AIM: To set up identification of Flos Lonicerae and determination of chlorogenic acid in Yingqiao jiedu Pills (Flos Lonicerae, Fructus Forsythiae, Radix Glycyrrhizae, Herba Menthae, etc.) by HPLC. METHODS: A YWG C 18 column was used with the mobile phase consisted of CH 3OH 10%Na 2HPO 4 (adjusting pH to 2.7 with HAc) as gradient elution. The flow rate was 1.0mL?min -1 , and the detection wavelength was at 326nm. RESULTS: Flos Lonicerae in Yinqiaojiedu Pills was identified by HPLC UV. The linear range of chlorogenic acid was 5.0～60?g?mL -1 ( r =0.9999). The average recovery was 98.71% with RSD of 1.55% ( n =5). CONCLUSION: The method is simple, accurate and rapid with good reproducibility. It can be used for the quality control of Flos Lonicerae in Yinqiaojiedu Pills.

AIM:To set up a determination of tanshinone Ⅱ_A and cryptotanshinone in Compound Danshen Tablet(Radix Salviae Miltiorrhizae, Radix Notoginseng, Borneolum Syntheticum) by RP-HPLC. METHODS:Two components could be separated through YWG-C_~18 column with methanol-water (75∶25 by volume) as a mobile phase. The flow rate was 1.0 mL?min~-1 , and the detection wavelength was at 270 nm. RESULTS: The linear range of tanshinone Ⅱ_A and cryptotanshinone were 2.5-50.0 ?g?mL~-1 and 0.625-12.5 ?g?mL~-1 , respectively. The average recovery was 99.76% with RSD 0.92% for tanshinone Ⅱ_A and 98.34% with RSD 0.71% for cryptotanshinone, respectively. CONCLUSION: The method is simple, accurate and rapid with good reproducibility. It can be used for the quality control of Compound Danshen Tablet.

Objective To observe the therapeutic effect of rude Rhubarb combined with Danshen root treating Cholestatic hepatitis E. Methods 60 cases of cholestatic hepatitis E were randomly recurited into a treatment group and a control group, with 30 cases in each group. The control group was administrated with liver protection therapy, symptomatic treatment and supportive care. Based on therapies of the control group, the treatment group was taken with Rhubarb 3 g orally, twice daily, and intravenously dropped with Danshen root injection 20ml, once daily. Results The total effective rate of the treatment group and the control group was 93.3% and 66.7% respectively, showing significant differance(P<0.01 ). The value of TBil and DBil in the treatment group was statistically improved compared with the control group (P<0.01) . besides the hospitalized time of the treatment group was 46±9 days and hospitalization expense was 6630±1032 RMB, demonstrating a significant difference compared with the control group. Conclusion Rude Rhubarb combined with Danshen root can treat Cholestatic hepatitis E by improving the symptoms and reducing serum bilirubin level. Besides this method also shortens therapeutic time and reduces hospitalization costs.

Objective To further study the effectiveness of endoscopic mucosal resection (EMR) for the treatment of early cancer and precancerous lesions on colon and rectum. Methods A total of 58 patients with 70 lesions were included in this study. EMR were performed by means of " injection and cut " method. Results All the lesions were resected completely by EMR. All the diagnoses were proved by pathology as follows: mucosal cancer 3 cases, adenoma with mild to severe dysplasia 53 cases, and inflammatory polyps 14 cases. No recurrence was found during the follow up survey for 1 23 months. Except 3 cases of treatable hemorrhage, no other complications were found. Conclusion The results of this study further confirm that EMR is effective and safe for the treatment of early cancer and precancerous lesions on colon and rectum

Objective To explore the diagnostic value of contrast-enhanced ultrasonic intravenous imaging and cholangiography in the diagnosis of malignant jaundice obstructive. Methods Forty three patients who were diagnosed with malignant obstructive jaundice by contrast-enhanced computed tomography and contrast-enhanced computed magnetic resonance imaging were enrolled in this study. All of them underwent conventional ultrasound, IV-CEUS and IC-CEUS. According to the results of operation, the diagnosis accuracies were compared among conventional ultrasound, IV-CEUS, IC-CEUS and IV- CEUS combined with IC-CEUS. Results Diagnostic accuracy by the conventional ultrasound , IV-CEUS , IC-CEUS and IV- CEUS combined with IC-CEUS were 72.1%(31/43), 83.7%(36/43), 81.4%(35/43) and 93.0%(40/43), respectively. IV- CEUS combined with IC-CEUS was superior to the conventional ultrasound (P = 0.021). There were no significant differences when the conventional ultrasound was compared with IV-CEUS or IC-CEUS alone (P = 0.194 and 0.307). Conclusions Preoperative evaluation by IV- CEUS combined with IC-CEUS can elaborate the intra-cavitary and extra-cavitary changes of malignant obstructive jaundice. The diagnostic accuracy rate could be effectively improved by IV-CEUS combined with IC-CEUS, which can bring favorable clinical benefit.

Objective To investigate the changes of cardiac structure and function in patients with hepatolenticular degeneration (HLD).Methods From March 2010 to February 2011,90 HLD patients who did not receive formal treatment (observation group) and 30 healthy people (control group) were collected and analyzed with color Doppler echocardiography in the Institute of Neurology,Affiliated Hospital of Anhui University of Traditional Chinese Medicine.Based on the clinical manifestations,cases were divided into hepatic type group (n =31),brain type group (n =42) and brain-visceral type group (n =17).According to the Child-Pugh classification,patients were divided into Child A group (n =71),Child B group (n =10) and Child C group (n =9).Results (1) The left atrial diameter ((28.00 ± 3.11),(29.62 ± 3.44) mm) and left ventricular diameter ((45.69 ± 3.75),(47.10-± 4.73) mm) of HLD patients in brain-visceral type group and hepatic type group were larger than that of the control group ((24.86 ± 2.63),(41.93 ±3.56) mm;t =3.143,4.761,P=0.018,0.000;t=3.764,5.167,P=0.018,0.000).The left atrial diameter and left ventricular diameter of hepatic type group were significantly larger than the brain type group (26.06 ± 3.68,43.34 ± 3.88;t =3.557,P =0.000;t =3.751,P =0.001).The value of E/A in the hepatic type group (1.57 ± 0.37) was significantly lower than the control group (1.93 ± 0.20;t =-0.352,P =0.006).(2) The left atrial diameter ((31.29 ± 1.70),(34.67 ± 1.97) mm) and left ventricular diameter ((48.29 ± 2.81),(53.67 ± 2.67) mm) of Child B and C groups were significantly larger than the control group ((24.86 ± 2.63),(41.93 ± 3.56) rm;t =6.429,9.810,P =0.000,0.000;t =6.357,10.738,P =0.000,0.000),and the Child A group ((26.42 ± 3.05),(43.89 ± 3.76) rm;t=4.871,8.252,P=0.000,0.000;t =4.399,8.780,P=0.003,0.000).The value of E/A of Child B and C groups (1.58 ± 0.32,1.26 ± 0.39) was lower than that of the control group (t =-0.347,0.662,P=0.020,0.000);At the same time,the value of E/A of Child C group was significantly lower than that of Child A group (1.80 ± 0.33;t =-0.530,P =0.000).Conclusions The HLD patients may have cardiac structural and functional changes,mainly manifested as left atrial and left ventricular enlargement and cardiac diastolic dysfunction,whereas a serious impact has not yet been found in systolic function.And the changes of cardiac structure and function were related to the degree of liver cirrhosis in patients with HLD.

Objective To investigate the clinical safety and efficacy of endoscopic submucosal dissection (ESD) in the treatment of superficial lesions of gastric mucosa, and to analyze the related factors and management of complications of ESD treatment. Methods We retrospectively analyzed the clinical data of 116 patients with superficial lesions of gastric mucosa undergoing ESD, evaluated the efficacy of ESD, observed the appearance and treatment of complications of ESD, and analyzed the factors influencing intraoperative and postoperative complications. Results The ESD was successfully completed in all cases, with the en bloc resection rate being 99.1% (115/116) and the complete cure rate being 95.7% (111/116). The average tumor size was (25.0 ± 11.6) mm, and the average operation time was (56.6 ± 20.5) min. The incidence rates of acute slight bleeding during operation and delayed bleeding were 3.4% (4/116) and 0.9% (1/116), respectively, without acute hemorrhage; 5 cases of bleeding were successfully treated by coagulation hemostasis and hemoclip. Perforation occured in 3 cases (2.6%) and was closed by hemoclip during operation; all cases of perforation had no pneumoperitoneum and were treated successfully by conservative method. Review at 2 months after ESD showed that the ulcer healing rate was 100%. The average follow-up time was (20.3 ± 5.1) months. Gastric angle χ2 = 7.937, P = 0. 01) and the postoperative pathological results as early carcinoma (χ2= 9.145, P=0. 005) were risk factors influencing the intraoperative bleeding and perforation complications. Conclusion ESD is a safe and effective minimally invasive treatment, and has high operation success rate. The prevention of bleeding should be emphasized during and after ESD operation. Perforation complications also should be discovered during the early stage of operation, which can contribute to complete effective closure of perforation under endoscope inmost cases.

Objective: To explore the diagnosis and treatment of fourth branchial cleft deformity. Methods: The clinical data of a patient with bilateral fourth branchial cleft deformity in the neck were summarized, and the literature was reviewed Results: The patient was a 17-year-old male who had a painless lump in his neck for 10 years. During specialized examination, a lump approximately 4.0 cm × 3.0 cm in size could be palpated subcutaneously on the right side of the neck, with clear boundaries, a regular shape, a soft texture, and a wave-like sensation without obvious tenderness. A fistula with a size of approximately 0.5 cm × 0.5 cm could be observed on the left side of the neck, and yellow clear liquid could be seen flowing out of the fistula. The surrounding skin was locally red and swollen, and the surface temperature of the skin was elevated. Computed tomography examination demonstrated a circular cystic low-density shadow approximately 4.4 cm × 3.4 cm in size in the right supraclavicular and anterior cervical regions. A flocculent isodense image could be observed in the middle; moreover, nodular calcification could be observed at the edge, and the surrounding fat spaces were blurred. The enhanced scan showed mild enhancement of the cyst wall but no obvious enhancement of the contents. On the left side, a circular nodular shadow with a diameter of approximately 1.4 cm could be seen, with enhanced scanning and circular enhancement. The surrounding skin was thickened, and the subcutaneous fat gap was blurred. Multiple small lymph nodes could be observed on both sides of the neck, with the larger nodes having a short diameter of approximately 0.8 cm. The size and morphology of the thyroid gland were not significantly abnormal, and there was no obvious abnormal density shadow inside of the gland. Upon admission, the diagnosis was a fourth gill fissure cyst in the right neck and a fourth gill fissure fistula in the left neck. Under general anesthesia and intravenous anesthesia, right branchial cleft cyst resection and left branchial cleft fistula resection were performed. Postoperative pathological examination demonstrated a left branchial cleft fistula and a right branchial cleft cyst. The wound healed by first intention, and there was no recurrence after 6 months of follow-up. According to the literature, fourth branchial cleft deformity is a congenital developmental abnormality of the branchial apparatus, the incidence of which accounts for only 1% of all branchial cleft deformities; moreover, it often occurs on the left side. The anatomical position is often located in the cervical root and supraclavicular region, thus demonstrating cysts or sinuses adjacent to the thyroid gland. The diagnosis should be confirmed by anatomical location, imaging examination or laryngoscopy combined with postoperative pathological results and should be differentiated from cervical masses such as thyroglossal duct cysts and lymph node metastasis. The main treatment methods include surgical procedures and endoscopic cauterization of the internal fistula. The prognosis is generally good, and there is a risk of recurrence; however, cancer rarely occurs Conclusion Deformity of the fourth branchial fissure is very rare; thus, it should be identified early to avoid excessive and ineffective surgical drainage, reduce potential complications during resection and completely remove the lesion to prevent recurrence.

Objective To investigate the serum vitamin and trace element levels in children with short stature and their correlation with bone age. Methods Levels of serum VA and VD, and trace elements Ca, Fe, Zn, Mg, Cu, Pb and Cd were measured in 322 children who were referred for height consultation. Bone ages were evaluated and the correlation between bone age and serum vitamin and trace element levels was analyzed. Results The VA and VD deficiency rates of these 322 children were 22.05% and 34.16%, respectively. The deficiency rates of trace elements Ca, Fe and Zn were14.29%, 21.43% and 6.83%, respectively. The Pb excess rate was as high as 42.55%. The rates of bone age (BA) retardation in Group Ⅰ (short) and Group Ⅱ (slightly short) were 49.38% and 37.57%, respectively, which was significantly higher than that of Group Ⅲ (normal). The Ca level of BA retardation children was lower than that of the normal BA children in Group I. The VD level of BA retardation children was lower than that of the normal BA children in Group Ⅱ. BA was negatively correlated with VD, Ca, and Cu levels in children (r=-0.241; r=-0.136; r=-0.162), and positively correlated with Fe (r=0.286) . Conclusion There were significant abnormalities of vitamins and trace elements in short children. Children's bone age had a certain correlation with serum vitamin D, calcium, copper, and iron levels. Serum vitamin and trace element levels in children should be monitored to guide a reasonable diet to better promote child growth and development.

Objective: To study the application of nurse-led management in the nursing safety quality of CCU transition patients. Methods: The control group of 60 patients who were transferred to the general ward after CCU treatment in Wuhan University Renmin hospital from October to December 2017 was selected, and 60 patients from January to March 2018 were set as the experimental groups. The control group carried out routine nursing, and the experimental group adopted nursing leading management model to carry out nursing intervention. To observe and compare the quality of nursing safety, quality of life and satisfaction of patients before and after intervention. Results: The nursing safety incidents, nursing gaps and CCU return rates of control group patients were 13.33%(8/60),23.33%(14/60) and 11.67%(7/60), respectively. For the experimental group patients, they were 3.33%(3/60),8.33%(8/60) and 3.33%(2/60), respectively. The difference was statistically significant (χ²= 4.415, 4.582, 4.312, P<0.05). After the intervention, the quality of life of the patients improved significantly. The conditions of physical function, emotional function, social function and overall quality of life of the control group were 56.07 ± 4.42, 66.62 ± 1.89, 56.34 ± 4.31, and 61.26 ± 4.15, respectively. For the experimental group, they were 71.88 ± 4.67, 73.52 ± 4.28, 63.94 ± 4.12, and 74.62±4.02, respectively. The difference was statistically significant(t=7.657-16.892, P<0.01). After the intervention, the patient's satisfaction also increased significantly. The control group′s psychological support dimension, cooperation dimension, and safety dimension were 7.96 ± 0.86, 7.39 ± 0.61, and 7.63 ± 0.16, respectively. For the experimental group, they were 9.56 ± 0.41, 9.08 ± 0.56, 9.21 ± 0.33, respectively. The difference between the two groups was statistically significant(t= 7.632, 9.116, 7.562, P<0.01) . Conclusion Nurse-led management can effectively improve the quality of care safety, quality of life and satisfaction of CCU transition patients, reduce the return rate of CCU, and provide clinical reference for safe care of CCU transition patients.