Objective To explore the effect of early drinking on keeping safety and improving comfort of mouth cavity in postoperative patients with transsphenoidal resection of pituitary adenoma. Methods A total of 70 postoperative patients with transsphenoidal resection of pituitary adenoma were divided into the experimental group and the control group with 35 cases each by random number table method. The control group were allowed to drink water after postoperative 6 hours, the experimental group were allowed to drink a small amount of water after 1 h when they recovered from anesthesia. The symptoms of heart rate, respiration, blood pressure, pulse oxygen saturation, nausea, vomiting, mis- aspiration, dry mouth,thirst, sore throat, oral pH value, oral cavity peculiar smell and the mood were observed 6 h after operation. Results After 6 hours, the heart rate, respiration, systolic blood pressure, and pulse oxygen saturation in the two groups were within normal range, which were (79.14±7.82) times per minute vs. (82.29±13.48) times per minute, (17.71± 1.10) times per minute vs. (18.31±1.92) times per minute, (121.66±10.61) mmHg vs.(121.55±12.86) mmHg (1 mmHg=0.133 kPa), (17.71±1.10) times per minute, (0.99±0.01) % vs. (0.99±0.01) %,there was no significant differences( t=-1.603-0.673, P > 0.05). The value of diastolic blood pressure in the control group were lower than that of the experimental group,(70.14±6.87) mmHg vs.( 74.34±7.29) mmHg, there was significant difference ( t=2.497, P < 0.05) .The incidence of mis- aspiration was zero in two groups. The rate of nausea, vomiting were 11.43%(4/35) and 5.71% (2/35) in the experimental group, which were significantly lower than 17.14%(6/35) and 11.43%(4/35) in the control group, there was no significant differences (χ2=0.467,0.182, P > 0.05). The rate of dry mouth,thirst in the experimental group were lower than those of the control group, 2.71±1.74 vs. 7.03± 1.98, 1.77±1.68 vs. 5.06±2.35, the difference was statistically significant (t=-9.685, -6.725, P < 0.01). T he value of sore throat in the experimental group was lower than that in the control group, 3.40±1.72 vs. 4.11± 2.23, there was no significant differences (t=-1.500, P > 0.05). There was difference in oral pH value(6.82±0.17 vs. 6.43±0.25, t=0.815, P < 0.01) between the experimental group and the control group. The rates of oral cavity peculiar smell and the mood in the experimental group were 8.57% (3/35) and 28.57% (10/35), which were better than those of the control group, 82.85% (29/35), 45.71%(16/35), the difference were significant (χ2=4.629, 10.516, P < 0.05). Conclusions Early drinking in postoperative patients with transsphenoidal resection of pituitary adenoma is secure and it can relieve uncomfortable symptoms, maintain normal oral pH value, improve comfort of mouth cavity and keep good mood of patients.

The chemical constituents from Aconitum richardsonianum var.pseudosessiliflorum were investigated.The roots of this plant were extracted three times with 90％ EtOH at the room temperature.The ethanol extracts were combined and concentrated under reduced pressure to yield residue,which was suspended in water and successively partitioned with chloroform.The chloroform extraction was isolated and purified by silica gel and Sephadex LH-20 column chromatography. Six compounds were isolated and elucidated as delelatine (1), isodelpheline (2),3-acetylaconitine (3),isoatisine (4),nordhagenine A (5) and yunaconitine (6).Compounds 1 - 5 were obtained from Aconitum Brunneum for the first time.Compound (1) showed significant cytotoxic activities (IC50 =4.36 tμM) against the human tumor cell line P388.

The chemical constituents from Aconitum richardsonianum var.pseudosessiliflorum were investigated.The roots of this plant were extracted three times with 90% EtOH at the room temperature.The ethanol extracts were combined and concentrated under reduced pressure to yield residue,which was suspended in water and successively partitioned with chloroform.The chloroform extraction was isolated and purified by silica gel and Sephadex LH-20 column chromatography.Six compounds were isolated and elucidated as delelatine（1）,isodelpheline（2）,3-acetylaconitine（3）,isoatisine（4）,nordhagenine A（5）and yunaconitine（6）.Compounds 1-5 were obtained from Aconitum Brunneum for the first time.Compound（1）showed significant cytotoxic activities（IC50=4.36 μM）against the human tumor cell line P388.

To investigate the chemical constituents of the roots of Aconitum taipaicum, silica gel column chromatography was used for the isolation and purification of compounds. A new norditerpenoid alkaloid, isodelelatine (1), along with five known alkaloids, atisine (2), delfissinol (3), liangshanine(4), hypaconitine (5) and delelatine (6) were isolated and identified. The structure of the new compound was elucidated on the basis of spectral data.

Objective To investigate the effect of thyroxine replacement therapy with residual subclinical hypothyroidism on the success rate of catheter ablation in elderly patients with atrial fibrillation(AF).Methods Among the consecutive patients with AF who underwent a first AF ablation in our center between 2009 and 2012,we identified 56 patients(41 paroxysmal AF,15 persistent AF)with subclinical clinical hypothyroidism after receiving thyroid hormone replacement therapy as study group.The control group consisted of 56 patients with euthyroidism and no history of thyroid dysfunction.All patients underwent catheter ablation.Results At the end of follow up,37.5%(21/56)patients were AF free after the first procedure in the study group,in comparison to 64.3%(36/56)in control group(χ2=8.655,P=0.003).Last procedure was performed in 27 patients of study group and in 15 patients of control group.After the last performed ablation,62.5%(35/56)study group patients and 80.4%(45/56)controls group patients had no recurrence(χ2=4.653,P=0.031).The major complications rate did not differ between two groups(P=0.642).Conclusions Thyroid hormone replacement therapy with residual subclinical hypothyroidism reduces catheter ablation success rate in elderly patients with atrial fibrillation.

Objective To investigate the incidence of enteric pathogens causing acute gastroenteritis (AGE) among children to measure the incidence of coinfections,and to compare the clinical characteristics of those infected with one versus multiple agents.Methods A retrospective study was conducted from January 2014 to December 2014.All patients between 1 month and 14 years of age admitted to the Pediatric department with a diagnosis of AGE were eligible for enrollment.Two stool samples for each patient were tested for gastrointestinal pathogens.We summarized the clinical severity of episodes,describing the duration of diarrhea,duration and frequency of vomiting,fever.All patients underwent medical evaluation with estimation of dehydration.Results One or more etiological agents were detected in 3595 out of 4728 patients(76.0％),while we did not detect any etiological agent in 1133 (24.0％).Rotavirus was detected in 1889 (40.0％),adenovirus in 412 (8.7 ％),norovirus in 309 (6.5 ％),verotoxigenic Escherichia coli (VTEC) in 274 (5.8 ％),Salmonella spp.in 276(5.8％),Klebsiella pneumoniae in 123 (2.6％),Shigella spp.in 78 (1.6％),Staphylococcus aureus in 70 (1.5％),C.perfringens in 126(2.7％).In 1370 children out of 4728(29.0％),we found evidence of coinfection.with rotavirus and norovirus was the most common 150 (3.2％),rotavirus and C.perfringens was also common 127(2.7％).Children with coinfection had a more severe clinical presentation.The difference has statistical significance.Conclusion Rotavirus is still the most common pathogen in children with acute diarrhea,followed by NV,adenovirus,Salmonella spp.and VTEC.Rotavirus with norovirus infection was the most common.VTEC combined with three kinds of virus infection had the highest incidence.Children with multiple viral infections were more severe than those of single virus infection in the duration of vomiting and dehydration.There was no significant difference in the duration of fever and diarrhea and the frequency of diarrhea.Children infected by viruses and bacteria had a more severe clinical presentation such as fever,vomiting and diarrhea lasting for a long time,more serious diarrhea and dehydration than those with single bacteria and single virus infection.The difference has no significant difference in degree and duration of diarrhea.

Objective:To investigate mucosal injury after high-dose methotrexate (HD-MTX) chemotherapy in treatment of children with acute lymphoblastic leukemia (ALL), and to analyze the association with methotrexate blood concentration, risk stratification and clinical efficacy.Methods:The data of 95 children with ALL who received 539 times of HD-MTX chemotherapy in the First Hospital of Harbin from November 2015 to October 2018 were retrospectively analyzed, and the association of mucosal injury with methotrexate blood concentration, disease risk degree and clinical efficacy was also analyzed.Results:Among 95 children who received 539 times of HD-MTX chemotherapy, the total incidence of mucosal injury was 8.4% (45/539); the incidence of mucosal injury was 4.6% (11/239), 7.6% (8/105), 13.3% (26/195), respectively in the low-risk group, middle-risk group and high-risk group. With the elevation of disease risk, the incidence of mucosal injury was increased ( χ2 = 10.787, P < 0.05). There was no correlation of the degree of mucosal injury with methotrexate blood concentration and disease risk degree (all P > 0.05), and the mucosal injury was not related with the clinical efficacy ( P > 0.05). Conclusion:After the application of HD-MTX in children with ALL, adjustment of the dose of rescue drug by monitoring of methotrexate blood concentration can improve the safety of therapeutic drugs.

Objective:To explore the therapeutic effect of low-dose arsenous acid/tretinoin with or without low-dose cytarabine induction regimen on myelodysplastic syndromes (MDS) with TET2 gene mutation in children.Methods:Nine children with MDS who were hospitalized at the First Hospital of Harbin from March 2009 to April 2018 were collected, including 3 cases of refractory cytopenia of childhood (RCC), 4 cases of MDS with excess of blasts type Ⅰ (MDS-EBⅠ) and 2 cases of MDS with excess of blasts type Ⅱ (MDS-EBⅡ). The next-generation gene sequencing method (NGS) was applied to detect the TET2 gene mutation in bone marrow cells of children with MDS. The low-dose arsenous acid/tretinoin with or without low-dose cytarabine induction regimen was adopted to conduct tiered therapy on children with MDS. The clinical efficacy was assessed in line with the MDS response evaluation criteria adopted by the MDS International Working Group (IWG) in 2006.Results:Among the 9 patients, the short-term clinical efficacy was observed in 8 cases. Two patients with TET2 gene mutation achieved the short-term clinical efficacy of bone marrow complete remission (mCR) and hematological improvement (HI). Among 7 patients without TET2 gene mutation, 4 patients obtained CR, 1 patients obtained mCR and HI, and 1 patients obtained stable disease (SD) in terms of the short-term clinical efficacy.Conclusion:The low-dose arsenous acid/tretinoin with or without low-dose cytarabine regimen may be beneficial to MDS children with TET2 gene mutation.

Accurate classification of the acetabular injuries and appropriate treatment plan are great challenges for orthopedic surgeons because of the irregular anatomical structure of the acetabulum and aggregation of important vessels and nerves around it. Letournel-Judet classification system has been widely applied to classify acetabular fractures. However, there are several limitations, including incomplete inclusion of fracture types, difficulty in understanding and insufficient guidance for surgical treatment, etc. Serious complications such as traumatic arthritis are common due to wrong classification and diagnosis and improper selection of surgical strategy, which brings a heavy burden to the society and families. Three-column classification, based on anatomic characteristics, has advantages of containing more fracture types and being easy to understand, etc. To solve the problems existing in the diagnosis and treatment process based on Letournel-Judet classification, achieve accurate diagnosis and treatment of patients with acetabular fractures, and obtain satisfactory prognosis, the Orthopedic Trauma Emergency Center of Third Hospital of Hebei Medical University and the Trauma Orthopedic Branch of the Chinese Orthopedic Association organized experts from relevant fields to formulate the Expert consensus on the accurate diagnosis and treatment of acetabular fractures based on three-column classification ( version 2023) in terms of principles of evidence-based medicine. Based on the three-column classification, 15 recommendations were proposed, covering the diagnosis, treatment, complication prevention and management, etc, so as to provide reference for accurate diagnosis and treatment of acetabular fractures.