Microwave-assisted extraction was optimized with response surface methodology for HPLC-fluorescence determination of puerarin and daidzein in Radix Puerariae thomsonii.The optimized extraction procedure was achieved by soaking the sample with 70% methanol（1∶15,v/v）for 30 min,and then microwave irradiation for 11 min at a power of 600 W.Coupling the extraction process with HPLC-fluorescence presented good recovery,satisfactory precision,and good linear relation.Compared with a method from the Chinese Pharmacopoeia,the proposed method enables higher extraction efficiency and more accurate analytical results.It can be of potential value in quality assessment of Radix Puerariae thomsonii medicinal materials.

OBJECTIVE:To guarantee the reliability of cold chain drug storage device and the quality of the drugs in the hospi-tal. METHODS:The establishment and effects of drug cold chain monitoring platform in our hospital were introduced as well as re-lated improvement and measures. RESULTS:The cold chain monitoring platform was established in our hospital through equipping with related equipment, constructing platform network, determining monitoring point, setting early warning condition, etc. All-weather and real-time monitoring of temperature and humidity were realized for different districts of the hospital and different cold chain equipments. The platform could provide the information about operating condition of equipment,and complete drug re-frigeration temperature record;equipment failure could be dissolved in time based on early warning message. Through analyzing rea-sons of early warning message,the unqualified equipment was updated in time,which further improve the system and procedure of cold chain monitoring platform. Within 2 years after the implementation of the platform,53 sets of special refrigerator for drug were updated. Monthly early warning message and the rate of refrigeration equipment early warning decreased from 6869 and 100% in Sept. 2014 at the early stage of short message warning function to 1083 and 40% in Feb. 2016,respectively. CONCLU-SIONS:The establishment of drug cold chain monitoring platform guarantees the reliability of cold drug storage condition so as to ensure the quality of drug in the hospital.

OBJECTIVE:To improve the drug turnover rate and the work efficiency of drug storehouse,and to reduce the cost of drug storage. METHODS:Based on ABC dynamic classification,original drug procurement management module in HIS was im-proved. Scientific,accurate and reasonable drug procurement plan was generated by the system automatically through setting pro-curement proportion coefficient. Drug procurement by type was achieved through adding classification scanning function,based on distribution mode and drug property classification. Related index were compared before and after improvement to evaluate the ef-fects of the improvement. RESULTS:Compared with before improvement,average monthly inventory amount of drugs in our hos-pital reduced by 6.44%,turnover rate increased by 47.13%(increasing from 4.18% to 6.15%),and the time for developing pro-curement plan decreased by 75.00%(decreasing from 8 h to 2 h). CONCLUSIONS:The improvement of drug procurement man-agement module effectively reduce drug inventory and improve turnover rate of drugs and work efficiency.

Objective To investigate the effects of pancreaticoenterostomy by separating and continuous suture on pancreatoduodenectomy.Methods The clinical data of 76 patients who underwent curative pancreaticoduodenectomy from March 2002 to October 2014 in Tumor Hospital of Zhengzhou University were retrospectively analyzed.Of all the patients,43 received pancreaticoenterostomy by separating and continuous suture (study group),and the other 33 patients received BPJ anastomosis (control group).All the patients used Child reconstruction,the diagnosis of pancreatic fistula was made according to ISGPF criteria.The operation time of pancreaticoenterostomy,the incidence of hemorrhage of anastomosis and the incidence of pancreatic fistula were retrospectively analyzed.Results The age,sex,hemoglobin,albumin,total bilirubin,the incidence of co-morbidity of diabetes,extent of surgical resection between 2 groups were comparable without significant difference.In study group,the time of pancreaticoenterostomy was 11 min(8 ～ 15 min),there were 4 patients with class Ⅰ pancreatic fistula,and 1 patient with class Ⅱ pancreatic fistula.No patient developed class Ⅲ pancreatic fistula or anastomotic bleeding.In control group,the time of pancreaticoenterostomy was 16 min(12 ～25 min) which was only available for 5 patients,and no records for other patients.There were 6 patients with pancreatic fistula including 4 patients with class Ⅱ,2 patients with class Ⅲ,while no records for class Ⅰ.Four patients were found to have anastomotic bleeding.Conclusions With the pancreaticoenterostomy by separating and continuous suture method,the surgical field is fully exposed,the suture time is shortened and the incidence of anastomotic bleeding and pancreatic fistula is reduced.

Objective To investigate the efficacy of wrapping and suturing of pancreatic stump with the avascular zone of the transverse mesocolon for preventing pancreatic leakage after distal pancreatectomy.Methods The clinical data of 69 patients who received distal pancreatectomy at the Affiliated Tumor Hospital of Zhengzhou University from May 2011 to March 2014 were retrospectively analyzed.The pancreatic stump was wrapped with the avascular zone of the transverse mesocolon after suturing the pancreatic stump in 34 patients (the modified group),and the pancreatic stump of 34 patients was sutured without any other treatment (the control group).The time for pancreatic stump management,complications,time for drainage tube placement and duration of postoperative hospital stay of the 2 groups were compared.Patients were followed-up through outpatient examination and telephone interview till June 2014.The measurement data and the count data were analyzed using the t test and the chi-square test,respectively.Results The time for pancreatic stump management of the modified group and the control group were (15.2 ± 2.1) minutes and (13.2 ± 3.2) minutes,with no significant difference between the 2 groups (t =1.565,P ＞ 0.05).No patient was complicated with other diseases in the modified group,while 9 patients in the control group was complicated with pancreatic fistula,with significant differences between the 2 groups (x2=9.399,P ＜0.05).The time for drainage tube placement of the modified group and the control group were (6.1 ± 2.2) days and (16.6 ± 3.5) days,the duration of postoperative hospital stay were (12.5 ± 2.5) days and (21.5 ± 3.5) days,with significant difference between the 2 groups (t =-11.902,-9.853,P ＜ 0.05).Sixty-three patients were followed up from 1 to 35 months with a mean time of 15 months.Fifteen patients died,and the condition of other patients was normal.Conclusion Wrapping and suturing of the pancreatic stump with the avascular zone of the transverse mesocolon is effective for preventing the pancreatic leakage after distal pancreatectomy and shortens the time of postoperative hospital stay.

Objective To investigate the clinical efficacy of three dividing lines in radical right hemicolectomy for right colon cancer.Methods The clinical data of 166 patients with right colon cancer (including ileocecal cancer,ascending colon carcinoma and hepatic flexure of the colon) who were admitted to the Affiliated Tumor Hospital of Zhengzhou University from March 2009 to August 2014 were retrospectively analyzed.Eightythree patients who underwent radical right hemicolectomy via three dividing lines were allocated to the modified group and 83 patients who underwent radical right hemicolectomy via medial approach were allocated to the control group.The operation time,volume of intraoperative blood loss,number of lymph node dissection and processing time and volume of the superior mesenteric vein (surgical trunk) hemorrhage were analyzed between the 2 groups.Patients were followed up by outpatient examination and telephone interview till November 2014.The measurement data with normal distribution were presented as x ± s.The comparison between groups was analyzed using t test.The count data were analyzed by the chi-square test.Results The operation time in the modified group and in the control group were (75 ± 7) minutes and (109 ± 13) minutes,respectively,with a significant difference (t =-36.700,P ＜0.05).The volume of intraoperative blood loss and number of lymph node dissection in the modified group were (118 ± 15)mL and 19 ±4,which were not significantly different from (116 ±22)mL and 18 ± 3 in the control group (t =0.104,12.300,P ＞ 0.05).During D3 lymph node dissection,the incidence of hemorrhage of the superior mesenteric vein,processing time of hemostasis and volume of blood loss were 3.6％ (3/83),(7 ± 3) minutes and (103 ± 25) mL in the modified group and 9.6％ (8/83),(20 ± 5) minutes and (209 ± 37)mL in the control group,respectively.There was no significant difference in the incidence of hemorrhage of the superior mesenteric vein between the 2 groups (x2 =2.434,P ＞ 0.05).There were significant differences in the processing time of hemostasis and volume of blood loss between the 2 groups (t =38.100,29.200,P＜0.05).The patients were followed up for 3 months to 5 years with a median time of 22 months.Of 166 patients,23 died,11 were loss to follow-up and others survived at the end of follow-up.Conclusion Three dividing lines is safe and feasible in radical right hemicolectomy for right colon cancer,with a good clinical efficacy.

Background and purpose: The clinical and pathological characteristics and treatment strategy for the patients with testicular diffuse large B cell lymphoma still need to be further studied. This study was done to evaluate the diagnosis and strategy for the disease by retrospective analysis of 21 patients with testicular diffuse large B cell lymphoma. Methods: 21 patients with pathologically proved as diffuse large B cell lymphoma after surgery in the Sun Yat-sen University Cancer Center and The Guangzhou General Hospital of PLA from September 2002 to April 2009 were accrued. There were 3 in stage Ⅰ_E , 4 in stage Ⅱ_E , 5 in stage Ⅲ_E and 9 in stage Ⅳ according to Ann Arbor stage standard. All patients received adjuvant chemotherapy with CHOP regimen initially after operation. Radiotherapy or other salvage chemotherapy regimen was given after failure of the initial treatment. The follow-up information was collected for to all of the patients. Results: Follow-up time ranged from 10 to 83 months. After completion of first-line chemotherapy(CHOP), overall response rate was 72.2%(13/18)with complete remission (CR) rate of 33.3%(6/18)and partial response rate(PR) of 38.9%(7/18). 3 patients in stage Ⅰ_E survived free from disease until now. Tumor relapsed and refractory eases were observed in 10 patients, and they all showed little response to chemotherapy with a response rate of 30.0%(3/10). Among the 21 patients, 11(52.3%) cases died of the disease with a median survival time of 28 months. Of these 21 patients, 7 patients were CD10(+), 5 patients overexpressed bel-6, 12 patients were bcl-2(+), and 15 patients overexpressed MUM1.Overexpressed bcl-2 and MUM1 indicated bad prognosis. Conclusion: Most of the testieular diffuse large B cell lymphoma patients were non-GCB. And they were sensitive to CHOP chemotherapy. The results suggested that all patients should receive chemotherapy after surgery. It was curable in the early stage. However,the options of treatment method for the patients with relapsed and refractory cases are limited and need to be further explored.

This study is designed to test the agreement in measuring left ventricular systolic function between transthoracic two-dimensional echocardiography (2DTTE) and "gold standard" of non-invasive cardiac imaging, magnetic resonance imaging (CMRI) and their impacts on the classification of patients according to the left ventricular ejection fraction (EF). 32 patients who were suspected with heart disease were evaluated by CMRI and 2DTTE examinations. End diastolic volume (EDV), end systolic volume (ESV), EF and left ventricular function category were then calculated and compared. There was no significant difference (P=0.504) for EDV, while ESV of CMRI was significantly higher than that of 2DTTE (P=0.049), and EF of CMRI was significantly lower than that of 2DTTE (P= 0.018). There was no significant difference (P=0.077) in left ventricular functional category. Bland-Altman analysis of LV volumetric data and EF measurements showed a good agreement between two methods. The 2DTTE over-estimated I (n=5) or II (n=1) degrees of functional classification when compared with the CMRI. Both CMRI and 2DTTE are of great clinical value in evaluating left ventricular systolic function, while CMR may be more beneficial to patients with abnormal LV functions.
Adolescent ; Adult ; Aged ; Echocardiography ; Female ; Heart Diseases ; physiopathology ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Retrospective Studies ; Systole ; physiology ; Ventricular Function, Left ; physiology ; Young Adult

ObjectiveTo explore the incidence of peristomal dermatitis in patients with colorectal cancer (CRC) receiving colostomy and to discuss the effects of related factors on its incidence. Methods? The clinical data of totally 397 CRC patients who received colostomy from January 2013 to December 2015 in Chinese PLA General Hospital were collected, and the incidence of peristomal dermatitis in these patients were analyzed. Results? Totally 146 of the 397 patients sustained peristomal dermatitis once or several times, with an incidence rate of 36.78%. Logistic regression analysis showed that body weight changes≥ 5 kg, adjuvant chemotherapy, adjuvant radiotherapy, comorbidities, diabetes, ileostomy and loop-type colostomy were independent risk factors of peristomal dermatitis, while regular guidance from colostomy surgeons and perioperative colostomy positioning were protective factors of peristomal dermatitis. Conclusions? We should control the independent influencing factors of peristomal dermatitis or take corresponding measures to reduce the incidence of peristomal dermatitis when providing clinical care and continuing care for CRC patients receiving colostomy.

OBJECTIVETo compare the efficacy of proximal gastrectomy(PG) and total gastrectomy(TG) for adenocarcinoma of esophagogastric junction.

METHODSClinical trials comparing PG with TG for adenocarcinoma of esophagogastric junction published from 1990 to 2012 were searched in Cochrane library, Medline, Embase and China National Knowledge Infrastructure (CNKI), Wanfang Data. Review manager 5.0 was used for meta-analysis and outcome measures included mortality and complication morbidity, as well as nutritional state.

RESULTSA total of 10 studies including 2481 patients were identified and analyzed. The results showed no significant differences in the mortality(OR=1.00, P=0.99) and complication morbidity(OR=2.14, P=0.12) between PG and TG. However, anastomotic stenosis(OR=5.40, P<0.01) and reflux esophagitis(OR=7.12, P=0.01) were more frequently observed in PG group. The nutritional state in TG group was comparable with PG group(WMD=2.09, P=0.57).

CONCLUSIONTG is superior to PG in reducing the morbidity of anastomotic stenosis and reflux esophagitis.

Adenocarcinoma ; surgery ; China ; Clinical Trials as Topic ; Esophagogastric Junction ; surgery ; Gastrectomy ; methods ; Humans ; Stomach Neoplasms ; surgery