Objective:To study the effect of the extracting time and solvent on the concentration of main active components in Salvia Miltiorrhiza Bunge, and to provide basic data and theoretical guide to GEP(general extraction practice). Methods: Salvianolic acid B and Tanshinone ⅡA were extracted by 90% alcohol and water respectively from Salvia Miltiorrhiza Bunge and their contents were etermined by means of HPLC at regular intervals. Results: Extracting time and solvent were significant factors in the prcess of concentrating Salvianolic acid B and Tanshinone ⅡA from extract of Salvia Miltiorrhiza Bunge. Conclusion: Water is suitable for extracting Salvianolic acids, the extracting time is 40～50 minutes; alcohol is suitable for extracting Tanshinones, the extracting time is 20～30 minutes.

AIM: To Structure a series of diversifying combination of ginsenoside in order to provide the different samples for the pharmacological and pharmacodynamics experiments. METHODS: UNIFAC group contribution method is used for simulating the liquid liquid extraction, the proper extractants are chosen to carry out the experiments, and then the contents of the ginsenosides obtained with different extractants are detected through HPLC. RESULTS: The contents of the main ginsenoside varied with the change of the extractants' ratio, as a result a series of diversifying combination of ginsenoside are constructured. Within the ginsenoside which has greater amount, ginsenoside Rb 1 can be easily separated from Re, while Rd is hard to be separated, the experimental data were accordant to the theoretical prediction. CONCLUSION: Theoretical calculation combined with the optimizing of the extractants can structure a series of distinguished ginsenoside.

Objective To compare the saccharometabolism with the pancreatic islets functions and insulin resistance index in children with severe stress. Methods Thirty children with severe stress and 30 healthy children in control group were tested. The levels of fasting blood glucose (FBG), fasting insulin (FINS) and fasting C - peptide (FCP) were detected by radioimmunoassay respectively and insulin sensitivity index (ISI), insulin resistance index (IR) and fasting blood cell function index (FBCI) were calculated statistically. Results There were significant differences between the children with severe stress and the normal controls in the levels of FINS, FCP and FBG,(all P0.05). Conclusion There is insulin resistance with the significant decrease in the insulin sensitivity index and significant increase in insulin resistance index in the children with severe stress, which may cause the disorder in glucose metabolism in children with severe stress.

Objective To investigate the effect of arthroscopic treatment of massive rotator cuff tears. Methods 62 patients with massive rotator cuff tears underwent arthroscopic treatment from January 2010 to February 2016 were enrolled in the study and divided into elder group (≥ 65 years old, n = 23) and control group (< 65 years old, n = 39) according to age. Scores of American Shoulder and Elbow Surgeons scale (ASES), University of California Los Angeles (UCLA) and Constant-Murley were compared before surgery and at 12 months after surgery between the two groups. Results The age in elder group was significantly higher than that in control group (P < 0.05). There were no significant differences in baseline data including gender, disease duration, etiology and history of shoulder trauma between the two groups (P > 0.05). No perioperative complication occurred in all cases and all surgery were completed safely and successfully. The scores of ASES, UCLA and Constant-Murley at 12 months after surgery in the two groups were all significantly higher than that before surgery (P > 0.05). There were no significant differences in the scores of ASES, UCLA and Constant-Murley before surgery and at 12 months after surgery between the two groups (P > 0.05). Conclusions Arthroscopic minimally invasive surgery could effectively improve shoulder function in patients with massive rotator cuff tears, and it could also achieve good results in elderly patients and is worthy of clinical application.

Steroid receptor RNA activator ( SRA) is a type of long non-coding RNA ( lncRNA ).The abnormal transcription of lncRNA -SRA were detected in the uterine , ovarian and breast , and the lncRNA-SRA level in breast cancer is higher than that of general population.LncRNA-SRA expression may serve as a new prognostic marker for patients with ER-positive breast cancers.Thus, elucidating the molecular mecha-nisms of lncRNA -SRA is important to develop novel proper strategies using target lncRNA -SRA in the diagnosis and treatment of breast cancer.

OBJECTIVESTo analyze the factors related to prognosis of hepatitis failure and to determine the factors which significantly affect it, and to build a scoring system for assessment of the prognosis of hepatitis failure and also to examine its efficacy for clinical use.

METHODSClinical data from 301 patients were analyzed retrospectively. The correlated degree between those single factors and prognosis of hepatitis failure was explored by logistic regression analysis. Independent risk factors of prognosis and those correlated coefficients, which were from logistic regression analysis, were used to build a scoring system. This system was used in analyzing the clinical data of 275 patients to examine its efficacy of the prognostic assessment.

RESULTSThe factors that significantly affected the prognosis of hepatitis failure included age, clinical typing, hepatic coma, total bilirubin, and others (P < 0.01). Some factors, including PTA, blood urea, sodium and hepatic coma, were independent risk factors of prognosis. The scoring system built gave different scores between the effective treatment group and ineffective treatment group with statistical significance (P < 0.01). When the score was less than 40, the probability of a recovery was 76.9%; when the score was 40 to 80, the probability of a recovery was only 12.5%. When the score was more than 80, the probability of a recovery dropped to 0%.

CONCLUSIONSThe factors, including PTA, blood urea and sodium and hepatic coma, are important in building a scoring system to assess the prognosis of hepatitis failure. The scoring system we built is very effective in evaluating the prognosis of hepatitis failure.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; China ; epidemiology ; Evaluation Studies as Topic ; Factor Analysis, Statistical ; Female ; Hepatitis, Viral, Human ; complications ; epidemiology ; Humans ; Liver Cirrhosis ; epidemiology ; etiology ; Liver Failure ; epidemiology ; etiology ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Risk Factors

OBJECTIVETo investigate the safety, efficacy and long-term outcomes of Jinling procedure in the treatment of adult Hirschsprung disease.

METHODSClinical and follow-up data of 125 patients with adult Hirschsprung disease undergoing Jinling procedure at the Department of General Surgery between January 2000 and January 2013 were summarized. All the patients were diagnosed by CT, barium enema, anorectal pressure detection and pathology examination. Abdominal symptoms, gastrointestinal quality of life index(GIQLI, the lower score, the worse quality of life), Wexner constipation score (higher score indicated worse symptom), defecography (evaluation included rectocele, mucosal prolapse, intramucosal intussusception, perineal prolapse) and other operative complications were compared before and after operation.

RESULTSAmong 125 patients, 69 were male and 56 were female with median age of (41.2±15.5) (18 to 75) years. The follow-up rates were 94.4%(118/125), 92.0%(115/125), 89.6%(112/125) and 88.0%(110/125) at postoperative months 1, 3, 6, and 12. Incidences of abdominal distension and abdominal pain were 100% and 82.4%(103/125) before operation, and were 7.3%(8/110) and 20.9%(23/110) at 12 months after surgery. Wexner score was significantly lower at postoperative months 1(8.7±2.9), 3 (7.2±2.8), 6(6.7±2.2) and 12(6.3±1.7) than that before operation (21.4±7.2) (P<0.01). GIQLI score was 51.6±11.9 before operation, though it decreased at 1 month (47.3±5.5)(P<0.05) after surgery, but increased significantly at postoperative months 3, 6, 12(68.9±8.0, 96.5±8.2, 103.2±8.6)(P<0.01). Abnormal rate of defecography was 70.4%(81/115), 48.2%(54/112) and 27.3%(30/110) at postoperative months 3, 6, 12, which was significantly lower than 91.2%(114/125) before operation (P<0.01). Morbidity of postoperative complication was 29.6%(37/125), including 5 cases of surgical site infection (4.0%), 2 of anastomotic bleeding (1.6%), 8 of anastomotic leakage (6.4%, one died of severe abdominal infection), 4 of urinary retention (3.2%), 3 of recurrent constipation (2.4%, without megacolon relapse), 11 of bowel obstruction (8.8%), 2 of anastomotic stricture(1.6%) and 2 of refractory staphylococcus aureus enteritis (1.6%, diagnosed by stool smear and culture, and both died finally).

CONCLUSIONJinling procedure is a safe and effective surgical procedure for adult Hirschsprung's disease.

Adolescent ; Adult ; Aged ; Anastomosis, Surgical ; Colectomy ; Constipation ; Defecography ; Digestive System Surgical Procedures ; Female ; Hirschsprung Disease ; surgery ; Humans ; Intestinal Obstruction ; Intussusception ; Male ; Middle Aged ; Perineum ; Postoperative Complications ; Postoperative Period ; Quality of Life ; Rectocele ; Staphylococcus aureus ; Treatment Outcome ; Young Adult

Adolescent ; Adult ; Aged ; Aged, 80 and over ; China ; Disasters ; Earthquakes ; Female ; First Aid ; Humans ; Male ; Middle Aged ; Transportation of Patients ; Wounds and Injuries ; therapy

OBJECTIVETo investigate the opportune time of secondary definitive surgery for patients with multiple injuries from earthquakes based on the acute physiology and chronic health evaluation II (APACHE II) score and the principles of damage control.

METHODSTwenty-one patients with critical earthquake injuries were treated with damage control strategies, followed by medical support and surgical intervention to restore their physical potential in the intensive care unit (ICU). Successive APACHE II scoring was adopted to evaluate the patients'physiological status, and then, internal fixation of fractures and other definitive operations were performed.

RESULTSAll the patients were effectively treated with few complications, low deformity rate and no death.

CONCLUSIONSAppropriate evaluation of patients?physiological potential, right decision on surgical time and proper operative method can reduce the rates of complications, disability and death for patients with critical earthquake injuries.

APACHE ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; China ; Disasters ; Earthquakes ; Female ; Humans ; Male ; Middle Aged ; Multiple Trauma ; surgery

OBJECTIVETo investigate the safety, effectiveness and long-term results of Jinling procedure.

METHODSA total of 1 100 patients with refractory constipation were admitted to the Institute of General Surgery between February 2000 and December 2013 and received Jinling procedure. There were 217 male and 883 female patients with an average age of (45±15) years and an average duration of (275±159) months. The Jinling procedure modifies the classic procedure of subtotal colectomy with colorectal anastomosis by adding a new side-to-side cecorectal anastomosis. The general clinical data, postoperative complications, gastrointestinal quality of life index (GIQLI), Wexner constipation score, satisfaction rate, body composition, nutritional status, homeostasis, anal manometry and defecography during follow-up were collected. Statistical analysis was performed by t-test analysis, χ(2) test or Fisher's exact probability.

RESULTSThe postoperative follow-up rate were 96.73%, 94.36%, 93.00% and 92.55% at 1, 3, 6, and 12 months. The satisfaction rate were 62.50%, 72.45%, 93.16% and 94.70% respectively during 1, 3, 6 and 12 months follow-up. The postoperative 1 month, GIQLI was lower than that of preoperative (P=0.038), but significantly better at postoperative 3 month than the preoperative (P=0.022), and gradually improve after then. Wexner score was significantly lower at postoperative 1 month than the preoperative (P=0.018), and with the gradually reduce. Compared to the preoperative baseline, all body composition and serum protein parameters decreased significantly at the one-month follow-up and then increased gradually over the remaining follow-up period. Weight and prealbumin were significantly higher than the preoperative at postoperative 12 month. Jinling procedure had no effect on electrolytes. All patients were detected in defecography before surgery, but these abnormal indicators were improved after surgery. Anal function, coordinated movement anorectal function, anorectal reflex and rectal sensation were injured at early postoperative, but as time goes on, these indicators gradually returned to preoperative levels, some indicators better than the preoperative level. Postoperative surgical site infection, anastomotic bleeding , anastomotic leakage, urinary retention, sexual dysfunction, recurrent constipation, bowel obstruction, anastomotic stricture and mortality rates were 4.36%, 5.45%, 6.00%, 6.91%, 0.64%, 0.45%, 8.82%, 4.00% and 0.27% respectively.

CONCLUSIONSJinling procedure is a safe and effective surgical procedure for refractory constipation. It can improve defecation function and quality of life significantly, and has a high follow-up satisfaction rate.

Adult ; Anastomosis, Surgical ; Colectomy ; Constipation ; surgery ; Defecation ; Defecography ; Female ; Follow-Up Studies ; Humans ; Intestinal Obstruction ; Male ; Middle Aged ; Postoperative Period ; Quality of Life ; Rectum ; Treatment Outcome