The pharmacological characteristics of recipes are multi-components, multi-ways, multi-links, and multi-targets, on which the efficacy substances in recipes are worth of studying. To explore the essential substances of Chinese herbs in recipe is one of the key points for modernization of Chinese materia medica. The pharmacological effects and bioactivities inside the target tissue of lesion body are still not clear, even though there are some progress in herb serum pharmacology, recipe pharmacokinetics, and pharmacodynamics. The main effective components of recipe to pancreas in acute pancreatitis models by ig or enema were investigated by HPLC-MS method so as to establish a new hypothesis (tissue pharmacology of recipe): i.e. guided hy fundamental theory of traditional Chinese medicine to study the effect and the mechanism of recipe's essential substances on target tissues with pharmacological methods; to establish the experimental method for searching the foundation, the principle, and the direct substances of recipes which act on target tissues; to form more effective formula if possible, and to explore in a new researching field for the recipes of Chinese materia medica.

Objective To investigate the effectiveness and methodology of percutaneous transluminal septal myocardial ablation (PTSMA). for hypertrophic obstructive cardiomyopathy (HOCM). Methods PTSMA with Sigwart's Method were performed in 57 patients with symptomatic HOCM from September 1999 to January 2005. Improvements were made about pressure monitoring, echocardiography guiding, the ablation procedure and the evaluation criteria of the operation. Results About 0.6-9.0 mL of absolute alcohol were consumed during PTSMA in each patient with 1-5 target septal branchs ablated per case. The resting and provoked left ventricular outflow tract pressure gradient monitored by catheter was reduced over 50% compared with preoperation level in all 57 cases. Two out of four cases with ECT exam had septal myocardial radioactive absence. During the follow-up of 2 weeks to 5 years, the clinical symptoms such as syncope, diziness, angina, palpitation and dyspnea, disappeared or were relieved in 54 cases compared with preoperation status. Two cases regained the above symptoms not long after the operation. One patient showed improvement in clinical symptoms and echocardiographic examination in 6 monthes, but she died of dilated congestive cardiomyopathy at 18 monthes after PTSMA. Follow-up echocardiographic examination was completed in 43 cases at 6 monthes and in 34 cases at 12 monthes after PTSMA. Further improvement was shown on UCG compared with 2 weeks after the operation. Some patients had transient or nonsustained ventricular tachycardia and atrioventricular block. Anteroseptal myocardial infarction was observed in 4 patients and 1 of them was accompanied by inferior myocardial infarction. Conclusion Percutaneous transluminal septal myocardial ablation for hypertrophic obstructive cardiomyopathy is safe and effective. Improvements have to be made for more satisfactory results of PTSMA.

With the increasing number of complex and difficult thyroid cancer patients, the traditional medical model is difficult to solve the problem of diagnosis and treatment of patients optimally. In recent years, multidisciplinary team (MDT) model is applied clinically. For complex and difficult thyroid cancer diseases, the model can play a multidisciplinary advantage and provide more personalized and accurate diagnosis and treatment scheme for patients. The diagnosis and treatment of complex and difficult thyroid cancer involve thyroid surgery, otolaryngology, thoracic surgery, anesthesiology, endocrinology, nuclear medicine, radiotherapy, oncology, ultrasound, imaging, pathology and other disciplines. Based on the important role of MDT in diagnosis, treatment, nursing, postoperative management and clinical research of thyroid cancer, as well as the challenges and difficulties faced in implementation of MDT, the status and progress of multi-disciplinary comprehensive diagnosis and treatment of thyroid cancer will be systematically elaborated in the paper.

OBJECTIVE:To develop and improve the quality standard for Kanggu zengsheng tablet. METHODS:TLC was used for the qualitative identification of Drynaria fortunei,Epimedii Folium and Spatholobus suberectus;HPLC was used for the contents determination of icariin and acteoside:the column was Diamonsil C18 with mobile phase of acetonitrile-0.1% formic acid solution (gradient elution) at a flow rate of 1.0 mL/min;detection wavelength was 270 nm for icariin and 334 nm for acteoside, Cdumn temperature was 25 ℃,and the injection volume was 10 μL. RESULTS:The TLC spots of D. fortunei,Epimedii Folium and S. suberectus were clear and well separated,negative control without interference. The linear range was 0.0188-1.88 μg for ac-teoside(r=0.9999)and 0.107-2.14 μg for icariin(r=0.9999);RSDs of precision,stability and reproducibility tests were lower than 2.0%;recoveries were 100.2%-105.0%(RSD=1.6%,n=9) and 96.2%-99.5%(RSD=1.4%,n=9). CONCLUSIONS:The improved standard can more effectively control the quality of Kanggu zengsheng tablet.

Objective: To explore the effects of ranitidine on pharmacokinetics of rhein in rats after oral administration of Dachengqi Decoction (DCQD), a compound traditional Chinese herbal medicine. Methods: Twelve male Sprague-Dawley rats were divided into DCQD group and DCQD plus ranitidine group, and were orally administered with DCQD at a dose of 10 g/kg or DCQD (10 g/kg) combined with ranitidine (150 mg/kg), respectively. Blood samples were gathered after a series of time intervals. Metabolism of rhein was determined with a reversed-phase high-performance liquid chromatography with internal standard of 1, 8-dihydroxyanthraquinone and the data were analyzed with DAS 2.1 program. The pharmacokinetic parameters were compared between the two groups. Results: The pharmacokinetic parameters of rhein in the DCQD group, including peak concentration (C(max)), area under the plasma concentration-time curve (AUC), distribution phase half-life (t(1/2alpha)), elimination rate constant (K(10)) and central to peripheral transfer rate constant (K(12)), were significantly different to those in the DCQD plus ranitidine group (P<0.05, P<0.01). There were no significant differences in the other parameters between the two groups. Conclusion: Ranitidine can influence the pharmacokinetics of rhein in rats after oral administration of DCQD.

Objectives To evaluate the effects of hypertonic-hyperoncotic solution (HHS) on cardiac function and extravascular lung water in children after open-heart surgery for congenital cardiac disease. Methods 50 children with congenital cardiac disease were randomly assigned to 2 groups. The HHS group received HHS (7.5% sodium chloride with 6% hydroxyethyl-stareh 200 kDa). The ISS group received isotonic saline solution (ISS 0.9% sodium chloride). Cardiac index (CI), extravascular lung water index (ELWI), stroke volume index (SVI), mean arterial pressure (MAP), and systemic vascular resistance index (SVRI) were measured. Immediately after sur-gery, patients were loaded either with HHS or with ISS (4 ml/kg). Sodium concentration, osmolality, thrombocyte count(TC), fibrinogen, and arterial blood gases were detected before operation, immediately after loading, 15 minutes, 1,4, 12, and 24 hours after the end of vol-ume loading. Hemodynamic parameters were recorded at the same time. The total amount of dobutamine required was documented. Results In HHS group, MAP, SVI and CI increased, and SVRI decreased significantly after the administration of HHS, compared with ISS group and before administration(P<0.01 or 0.05). Both CVP and HR were unchanged in both groups. In HHS group, ELWI decreased signifi-cantly, compared with before volume administration. But ELWI increased directly and remained elevated for 60 minutes after the administra-tion of ISS. Sodium concentration increased immediately after infusion of HHS. The postoperative need for infused dobutamine in the patients in HHS group was decreased, compared with ISS group (P<0.05). All patients left the hospital in a clinically sufficient state. Condu-sions A single infusion of HHS after cardiac surgery is safe. After cardiopuimonary bypass surgery, the administration of HHS increased CI by elevating SVI in combination with a decreased SVRI. ELWI significantly decreased, which suggest that HHS effectively counteracts, the capillary leakage.

Objective To investigate the expression of CD14/CD16 by monocytes and the anti-inflammatory effects of hypertonic saline plus dextran (HSD) in adult blunt trauma patients in hemonhagic shock. Method A total of 30 adult patients were eligible for inclusion in the study if they sustained blunt trauma from March to October 2007 and had at least one recorded episode of hypotension (systolic blood pressure ≤ 90 mm Hg) with clear evidence of blood loss (external or internal including the thorax, abdomen or retroperitoneum). Patients were excluded if they refused to participate, were admitted ≥ 6 hours after injury, were pregnant, or had chronic disease. The enrolled patients were randomly divided in a double-blinded manner into an HSD group which was administered 7.5% Nad plus 6% dextran - 70, and a control group which was administered 0.9% NaCl. A single 250 ml dose of either HSD or NaO was immediately administered to the patients in each of the two groups while they were in the emergency room. The primary outcomes were to measure the changes in CD4/CD16 expression by monocytes and the levels of anti-inflammatory cytokines, including tumor necrosis factor-alpha (TNF-α), interleukin (IL)-lra and IL-10. Patient demographics, fluid requirements, organ dysfunction, infection and death were recorded. Results A total of 28 patients were enrolled with no significant differences in their clinical measurements. Hyperosmolarity was modest and transient. HSD altered the shock-induced monocyte redistribution pattern by reducing the drop in the "classic" CD14 ++ subset and remarkably affecting the expansion of the "pro-inflammatory" CD14+CD16+ subsets. In parallel, HSD significamly reduced pro-inflammatory TNF-α production while increasing anti-inflammatory IL-lra and IL-10 production. Conclusions This human trial demonstrates that HSD has anti-inflammatory and immunologic properties for trauma patients in hemorrhagic shock. HSD exerts profound immunomodulatory effects, promoting more balanced pro-/anti-inflammatory responses and reducing post-traumatic complications. Therefore, it could be useful in attenuating post-trauma multiorgan dysfunction (MOD).

Child ; Congresses as Topic ; Hong Kong ; Humans ; Neurology ; Pediatrics

Acidosis ; etiology ; Humans ; Kidney Diseases ; etiology ; Toluene ; toxicity

OBJECTIVETo investigate the incidence of depression and its etiological factors in patients with cryptorchidism 6-16 years after surgical treatment.

METHODSUsing Self-Rating Depression Scale and Correlation Factor Questionnaire, we investigated the incidence of depression symptoms among 70 patients with cryptorchidism 6-16 years after surgical treatment and another 70 healthy males as controls, and analyzed the related factors of depression symptoms.

RESULTSThe incidence rate of depression symptoms was 50% in the cryptorchidism patients postoperatively, extremely significantly higher than 4.3% in the control group (χ2 = 23.5, P <0.01). Multiple stepwise regression analysis showed that the main risk factors of depression symptoms were worries about natural fertility (F = 15.8992, P <0.01), dissatisfaction with scrotal appearance (F = 4.6003, P <0.05), and the status of being married (F = 4.1002, P <0.05).

CONCLUSIONSymptoms of depression often occur in cryptorchidism patients after operation, and the major etiological factors are infertility, dissatisfaction with scrotal appearance, and the status of being married.

Adult ; Body Image ; psychology ; Case-Control Studies ; Cryptorchidism ; psychology ; surgery ; Depression ; epidemiology ; etiology ; Female ; Humans ; Incidence ; Infertility, Male ; psychology ; Male ; Marital Status ; Multivariate Analysis ; Risk Factors ; Scrotum ; pathology ; Surveys and Questionnaires ; Time Factors