Natural products were the material basis of drug discovery and drug screening, and high-performance techniques were the important prerequisite of earning hits. In this paper, we reviewed the current situation and future prospects of drug screening, including the pharmaceutical environment, the challenges facing drug discovery, the screening tools and the methods of generating analogs.

Objective To summarize the experience in the management of incarcerated umbilical hernia in cirrhotic patients with aseites. Methods The operative methods, perioperative management and fellow-up data of 15 patients diagnosed incarcerated umbilical hernia in the setting of cirrhosis and ascites were studied retrospectively. All the patients underwent emergency operation to remove necrotic umbilical skin and hernial content, including incarcerated greater omentum (6 cases) and strangulated segment of small bowel (5 cases). After debriding the operating field thoroughly, the umbilical hernia was repaired with polypropylene mesh, among those Sublay repair was used in 11 cases with the longest diameter of hernial ring more than 3 cm and Onlay repair in 4 cases with the longest diameter of hernial ring less than 3 cm. During the perioperative period, albumin and fresh frozen plasma transfusion, as well as diuresis and ascites paracentesis, was adopted to treat eirrhosis and ascites. Results All the patients underwent operation successfully. The operative time was 90～185 min, averaging at 122 min. Seroma formation in 2 cases and incision infection in one were cured with conservative therapy. One patient died of multiple organ dysfunction after the operation. During the fellow-up of 1～5 years, 1 patient died of liver function failure and there was no hernia recurrence. Conclusion With appropriate perioperative management and correct operative method, polypropylene mesh could be adopted in the emergency repair operation of incarerated umbilical hernia in the setting of cirrhosis and ascites.

Vaccination in children suffering neurological diseases is a troublesome issue that people es-pecially pediatricians are reluctant to mention. Due to worrying about the emergence of adverse reactions and concerning on the heat induced seizure,doctors and parents tend to cancel or do not recommend these children to be vaccinated. Additionally,the heat sensitive seizures,such as febrile seizure( FS) ,generalized epilepsy with fe-brile seizure plus(GEFS+),Dravet syndrome account for the largest proportion of the seizure related disease and epilepsy syndrome. Their pathogenesis has been proved relating to the mutation of SCN gene of the sodium channel. For children with FS,GEFS+,and Dravet syndrome,vaccination may lead to fever,which even may bring about convulsions,but it will not result in worse prognosis.

Objective To investigate and summarize preliminarily the clinical experiences of laparoscopic incisional hernia repair with intraperitoneal patch placement for the patients over 70 years old.Methods From July 2005 to July 2008,laparoscopic incisional hernia repair with intraperitoneal onlay meshes were applied in 8 patients,and whose clinical data were studied retrospectively.Results The procedures were performed successfully in all patients except one converted to open because of severe adhesion.The mean operative time was 105 min(ranged from 50 min to 180 min).One postoperative hypercapnia was resolved through mechanic ventilation for 24 h.One seroma and 1 prolonged postoperative pain over 1 month occurred,which were cured with conservative therapy.Mean postoperative hospital stay was 9.5 d(ranged from 7 d to 14 d).There was no recurrence or local discomfort during 12-36 months(average 26.5 months)follow-up.Conclusions Laparoscopic incisional hernia repair with intraperitoneal onlay mesh for the patients over 70 years old is safe and feasible,which has some advantages such as less trauma and rapid recovery.The perioperative management and operative technique are very important for the success of operation.

Objective To explore a biodegradable drug?loaded composite scaffold and determine its bone regeneration and local long?term drug release ability. Methods In this study, RFP?loaded a novel poly (caprolactone)?b?poly (lactide?co?gly?colide)/β?TCP composite scaffold was produced using particle?leaching/freeze?drying technique. And the obtained composite scaffold was characterized by SEM, TGA, UV spectrophotometer, universal testing machine and so on. New Zealand rabbits were used to prepare bone defects, which was treated by the implantation of active artificial bone loaded with or without RFP. The blank group was untreated. Then the repairing effects of the materials were examined. Results The obtained porous scaf?fold has inter?connected and uniformly distributed pores, and the diameters of pores range from 200 μm to 300 μm. Many mi?cropores (10 μm to 50 μm) can be observed on the wall of macropores. The total porosity of the porous composite scaffold can reach as high as 83.4%; the β?TCP content of the scaffolds is 51.2%. Meanwhile, the addition of β?TCP avoided volume shrinkage compared with b?PLGC scaffold; Additionally, the porous composite scaffold has good compressive strength ( 240 kPa) and compressive modulus (1.0 MPa); And the drug loading of the scaffold was 3.2%,which could smoothly release drug for 63 days after a period of burst release for a week. All defects in the experimental groups were radiographically repaired. There were significant differences between the experimental groups and the control group. Conclusion RFP?loaded poly (cap?rolactone)?b?poly (lactide?co?glycolide)/β?TCP composite scaffold is expected to benefit in drug therapy and bone repair in the treatment of bone tuberculosis.

BACKGROUND:Interbody fusion is widely used in spine surgeries. Failed fusion may cause many complications, so it is very important to evaluate fusion before surgery. Imaging methods are commonly used to evaluate fusion, including X ray, CT and MRI. Above methods have their own specific methods and characteristics, which cause their differences in sensibility and specificity. OBJECTIVE:To review the research progress of imaging methods in interbody fusion. METHODS:The English key words were“lambar fusion, cervical fusion, interbody fusion, evaluation method”in the PubMed database. The literatures with detailed description of interbody fusion were selected for further review, including comparative study on a variety of evaluation methods of imaging means. RESULTS AND CONCLUSION:According to the inclusion criteria and exclusion criteria, a total of 40 papers were included. X-ray and CT are the most commonly used methods, while CT is more reliable. MRI, bone scan and other methods cannot correctly and directly evaluate spinal fusion. Overal judgment of symptoms, signs and different kinds of image data are more reasonable fusion evaluation strategies.

BACKGROUND:How to preserve the biological properties and osteogenic activity of bone xenograft materials after antigen removal has become one of the hot spots. OBJECTIVE:To investigate the effect of bone xenograft extract on proliferation, migration and osteogenic differentiation of bone marrow mesenchymal stem cel s. METHODS:Bone marrow mesenchymal stem cel s from Sprague-Dawely rats were cultured respectively in bone xenograft extract (experimental group) and DMEM/F12 medium containing 10%fetal bovine serum (control group). MTT, Transwel chamber and flow cytometry were used to detect cel proliferative ability, migration ability and cel cycle changes. Passage 3 bone marrow mesenchymal stem cel s were selected in the two groups and cultured in osteogenic induction medium. At 7 and 14 days of osteogenic induction, alkaline phosphatase staining was done;at 21 days of osteogenic induction, alizarin red staining was performed to observe calcium nodule formation. RESULTS AND CONCLUSION:After 1, 3, 5, 7 days of culture, the cel proliferative activity and cel cycle had no significant difference between the two groups, but the number of migrating cel s was significantly lower in the control group than the experimental group (P<0.05). At 7 and 14 days of culture, the alkaline phosphatase level was significantly higher in the experimental group than the control group (P<0.05);at 21 days of culture, calcium nodes formed in both two groups, but the calcium nodule area was larger in the experimental group than the control group. These findings indicate that bone xenograft materials have no cytotoxicity but possess good cytocompatibility, which can promote the proliferation, migration and osteogenic differentiation of bone marrow mesenchymal stem cel s.

Objective To validate the accuracy of the revised Atlanta classification (RAC) and the determinant-based classification (DBC) for severity of acute pancreatitis.Methods We retrospectively analysed the clinical data from 192 patients with acute pancreatitis who were admitted to our hospital between January 2014 and October 2014.Using the RAC and the DBC,The duration of total parenteral nutrition,length of ICU and hospital stay,operation rate and mortality were assessed in the subgroups,respectively.Results Fluid collections in and around the pancreas was present in 74 patients (38.5％),pancreatic or peripancreatic necrosis in 51 (26.6％),and infection in 18 (9.4％).On the basis of the RAC,106 patients (55.2％),77 patients (40.1％),and 9 patients (4.7％) were classified to have mild,moderately severe,or severe AP,respectively.On the basis of the DBC,11l (57.8％),62 (32.3％),14 (7.3％),and 5 (2.6％) patients were classified to have mild,moderate,severe,or critical AP,respectively.The different categories of severity for each classification system were significantly associated with the duration of total parenteral nutrition,the length of ICU and hospital stay,the operation rate and mortality.Conclusion Both the RAC and DBC accurately classified the severity of AP and differentiated prognosis in the subgroups of patients.

Objective To observe the effect of Zhi Qing Capsule on the plaque formation of hyperlipemia rabbits and to discuss its mechanism.Methods Forty-eight New-Zealand rabbits were randomly divided into normal control group,hyperlipemia group,Xuezhikang control group and three Zhi Qing capsule groups.Before and after 2-week treatment,the serum levels of total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C) and high density lipoprotein cholesterol(HDL-C) in the serum were determined.After 4-week treatment,TC and TG contents in the liver,and nitric oxide(NO),thromboxan B2(TXB2) and endothelin-1(ET-1) levels in the serum were measured.At the end of the sixth week,all rabbits were killed to observe aorta pathological changes.Results Zhi Qing Capsule can obviously counteract the increase of serum TC,LDL-C and liver TC in the hyperlipemia rabbits,restrain the formation of aorta atherosclerotic plaques,increase the level of NO and decrease the levels of TXB2 and ET-1.Conclusion Zhi Qing Capsule has an evident effect on resisting the lipid metabolism disturbance and atherosclerosis.

OBJECTIVE:To compare the therapeutic effect,adversere reactions and cost-effectiveness between granisetron and ondansetron in preventing nausea and vomiting caused by cancer chemotherapy.METHODS:Using pharmacoeconomic co_st-effectiveness analysis,the relevant therapeutic indices were evaluated.RESULTS:The effective rates of granisetron in preventing nausea and vomiting were 83.6% and 86.8% with an average cost of 210.48 yuans in a therapeutic couse,the cost-ef_fective ratio being 251.77 and 242.37,and those of ondansetron were 72.9% and 83.7% with an average cost of 381.35 yuans,the cost-effective ratio being 523.11 and 456.62.CONCLUSION:Granisetron can effectively prevent nausea and vomiting caused by cancer chemotherapy,and its cost-effective ratio is superior to that of ondansetron.