Objective:To investigate the factors influencing the success of external cephalic version.Methods:Pregnant women who underwent an external cephalic version due to breech or transverse presentation by the same operator in the Third Affiliated Hospital of Zhengzhou University from July 2015 to July 2021 were selected as the study objects. Univariate analysis and logistic regression analysis were used to explore the clinical factors influencing the success of the external cephalic version. The receiver operating characteristic (ROC) curve was used to analyze the best cut-off value of gestational week and amniotic fluid index at the time of operation and to evaluate the predictive value of the influencing factors on the success of the external cephalic version.Results:(1) A total of 118 cases finally entered this study. Among the 118 cases,77 cases (65.3%) succeeded in the external cephalic version, among which the success rate was 49.1% (27/55) for primipara and 79.4% (50/63) for multipara. The vaginal delivery rate was 56.8% (67/118). (2) Complications occurred in 19 (16.1%) of the 118 cases. The main complications were abnormal fetal heart rate (13 cases, 11.0%), umbilical cord presentation, and fetal position reversion (two cases and 1.7% in each), and the serious complications were intrauterine fetal death and placental abruption (one case and 0.8% in each).The complication rate of patients with successful external cephalic version was 7.8% (6/77), which was lower than that of those who failed the external cephalic version [31.7%(13/41)] ( χ 2=11.33, P=0.001). (3) Multivariate analysis showed that gestational week at surgery before 38, amniotic fluid index >11.10 cm, and multipara were the factors affecting the success of the external cephalic version [ OR(95% CI)=0.561(0.351-0.897), 1.173(1.018-1.351) and 4.201(1.547-11.404), all P<0.05]. (4) The area under the ROC curve of the combination of the gestational week at surgery, amniotic fluid index, and parity was 0.744 (95% CI: 0.640-0.848, P<0.001), and the Youden index was 0.518, with a sensitivity of 70.0% and a specificity of 81.8%. Conclusion:Gestational weeks, amniotic fluid index, and multipara are related to the success of the external cephalic version, and the combination of the three has certain predictive power for the success of the surgery.

Objective To explore the independent risk factors of the prolonged time of retention ICU after type A aortic dissection operation,to establish a corresponding perioperative risk assessment system.Methods A total of 509 consecutive patients with type A aortic dissection were enrolled in the study from September 2011 to May 2016,among which,418 patients received emergency operation.The prolonged retention time of ICU was considered as endpoint event.A perioperative assessment system was established through the analysis of related risk factors of the most common complications after type A aortic dissection operation.The possible risk factors of prolonged retention time of ICU were introduced into a single factor analysis.The meaningful variables in the single factor analysis were introduced into logistic regression analysis.The independent risk factors which were obtained from logistic regression analysis were used to establish risk prediction modeL,and the ROC curve and Hosmer-Lemeshow goodness of fit test were used to evaluate the model.Results The perioperative mortality rate was 8.64％,the prolonged retention time of ICU was 5.06 days,and 98 cases exceeded 7 days.The results of logistic regression analysis showed that age,the history of stroke,obesity,emergency operation,cardiopulmonary bypass time,deep hypothermic circulatory arrest time,renal inadequacy,massive transfusion,hypoxemia,and pulmonary infection were the independent risk factors for prolonged retention time of ICU.Accordingly,a mathematical model was established.The area under ROC cure for prediction model(AUC) =0.761,Hosmer-Lemeshow goodness of fit test P =0.512.Conclusion The logistic model estabhshed in this study can successfully predict ICU retention time after type A aortic dissection operation,and the efficacy was predicted satisfactorily.

Objective To study the computed tomograhpy (CT) features of non-tuberculous mycobacteria (NTM) and multidrug-resistant pulmonary tuberculosis (MDR-TB), and to improve the differential diagnosis of the disease. Methods The CT imaging data of 67 patients diagnosed with NTM pulmonary disease (NTM lung disease group) and 103 patients with MDR-TB (MDR-TB group) were selected from January 2010 to December 2015 in our hospital. The imaging findings and differences in lesion location were compared between two groups. Results Lesions of NTM lung disease occurred in the posterior segment of the posterior and posterior lumbar dorsal (Ⅰarea), clustered lobular central nodules, accompanied by bronchiectasis and subpleural thin wall empty, rare bronchial foci. MDR-TB lesions occurred in the middle lobe of the right lung and the upper lobe of the left lung (Ⅱarea). The upper lung of the lungs were patch, nodules and caseous lesions, with thick wall and chronic lung inflammation, showing thick wall empty, pulmonary consolidation, atelectasis, calcification (lung), hilar mediastinal lymph node calcification, lung volume reduction, pleural thickening and pleural effusion. Conclusion Chest CT images are similar in NTM lung disease and MDR-TB, but there are differences. The detailed analysis of image features can provide a basis for clinical differential diagnosis.

This study was aimed to investigate the effects of extract from Tibetan medicine Berberis Cortex (TMBC) on expressions of protein kinase C (PKC-β), vascular endothelial growth factor (VEGF) and hypoxia-inducible factor (HIF-1α) in the retina of diabetic rats. Diabetic rats were established by one time intraperitoneal injection of strepto-zocin (STZ). Rats were randomly divided into the model group, low-dose TMBC group, medium-dose TMBC group, high-dose TMBC group, metformin group, calcium dobesilate group, berberine group and the normal control group. Intragastric administration was given. The medication amounts of TMBC in the low-dose, medium-dose and high-dose group were 5, 10, and 20 times to the adult medication dose. In the metformin group and the berberine group, 10 times of the adult medication dose were given. Distilled water was given in the model group and the normal con-trol group. After 6-week intragastric administration, all experimental rats were sacrificed. The expressions of PKC-β, VEGF and HIF-1α were examined by real-time fluorescence quantitative PCR assay and western blot. HIF-1α ex-pression was detected by immunohistochemistry. The results showed that compared with the normal control group, the mRNA and protein expression of PKC-β, VEGF and HIF-1α increased obviously in the retina of diabetic rats ( P<0.01). Compared with the model group, the mRNA expression of PKC-β, VEGF and HIF-1α in the high-dose and medium-dose TMBC group reduced obviously (P< 0.01). The protein expression levels of PKC-β, VEGF and HIF-1α were also obviously reduced (P< 0.05). The expressions of PKC-β, VEGF and HIF-1α in the low-dose TMBC group were obviously reduced (P < 0.05). It was concluded that TMBC can depress the expressions of HIF-1α, PKC-β and VEGF in the retina of diabetic rats, which can be served as a protective effect to prevent progress of di-abetic retinopathy.

This study was aimed to reveal the species characteristics of Chinese patent medicines for antitussive ef-fect and provide references for developing new drugs. This research targeted Chinese patent medicines for antitussive effect which were included in the Pharmacopoeia of the People's Republic of China and the New National Chinese Patent Medicines as well as those characterized by keywords such as cough cure, cough alleviating, antitussive effect, cough, persistent cough. The analysis was made on the species characteristics, such as the number of Chinese patent medicines for antitussive effect, license number, ethnomedicine patent medicines, drugs for children use, protection of varieties of traditional Chinese medicine, the number of drugs, the generic names of drug, and drug forms. The results showed that 684 Chinese patent medicines for antitussive effect collected in this research had ac-counted for 8.60% of the total 7 260 of Chinese patent medicines. A total of 7 450 license numbers were approved, and 33% of the Chinese patent medicines shares one license number. One Chinese patent medicine owns 16.6 li-cense numbers on average. Ethnomedicine patent medicines had 3 Tibetan prescriptions such as the Shiwuwei Chenxiang pill and 4 Mongolian prescriptions, such as the Siwei Tumuxiang powder. Drugs for children accounted for 14%, including 9 forms. The type of the generic names of drug reached 16 and most of them originate from abbrevia-tions of the main drug in prescription. The number of drugs in prescription ranges from 8 to 16. Chinese patent medicines for antitussive effect involved 16 forms, of which the proportion of the use of solid preparation was higher than the liquid preparation. It was concluded that Chinese patent medicines for antitussive effect were characterized by such advantages such as a variety of species, various forms, the reasonable number of drugs, considerable medicine retail market share and drug for children use which can meet the clinical needs, and meanwhile some prob-lems, such as a lack of criteria for the generic names of drug, the homogenization of fierce competition, and inade-quacy of ethnomedicine patent medicines.

This study took geo-authentic medicinal material Rhizoma Coptidis as an example and analyzed soil characteristics of the growing environment of Rhizoma Coptidis . The methods of ISSR, HPLC, 1H-NMR and NIR were respectively used for exploring its genotype and investigating on its chemitype . In the respects of an-ti-endotoxin, anti-bacterial activities and insulin resistance that was related to the treatment of diabetes, the pharmacodynamic type was studied and the relationship was comprehensively analyzed . The quality evaluation of geo-authentic medicinal materials was preliminarily established based on ecotype , genotype chemitype and phar-macodynamic type of Rhizoma Coptidis . Simultaneously, quality standards of Rhizoma Coptidis were set up in combination with genuine character , which provided the scientific basis for establishing Chinese medicine char-acteristic methods of quality evaluation of Rhizoma Coptidis .

This study was aimed to reveal characteristics of functions, main indications and applications of Chinese patent medicines in order to provide references for development of new Chinese patent medicines for antitussive ef-fect. Chinese patent medicines recorded in the Pharmacopoeia of the People's Republic of China and the New Na-tional Chinese Patent Medicines were taken as research subjects. Chinese patent medicines classified in the function and indication with key words of cough-relieving, cough-suppressing, cough and chronic cough were col-lected. Analysis was made on the prescription characteristics, such as functions, main indications and applications. The results showed that there were 684 Chinese patent medicines and 462 terms, which were used for a total of 1533 times. The frequently-used terms are antitussive effect with expectorant, antitussive effect, expectorant, heat-clearing and exterior-releasing, antiasthmatic, wind-expelling and antipyretic, antitussive effect with antiasthmatic, purging lung heat, relieving exterior syndrome and moistening the lungs. All 684 Chinese patent medicines were used 48 ma-jor treatments for a total of 1107 times. The main indications include acute and chronic trachitis / bronchitis, exoge-nous wind-heat type of common cold, exogenous wind-cold type of common cold, cough with abundance of phlegm due to phlegm-heat obstructing the lung, acute upper respiratory tract infection, asthma, acute and chronic pharyngi-tis, lung heat cough, and etc. All 684 Chinese patent medicines used a total of 537 kinds of herbs and chemical medicines, including 441 kinds of herbal medicine, 36 kinds of animal medicine, 25 kinds of mineral medicine and 35 kinds of chemical medicine. The top ten herbs in terms of using frequency are Glycyrrhizae radix et rhizoma, Platycodonis radix, Armeniacae semen amarum, Menthae haplocalycis herba, Citri reticulatae pericarpium, Ephedrae herba, Scutellariae radix, Perilla frutescens (L.) Britt, Pinelliae rhizoma, Fritillariae cirrhosae bulbus. Among them, 1/4 of Chinese patent medicines used extract. Five kinds of food or fruits were also used, which were orange, fresh gin-ger, pear, watermelon and dried mushroom. It was concluded that Chinese patent medicines for antitussive effect can be adopted in the treatment of various kinds of diseases, especially for the treatment of cough(heat cough in partic-ular), abundance of phlegm, asthma, pharyngitis, laryngitis, and etc. The treatment methods of clearing heat, dis-pelling wind and relieving exterior syndrome played an important role in the realization of antitussive effect. However, the expression of functions and main indications is far from standardized and clear. Drugs commonly used are herbal medicine plus animal medicine, mineral medicine and chemical medicine as well as food and fruit. The discovery of preparations with certain clinical curative effect from ethnomedicine and the using of their extracts as a major ingre-dient are one important way to develop new Chinese patent medicines with antitussive effect.

OBJECTIVETo develop an HPLC method for determination of loganin in Pterocephalus hookeri.

METHODThe analysis was performed on a Welchrom C18 column (4.6 mm x 250 mm, 5 microm) with acetonitrile-water (12:88) as the the mobile phase at a flow rate of 1 mL x min(-1) and the detection wavelength was 240 nm.

RESULTThe peak areas and injection amounts of loganin had a good linear relationship at the range of 0.06-1.2 microg. The average recovery was 97.0%, and the RSD was 1.4%.

CONCLUSIONThe method is simple, accurate, and can be used for its quality control.

Objective To investgate the proper perioperative management of Debakey Ⅰ aortic dissection by new type of three branches aortic arch covered stent graft implantation. Methods A total of 56cases with Debakey Ⅰ aortic dissection were enrolled into the study and operated by new type of three branches aortic arch covered stent graft implantation from July 2009 to August 2010. Results The cardiopulmonary bypass time during the operation was 90. 0 -248.0 min( median time 180. 6 ains) ,aortic cross clamp time was 69. 0 - 180. 0 min(median time 108. 2 mins) ,circulation arrest time was 17.0 -37.0 min ( median time 22. 6mins) ,the time using reathing apparatus was 16.0 -260.0 hours (median time 42. 8 hours),ICU residence time was 3.0 -23. 0 days( median time 6. 6 days). Fifty-four patients got well and were discharged. One patient died of multi-organ failure postoperatively and another died of large area of acute myocardial infarction. After the operation, six cases had acute renal failure, five cases had tracheotomy, three cases had reoperation for hemorrhage,one case had retardant pericardial tamponade, one case suffered from spinal cord injury, one had cerebral hemorrhage, and five cases had refractory arrhythmias. Conclusion The new type of three branches aortic arch covered stent graft simplified the procedures of aortic arch operation and lowered the operative risk in treatment of Debakey Ⅰ aortic dissection. Properly control of blood pressure and pain before surgery, shorten circulatory arrest time, maintain good organ perfusion seem to be the key points to improve the prognosis in patients with aortic dissection.