ObjectiveTo study the clinical features, treatment and prognosis of hepatic hemangioma. MethodsClinical treatment of 160 cases of hemangioma was analyzed retrospectively, including partial hepatectomy in 66 cases, suture ligation in 30 cases, hepatic embolization performed in 37 cases, radiotherapy in 27 cases. Follow up was made from six months to 3 years. ResultsPartial hepatectomy has a recurernce rate of 4% in 3 years . Suture ligation was found with recurernce rate of 40% for 3 years. Hepatic artery embolization failed to hamper the growth of hemangiomas in 67% of the 37 cases. ConclusionPartial hepatectomy is the treatment of choice for patients suffering from a single huge hemangioma.

Objective To explore the feasibility of carrying out the common imprecision range among different biochemical systems in different laboratories.Methods Biochemical professionals visited 18 third-grade class A hospitals in Hebei Province,investigated the internal quality control data of 21 biochemical tests and made classification according to certain parameter criterias.Data were collected from April to September,2010 and calculated for cumulative mean,standard deviation (s) and CV.Data were compared according to 1/3,1/4 of TEa established by CLIA'88 and allowable CVb％ derived from biological variants.Results Among 18 hospitals,5 (27.8％) set their target value by mean value of 6 months,5(27.8％) by continuous 20 days and 8(44.4％) by the given value of the supplier.CVs of 21biochemical tests were quite different among 18 biochemistry laboratories,in which LDH was 6.79 times and CK was 76.79 times different from one another.35.5％-94.1％ biochemical tests met the requirement of CV ＜ 1/3TEa and 0.0％-91.7％ met the requirement of CV ＜ 1/4TEa.0.0％-94.1％ of tests were below allowable CVb％ 16/21 (76.2％) tests could satisfy the requirement of CV ＜ 1/3TEa.The top five tests which didn't meet the requirements were Na,Urea,TBIL,ALT and Glu.Conclusions The internal quality control among biochemistry laboratories in Hebei Province has not been standardized yet.According to the survey data,biochemistry laboratories of third-grade class A hospitals may set 75％ point of imprecision as a reference.After a period of improvement,we will set common imprecision range among biochemistry laborotories in Hebei Province and even in China.

This study established a population pharmacokinetics-pharmacodynamics model of clopidogrel in patients with acute coronary syndrome. Fifty-nine patients were enrolled. The plasma concentration of clopidogrel active metabolite and vasodilator stimulated phosphoprotein platelet reactivity index (VASP-PRI) were selected as the pharmacokinetics index and the pharmacodynamics index, respectively. The covariates including demographic characteristics, laboratory indexes, combined medication, complications and genetic polymorphisms of related enzymes were screened for their influence on the pharmacokinetic and pharmacodynamics parameters. Population pharmacokinetic and pharmacodynamics data analysis was performed using NONMEM software. The general linear model and the indirectly effect model-turnover model for pharmacokinetic and pharmacodynamic analysis were selected as the basic model, respectively. The population typical values of K12, CL/F, V/F, EC50, K(in), and E(max) were 0.259 h(-1), 179 L x h(-1), 632 L, 1.57 ng x mL(-1), 4.29 and 0.664, respectively. CYP2C19 was the covariate in the final pharmacokinetic model, and the model was to design a prior dosage regimen.

Objective To evaluate the long-term clinical effect of Thoracic endovascular aortic repair (TEVAR) for traumatic Type B aortic dissection,and to provide a reference for the next stage treatment.Methods Twenty-one patients with traumatic Stanford type B aortic dissection treated in our center from December 1999 to June 2012 were retrospectively analyzed for the treatment effectiveness and follow-up results.The average age of 21 Traumatic Type B aortic dissection patients was 42.7 years (range:19 to 67 years).Men accounted for 85.7％ (18/21).80.9％ (17/21) of the dissection were caused by car accident,4 were due to falling accident from high places.There were 7 cases of hypertension,4 cases of diabetes,4 cases of hyperlipidemia,2 cases of chronic ischemic heart disease,14 cases of pneumothorax,8 cases of rib fracture,3 cases of craniocerebral trauma / neuropsychiatric symptoms,and 1 patient with shock.The median time from onset to treatment was 5 days (range:1-73 days).There were 16 cases (≤14 days) in the acute phase,2 cases (15-60 days) in the subacute phase,and 3 cases (＞ 60 days) in the chronic phase.There was no patient in super acute phase in the study group (0-24 hour).Results The perioperative mortality was 9.52％ (2/21) for the patients traumatic type B aortic dissection,4.76％ (1/21)for those with postoperative endoleaks;2-year and 5-year survival rates were 90.48％ and 85.71％.Conclusion Intracavitary treatment of traumatic Stanford B type aortic dissection is effective and has good long-term clinical benefit,which provides a guidance for future clinical treatment of traumatic type B aortic dissection.

OBJECTIVETo elucidate the immunomodulatory mechanism of phenylethanoid glycosides from the seeds of Plantago asiatica by testing its effects on the maturing of murine bone marrow derived dendritic cells (DCs).

METHODMonocytes generated from bone marrow of Balb/cj mouse were cultured for 6 days in complete RPMI 1640 medium containing 10% FBS, rmGM-CSF and rmIL-4.50 mg x L(-1) acteoside or isoacteoside was added to cells on day 6 of culture for 24 h. The surface molecules expression level of DCs and their phagocytose ability were analysis by flow cytometry.

RESULTBoth acteoside and isoacteoside could increase the expression of CD11c, CD86, MHC II and CD80 on DCs surface. The ability of unstimulated DCs to uptake FITC-dextran was higher than that of phenylethanoid glycosides or LPS treated DCs.

CONCLUSIONBoth acteoside and isoacteoside could induce maturation of murine dendritic cells.

Animals ; B7-1 Antigen ; immunology ; metabolism ; B7-2 Antigen ; genetics ; immunology ; Cells, Cultured ; Dendritic Cells ; drug effects ; immunology ; Gene Expression ; drug effects ; Glycosides ; pharmacology ; Male ; Mice ; Mice, Inbred BALB C ; Phagocytosis ; drug effects ; Plant Extracts ; pharmacology ; Plantago ; chemistry ; Seeds ; chemistry

OBJECTIVE： To evaluate efficacy and safety of individualized antiplatelet therapy in patients with coronary artery disease （CAD） systematically according to the results of laboratory examination， and to provide reference for individualized antiplatelet therapy in clinic. METHODS： Retrieved from PubMed， Embase and the Cochrane library during the establishment of database to Feb. 2018， RCTs about individualized antiplatelet therapy vs. routine antiplatelet therapy in CAD patients based on the results of laboratory examination were collected. Meta-analysis was conducted for the incidence of main adverse cardiovascular adverse events （MACE）， all-cause death， cardiovascular death， myocardial infarction， stent thrombosis， stroke and severe bleeding by using Rev Man 5.3 statistical software after data extraction and quality evaluation with Cochrane system evaluator manual 5.2.0. Subgroup analysis was carried out for different races， laboratory testing methods and intervention courses. RESULTS： Totally 7 RCTs involving 8 615 patients were included. Results of Meta-analysis showed that compared with routine antiplatelet therapy， there was no significant difference in the incidence of MACE [RR＝0.93， 95％CI （0.74， 1.16）， P＝0.51]， all-cause death [RR＝0.89， 95％CI （0.56， 1.41）， P＝0.61]， cardiovascular death [RR＝0.68， 95％CI （0.36， 1.25）， P＝0.21]， myocardial infarction [RR＝1.03， 95％CI （0.92， 1.16）， P＝0.56]， stent thrombosis [RR＝0.52， 95％CI （0.22， 1.24）， P＝0.14]， stroke [RR＝1.03， 95％CI （0.65， 1.63）， P＝0.90]， and severe bleeding [RR=0.78，95％CI （0.53， 1.14）， P＝0.20] based on the results of laboratory examination. Subgroup analysis showed according to CYP2C19 genotype， individualized medication could reduce the incidence of MACE [RR＝0.29， 95％CI （0.14， 0.64）， P＝0.002] and all-cause death [RR＝0.11， 95％CI （0.01， 0.87）， P＝0.04]， and trials with intervention duration of 6 months could significantly decrease the incidence of all-cause death [RR＝0.11， 95％CI （0.01， 0.87）， P＝0.04]， there were no significant difference between 2 groups in other subgroup analysis. CONCLUSIONS： Compared with routine antiplatelet therapy， individualized antiplatelet therapy based on the results of laboratory examination cannot reduce the incidence of MACE and bleeding event risk in real-world patients with CAD. Although subgroup analysis show that individualized medication on the basis of CYP2C19 genotype can significantly reduce the incidence of MACE and cardiovascular death. But more large-scale samples and high-quality studies are needed to confirm this conclusion.

Objective: To investigate the relationship between the maximum thickness of carotid atherosclerotic plaque and the incidence of complications after carotid stenting in patients with severe carotid stenosis. Methods: The clinical data of 85 patients with severe carotid stenosis undergoing CAS were analyzed. The maximum thickness of carotid plaque was evaluated according to ultrasound imaging data.Patients were divided into two groups according to the optimal threshold value: 0.435 mm, which calculated in the ROC curve of plaque thickness. The incidence of complications within two years after CAS was analyzed. Results: 85 patients were followed up for 2 years: restenosis occurred in 12 cases, the incidence rate was 14.1%, which was significantly correlated with the maximum thickness of atherosclerotic plaque(P=0.002). Postoperative restenosis occurred in 2 cases (3.70%) in group A and 10 cases (32.26%) in group B(P<0.001); Three cases (9.68%) suffered from relapsing cerebral infarction in group B compared to none in group A(P=0.020). Conclusion With the carotid plaque growing thicker, the incidence of restenosis after CAS in patients with carotid stenosis increases. Especially in patients whose maximum plaque thickness is more than 0.435 mm, the incidence of restenosis postoperative increases remarkably.

OBJECTIVE：To provide reference for the identification and proces sing end-point determination of raw Morus alba and its processed products （honey-processed M. alba ）. METHODS ：UPLC method was adopted. The determination was performed on Waters BEH Shield RP C 18 column with mobile phase consisted of acetonitrile- 0.1％ phosphoric acid solution （gradient elution ） at the flow rate of 0.30 mL/min. The column temperature was set at 30 ℃. The program wavelengths were set at 280 nm（0-4 min） and 320 nm（4-35 min）. Similarity Evaluation System for Chromatogram Fingerprint of TCM （2012 edition）was used to establish UPLC fingerprint and carry out similarity evaluation of 13 batches of M. alba and honey-processed M. alba . The chromatographic peaks were identified with reference substance fingerprint. The colorimetric value （L，a，b） of 13 batches of M. alba and honey-processed M. alba powder were determined ，and average total colorimetric value （E）was calculated. OPLS-DA and cluster analysis were adopted to analyze the differences in fingerprints and colorimetric values of M. alba before and after processing. At the same time ，the dynamic change rule of fingerprint and colorimetric value of honey-processed M. alba at different processing time points were analyzed to determine the processing end-point. RESULTS ：There were obvious differences in fingerprints before and after processing ，and the similarity of 13 batches of M. alba and honey-processed M. alba were all higher than 0.9. Totally 21 common peaks were calibrated for M. alba ，and 23 common peaks for honey-processed M. alba ；peak 1 and peak 2 were newly produced compounds of honey-processed M. alba . Peak 2，peak 7，peak 14 and peak 19 were identified as 5-hydroxymethylfurfural， mulberry glucoside A ，oxidized resveratrol ，mulberry flavonoids G. Results of OPLS-DA showed that the peak area-sample quantity ratio of peak 1，peak 2，peak 18，peak 20 and the chromaticity values （L，a，b）were the most important factors affecting the difference of raw and processed products of M. alba . When the E ranged 75.84-80.88 as the processing end-point of honey-processed M. alba ，the processing time was determined as 22-34 min. CONCLUSIONS ： The established UPLC fingerprint and colorimetric value determination method can be used to identify the raw and processed products of M. alba as well as determine the processing end-point of honey-processed M. alba .

In recent years, the number of lung surgeries has increased year by year, and the number of patients with postoperative cough has also increased gradually. Chronic cough after lung surgery seriously affects patients' quality of life and surgical outcome, and has become one of the clinical problems that clinicians need to solve. However, there is currently no guideline or consensus for the treatment of chronic cough after lung surgery in China, and there is no standardized treatment method. Therefore, we searched databases such as PubMed, Web of Science, CNKI, and Wanfang databases ect. from 2000 to 2023 to collected relevant literatures and research data, and produced the first expert consensus on chronic cough after lung surgery in China by Delphi method. We gave 11 recommendations from five perspectives including timing of chronic cough treatment, risk factors (surgical method, lymph node dissection method, anesthesia method), prevention methods (preoperative, intraoperative, postoperative), and treatment methods (etiological treatment, cough suppressive drug treatment, traditional Chinese medicine treatment, and postoperative physical therapy). We hope that this consensus can improve the standardization and effectiveness of chronic cough treatment after lung surgery, provide reference for clinical doctors, and ultimately improve the quality of life of patients with chronic cough after lung surgery.