To improve the impurity control of extrinsic residues in Chinese crude drugs and ensure the quality of crude drugs, relative suggestions should be provided. The present situation of extrinsic residues control in crude drugs was reviewed, and relative problems existed were analyzed. To develop the impurity control of extrinsic residues in Chinese crude drugs, more effort focus on strengthening basic research, improving analytical methods and optimizing the pattern of administration should be made.
Drug Contamination ; prevention & control ; Drugs, Chinese Herbal ; analysis ; standards ; Medicine, Chinese Traditional ; standards ; Quality Control

Objective To investigate the efficacy and safety of using various sedative regimens during transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC).Methods 156 HCC patients were randomly divided into four groups.The control group (n =30):intramuscular injection of 10 ml saline;The diazepam group (n =42):intramuscular injection of 10 mg of diazepam;The promethazine group (n =42):intramuscular injection of promethazine 25 mg;and The combined group (n =42):intramuscular injection of 10 mg of diazepam and promethazine 25 mg.Results The blood pressure and heart rate of the control group was significantly higher than the other three groups,while the combined group was significantly lower than the diazepam and the promethazine groups.The sedative rating:Grade 0 of the four groups were:30,11,18,0 patients respectively;Grade 1 of the four groups were:0,21,15,24 patients respectively;Grade 2 of the four groups were:0,10,9,18 patients respectively;No patients were in grades 3 and 4.The anxiety score of the control group was significantly higher than the other three groups.There was no significant difference in complications among the four groups.Conclusion Diazepam and/or promethazine could be used effectively and safely during TACE,and they could reduce stress response of HCC patients during TACE,and improved tolerance of TACE.

Objective To study the effect of protein C mutation on venous thrombosis (VTE) by PROC gene sequencing in patients with VTE. Methods Human PROC gene sequence was designed to amplify the third exon region of the PC-Gla domain , and then the PCR products were sequenced to search for a single nucleotide mutation (SNVs). The SNVs was constructed into eukaryotic expression system and a stable expression of wild-type and mutant PC cells were also constructed. At the same time , the distribution of PC levels in normal and VTE patients were detected with ELISA. Results Three single nucleotide mutations were found in different patients. In HUVEC cells, the synthesis of PC decreased in each mutant strain. The PC level in the normal patients , VTE patients , and the mutant samples were detected , which were significantly lower in the mutant samples than that of the VTE group (P = 0.035 3) and the normal level (P < 0.000 1). Conclusion Three mutation sites PCArg-1Cys , PCVal34Met and PCArg9Cys are important genetic factors lead to a significant decrease in plasma PC levels and the increase of VTE risk.

BACKGROUND: Based on our previous researches in mechanism studies and clinical applications of human hair keratin (HHK), a new concept "in vivol in situ tissue engineering" has been proposed. Under the guidance of this theory, a scaffold of HHK-collagan sponge (inner layer) combined with poly (2-hydroxyethyl methacrylate) (PHEMA) (outer layer as a drug delivery carrier) would be developed to investigate its feasibility to be as a dermal dressing. OBJECTIVE: To develop a scaffold composed of HHK-collagan sponge (inner layer) combined with PHEMA film containing polydatin(PD)(outer layer as a drug delivery carrier) and to evaluate the therapeutic efficacy of the HHK-collagen sponge-PHEMA/PD complex on burn wound healing. DESIGN, TIME AND SETTING: A randomized controlled animal experiment was performed at the Department of Histology and Embryology, Southern Medical University between March and December 2005. MATERIALS: Burn was induced in 15 male Sprague-Dawiey (SD) rats, Rat models of burn were evenly randomized to 3 groups: experimental, positive control, and negative control. METHODS: ①HHK-collagen sponge was prepared through combination of a HHK meshwork (1mm × 1 mm in size for each grid) made up of three components (determined according to biochemical procedures of various degrees, i.e., light, medial, and severe) at a ratio of 4:3:3 with primary collagen sponge extracted from bovine tendons in a mould. Sponge film (used as inner layer dressing) was made by vacuum freeze-drying. ② PHEMA was prepared by polymerization. Than PD was added to prepare PHEMNPD film (used as outer layer dressing).③ Degree Ⅱ burn wound models were established in SD rats by scalding, Superficial necrotic tissue was removed from burn wounds at postnatal 3 days and leave the denatured dermis remained. The wounds were either covered with human HHK-collagen- PHEMNPD complex in the experimental group, or with glutaraldehyde-treated porcine skin in the positive control group, and sterile absorbent gauze was used in the negative control group. MAIN OUTCOME MEASURES: ① Complete epithelization was taken as the standards, and at postoperative 7, 14, and 21 days, wound healing was respectively calculated. ② At postoperative 1, 2, 4, 6, and 8 weeks, the whole wound surface and its peripheral tissue were dissected for observing granulation tissue growing under an optical microscope and detecting the collagen fiber and elastic fiber in the newly formed tissue by immunohistochemical staining. RESULTS: ① Gross observation results revealed that in the experimental group, the volume of the diffusate under the ideal moisture was less compared with the positive control group; the healing time was slightly shorter in both the experimental group and the positive control group than in the negative control group (P= 0.000); At postoperative 7, 14, and 21 days, the healing rate was higher in the experimental and positive control groups than in the negative control group (P=0.000), in addition, the experimental group exhibited higher healing rate than the positive control group at postoperative 14 days ( P ＜ 0.05). ②Optical microscope results showed that at postoperative 2 weeks, a small quantity of collagen fibers were found in the wound granulation tissue in all 3 groups, in particular in the experimental group. Immunohistochemical staining results regarding collagen protein and elastin revealed that at postoperative 2 weeks, both the fine strip-like type Ⅰ collagen fibers and a few silk-like elastic fibers were stained yellowish-brown in the dermal matrix in the experimental group, which were weakly positive in the positive control group, while there was no elastin detectable in the negative control group; at postoperative 8 weeks, burn wounds in all the 3 groups werefully recovered. Remodeling of collagen fibers was more obvious in the experimental and positive control groups than in thenegative control group, while the tendency to scar formation with derangement of epithelial cells and collagen fibers in dermis was more prominent in the negative control group than in the remaining two groups.CONCLUSION: HHK-collagen sponge-PHEMA/PD complex may be a new burn dressing via in vivo construction of tissueengineered epidermis, in which PHEMA may be a feasible drug-delivery carrier.

Objective To investigate the efficacy and safety of endovascular treatment for subclavian steal syndrome (SSS). Methods During the period from April 2004 to Feb. 2013 at authors’ hospital, a total of 12 patients with SSS, including subclavian artery stenosis (n = 7) and occlusion (n = 5), underwent endovascular treatment. Percutaneous transluminal angioplasty (PTA) was carried out in 4 cases and stent implantation in 8 cases. The clinical data were retrospectively analyzed. Results Technical success rate was 100%(12/12). The diseased side/healthy side blood pressure ratio increased from preoperative (0.46 ± 0.28) to postoperative (0.89 ± 0.32), and the difference was statistically significant (P < 0.05). After the treatment, the clinical symptoms were improved in different degrees in all patients. During the follow - up period lasting for (16.7 ± 7.9) months, restenosis occurred in one case with left SSS thirteen months after PTA, and the condition was improved after stenting angioplasty. Another patient with severe subclavian artery stenosis developed peripheral micro- vascular thrombosis of the diseased limb in 23 days after PTA, which was relieved after medication to improve microcirculation and vasodilation. No severe complications such as stroke occurred. Conclusion For subclavian artery steal syndrome, endovascular management is a minimally invasive, safe and effective treatment. It can significantly relieve the clinical symptoms due to vertebral- basilar artery insufficiency caused by subclavian steal syndrome, and improve limb weakness, low body temperature, etc. Therefore, this technique should be recommended in clinical practice.

Objective To screen the most suitable medium for Brucella drug susceptibility test, and observe the resistance of human derived Brucella to different antibiotics. Methods Totally 180 strains of Brucella isolated from 25 provinces (municipalities, autonomous regions) in recent years were taken as observation objects. Mueller-Hinton ( MH ) agar , MH blood agar and Brinell agar were used to carried out the drug susceptibility test in vitro, and to compare the results of drug susceptibility test of different medium; the most suitable Brucella drug susceptibility test medium was used to detect the resistance of human derived Brucella to Doxycycline, Rifampicin, Streptomycin, Levofloxacin, Moxifloxacin, Ceftriaxone sodium, Co-trimoxazole and Amoxicillin/Clavulanic acid by K-B drug sensitive paper, and to observe the formation of antibacterial ring around the drug sensitive paper. Results The growth of Brucella on the MH agar and MH blood agar were slower than that on the Brinell agar, and the antibacterial rings were not obvious. All the 180 strains of Brucella were sensitive to seven antibiotics such as Doxycycline, Rifampicin, Streptomycin, Levofloxacin, Moxifloxacin, Ceftriaxone sodium, and Amoxicillin/Clavulanic acid; and 70 strains of Brucella were resistant to Co-trimoxazole, accounting for 39％ (70/180); Brucella strains resistant to Co-trimoxazole were found in 21 provinces. Conclusions Brinell agar is the most suitable medium for Brucella susceptibility test. The human derived Brucella is resistant to Co-trimoxazole; the resistant strains are distributed in 21 provinces ( municipalities , autonomous regions ) . It is recommended that relevant departm ents of the province ( municipalities , autonomous regions ) carry out epidemiological investigations on the resistance of Brucella, and strengthen the monitoring of drug resistance in clinical drugs of brucellosis patients.

Objective Molecular biological methods were used to classify and analyze the isolated Brucella strains,and to understand the geographical distribution characteristics,genetic types and regional distribution characteristics of Brucella in Qinghai Province.Methods Molecular biology typing of species of isolated Brucella strains in Qinghai was studied using Multiple Locus Variable-number tandem repeat Analysis (MLVA) technology.The classification results were described by geographical information system (GIS).Results There were 3 species Brucella melitensis,Brucella abortus,and Brucella suis among the 65 strains of Brucella in Qinghai.Brucella melitensis was the dominant species.The genotypes of MLVA were 42,43,47,28,36,112 and 6.The geographical distribution features showed that the 42 belonged to the evolutionary branches of A and B,which was widely distributed.The 43 of the C evolutionary branch and 47 of the E evolution branch were mainly in the hinterland of the Qinghai-Tibet Plateau.When searching in the Brucella2012 MLVA database,none of the genotypes obtained in this study were identical to those in the database.Conclusions The MLVA genotypes of Brucella are varied in Qinghai Tibet Plateau.They are widely distributed,completely different from those in other areas,and different genetic variations are found in different places.

Yttrium-90 (90Y) radioembolization therapy can directly deliver a high dose of radiation to the tumor being targeted,which has been demonstrated to be effective in treating patients with hepatic malignancy.Compared with transarterial chemoembolization,90Yradioembolization is less frequently associated with toxicities such as abdominal pain,fever,nausea,and vomiting.However,the efficacy and safety of 90Y radioembolization therapy are largely reliant on careful preprocedural evaluation and diligent follow-up.This review discusses the details of essential preprocedural work-up and postprocedural follow-up for patients treated with 90Y radioembolization.

Potential complications arising from yttrium-90 (90Y) radioembolization are often related to inadvertent embolization of non-target vasculature during particle administration.Therefore,careful pretherapeutic planning with arterial mapping is especially important to help identify potential high-risk arteries and vascular communications.A complete pre-therapeutic evaluation of hepatic arterial vasculature includes selective arteriography,precautionary embolization of potential risk arteries and identification of occurrences of hepatopulmonary shunting secondary to tumor-related pathologic arteriovenous channels.The aim of this review is to discuss the pertinent arterial anatomy during 90Y radioembolization therapy and strategies on how to evaluate the risk and prevent the occurrence of non-target embolization through those vascular structures.

Radioembolization with yttrium-90 (90Y) microspheres is a locoregional procedure during which either resin or glass microspheres loaded with β-emitting 90Y are selectively injected into a hepatic artery.The microspheres are trapped in downstream vasculatures,at which point they deliver a cytotoxic dose of radiation to the target tumor.The safety and efficacy of this method have been demonstrated in studies of survival outcomes in patients with nonresectable hepatic malignancies.In this first part of a series of reviews on radioembolization with 90Y microspheres,we cover the basic characteristics of 90Y and 90Y microspheres,techniques for the radioembolization procedure,and methods for ensuring radiation safety and protection.