Scutellarin is the main effective constituent of breviscapine, a flavonoid mixture isolated from the dried whole plant of Erigeron breviscapus (Vant.) Hand-Mazz, and valsartan is used as an antihypertensive drug. These two drugs have already been clinically used together to treat diabetic nephropathy (DN) in China, and the combined medications showed some enhanced protection against DN. The aim of this study is to investigate the potential pharmacokinetic interaction between scutellarin and valsartan in rats. Breviscapine injection (20 mg x kg(-1), i.v.) and valsartan (15 mg x kg-, i.g.), either alone or together were given to 18 male Sprague-Dawley rats. Concentrations of scutellarin and valsartan were quantified by HPLC, and pharmacokinetic parameters were calculated by non-compartmental methods. We found that the pharmacokinetic parameters of scutellarin altered significantly after co-administration of oral valsartan. The plasma clearance (CL(p)) and the bile clearance (CL(b)) of scutellarin were reduced significantly in the presence of valsartan. After oral administration of valsartan with or without intravenous scutellarin, however, the pharmacokinetic parameters of valsartan were comparable. In conclusion, our data suggests that the concurrent use of valsartan reduces the biliary excretion of scutellarin, and this may be due to the inhibitory effect of valsartan on the biliary excretion of scutellarin mediated by Mrp2 (Multidrug resistance-associated protein 2).

Objective:To study the clinical application of laparoscopic combined with multi-video debridement in treatment of complicated infectious pancreatic necrosis (CIPN).Methods:The clinical data of 34 patients with CIPN who were treated at the Department of General Surgery, Xuanwu Hospital, Capital Medical University from August 2017 to December 2019 were retrospectively studied. Based on the different video methods used, these patients were divided into 3 groups: the laparoscopic combined with intraoperative ultrasound group, the laparoscopic combined with choledochoscopy group and the laparoscopic group. The number of operations, operation time, blood loss, postoperative complication rates, mortality rates and total length of hospital stay were compared.Results:There were 13 patients in the laparoscopic combined with intraoperative ultrasound group, with age of (56.4±13.4) years. There were 7 patients in the laparoscopic combined with choledochoscopy group, with age of (48.0±8.4) years. There were 14 patients in the laparoscopic group with age of (51.4±15.6) years. The number of operations of the laparoscopic combined with intraoperative ultrasound group, the laparoscopic combined with choledochoscopy group and the laparoscopic group were (2.2±1.1), (1.6±0.8), (2.9±1.4), respectively. The number of operations of the laparoscopic combined with choledochoscopy group were significantly less than that of the laparoscopic group ( P<0.05), but there were no significant differences among the other groups ( P>0.05). The operation time of the laparoscopic combined with intraoperative ultrasound group, the laparoscopic combined with choledochoscopy group and the laparoscopic group were (70.5±22.9) min, (65.7±19.9) min, (51.5±15.4) min, respectively. The operation time of the laparoscopic combined with intraoperative ultrasound group was significantly longer than that of the laparoscopic group ( P<0.05), but there were no significant differences among the other groups ( P>0.05). There were no differences in blood loss, postoperative complication rate, mortality rates and total lengths of hospital stay among the three groups ( P>0.05). Conclusion:Laparoscopic combined with multi-video debridement after making full use of the advantages of each of the video methods, can be used to improve treatment outcomes of patients with CIPN.

The effectiveness of traditional Chinese medicine (TCM) against various diseases urges more low cost,speed and sensitive analytical methods for investigating the phamacology of TCM and providing a theoretical basis for clinical use.The potential of second-order calibration method was validated for the quantification of two effective ingredients of Schisandra chinensis in human plasma using spectrofluorimetry.The results obtained in the present study demonstrate the advantages of this strategy for multi-target determination in complex matrices.Although the spectra of the analytes are similar and a large number of interferences also exist,second-order calibration method could predict the accurate concentrations together with reasonable resolution of spectral profiles for analytes of interest owing to its ‘second-order advantage'.Moreover,the method presented in this work allows one to simply experimental procedure as well as reduces the use of harmful chemical solvents.

Objective: To examine the indications and effects of different surgical approaches in laparoscopic debridement for patients with infected pancreatic necrosis(IPN). Methods: The clinical data of 213 IPN patients treated by laparoscopic debridement at Department of General Surgery, Xuanwu Hospital, Capital Medical University from June 2012 to February 2019 were retrospectively analyzed.The therapeutic effects were summarized and analyzed according to different surgical approaches. There were 123 cases in retroperitoneal approach group, including 73 males and 50 females, aging of (51.3±12.4) years; 59 cases in omental sac approach group, including 32 males and 27 females, aging of (48.3±14.2) years; 23 cases in combined approach group, including 13 males and 10 females, aging of (54.3±19.7) years; 8 cases in digestive tract approach group, including 5 males and 3 females, aging of (50.2±12.5) years. Results: The time from onset to operation in retro-peritoneal, omental sac, combined and digestive tract approach groups were (44.3±22.8), (47.3±24.3), (52.6±21.2), (51.2±30.1) days, respectively; the operation time was (52.3±26.4), (64.3±29.2), (82.8±24.7), (78.2±38.1) minutes respectively; the median bleeding volume was 18, 33, 42 and 30 ml, respectively; and the first time to eat after operation was (2.5±1.6), (3.8±1.8), (3.7±2.0), (8.4±3.9) days, respectively.The incidence of complications (Clavien-Dindo grade Ⅲ and above) was 10.6%(13/123), 10.2%(6/59), 17.4%(4/23), 1/8 and the mortality was 4.9%(6/123), 3.4%(2/59), 4.3%(1/23) and 0, respectively.The overall mortality of all patients was 4.2%(9/213). The levels of inflammatory factors were significantly lower in all groups 7 days after operation than before, and no patients was converted to open surgery. Conclusion Individualized selection of the optimal laparoscopic debridement approach of pancreatic necrosis plays an important role in improving the efficacy and prognosis of IPN patients.

The FMS-like tyrosine kinase 3 (FLT3) gene mutation is the most common genetic mutation in acute myeloid leukemia (AML) and is associated with poor prognosis. Various targeted inhibitors have been developed for FLT3 mutations and have shown promising clinical efficacy. However, the emergence of resistance poses new challenges for targeted therapy in AML. This article provides an overview of the pathological and prognostic role of FLT3 mutations in AML, the current research progress on commonly used FLT3 inhibitors (type I and type II), the mechanisms of FLT3 inhibitor resistance, and strategies for overcoming resistance.

Objective: To compare the clinical effect of the Yu flap and the Karapandzic flap in repairing greater than 2/3 defects of the lower lip and to provide a reference for clinical application. Methods: Ten patients with greater than 2/3 lower lip defects after surgical resection of lower lip tumors and vascular malformations were enrolled: 5 patients were repaired with the Yu flap (Yu flap group) and 5 patients were repaired with the Karapandzic flap (Karapandzic flap group). Follow-up for at least 1 year was conducted to evaluate the morphology (symmetry, stoma, exposure of vermilion) and function (sensory function, motor function) of the reconstructed lower lip. Results : All the flaps survived, and all wounds showed primary healing. The lower lips reconstructed with the Yu flap or the Karapandzic flap obtained similar satisfactory oral function. The sensory function was essentially restored. There were no obvious obstacles in speech and expression, and no saliva leakage occurred. In the Yu flap group, only 1 patient had slight microstomia. In the Karapandzic flap group, 2 patients had slight microstomia and 3 patients had moderate microstomia. 90% (9/10) of the patients were very satisfied with the postoperative outcome, and 1 patient in the Karapandzic flap group was basically satisfied. Conclusion Both the Yu flap and the Karapandzic flap can be used to repair greater than 2/3 lower lip defects and reliable outcomes can be achieved. These two methods can achieve similar oral functions, but the effect of the Karapandzic flap is inferior to that of the Yu flap in terms of aesthetic appearance, and microstomia often occurs, while the Yu flap can generally maintain the original size of the mouth cleft.