NIHSS) score of patients after four weeks treatment was compared between the two groups.The recovery of neurological function of patients in the two groups was evaluated by modified Rankin grading after three months treatment.Results There was no statistic difference in the CRP,IL-6 levels and platelet aggregation rate before treatment between the two groups (P ＞ 0.05).The CRP,IL-6 levels and platelet aggregation rate of patients in the two groups after one week treatment were significantly lower than those before treatment (P ＜ 0.05);and the CRP,IL-6 levels and platelet aggregation rate of patients in the treatment group were significantly lower than those in the control group after one week treatment (P ＜ 0.05).The NIHSS score of patients in the treatment group was significantly lower than that in the control group after four weeks treatment (P ＜ 0.05);the Rankin score of patients in the treatment group was significantly lower than that in the control group after three months treatment (P ＜ 0.05).The total effective rate of patients in the treatment group was significantly higher than that in the control group (x2 =13.22,P ＜ 0.05).Conclusion Butylphthalide soft capsules can significantly reduce the inflammatory reaction in patients with acute cerebral infarction,improve and recover the neurologic impairment;and its curative effect is remarkable.

Objective To compare the dose distribution of postoperative plans with preoperative plans for 3D printing coplanar template assisted radioactive seed implantation,and to explore the accuracy of the technique in seed implantation.Methods From November 2015 to December 2016 a total of 32 patients were selected and underwent 3D printing coplanar template assisted radioactive seed implantation in Tengzhou Central People's Hospital of Shandong province.There were 36 implanted lesions,including l0 in the lungs,5 in neck lymphs,3 in pelvic cavities,3 in vertebral body,2 in pancreas,2 in abdominal lymph nodes,2 in portal veins,and 9 in the other parts.All patients were given preoperative planning and guided by the coplanar templates.Compared with the preoperative plan,all levels needles inserted at the same time.According to preoperative planning the implantation surgery was completed accurately.The postoperative dosimetry was evaluated.The preoperative and postoperative dosimetry parameters were compared,including Dg0,D100,V90,V100.V150,V200 and conformal index (CI),external index (EI),and homogeneity index(HI).The paired t test was used to perform the statistical analysis.Result There was no significant differences in Dg0,D100,V90,V100,V150,V200,CI,EI and HI between before and after operation(P ＞ 0.05).Conclusions The dose parameters in postplan showed no difference compared with preplan in this study.For fixed and moving organ tumors,3D printing coplanar template assisted radioactive seed implantation has good therapeutic accuracy,and may be a standardized surgicalmethod for seed implantation in the future.

Objective To construct a prokaryotic expression vector in BL21 to secretorily expressα-Cyclodextrin Glycosyltransferase(α-CGTase). Methods α-CGT gene was amplified from Bacillus macerens genome by PCR.pET26b and α-CGT gene were connected after digested with Nco I, Xho I respectivly, and then transformed into Escherichia coli BL21 strain.α-CGTase was expressed in fermentation culture medium and AA-2G was prepared by using α-CGTase, VC and starch.Results α-CGTase was expressed secretorily and the enzyme activity was up to 120 U/mL.AA-2G was prepared by the biotransformation of VC and starch using α-CGTase which proved to be correct by HPLC.Conclusion AA-2G was prepared by using self-madeα-CGTase, after optimized the preparation conditions the yield of AA-2G was 17.46 g/L, and the conversion rate reached 58.2%(mg/mg).

Liver fibrosis is a major disease that affects human health. Currently,drugs used for the treatment of hepatic fibrosis have such problems as low drug solubility,lack of liver specificity and possible occurrence of side-effects. In order to improve the anti-fibrosis therapeutic efficacy,various nano-drug delivery systems and targeting strategies are explored in liver fibrosis therapy. This review summarizes the drug delivery systems and targeting strategies that have been applied to liver fibrosis therapy in recent years from the types of carriers and modified ligands,which serve as a basis of designing safe and effective drug delivery systems for liver fibrosis therapy.

Objective To evaluate the efficacy of facial acupoint injection combined with nerve block in treating hemifacial spasm. Methods Fifty?four patients of both sexes, aged 26-73 yr, with the course of disease 6 months-17 yr from February 2015 to January 2016, were included in this study accord?ing to diagnostic criteria for hemifacial spasm based on expert consensus in 2014. Patients were divided into 2 groups(n=27 each)using a random number table: facial acupoint injection combined with nerve block group(group A)and nerve block group(group B). In group A, the mixed injection 2 ml(2% lidocaine hydrochloride 5 ml, compound betamethasone 1 ml, mecobalamin 1 mg, diluted to 18 ml in normal sa?line)was given at facial Sibai, Jiachengjiang, Xiaguan and Yifeng acupoints once every 5 days, 3 times in total;facial nerve block was performed via the stylomastoid foramen with the mixed injection(5 ml) previously described once every 5 days, 3 times in total;stellate ganglion block was performed on the right and left side alternately once a day, 5 times on each side. In group B, patients received facial nerve block and stellate ganglion block, and no facial acupoint injection was applied. The Cohen rating and Shorr out?come were recorded before treatment and at 10th day, 3rd month and 1 yr after treatment, and the recur?rence was recorded at 3 months and 1 yr after treatment. Results Compared with group B, Cohen classifi?cation was significantly decreased, and the effective rate was increased at 10th day, 3rd month and 1 yr af?ter treatment, and the recurrence rate was decreased at 3 months and 1 yr after treatment in group A(P<0.05). Conclusion The facial acupoint injection combined with nerve block produces better long?term ef?ficacy in treating hemifacial spasm than nerve block alone.

Objective To explore and discuss the factors for restricting the two-way referral system from the patient's perspective in order to promote the formation of hierarchical medical system in Changsha City.Methods The stratified random sampling method was adopted to divide the Chansha City into the 3 grades of high,middle and low according to the regional economical development situation,2 districts in one grade,including 6 districts.Then each district was redivided into high,middle and low grades according to the economic situation,2 basic medical institutions were selected from each grade.A total of 360 patients were randomly sampled for conducting the questionnaire investigation.The patients and doctors specially participating in the two-way referral conducted the deep interview.Results The patients choosing to primary hospital for first visit accounted for 60.9％.The awareness degree of patients to two-way referral system was 21.1％,and the two-way referral service satisfaction in the patients with two-way referral was 85.7 ％.The patients' will of transfer treatment from primary hospital to superior hospital in case of disease condition need was 82.9 ％.The patients' will for conducting rehabilitation treatment from superior hospital to primary hospital was 77.6 ％.Conclusion Few patients choose primary hospital for first visit.The signing rate of family contract services is low and awareness degree of two-way referral system is not high.

Objective To investigate the distribution of common carbapenem resistance genes and virulence genes in and understand the molecular epidemiology of carbapenem-resistant Klebsiella pneumoniae (CRKP) strains.Methods A total of 84 non-duplicate CRKP isolates were collected from Renji Hospital,Shanghai Jiao Tong University School of Medicine and Changzheng Hospital,the Second Military Medical University,in 2015.Kirby-Bauer disk diffusion method was used to test their susceptibility to 15 antimicrobial agents.The HM phenotype of K.pneumoniae was determined by string test.Carbapenem-resistant genes and virulence genes were detected by polymerase chain reaction (PCR).The molecular epidemiology of the 84 isolates were further analyzed by multi locus sequence typing (MLST).The population structure of CRKPs was evaluated by eBURST with the results of MLST.Results Antimicrobial susceptibility test showed that 84 isolates were highly resistant to most antimicrobial agents such as carbapenems,penicillins,cephalosporins and aztreonam.More than 90％ of the strains were resistant to most of the antibiotics tested except ciprofloxacin (77.4％,65/84) and amikacin (82.1％,69/84).Two strains showed HM phenotype.PCR results showed that 90.5％ (76/84) of the strains were positive for blaKPC-2,1.2％ (1/84) positive for blaNDM and blaIMP each,but either blaOXA or blaVIM was not identified.The overall prevalence of virulence genes was low except for mrkD (97.6％,82/84),ybtS (92.9％,78/84) and entB (100％,84/84).Eight sequence types (STs) were obtained.The dominant clone was ST11 (84.5％,71/84),and the two strains of HM phenotype were ST11.eBURST analysis identified 2 ST groups among the 84 CRKPs.Each ST group includes 2 ST types (ST11 and ST1869,ST15 and ST709),respectively.The other four ST types were single ST type.In this study,71 strains of ST11,4 ST15 and 4 ST323 belonged to CC258,CC15 and CC163 clones,respectively.Conclusions CRKP is highly resistant to the commonly used antibiotics.The multidrug resistance or pandrug-resistance of K.pneumoniae is mainly associated with the expression of blaKPC-2 gene.Three virulence genes mrkD,ybtS and entB are highly prevalent in the CRKP isolates.The dominant clone of KPC-producing K.pneumoniae is ST11 in both hospitals.

Objective:To investigate the technical method and clinical efficacy of CT-guided radioactive 125I seed implantation (RISI) assisted by 3D-printed coplanar template(3D-PCT) in the treatment of metastatic tumors of chest wall, and analyze the influence of dosimetric parameters on the treatment efficacy. Methods:A retrospective analysis was conducted for 55 patients with metastatic tumors of chest wall treated with 3D-PCT-assisted 125I radioactive seed implantation in Tengzhou Central People′s Hospital from January 2014 to March 2021.Preoperative plans were made using a brachytherapy treatment planning system, and dosimetric parameters were assessed at 3d after surgery. During regular CT reexaminations after surgery, the local control rate and overall survival (OS) rate were calculated and the pain relief degree and complications were assessed. The Logrank test and Cox regression were used for univariate and multivariate analyses of local control time (LCT). Meanwhile, receiver operating characteristic (ROC) curves were plotted to analyze the critical values of dosimetric parameters and to predict the LCT. Results:The 1-, 2-, and 3-year OS rates ofthe 55 patients were 72.7% (40/55), 21.8% (12/55), and 16.4% (9/55), respectively.The local control rates of 3, 6, 12, and 24 months were 96.4%(53/55), 86.5%(45/52), 85.0%(34/40), and 91.7%(11/12), respectively. There was no statistically significant difference between postoperative and postoperative dosimetric parameters of GTV, particle number, D90, D100, V100, V150, V200, CI, EI, and HI ( P> 0.05). Compared with postoperative V90, the postoperative V90 decreased with a statistically significant difference( P=0.006). As indicated by the univariate Cox regression analysis, the pathological grade, D90, D100, V90, and V200had significant effects on the LCT( P<0.05). Among them, the pathological grade and D90 were independent influencing factors of the LCT, while the other factors showed no statistically significant difference according to the multivariate Cox regression analysis.The LCT of patients with D90≥127 Gy was significantly longer than that of patients with D90<127 Gy (χ 2=16.61, P=0.000). The pain relief rate was 80.8%(21/26) after three months. Five cases suffered from grade Ⅰ-Ⅱ radioactive dermatitis and one case experienced grade Ⅲ radioactive dermatitis. Conclusions:The 3D-PCT-assisted CT-guided 125I radioactive seed implementation can achieve precise and controllable dose and definite efficacy in the treatment of metastatic tumors of chest wall, with few complications.The LCT was remarkably prolonged in the case of D90≥127 Gy, and D90 is an independent influencing factor of the LCT.