ObjectiveThrough qualitatively and quantitatively analysis of the differences in chemical composition between the combined decoction and single decoction of Huaganjian and comparison of their core efficacy， to explore the rationality of the flexible clinical application of Huaganjian compound preparations and single-flavored dispensing granules. MethodsUltra performance liquid chromatography-quadrupole-electrostatic field orbitrap high resolution mass spectrometry（UPLC-Q-Exactive Orbitrap MS） was used to qualitatively analyze the combined decoction and single decoction samples of Huaganjian， and meanwhile， the contents of four index components（geniposide， paeoniflorin， hesperidin and paeonol） were quantitatively analyzed by high performance liquid chromatography（HPLC）. Nonalcoholic fatty liver disease（NAFLD） rat model induced by high-fat diet was applied to compare the efficacy of combined decoction and single decoction of Huaganjian. A total of 30 male SD rats were randomly divided into the control group， model group， lovastatin group（1.8 mg·kg^-1）， combined decoction group（1.26 g·kg^-1） and single decoction group（1.18 g·kg^-1）. After successful modeling， lovastatin group， combined decoction group and single decoction group were given corresponding doses of drugs by intragastric administration every day， and the control group and model group were given equal amounts of normal saline by intragastric administration， after 4 weeks of administration， the serum and liver tissues were collected， and the contents of alanine aminotransferase（ALT）， aspartate aminotransferase（AST）， total cholesterol（TC）， triglyceride（TG）， low-density lipoprotein cholesterol（LDL-C） and high-density lipoprotein cholesterol（HDL-C） in serum of rats were detected， and the liver pathological examination was carried out by hematoxylin-eosin（HE） staining and oil red O staining， so as to compare differences of their efficacy. ResultsSeventy chemical components were initially identified and attributed from the lyophilized powder of the combined decoction and single decoction samples of Huaganjian， and there was no obvious difference in composition between the two. Further quantitative analysis showed that the contents of geniposide， paeoniflorin， hesperidin and paeonol in the combined decoction samples were significantly increased when compared with those of the single decoction samples（P<0.01）. The pharmacodynamic results showed that compared with the model group， both the combined and single decoction groups of Huaganjian could improve the liver index of NAFLD rats， reduce the serum levels of AST， ALT， TC， TG and LDL-C， increase the serum level of HDL-C， and ameliorate the pathological changes of liver cell steatosis and fat accumulation. However， there was no significant difference in pharmacodynamic effects between the combined decoction group and the single decoction group. ConclusionThere is no significant difference between the combined decoction and single decoction of Huaganjian in terms of chemical composition， but the contents of the four index components show significantly difference. Both of them can significantly improve the fat accumulation and liver function in NAFLD rats. This study provides a reference basis for the rational clinical application and evaluation of famous classical formula compound preparations and single-flavored dispensing granules.

Objective:To understand the information needs and experiences of primary caregivers of patients in the emergency resuscitation room of the emergency department, and to provide a reference for clinical staff to meet caregivers′ information needs as well as to develop targeted and effective health information support for doctors and patients.Methods:A descriptive phenomenological research method was used to conduct semi-structured interviews with primary caregivers of 14 patients in the emergency resuscitation room of the First Affiliated Hospital of Nanjing Medical University from November 2023 to February 2024 through purposive sampling, and the Colaizzi 7-step analysis method was applied to summarize and analyze the interview data and refine the themes.Results:Totally 14 respondents aged 28-66, including 6 males and 8 females. Four themes were refined including diverse information needs, information access dilemma, integration of doctor-patient information for joint decision-making and communication, and desire for information and emotional support.Conclusions:The information needs of primary caregivers of patients in the emergency department were diverse, and caregivers were eager to seek patient-related information and crave emotional support and communication when faced with the onset of a patient's illness. Healthcare professionals should strengthen the assistance of caregivers′ information needs to improve the experience of patients and caregivers in medical consultation services and realize the sustainable development of the doctor-patient relationship.

Objective:To understand the information needs and experiences of primary caregivers of patients in the emergency resuscitation room of the emergency department, and to provide a reference for clinical staff to meet caregivers′ information needs as well as to develop targeted and effective health information support for doctors and patients.Methods:A descriptive phenomenological research method was used to conduct semi-structured interviews with primary caregivers of 14 patients in the emergency resuscitation room of the First Affiliated Hospital of Nanjing Medical University from November 2023 to February 2024 through purposive sampling, and the Colaizzi 7-step analysis method was applied to summarize and analyze the interview data and refine the themes.Results:Totally 14 respondents aged 28-66, including 6 males and 8 females. Four themes were refined including diverse information needs, information access dilemma, integration of doctor-patient information for joint decision-making and communication, and desire for information and emotional support.Conclusions:The information needs of primary caregivers of patients in the emergency department were diverse, and caregivers were eager to seek patient-related information and crave emotional support and communication when faced with the onset of a patient's illness. Healthcare professionals should strengthen the assistance of caregivers′ information needs to improve the experience of patients and caregivers in medical consultation services and realize the sustainable development of the doctor-patient relationship.

AIM: To evaluate the bioequivalence of the test and reference formulations of mycophenolate mofetil capsule in Chinese healthy male subjects under fasting and fed conditions. METHODS: This was a 2-treatment, 2-sequence, 4-period, fully replicated crossover study that included 80 Chinese healthy male subjects (40 subjects in the fasting group and 40 subjects in the fed group, respectively). Subjects were assigned to receive a single oral administration of the test or reference formulation at a dose of 0.25 g in each period. The plasma concentration of mycophenolate mofetil (MMF) and metabolite mycophenolic acid (MPA) were analyhed by LC-MS/MS. The major pharmacokinetic parameters of MMF and MPA were calculated using non-compartmental analysis by WinNonlin 8.0. The statistical analysis was performed by SAS 9.4. Average bioequivalence (ABE) analysis was applied where it has been demonstrated that the within-subject standard deviation of the reference formulation (S

Objective To explore the clinical efficacy and safety of Hydromorphone combined with Propofol therapy in painless gastroscopy combined with colonoscopy examination in elder patients.Methods Sixty-one patients aged 65-80 years underwent a painless gastroscopy combined with colonoscopy examination in the Affiliated Tumor Hospital of Zhengzhou University from June 2015 to January 2016.The patients were randomly divided into the Hydromorphone combined with Propofol group (Group H,n=31) and the Fentanyl combined with propofol group (Group F,n=30).Results The levels (H vs F group) of VAS at 5,15,30 min after anesthetic recovery were lower in H group thanin F group[(2.4±0.5) vs (3.4±0.6),(2.0±0.5) vs (3.2±0.6),(1.6±0.4) vs (2.6±0.7) respectively,(all P＜0.05)],and those of ramsay sedation scores at 5,15,30,45,and 60 min after anesthetic recovery were lower in H group than in F group[(2.6 ± 0.4) vs (3.3 ± 0.5),(2.3±0.5) vs (2.9±0.4),(2.1±0.3) vs (2.6±0.3),(1.9±0.3) vs (2.2±0.3),(1.8±0.3) vs (2.0±0.3) (all P＜0.05)] respectively.Additionally,the incidence rates (H vs F group) of nausea and vomit (3.2％ vs.26.7％),respiratory depression (0.0％ vs.33.3％) and restlessness (6.5％ vs.30.0％) within 60 min after anesthetic recovery were lower in the group H than in the group F (all P＜ 0.05).However,there were no statistical differences in the indexes of postoperative gastrointestinal function between two groups (all P＞0.05).Conclusions The clinical efficiency of hydromorphone combined with propofol used in painless gastroscopy combined colonoscopy examination is favourable and safe without increasing postoperative adverse reactions in elder patients.Hydromorphone combined with propofol is superior to fentanyl combined with propofol as a general intravenous anesthesia.

The manufacturing process of Chinese medicines is the significant link to achieve "effect-enhancing and toxicity-reducing", including an interaction between "toxicity and effect". This paper would elucidate the effects of Chinese herbal compound decoction, preparation, dosage forms, route of administration and quality of pharmaceutical excipients on "toxicity-effect" theory from the formulation approaches. The article pointed out that the comprehensive analysis on "toxicity-effect" theory should be strengthened from the aspects of overall manufacturing, fundamental research and modern Chinese preparation, to explore the mechanism of "effect-enhancing and toxicity-reducing" in the manufacturing process, clarify the core status of Chinese preparation in "toxicity-effect" theory, and ensure the security and effectiveness in traditional Chinese medicine clinical application.

OBJECTIVETo investigate the clinical application of 256 multi-slice spiral computed tomography angiography (MSCTA) technique in the preoperative evaluation of mesenteric angiography in order to provide a reference to vessel anatomy and dissociation in laparoscopic radical operation for colorectal carcinoma.

METHODSClinical data of 50 patients with colorectal cancer who underwent preoperative MSCTA+FDCT and laparoscopic curative operation at our hospital from October 2013 to March 2015 were collected (MSCTA group). The evaluation item was visualization of mesenteric artery, which was compared with the findings under laparoscopic surgery. Meanwhile, another 50 colorectal cancer patients undergoing laparoscopic radical operation by the same surgeon team without preoperative MSCTA examination were used as control(control group). Clinical data were compared between the two groups.

RESULTSMSCTA precisely and correctly demonstrated anatomy and variations of the mesenteric artery and relative nutrient vessel in carcinoma. The angiography reconstruction images were consistent with the visual anatomy and variation from laparoscopic findings, whose diagnostic conformity rate of 100%. As compared to control group, operative time was shorter [(195.0±23.2) minutes vs.(218.0±19.6) minutes, t=8.326, P=0.015], and blood loss was less[(168.1±18.8) ml vs. (206.5±14.3) ml, t=-19.369, P=0.002] in MSCTA group. Differences of number of harvested lymph node, postoperative complication morbidity, postoperative hospital stay and hospitalization cost were not significant between two groups(all P>0.05).

CONCLUSIONPreoperative MSCTA can demonstrate anatomy and variations of the mesenteric artery precisely and correctly, thus it is beneficial to shorten the operation time and to reduce blood loss.

Angiography ; Colorectal Neoplasms ; diagnostic imaging ; surgery ; Humans ; Image Processing, Computer-Assisted ; Laparoscopy ; Lymph Nodes ; Mesenteric Arteries ; diagnostic imaging ; Operative Time ; Tomography, Spiral Computed

Powder of Notarchus is a traditional Chinese medicine originated from the eggs of various sea hares species of family Aplysiidae Lamarck, especially Notarchus. leachii cirrosus, Aplysia kurodai and A. pulmonica. It has been used for clinical treatment of cancer and cancer-like diseases in China since the Ming dynasty. Isolation and identification of numerous cytotoxic ingredients from sea hares organisms were reported. Bioactive components of sea hares in China sea including 23 species from six genera of the Aplysiidae were reviewed in this paper. Approximately 300 molecules were identified in 11 species. More than 85 compounds extracted from 7 species were confirmed to have antitumor activity, which indicated that powder of Notarchus would have potential in developing new antineoplastic agents.
Animals ; Antineoplastic Agents ; chemistry ; pharmacology ; Biomedical Research ; Gastropoda ; chemistry ; Humans ; Medicine, Chinese Traditional ; Molecular Structure ; Neoplasms ; drug therapy ; Powders ; chemistry ; pharmacology

This study examined the effect of subcellular localization of P21 on the proliferation and apoptosis of HepG2 cells. The coding genes of the wild and the mutant P21 were amplified by mega primer PCR from the plasmid pCEP-WAF1 which contains human P21 cDNA in the nuclear localizational signal (NLS) sequence, and then inserted into the eukaryotic expression vector pDsRed1-C1. The recombinants were transfected into HepG2 cells. The transcription and expression of P21 were determined by RT-PCR and fluorescence microscopy. The cell proliferation was measured by MTT, and the cell cycle and apoptosis of HepG2 cells by flow cytometry. The results of restriction analysis, DNA sequencing and fluorescence microscopy confirmed the construction of the wild and the mutant P21 in the eukaryotic expression plasmid. The plasmid containing the mutant P21 was found to accelerate cell proliferation and the wild P21 plasmid to inhibit cell proliferation. Cell cycle analysis showed that the cell ratio of G(0)/G(1) in the wild type group was significantly increased as compared with that in the mutant type group, and cell apoptosis analysis revealed that the apoptosis rate in the wild type group was much higher than that in the mutant type group. It was concluded that the subcellular localization of P21 may contribute to the development of hepatic cancer.

This study examined the effect of subcellular localization of P21 on the proliferation and apoptosis of HepG2 cells.The coding genes of the wild and the mutant P21 were amplified by mega primer PCR from the plasmid pCEP-WAF1 which contains human P21 cDNA in the nuclear localizational signal (NLS) sequence,and then inserted into the eukaryotic expression vector pDsRed1-C1.The recombinants were transfected into HepG2 cells.The transcription and expression of P21 were determined by RT-PCR and fluorescence microscopy.The cell proliferation was measured by MTT,and the cell cycle and apoptosis of HepG2 cells by flow cytometry.The results of restriction analysis,DNA sequencing and fluorescence microscopy confirmed the construction of the wild and the mutant P21 in the eukaryotic expression plasmid.The plasmid containing the mutant P21 was found to accelerate cell proliferation and the wild P21 plasmid to inhibit cell proliferation.Cell cycle analysis showed that the cell ratio of G0/G1 in the wild type group was significantly increased as compared with that in the mutant type group,and cell apoptosis analysis revealed that the apoptosis rate in the wild type group was much higher than that in the mutant type group.It was concluded that the subcellular localization of P21 may contribute to the development of hepatic cancer.