Objective: To establish the method of purifying astragaloside. Methods: Astrageloside was determined by HPLC fingerprinting to compare macroporous resin absorbing method with extraction refine by n butyl alcohol. Results: The HPLC fingerprints of each method were difference. Conclusion: AB 8 macroporous resin is better than the others for purifying astrageloside.

Objective　To investigate the possible relationship between the vitamin E(VE) contents in the plasma and development of hepatosis.Methods　VE and malondialdehyde(MDA) contents in 217 cases infected by various types of viral hepatitis were measured by means of fluorescence and TBA.Moreover,the relationship between both of the contents and the alteration of liver function was observed dynamically.Results　The plasma levels of VE in all cases were decreased obviously.Interestingly,lower the contents of VE were,more severity the disease was.Howevey,the levels of VE recovered step by step when the liver function return to normal in the acute hepatitis cases.Unfortunately,the levels in the chronic hepatitis cases were higher in the recovering phase than in the acute phase,but still lower than normal.Moreover,VE kept low levels and showed a negative relationship to the bilirublin in both worsening and dying cases.Conclusion　To observe the VE contents is helpful to the clinical evaluation of the hepatosis progress and prognosis.

Objective To investigate the expression and significance of P-glycoprotein in triple negative breast cancer (TNBC).Methods One hundred and seventy-one cases of breast invasive ductal carcinoma in our hospital were retrospectively analyzed.According to the expression of ER,PR,Her2,we categorized those paitents into triple negative breast cancer group (58 cases) and non triple negative breast cancer group (113 cases).The different expression of P-glycoprotein was detected by immunohistochemieal technology in two groups.We analyzed the relationship between the expression of P-glycoprotein and clinical and pathological features in TNBC,and investigated the effect of P-gp on the rate of recurrence and metastasis in 3 years.Results (1) The expression of P-gp in TN BC was significantly higher than that of NTNBC (53.45％ vs 37.17％) (P ＜ 0.05).(2) The expression of P-gp in TNBC was associated with TNM stage,histological grade,lymph node status and vascular invasion (P ＜ 0.05),but not with age and size of the tumor (P ＞ 0.05).(3) The rate of recurrence and metastasis in positive expression of P-gp in TNBC was 58.06％,which was significantly higher than negative expression of P-gp in TNBC (44.44％),but no statistically significant was found(P ＞ 0.05).Survival analysis showed that P-glycoprotein expression had no relationshiop to 3-year cumulative survival rate (P =0.161 ＞ 0.05).Conclusions The positive expression of P-gp in TNBC is associated with drug resistance and metastasis,but has no obvious significance to recurrence and metastasis,so as to 3-year cumulative survival rate.

Objective:To investigate the value of bedside transthoracic echocardiography(TTE) in volume reactivity assessment of children with septic shock.Methods:A total of 41 children aged from 1 to 5 years with septic shock requiring mechanical ventilation admitted to PICU from January 2017 to June 2020 were prospectively included.Under the condition of complete mechanical ventilation, full sedation and analgesia, and no spontaneous breathing(tidal volume 8 to 10 mL/kg), volume expansion was given to children.Hemodynamic indexs such as cardiac index(CI), stroke volume index(SVI) and stroke volume variability(SVV) were measured before and after volume expansion by noninvasive cardiac output monitoring(NICOM) and TTE.Moreover, aortic flow velocity time integral variable degrees(ΔVTI), inferior vena cava variability(ΔIVC) and inferior vena cava dilation index(dIVC) were also measured by TTE.Patients were considered to be responsive to volume expansion if SVI NICOMincreased≥15%.Based on the responsiveness of volume expansion, all the patients were divided into response group and non-response group.The value of SVV TTE, ΔVTI, ΔIVC, dIVC, ΔCVP and SVV NICOMin predicting volume responsiveness were analysed. Results:(1) There were 23 cases in response group and 18 cases in non-response group.Before volume expansion, there were no statistically significant differences in general hemodynamic indexes HR, MAP, CVP, EF, CI NICOM, and CI TTEbetween two groups( P>0.05). (2) In response group, HR, MAP, CI, SVI and CVP were all improved after volume expansion( P<0.001). In non-response group, only CVP was significantly increased after volume expansion, while other indexes were not improved( P>0.05). (3)Before the volume expansion, SVV TTE, ΔVTI, ΔIVC, and dIVC in response group were higher than those in non-response group( P<0.001). After volume expansion, these indicators were significantly reduced in response group.In non-response group, only ΔIVC significantly reduced after volume expansion.(4) The receiver-operating characteristic curve analysis showed that the area under the curve of SVV TTEand ΔVTI was 0.971, with 12.04% as the threshold, the sensitivity was 0.957 and the specificity was 0.944. The area under the curve of ΔIVC was 0.981, with 25.98% as the threshold, the sensitivity was 0.870 and the specificity was 1.000.The area under the curve of dIVC was 0.980, with 29.86% as the threshold, the sensitivity was 0.870 and the specificity was 1.000. The area under the curve of ΔCVP was 0.778, with 2.5 cmH 2O(1 cmH 2O=0.098 kPa) as the threshold, the sensitivity was 0.913 and the specificity was 0.556. The area under the curve of SVV NICOMwas 0.874, with 12.50% as the threshold, the sensitivity was 0.869 and the specificity was 0.778. Conclusion:The dynamic indexes SVV, ΔVTI, ΔIVC and dIVC monitored by TTE have good accuracy in evaluating children′s volume responsiveness, among which the accuracy of ΔIVC and dIVC is relatively the highest; the value of ΔCVP in predicting volume responsiveness is limited.

Objective:To explore the clinical effect of phase Ⅰ cardiac rehabilitation exercise on patients with acute myocardial infarction after percutaneous transluminal coronary intervention (PCI).Methods:Convenient sampling method was adopted, totally 84 acute myocardial infarction patients after PCI was randomized into an observation group and control group. Both groups accepted general nursing care. The observation group also accepted the phase Ⅰ cardiac rehabilitation exercise. Cardiac ultrasonic, the 6-minute walk test were used to evaluate the patients′ cardiac function and exercise tolerance, the SF-12 were used to evaluate the quality of life.Results:After repeated measurement ANOVA, before the intervention, there was no significant difference in cardiac function and quality of life between the two groups ( P>0.05); before discharge, the 6-minute walk distance of the observation group was longer than that of the control group, and the difference was significant( F value was 5.279, P=0.024). At 1 month after discharge, there were significant differences in the LVEF( F value was 8.119, P=0.006) and 6-minute walking distance( F value was 9.829, P=0.002) between the two groups ( P<0.05), analysis of the six items of SF-12 including general health( F value was 6.905, P=0.010), physical functioning( F value was 10.595, P=0.002), role physical( F value was 11.168, P=0.001), bodily pain( F value was 12.548, P=0.001), mental health( F value was 7.362, P=0.008) and vitality( F value was 13.692, P<0.001) having shown significant differences between the two groups. At 3 months after discharge, there were significant differences in the LVEF( F value was 11.156, P=0.001), 6-minute walk distance( F value was 16.554, P<0.001)and quality of life in all dimensions between the two groups ( P<0.05). Conclusion:Phase Ⅰ cardiac rehabilitation exercise can improve cardiac function and the quality of life in patients with acute myocardial infarction undergoing PCI, and enhance the exercise tolerance.