AIM To establish the quality standard for Tibeten medicine Ershiwuwei Feibing Pills [Inula racemosa Hook.f.,Swertia bimaculata (Sieb.et Zucc.) Hook.Thors.ex Clarke,Phyllanthus emblica Linn.,Terminalia billerica (Gaertn.) Roxb.,etc.].METHODS TLC was applied to the qualitative identification of L racemosa,S.bimaculata,P.emblica and T.billerica,and HPLC was adopted in the quantitative determination of alantolactone,oleanolic acid,gallic acid and hydroxysafflor yellow A.RESULTS The TLC spots were clear without negative interference.Alantolactone,oleanolic acid,gallic acid and hydroxysafflor yellow A showed good linear relationships within the ranges of 4.324-216.2 μg/mL (r =0.999 9),32.222-1 611.1 μg/mL (r =0.999 9),4.072-203.6 μg/mL (r =0.999 9) and 4.266-213.3 μg/mL (r =0.999 9),whose average recoveries (RSDs) were 100.6％ (0.93％),100.3％ (2.1％),101.5％ (3.0％) and 100.1％ (1.8％),respectively.CONCLUSION This simple method can be used for the rapid quality control of Ershiwuwei Feibing Pills.

Objective:To analyze the clinical epidemiological characteristics and the prognostic risk factors of patients with hemorrhagic fever with renal syndrome (HFRS).Methods:A total of 2 245 HFRS patients who were admitted to the Second Affiliated Hospital of Air Force Medical University from September 2008 to December 2021 were enrolled. Clinical epidemiological data (including gender, age, onset season, onset region, case fatality rate, et al) of HFRS patients were analyzed. The clinical epidemiological characteristics of patients with HFRS in the 2008 to 2012, 2013 to 2017, and 2018 to 2021 groups were compared. Statistical comparisons were performed using chi-square test. The Bonferroni adjusted P-value method was used for pairwise comparisons between groups, and logistic regression analysis was used to screen and evaluate the risk factors associated with the prognosis of HFRS patients. Results:The age of 2 245 HFRS patients was (42.3±15.9) years old. Most of them were male (79.24%(1 779/2 245)), and the main incidence area was Xi′an City (69.53%(1 561/2 245)). There were 132 deaths with an overall case fatality rate of 5.88%. There were 1 088 patients (48.46%) from 2008 to 2012, 647 patients (28.82%) from 2013 to 2017, and 510 patients (22.72%) from 2018 to 2021, with a mortality rate of 7.17%(78/1 088), 5.10%(33/647) and 4.12%(21/510), respectively. From 2008 to 2021, both the number of HFRS cases and the case fatality rate had shown a fluctuating downward trend. There were significant differences in case fatality rate, age distribution, onset season, and onset region among patients in the different year groups ( χ2=6.84, 49.22, 83.47 and 19.29, respectively, all P<0.05). The results of pairwise comparisons showed that the proportion of patients aged >60 years in the 2018 to 2021 group (23.33%(119/510)) was higher than those in the 2008 to 2012 group (12.13%(132/1 088)) and the 2013 to 2017 group (12.36%(80/647)), and the differences were statistically significant (both P<0.05). The proportions of patients at large peak (October to December) were 62.35%(318/510) in the 2018 to 2021 group and 56.26%(364/647) in the 2013 to 2017 group, which were both lower than that in the 2008 to 2012 group (75.18%(818/1 088)), and the differences were both statistically significant (both P<0.05). The case fatality rate of patients aged >60 years was 9.67%(32/331), which was higher than those of patients aged <30 years (2.86%(16/559)) and patients aged 30 to 60 years (6.20%(84/1 355)), with statistically significant differences (both P<0.05). Univariate analysis showed that age 30 to 60 years, age >60 years, smoking, complicated with hypertension, hypotensive shock and hypoxemia were significantly correlated with the prognosis of HFRS patients (odds ratio ( OR)=2.243, 3.632, 1.484, 3.532, 79.422 and 143.955, respectively, all P<0.05). The results of multivariate logistic regression analysis indicated that complicated with hypertension ( OR=2.467, P=0.004), hypotensive shock ( OR=11.658, P=0.001), and hypoxemia ( OR=67.767, P<0.001) were the independent risk factors affecting the prognosis of HFRS patients. Conclusions:The prevalence of HFRS has shown new changing characteristics from 2008 to 2021. The numbers of HFRS patients and the case fatality rates show a downward trend, and the proportion of HFRS patients aged >60 years increases. Complicated with hypertension, hypotensive shock and development with hypoxemia are the independent risk factors for the prognosis of HFRS.

Objective To analyze the correlation between the pathological types of parathyroid and clinical manifestations in patients with renal secondary hyperparathyroidism (SHPT),so as to improve the efficacy and safety of treatment.Methods The pathological and clinical data of 130 patients with renal SHPT and maintenance hemodialysis (MHD) who had undergone total parathyroidectomy with autotransplantation (TPTX + AT) were collected.A total of 545 parathyroid glands were obtained and 998 slices were made and read.According to the pathological types of parathyroid hyperplasia,the patients were divided into diffuse hyperplasia (DH) group,diffuse between hyperplasia and nodular hyperplasia (DH/NH) group as well as nodular hyperplasia (NH) group.The clinical and biochemical characteristics of different groups before and after operation (1-,3-,6-,9-,12-month) were compared and analyzed by statistical tests.Results (1) The preoperative status:the dialysis age,serum calcium as well as incidence of bone pain,skin itching and shorten height in the NH group were significantly higher than those in the DH group (all P ＜ 0.05),and the serum phosphorus and iPTH in the NH group were significantly higher than those in DH and DH/NH group (all P ＜ 0.05).(2) The postoperative status:the serum calcium of the NH group at 1-month was lower than that of the DH group,and the incidence of hypocalcemia of the NH group at 1-month was higher than that of the DH group (P ＜ 0.05);the serum phosphorus at 3-,6-,9-month and iPTH at 1-,3-month of the NH group were significantly lower than that of the DH group (all P ＜ 0.05),and the serum phosphorus at 3-month and iPTH at 1-month of the NH group were lower than that of the DH/NH group (all P ＜ 0.05).Among the 3 groups the serum phosphorus change from 1 to 12 months had difference (F=3.241,P=0.042),while the differences of serum calcium and iPTH changes were statistically insignificant.Conclusions The clinical manifestations,serum calcium,phosphorus and iPTH in patients with renal SHPT before and after TPTX+AT are closely related to the pathological types of parathyroid hyperplasia.Compared with the DH patients,before the operation the NH patients have longer dialysis age,more serious the clinical symptoms such as bone disease,higher calcium,phosphorus and iPTH,while greater reduction of the serum calcium,phosphorus and iPTH in the short term after operation.