AIM: To establish the method for quality control of Quzhi Capsules(Radix et Rhizoma Rhei, Semen Cassiae, Herba Artemisiae Scopariae, Rhizoma Atractylodis, etc.). METHODS: Herba Artemisiae and Rhizoma Atractylodis in this medicine were identified by TLC. The content of chrysophanol was determined by HPLC on ODS column. The mobile phase was composed of methanol 0.5% phosphoric acid(85∶15,v∶v) and detection wavelength was at 254nm. RESULTS: The spots on TLC plates were clear without interference in the blank reference. The linearity of HPLC was good( r =0.9999), and the average recovery was 101.00%, RSD =1.3%. CONCLUSION: This method is simple, sensitive and accurate, and available for control of Quzhi Capsules.

Objective:To investigate the effects of Dexmedetomidine for supplemental anesthesia on perioperative hemodynamics and postoperative sedation and analgesia in elderly patients receiving radical gastric cancer surgery under general anesthesia.Methods:From January 2019 to April 2020, 63 patients admitted to our hospital for radical gastric cancer surgery were included as observation objects.They all underwent general anesthesia and were divided into the Dexmedetomidine group(odd-numbered group)and the normal saline group(even-numbered group)according to the parity of serial numbers the subjects were assigned to.Changes in perioperative hemodynamic index values and the amounts of anesthetic drugs used in the two groups were monitored and recorded, and postoperative sedation and analgesia effects were evaluated by using the Ramsay sedation scale and the visual analog scale(VAS).Results:The mean artery pressure(MAP)and heart rate(HR)were lower in the Dexmedetomidine group than in the normal saline group before anesthesia induction(T1), immediately after intubation(T3)and immediately after extubation(T5)( P<0.05). The Ramsay scores were higher and the VAS scores were lower in the Dexmedetomidine group than in the normal saline group at 1 h and 4 h after surgery( P<0.05). The doses of intraoperative propofol and remifentanil were lower in the Dexmedetomidine group than in the normal saline group[(1121.5±198.5)mg vs.(1395.6±332.7)mg, (3.1±0.9)mg vs.(5.5±1.2)mg, P<0.05]. Conclusions:The use of Dexmedetomidine for supplemental anesthesia can effectively maintain the stability of the patient's intraoperative hemodynamics and enhance the sedative and analgesic effects while reducing the amount of anesthetic drugs in patients receiving radical gastric cancer surgery under general anesthesia.

Objective To establish a method for the content determination of ferulic acid in Bogu Pill(BP). Methods Ferulic acid was obtained by ultrasonic extraction at room temperature and detected by HPLC. HPLC was performed with ODS chromatographic column, methanol-acetonitrile-1%acetic acid(15: 15: 70) as mobile phase and detection wavelength at 323 nm. Results The linearity of ferulic acid was in the range of 0.56 ?g～11.20 ?g/mL(r=0.9996), and the average recovery was 100.26%, RSD=1.48%. Conclusion This method was efficient and can be used for the quality control of BP.

Anesthesia safety plays an important role in the medical safety of the perioperative.At present the medical institutions in many countries apply crew resource management model for training and assessment in anesthesiology,surgery and emergency.It emphasizes the training of nontechnical skills,called crisis resource management(CRM).This article analyzes the causes of human error incidents and preventive measures and introduces CRM principles in medical principles and anesthesia correlation and applications.CRM helps to foresee the crisis of environment and deal with the crisis source to ensure the safety of patients.

Objective To explore the effection of four types of surgery for the treatment of adenoid hypertrophy . Methods 148 cases of with adenoid hypertrophy treated in our hospital between April 2012 and April 2015 were chose;they were randomly divided into 4 groups ,each group of 37 people .A group of patients with adenoid hypertrophy were taken traditional ade‐noidectomy curettage;Group B with nasal endoscopic adenoidectomy and cutting aspiration biopsy ;Group C by adenoidectomy shave their + residual endoscopic adenoidectomy bit cut method combined treatment ;Group D with nasal endoscopic adenoidectomy plas‐ma cutting treatment .The curative effect ,operation time ,blood loss were observed ;patients were followed‐up for half a year ,ade‐noidectomy residual rate and complications of each group were compared .Results The total effective rate of B ,C ,D three groups were significantly higher in group A patients (χ2 =7 .731 ,5 .045 ,7 .731 ,P<0 .05) ,the efficient between three groups was not sta‐tistically different (P>0 .05) .B ,C ,D three groups of operation time is significantly higher than A group of patients (t=5 .819 , 5 .829 ,2 .759 ,P<0 .05);B and C group had long operation time than group D (t=3 .555 ,3 .637 ,P<0 .05);But operation time of B and C had no significant difference between the two groups (t=0 .149 ,P>0 .149) .Bleeding of B and C group were significantly higher than group A (t=9 .305 ,4 .126 ,P<0 .05);Group D was significantly lower than A ,B ,C three group (t=8 .054 ,16 .559 , 12 .837 ,P<0 .05);Group C and group B was significantly higher than the bleeding (t=5 .739 ,P<0 .05) .Retention rate of group A is significantly higher than the other three groups (χ2 =31 .308 ,31 .308 ,24 .667 ,P<0 .05) ,the residual rate of B ,C ,B group were lower ,there was no statistically significant difference(P> 0 .05) .Complication rates between the four groups was no statistical difference(P>0 .05) .Conclusion we should choose the right means of surgical treatment according to patients condition and eco‐nomic situation to .

Objective To approach the selection of appropriate period and mode of blood purification for treatment of patients with severe acute pancreatitis(SAP)based on acute physiology and chronic health evaluationⅡ(APACHEⅡ)score. Methods The clinical data of 89 patients with SAP were retrospectively analyzed. They were assigned into two groups:the hemoperfusion(HP)and short continuous veno-venous hemodiafiltration(SCVVHDF) group(HP+SCVVHDF,49 cases)and the HP and hemodiafiltration(HDF)group(HP+HDF,40 cases). All the patients were evaluated by APACHEⅡscore. In the HP+HDF group,26 cases with APACHEⅡ<15 were in group A, while 14 cases with 15-25 in group B. In the HP+SCVVHDF group,31 cases with the score 15-25 were in group C, and 18 cases with<15 in group D. One week after the treatment,APACHEⅡscore,oxygenation index(PaO2/FiO2), C-reactive protein(CRP),serum creatinine(SCr),alanine transaminase(ALT)and mortality were observed in all the groups. Results Compared to those before treatment,the APACHEⅡ scores(group A:7.35±2.12 vs. 10.52±3.26,group B:14.35±4.76 vs. 18.43±4.08,group C:11.83±3.85 vs. 19.39±3.64,group D:6.92±2.54 vs. 11.61±2.19),the levels of CRP(mg/L,group A:85.28±23.48 vs. 195.23±56.77,group B:172.67±36.69 vs. 232.65±62.86,group C:112.43±29.48 vs. 257.29±68.39,group D:76.23±29.05 vs. 206.37±65.49),SCr (μmol/L,group A:107.56±73.01 vs. 225.81±119.06,group B:291.49±123.27 vs. 391.76±273.48,group C:254.89±104.37 vs. 403.62±261.53,group D:112.36±55.36 vs. 258.74±128.25)and ALT(U/L,group A:86.93±27.04 vs. 127.56±84.35, group B:116.34±43.98 vs. 189.15±102.85, group C:94.85±74.42 vs. 178.73±87.21,group D:88.49±29.32 vs. 138.24±90.58)after treatment were all decreased markedly in the four groups. The levels of PaO2/FiO2 were obviously higher in the 4 groups after treatment〔mmHg(1 mmHg=0.133 kPa), group A:293.42±31.26 vs. 253.60±26.62,group B:254.12±35.73 vs. 137.56±23.48,group C:283.21±37.48 vs. 131.96±0.45,group D:305.75±29.66 vs. 267.74±31.42〕,but no statistical significant differences in above indexes between group A and group D were found(all P>0.05),while the APACHEⅡ score,PaO2/FiO2,CRP, SCr and ALT were improved more significantly in group C than those in group B(P<0.05 or P<0.01). The mortality rate of those SAP patients with APACHEⅡscore<15 was lower than those in cases with APACHEⅡscore 15-20〔6.82%(3/44)vs. 24.44%(11/45),P<0.05〕. Conclusions Blood purification is an effective measure to save patients with SAP. The APACHEⅡ score used to select the mode of blood purification in appropriate period for treatment of SAP has guiding significance. Currently the modes of blood purification have limited value and cannot cure all SAP patients.

OBJECTIVETo observe the expression profiles of osteoblast-related genes in human mesenchymal stem cells (MSCs) derived from bone marrow during osteogenic differentiation.

METHODSMSCs were induced to differentiate with MSC osteogenic differentiation medium for 7, 14, 21 and 28 days respectively. Alizarin Red staining was used to detect matrix mineralization. Expression of osteoblast-related genes, including osteocalcin, osteopontin, Runt-related transcription factor 2 (Runx2), alkaline phosphatase and collagen type 1, was assessed with quantitative reverse transcription-polymerase chain reaction.

RESULTSOn day 14 after induction of differentiation, cells were stained positively with Alizarin Red. The expression levels of these genes exhibited an upward trend as induction time was prolonged. Exposure to osteogenic differentiation medium less than 21 days did not significantly induce osteocalcin expression; osteocalcin expression levels in the differentiated cells induced for 21 and 28 days were 1.63 and 2.46 times as high as the undifferentiated cells respectively (all P<0.05). Stimulation with MSC osteogenic differentiation medium over 14 days significantly enhanced bone marrow-derived MSCs to express osteopontin and Runx2 genes (all P<0.05). Osteogenic differentiation medium could significantly induce the expressions of alkaline phosphatase and collagen type1 genes (all P<0.05). Their expressions reached the peak levels on day 21, which were increased more than 4- and 3-fold respectively.

CONCLUSIONHuman bone marrow-derived MSCs could exhibit the sequential expression pattern of osteoblast marker genes during osteogenic differentiation in vitro.

Alkaline Phosphatase ; genetics ; Cell Differentiation ; Cells, Cultured ; Collagen Type I ; genetics ; Core Binding Factor Alpha 1 Subunit ; genetics ; Genetic Markers ; Humans ; Mesenchymal Stromal Cells ; metabolism ; Osteocalcin ; genetics ; Osteogenesis ; Transcriptome

Objective To study the expression and pathologic significance of CD147,cyclophilin A (CyPA)and cyclophilin B(CyPB)in psoriatic lesions.Methods Immunohistochemical method was ap- plied to detect the expression of CD147,CyPA and CyPB in skin specimens of 15 patients with psoriasis pustulosa(PP),20 patients with progressive psoriasis vulgaris(PPV),and 20 patients with inactive psori- asis vulgaris(IPV).Immunoreactivity intensity distribution index(IRIDI)was calculated to assess the expres- sion intensity of CD147,CyPA and CyPB.Results CD147,CyPA and CyPB were detected in all speci- mens.The IRIDI scores of CD147 and CyPA were significantly higher in keratinocytes of psoriatic lesions than in those of the control specimens(all P0.05).The IRIDI score of CyPB in T lymphocytes of PP lesions was significantly elevated than that in PPV lesions,which was in turn higher than that in IPV lesions(all P0.05).Conclusion CD147,CyPA and CyPB may play a role in the occurrence and development of psoriasis.

To investigate the utility of optomap panoramic 200Tx in screening fundus disease among the patients after cataract surgery.
●METHODS: From November 18 th to December 31st , 2013 all 146 post- cataract surgery patients were recruited. All non - mydriatic fundus images were taken with the optomap panoramic 200Tx and were diagnosed by one masked retinal specialist. Non - mydriatic direct ophthalmoscope exam and mydriatic slit-lamp lens exam were also done by other two masked specialists. Comparisons of the three methods were made.
●RESULTS: Among 146 patients ( 161 eyes), 40 eyes (24. 8%) of retinal lesions was detected by non-mydriatic direct ophthalmoscope exam, 59 ( 36. 7%) by non -mydriatic optomap 200Tx exam, and 61 (37. 9%) by slit-lamp lens exam. Nine eyes ( 5. 6%) needed medical intervention immediately. Results of optomap 200Tx exams and slit - lamp lens exams were similar without statistically significant difference ( P > 0. 05), better than direct ophthalmoscope exam ( P < 0. 05) with statistically significant difference.
● CONCLUSlON: Opacification of the refractive medium makes thorough fundus examination impossible. So post-operative fundus examination is highly necessary and should be a routine. Optomap panoramic 200Tx, which shows no statistically difference from mydriatc slit- lamp lens exam, is a convenient and feasible method in discovering fundus pathological changes.

Objective To analyze the correlation of hypersensitive C-reactive protein(hs-CRP),homocysteine(Hcy) and D-dimer(D-D) with pathological change degree of coronary heart disease(CHD),and to investigate the diagnostic specificity and sensitivity of joint detection in CHD.Methods A total of 100 cases of CHD patients(experimental group) and 100 healthy subjects(control group) were enrolled,.Patients of the experimental group were divided into four groups on the basis of complications,including simple CHD group(32 cases),amalgamating hypertension group(46 cases),amalgamating diabetes group(9 cases),amalgamating hypertension diabetes group(13cases).The levels of hs-CRP,Hcy and D-D in the five groups were detected and analyzed.Results The levels of hs-CRP,Hcy and D-D in the experimental group were all higher than the control group(P<0.05).Logistic regression confirmed that three indexes were the independent risk factors for CHD.Each indicator has a certain clinical significance to the diagnosis and treatment of CHD but the value of Hcy could be better.Joint detection of hs-CRP and Hcy could be an ideal combination of detection,and the three joint detection might not be suitable for early diagnosis and treatment of CHD.The levels of hs-CRP and D-D in simple CHD group,amalgamating hypertension group,amalgamating hypertension diabetes group were all higher than amalgamating diabetes group(P<0.05).Conclusion hs-CRP,Hcy and D-D could be the independent risk factors of CHD,and joint detection might be with important clinical value for diagnosis of CHD.