Objective To optimize the process of extracting total saponins from Platycodon grandiflorum by orthogonal experimental design and central composite design-response surface method. Methods Independent variables were concentration of ethanol, reflux extraction time, reflux time and solvent fold. Dependent variables were extraction rate of total saponins in Platycodon grandiflorum and the yield of dry extract.Linear or nonlinear mathematic models were used to estimate the relationship between independent and dependent variables. Results The result of the orthogonal experimental design was 70%ethanol, 180 min for reflux, 6 fold of solvent and 2 times for extraction. The result of central composite design-response surface method was 70% ethanol, 140 min for reflux, 10 fold of solvent and 2 times for extraction. Conclusion The central composite design-response surface method is better than orthogonal experimental design in studying extraction process of Platycodon grandiflorum, which provides basis for feasibility of application of central composite design-response surface method in optimization of extraction process of Chinese traditional medicine.

Objective To explore the diagnostic value of 18F-FDG PET-CT in lymphoma associated hemophagocytic syndrome (HSP).Methods Retrospective analysis of 30 patients with HPS who underwent 18F-FDG PET-CT detection,and was also compared to pathologically confirmed lymphoma associated HPS to evaluate its diagnostic sensitivity,specificity,positive predictive value and negative predictive value,and to analyze the characteristics of PET-CT imaging in lymphoma associated HPS.Results In the 30 patients,the sensitivity,specificity,positive predictive value and negative predictive value in detecting lymphoma associated HPS by 18F-FDG PET-CT were 85.71％ (12/14),93.75 ％ (15/16),92.31％ (12/13) and 88.24 ％(15/17),respectively.The sensitivities of PET-CT between T-cell and B-cell lymphoma related HPS had no significant difference (P =0.066).In superficial lymph nodes,supraclavicular lymph nodes were the most commonly involved.In deeper tissues and organs,spleen was the most commonly involved site,followed by liver,abdominal retroperitoneal lymph nodes and bone marrow.Conclusion 18F-FDG PET-CT has a high sensitivity and specificity in the detection of lymphoma associated HPS,and may provide valuable information for diagnosis and treatment.

Objective To evaluate the clinical outcome of Osteoset artificial bone mixed Rifampicin for injection after radical debridement in the treatment of sacroiliac joint tuberculosis,and compare with debridement alone.Methods From May 2005 to August 2010,48 patients with sacroiliac joint tuberculosis patients underwent two different surgical methods were selected as analysis subjects in the Orthopedics Department of Chest Hospital of Hebei Province.Among them,27 cases underwent radical debridement and fusion with Osteoset artificial bone combined with Rifampicin for injection (Grafting group),and 21 case were treated with radical debridement only(Control group).The local wound healing,adverse reactions and regular imaging examination (pelvic X-ray and CT scan) were observed,and the surgical time,the intraoperative blood loss,postoperative 6 months and 12 months,18 months bone graft fusion rate,and Majeed scoring results of the patients were recorded and statistically analyzed.Results All patients were followed up from 20 to 30 months with an average of 24 months.There was no significant difference in terms of surgical time and operative bleeding between the two groups(P＞0.05).The rate of bone fusion in grafting group was 33.33％ (9/27) of 6 months after operation,88.9％(24/27) of 12 months after operation,and 96.3％ (26/27) of 18 months after operation.While that in control group was 4.76％ (1/21) of 6 months after operation,42.85 ％ (9/21) of 12 months after operation,and 42.85％ (9/21) of 18 months after operation.The differences of these parameters between the two groups were significant(x2 =5.85,20.92,15.90;P＜0.05).According to Majeed scoring system,the excellent and good rates were 100％ (27/27) in grafting group,76.19％ (16/21) in control group,the difference was statistically significant(x2=7.18 P＜0.05).Conclusion With Rifampicin loaded Osteoset artificial bone can recruit bone graft mass during the bone fusion for sacroiliac joint tuberculosis,and reduce the adverse reactions,achieve bone fusion earlier than the control group.

Hepatitis B virus infection is a serious threat to human life and health. The approved anti-HBV drugs including interferons and nucleos(t)ide analogues have serious adverse effect, rebound phenomena after drug withdrawal, and drug resistance. And the cccDNA cannot be completely eliminated by both of them, which is the reason why a complete cure for hepatitis B cannot be achieved. Therefore, developing anti-HBV drugs directly targeting protein or nucleic acid of HBV remains a current public health priority. Based on the analysis of representative literature from the last decade, this article reviews recent developments in small molecule inhibitors directly targeting HBV from a medicinal chemistry perspective.

Objective To explore the effect of intraoperative parathyroid hormone (IOPTH) examination on parathyroidectomy for primary hyperparathyroidism.Methods The clinical data of 41 PHPT patients who received IOPTH monitoring (IOPTH group) from Jan.2009 to Dec.2014 were retrospectively analyzed.The clinical manifestation,examination and changes of parathyroid hormone and calcium before and after operation were collected.Results There were 12 males and 29 females.36 cases had parathyroid adenoma,and 5 cases were parathyroid carcinoma.23 cases were positive in 24 cases of 99Icm-MIBI parathyroid adenoma radionuclide examination,and 2 cases were positive in 3 cases of parathyroid carcinoma radionuclide 99Tcm-MIBI inspection (P＝ 0.213).10 mins after tumor resection,PTH in all cases decreased by 50％ or more than that before tumor resection except for one case of parathyroid carcinoma.23 cases appeared hypocalcemia in 36 cases of parathyroid adenoma after surgery and 2 cases appeared hypocalcemia in 5 cases of parathyroid cancer patients (P＝0.361).No postoperative hoarseness,cough,bleeding occoured.Patients were followed up from 6 to 72 months.Hypocalcemia symptoms recovered 2 weeks to 3 months after surgery.No permanent hypoparathyroidism occured.One case of parathyroid carcinoma died of hypercalcemia 5 months after surgery.The remaining 40 cases survived without recurrence or death.Conclusions Intraoperative PTH monitoring can help doctors analyze whether all the hyperthyroidism glands have been removed,which can help to avoid miss diagnosis of multiple gland disease and unnecessary bilateral neck exploration.This method is highly accurate so it is recommended for routine use in PHPT surgery.

Objective:To analyze the molecular characteristics of Echovirus 11 (Echo11) strains isolated in Xiangyang, Hubei Province from 2016 to 2017 based on the sequences of VP1 gene.Methods:Rectal and throat swab specimens were collected from children with hand, foot and mouth disease (HFMD) in Xiangyang from 2016 to 2017. Echo11 strains were detected by real-time reverse transcriptase PCR (RT-PCR) and isolated after cultured in human rhabdosarcoma (RD) cells. The VP1 regions of Echo11 strains isolated from RD cells and the whole genomes of three representative Echo11 strains were amplified by conventional RT-PCR and the sequences were analyzed. DNAStar7.0 (MegAlign) and MEGA6.0 (Data) were used to analyze the homology and mutation sites in nucleotide and amino acid sequences. Neighbor-joining method was used to construct phylogenetic trees. Recombination analysis was performed with SimPlot software (BootScanning).Results:A total of 11 Echo11 strains were isolated from 3 494 HFMD cases, accounting for 0.31%. They were highly homologous in the VP1 gene. These strains shared 98.4%-100.0% homology in nucleotide sequences and 98.3%-100.0% homology in amino acid sequences. The homology between the 11 Echo11 strains and the prototype strain (Echo11/Gregory, X80059) was 73.9%-74.8% in nucleotide sequences and 87.7%-88.7% in amino acid sequences. All of the Echo11 strains circulating in Xiangyang were classified into lineage D, having a similarity to the strains circulating in some regions of mainland China since 2013. In multiple regions of the genome, the Echo11 strains isolated in Xiangyang were highly similar to the Henan Echo1 strains in 2010 and the Hubei Echo6 strains in 2015, suggesting there was recombination within the genome of Echo11 strains in Xiangyang.Conclusions:The Echo11 strains circulating in Xiangyang from 2016 to 2017 belonged to lineage D and were recombinant strains.

·AIM: To study the therapeutic method of XL -radiofrequency ablation skin apparatus (invented by Rehabilitation medicine, PLA General Hospital) in micro-resecting the lacrimal punctum neoplasm and to observe its clinical effects. ·METHODS:XL-radiofrequency ablation skin apparatus was performed on 7 cases (7 eye lesions) of lacrimal punctum neoplasm including 3 intradermal nevus, 1 boundary nevus, 1 mixed nevus with inflammatory granuloma,1 inflammatory granuloma,and 1 squamous papillary cell tumor by separating layer, point and flake removing methods. The clinical effect was investigated 2-6mo postoperatively and leftover was removed by twice. The postoperative follow- up durations ranged from 6 to 60mo. ·RESULTS: Totally 6 cases (6 eye lesions) were cured successfully by once but 1 case by twice. They were all without recurrence, cicatrix, palpebral margin deformity, obstruction of lacrimal punctum, stenosis of lacrimal punctum or epiphora. Micro - resecting the lacrimal punctum neoplasm using the XL-radiofrequency ablation skin apparatus had several advantages, such as high accuracy,no cicatrix,no bleeding,no epiphora,no damage to the structure of lacrimal canaliculus, short operation time, little pain during the procedure, without hospitalization, slight inflammation reaction after procedure. ·CONCLUSION: The efficacy of XL - radiofrequency ablation skin apparatus is significantly more evident and highly accurate in micro - resecting lacrimal punctum neoplasm.

AIM To investigate the protective effects of Miaoling Natto Capsules (MNC) on myocardial ischemia-reperfusion injury (MIR) in rats.METHODS Forty-eight healthy male Sprague-Dawley (SD) rats randomly divided into sham group,model group,positive control group (propranolol),MNC groups (low dose,medium dose,and high dose groups) underwent corresponding 7-day oral administration at a frequency of twice daily (rats of the sham group and the model group were dosed with saline water at 1 mL/100 g).Anesthetized by 8％ chloral hydrate,rat models were made by left anterior descending coronary artery ligation,30 min coronary occlusion followed by 3 h of reperfusion for ST segments and T waves monitoring,and rats in the sham group were performed opening and suture procedures.The rats had their serum levels of acetic transaminase (AST),lactate dehydrogenase (LDH),creatine kinase isoenzyme (CK-MB),cardiac troponin-Ⅰ (cTn-Ⅰ),superoxide dismutase (SOD),malondialdehyde (MDA),and tumor necrosis factor-α (TNF-α) detected,real time ECG changes monitored and myocardial infarction area assessed by TTC.RESULTS Compared with the sham group,the model group was observed with markedly elevated ST segments or high T waves rise,significantly increased activities of CK-MB,LDH,AST and the content of cTnⅠ,MDA,TNF-α,and decreased activity of SOD (P ＜ 0.01 or P ＜ 0.001).Compared with the model group,the positive control group and the low,medium and high dose MNC groups achieved controlled ST segments elevation or greater T waves amplitude,significantly decreased activities of CKMB,LDH,AST and the content of cTnⅠ,MDA,TNF-α increased activity of SOD (P ＜0.01 or P ＜0.05) and mycocardial infact range reduction (P ＜ 0.001).CONCLUSION MNC is protective to rats with myocardial ischemia-reperfusion injury.

Objective To compare the effect of intravenous infusion of low dosage fructose with glucose infusion on blood glucose variability in type 2 diabetic patients in stable phase.Methods Data of 22 patients (male:female,18:4)with type 2 diabetes mellitus in stable phase were collected for the study.From 9am to 11 am,all the subjects were administrated one of the following solutions at constant speed on consecutive days randomly:5% glucose injection 200 mL with insulin 3 U,0.9% normal saline 200 mL or 5%fructose injection 200 mL. The blood glucose concentrations were detected every 5 minutes after infusion by confinuous glucose monitoring system(CGMS).The variability of blood glucose was compared using these 3 kinds of solutions.A two-tailed P value of ≤0.05 was considered statistically significant. Statistical analysis was carried out with SPSS version 13.0.Results No significant difference was found among these 3 kinds of solutions.In addition,no adverse effects were founded.Conclusion Low dosage infusion of neither fructose nor glucose had apparent effect on blood variability of patients with type 2 diabetes mellitus in stable phase.