Objective: To establish the fingerprint of Xuesaitong Dropping Pills (XDP) using ultra-high pressure liquid chromatography (UPLC), determine the content of its main components and propose a chemometrics method for the systemic, comprehensive and scientific quality evaluation. Methods: The Agilent 1290 UPLC and Acquity UPLC BEH C18 column were used for the establishment of the UPLC fingerprints of 14 batches of XDP with acetonitrile and water as mobile phase for gradient elution, and the content of five kinds of notoginsenosides wsa determined. Then, the further quality assessment of XDP was carried out with similarity evaluation, principal component analysis (PCA) and orthogonal partial least squares discriminant analysis (OPLS-DA). Meanwhile, the Hotelling’s T2 and DModX control ranges were set for the different batches of samples. Results: Among the 14 batches, the content of five kinds of notoginsenosides was relatively stable, and the quality control ranges for notoginsenosides R, ginsenoside Rg1, Re, Rb1, Rd were set at 24.69-30.03 mg/g, 102.60-122.44 mg/g, 12.93-15.45 mg/g, 99.74-112.12 mg/g, and 23.35-31.75 mg/g, respectively. In this research, 15 chromatographic peaks were recognized as common peaks in the fingerprints, five peaks were identified with standard references compounds, which were notoginsenoside R1, ginsenoside Rg1, ginsenoside Re,ginsenoside Rb1 and ginsenoside Rd. The similarity values of the drugs were all above 0.998. In the PCA analysis, 14 batches of samples had no abnormal batch, indicating that the quality was relatively stable, however, the difference of the storage time was reflected in the fingerprint. According to the OPLS-DA result, the quantitative ginsenoside Rb1 and ginsenoside Rd had greater influence on the variables causing the gradual trend in 14 batches of samples. The upper limit of control for Hotelling’s T2 and DModX was 31.17 and 1.82, respectively. Conclusion: The established method was accurate, reliable, and simple. It can be used not only for the quality control of XDP, but also for the comprehensive evaluation of batch consistency. The study also provides a reference for solving the common problem of the consistency evaluation of Chinese materia medica.

Objective Taking the concentration process of liquorice extract as the research object, the dynamic simulation process of concentration of Chinese materia medica (CMM) was constructed by combining experimental analysis with theoretical simulation, which provided the model support and theoretical analysis basis for the process research and equipment development of concentration process of CMM. Methods The corresponding relationship between boiling point and saturated vapor pressure of liquorice solution was determined by dynamic method. The experimental data were fitted by thermodynamic model to obtain relevant parameters. On this basis, the simulation process of liquorice water extract concentration was constructed by using ASPEN PLUS. According to the simulation of dynamic process, the effects of heating power, feed rate, and vacuum degree on liquorice solution concentration process in an external thermal concentrator were discussed. Finally, the equations about concentration time and heating power were obtained by simulation. Results The results of parameter fitting were Aij = 1.63, Aji = 2.32, Bij = 336.38, Bji = 792.00, and Cij = 0.5. Finally, the functional equation for the concentration time and heating power was t = 2 329 c1H/c0Q. Conclusion In this study, the effects of different process parameters on the concentration process of TCM were analyzed by simulation and related theories, and a simple prediction of the concentration process was realized. It also perfected and optimized the process simulation data, filled the relevant scientific research gap, and was of great significance to industrial guidance. Firstly, the relevant experimental data was obtained by fitting the thermodynamic model with the relevant experimental data. Then, under the ideal process conditions, the influencing factors of liquorice concentration process were analyzed and discussed by dynamic simulation. It was concluded that heating power was the key factor affecting the concentration process, and the concentration time gradually decreased with the increase of heating power. However, their functional relationship was non-linear. At the same time, the functional equation can be used to roughly predict the concentration time of CMM. To a certain extent, this fills in the gap between the related theoretical research and data of chemical thermodynamics, which provides theoretical support for the process research and equipment development of the concentration process of CMM.

Objective: To evaluate the safety and feasibility of hybrid thoracoscopic surgery and catheter ablation in treating the patients of long-standing persistent atrial fibrillation (AF) with preliminary experience. Methods: A total of 15 consecutive relevant patients treated in our hospital by hybrid thoracoscopic surgery and catheter ablation from 2014-04 to 2016-03 were studied. The average AF time was (4.0±3.9) years including 13 male. All patients received thoracoscopic surgical ablation including pulmonary vein isolation, left atrial (LA) posterior wall isolation, Waterston's groove Ganglionated plexi ablation by bipolar radiofrequency ablation clamp and LA appendage removal, Marshall ligament dividing. Then establishing LA 3D-modeling, based on LA 3D voltage mapping, catheter ablation was conducted to reinforce surgical ablation or modification in order to confirm bidirectional blocking. Meanwhile, LA ridge and mitral isthmus ablation was performed, some patients received LA anterior wall and tricuspid isthmus ablation. The patients were followed-up at 3, 6 and 12 months after the procedure. Results: 13 patients were restored to sinus rhythm after the procedure and no operative complications occurred. The average follow-up time was (12.1±11.5) months. 2 patients with recovered sinus rhythm had re-catheter ablation since atrial flutter at 3 months post-procedure and sinus rhythm was restored. The overall success rate was 86.7% (13/15), no patient had anti-arrhgthmia medication. Conclusion: Hybrid thoracoscopic ablation and catheter ablation have been a minimally invasive, safe and effective method in treating the patients of long-standing persistent AF.

OBJECTIVEThe pathophysiology of beta-thalassemia is the imbalance of the alpha and non-alpha globin chain which leads to a series of clinical symptoms of hemolytic anemia. Scientists continuously try to explore gene-activated drugs to increase the level of non-alpha globin chain or decrease the level of alpha globin chain in the treatment of beta-thalassemia. To probe into the effects on globin-gene expression of meisoindigo (Me) in cultured erythroid cells derived from peripheral blood, so as to provide the theoretical basis for applying Me in the treatment of beta-thalassemia.

METHODSBy using the two-step liquid culture of erythroid progenitor cells and reverse transcription polymerase chain reaction (RT-PCR), and by using alpha mRNA as an inner control, the level of gamma mRNA and beta mRNA in cultured erythroid cells derived from peripheral blood of 11 patients with severe beta-thalassemia and 6 normal volunteers were measured under the effect of different concentration (2.5 micro mol/L, 5 micro mol/L and 10 micro mol/L) of Me.

RESULTS(1) No statistic significance was found in the ratio of beta/alpha mRNA by Me in cultured cells from both normal individuals and beta-thalassemia. (2) Me can significantly increase the ratio of gamma/alpha mRNA and (beta + gamma)/alpha mRNA (that is non-alpha/alpha mRNA) in cultured cells from normal individuals and beta-thalassemia. The ratio of gamma/alpha mRNA was increased 0.31 - 0.45 times and the ratio of non-alpha mRNA/alpha mRNA increased 0.21 - 0.32 times in Me induced cells from normal individuals. No significant result was observed among the different concentrations of Me (2.5 micro mol/L, 5 micro mol/L and 10 micro mol/L) in normal individuals. With the increasing of Me concentrations, the ratios of gamma/alpha mRNA and alpha/alpha mRNA were increased in cultured cells from beta-thalassemia. The ratio of gamma/alpha mRNA was increased 0.33 - 1.17 times and the ratio of non-alpha/alpha mRNA increased 0.25 - 0.89 times in Me induced cells from beta-thalassemia. There was no significant difference between the concentrations of 2.5 micro mol/L and 5 micro mol/L concentration in beta-thalassemia. However, there was significant difference between the concentrations of 10 micro mol/L and the concentrations of 2.5 micro mol/L and 5 micro mol/L in beta-thalassemia. (3) The increase of the ratio of gamma/alpha mRNA and non-alpha/alpha mRNA in beta-thalassemia was higher than that in normal individual with induction by Me with a higher concentration (10 micro mol/L).

CONCLUSIONMe can raise the ratio of gamma/alpha mRNA and non-alpha/alpha mRNA in cultured erythroid cells derived from peripheral blood of both normal individual and beta-thalassemia in the level of transcription, which can improve the imbalance of the alpha and non-alpha globin chain. So Me has a latent value in the therapy of beta-thalassemia.

Cells, Cultured ; Child ; Child, Preschool ; Erythroid Precursor Cells ; drug effects ; metabolism ; Female ; Gene Expression ; drug effects ; Globins ; genetics ; Humans ; Indoles ; pharmacology ; Infant ; Male ; RNA, Messenger ; drug effects ; metabolism ; Reverse Transcriptase Polymerase Chain Reaction

Bronchoalveolar Lavage ; Extracorporeal Membrane Oxygenation ; Humans ; Male ; Middle Aged ; Pulmonary Alveolar Proteinosis ; therapy

Objective: To preliminarily analyze the graft flow of right internal mammary artery (RIMA) in patients after coronary artery bypass grafting (CABG) using bilateral internal mammary artery (BIMA). Methods: A total of 52 patients received CABG by BIMA in our hospital from 2015-12 to 2016-07 were studied. The patients were younger than 65 years at the mean age of (56.6±6.8) years including 46 male. According to conduit grafting to left anterior descending artery (LAD), the patients were divided into 2 groups: RIMA anastomosed to LAD group, n=42 and LIMA anastomosed to LAD group, n=10. The immediate graft flow was measured by Veri Q system, surgical outcomes and graft flows were compared between 2 groups. Results: There were no operative death in all 52 patients, 1 had poor wound healing and received debridement and suturing, no one had operative complication in left 51 patients. The average LAD bridge flow in both groups were (28.7±11.5) ml/min and (31.8± 11.7) ml/min, the mean pulsation index (PI) were (2.3±0.7) and (2.0±0.4), P>0.05; the average RIMA graft flow were (28.7±11.5) ml/min and (21.1±11.0) ml/min, the mean PI were (2.3±0.7) and (2.6±1.1), P>0.05. Conclusion: Flows in RIMA-LAD graft and LIMA-LAD graft were similar; the flow of RIMA anastomosed to other target vessel was satisfactory which was an ideal graft for CABG.

With the dropping process of Xuesaitong Dropping Pills(XDP) as the study object, critical factors affecting the quality indicators of pill pass rate, average weight of drop pills and roundness were screened out, so as to deepen the understanding of the dropping process. The critical process units, critical quality attributes and potential critical process influencing factors of XDP were determined by risk analysis and prior knowledge, and then the critical influencing factors were screened out by Plackett-Burman design. First, according to the risk assessment, the critical technique of XDP preparation process was dropping, and then the critical quality attributes of dropping process were pill pass rate, average weight of drop pills and roundness. Then, according to fishbone diagram and failure mode and effects analysis(FMEA), potential critical influencing factors were determined as flow rate, matrix ratio, solid-liquid ratio, feed-liquid temperature, top temperature of condensate, bottom temperature of condensate and dropping distance. Finally, among these seven potential factors, the critical influencing factors were determined as material liquid ratio, dropping distance, top temperature of condensate, bottom temperature of condensate. This study revealed the potential of Plackett-Burman design in screening and understanding the influence of selected factors on XDP dropping process, which could provide a reference for studying the dropping process.
Drugs, Chinese Herbal ; Saponins ; Temperature

Genetic as well as genomic study has advanced the development of precision medicine. We are marching on the road for right patients who are receiving more and more right treatment at right time. In hypertension field, precision medicine is available, actionable and affordable. First and the most practical advancement is monogenic hypertension, the disease-genes have been found for at least 17 types of monogenic hypertension. These patients can be precisely treated according to their carried gene mutation. Secondly, pharmacogenetic and pharmacogenomic guided anti-hypertensive drug selection, very promising but lack of clinic outcome data to support widely clinical application. Majority of hypertension are due to multiple genetic and environmental factors. GWAS fund some genetic variants related to primary hypertension, but these variants can only be responsible for 1-10% of blood pressure variation. We have a long way to go in exploring the real cause of primary hypertension.

Objective    To analyze the correlation between the gray value of epicardial fat and the prognosis of patients with atrial fibrillation (AF) treated by thoracoscopic radiofrequency ablation. Methods    The clinical data of 97 patients, including 75 males and 22 females with an average age of 57.8±9.4 years, who underwent thoracoscopic radiofrequency ablation in Fuwai Hospital from 2017 to 2018 were analyzed retrospectively. The left atrial fat volume and average gray scale were calculated by left atrial enhanced CT. According to the average gray scale of left atrial fat tissue, the patients were divided into three groups: a high gray scale group, a medium gray scale group and a low gray scale group. The patients were followed up at 3, 6 and 12 months after operation. The end point of follow-up was the recovery rate of sinus rhythm. Survival analysis was used to analyze the correlation between CT features of epicardial fat enhancement and prognosis. Results    After adjustment of body mass index, body surface area, gender and left atrial end diastolic diameter, regression analysis showed that the fat gray of left atrial enhanced CT was correlated with the type of AF (OR=0.30, 95%CI 0.12-0.79, P=0.014). Cox regression analysis showed that the fat gray value of left atrial CT predicted the recurrence of AF after thoracoscopic radiofrequency ablation (OR=0.92, 95%CI 0.85-0.99). The Kaplan-Meier curve showed significant difference in the long-term recurrence rate of AF among the three groups (P=0.011). The lower left atrial fat enhanced CT gray scale was, the higher long-term recurrence rate of AF was. Conclusion    The gray value of left atrial fat enhanced CT can effectively predict the recurrence of AF after radiofrequency ablation in thoracoscopic surgery.

Objective    To evaluate short-term clinical outcomes of skeletonized bilateral internal mammary artery (sBIMA) in coronary artery bypass grafting (CABG). Methods    The clinical data of 62 patients (54 males and 8 females with an average age of 56.8±6.0 years) undergoing isolated CABG using sBIMA in our hospital from October 2016 to May 2017 were retrospectively analyzed. The coronary graft flow, perioperative clinical outcomes and CT results were reviewed. Results    All the operations were carried out under extracorporeal circulation. Anastomosis of 124 internal mammary arteries was performed and 116 great saphenous veins were used simultaneously with an average anastomosis site of 4.5±0.8 for each patient. The cardiopulmonary bypass time was 116.4±22.9 min, aortic clamping time was 83.0±18.3 min, mechanical ventilation time was 20.8±21.3 h and ICU stay was 2.7±1.7 d. The graft flow of left internal mammary artery (LIMA), right internal mammary artery (RIMA) and great saphenous vein were 28.8±12.4 mL/min, 32.8±13.8 mL/min and 41.5±21.5 mL/min, respectively. There was no significant difference in the graft flow between LIMA and RIMA (P=0.112). There was no perioperative mortality, myocardial infarction or cerebrovascular accident. Only one male patient suffered sternal complication and poor wound healing and then received debridement as well as suturing. Coronary CT angiography showed that distal anastomosis of 7 vein grafts and 5 artery grafts was demonstrated shallow and 1 vein graft was undemonstrated, suggesting occlusion. Conclusion    CABG with sBIMA is a safe and reliable technique with excellent early results.