Objective To establish a method for simultaneous determination of HPLC fingerprint and multi-target ingredients in Atractylodis Macrocephalae Rhizoma(AMR),in order to provide reference for its quality control.Methods HPLC-DAD multi-wavelength switching method was used to establish fingerprint of AMR,similarity evaluation combined with hierarchical clustering analysis(HCA),principal components analysis(PCA)and discriminant analysis of partial least squares(PLS-DA)were used to carry out chemometric study.The contents of differential component such as atractylenolide Ⅰ,Ⅱ,Ⅲ and atractylon were determined simultaneously.Results The HPLC fingerprint of 37 batches of AMR was established.Nine common peaks were marked,and 4 of them were identified as atractylon,atractylenolide Ⅰ,Ⅱ,Ⅲ.The similarity degrees were between 0.539 and 0.996,the quality of AMR from different origin and different batches varies greatly.Atractylon,atractylenolide Ⅰ,Ⅱ,Ⅲ and one unknown component(peak 9)are the important factors affecting the quality of AMR.Conclusion The combination methods of HPLC fingerprint and simultaneous determinations of multiple components are simple,stable,accurate and reliable,which can provide reference for the quality evaluation of AMR and the improvement of quality standard,as well as lay a foundation for the basic research of its pharmacodynamic substances and related compound.

Objective:To analyze the prognostic value and threshold effect of serum C3,C4 in patients with multiple myeloma (MM). Methods:The clinical data of 146 patients with MM who visited Suqian First People's Hospital from October 2016 to October 2019 were collected. The patients were divided into deceased group (42 cases) and survival group (104 cases) according to their prognosis and survival. The risk factors affecting the prognosis of the patients were analyzed. The correlation of serum C3 and C4 with prognosis was analyzed by threshold effect. The predictive value of serum C3/C4 on the prognosis of MM patients was evaluated by the receiver operating characteristic (ROC) curve. Nomogram model was constructed,and the discrimination and accuracy of the model were evaluated. The nomogram model was internally validated by bootstrap resampling. Results:Durie-Salmon (DS) stage Ⅲ,decreased low density lipoprotein cholesterol (LDL-C) and apolipoprotein B (Apo B),elevated homocysteine (Hcy),uric acid (UA),and serum C3 and C4 were independent risk factors affecting the prognosis of MM patients (P<0.05). Curve fitting showed that the mortality probability of MM patients increased with the increase of serum C3 and C4 levels. The threshold effect analysis showed that when serum C3 was higher than 1.2 g/L or serum C4 was higher than 0.37 g/L,the mortality rate of MM patients increased with the increase of the index levels;When serum C3 was lower than 1.2 g/L or serum C4 was lower than 0.37 g/L,the mortality rate of MM patients had no significant correlation with the indexes. Serum C3 and C4 had a good predictive value for the prognosis of MM patients,and the combination of C3 and C4 had a higher predictive value. The validation results showed that the nomogram model constructed in our study had good discrimination and high accuracy. Conclusion:Elevated levels of serum C3 and C4 are independent risk factors for mortality in patients with MM. The combination of serum C3 and C4 is more valuable in predicting mortality in MM patients than C3 or C4 alone,which can be used as a sensitive index to evaluate the prognosis of MM patients.

Objective: Pontine infarction is a common type of stroke in the cerebral deep structures, resulting from occlusion of small penetrating arteries, may manifest as hemi-paralysis, hemi-sensory deficit, ataxia, vertigo, and bulbar dysfunction, but patients presenting with restless legs syndrome (RLS) are extremely rare. Herein, we reported five cases with RLS as a major manifestation of pontine infarction.Methods: Five cases of pontine infarction related RLS were collected from July 2013 to February 2016. The diagnosis of RLS was made according to criteria established by the International RLS Study Group (IRLSSG) in 2003. Neurological functions were assessed according to the National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS). Severity of RLS was based on the International RLS Rating Scale (IRLS-RS). Sleep quality was assessed by Epworth Rating Scale (ERS), and individual emotional and psychological states were assessed by Hamilton Depression Scale (HDS) and Hamilton Anxiety Scale (HAS).Results: The laboratory data at the onset including hemoglobin, serum concentration of homocysteine, blood urea nitrogen (BUN), creatinine, electrolytes, and thyroid hormones were normal. The electroencephalogram (EEG), lower-extremity somatosensory evoked potential (SEP), and nerve conduction velocity (NCV) in four limbs were normal. The average period of follow-up was 34.60 ± 12.76 months. The MRI examination showed acute or subacute pontine infarction lesions, 3 cases in the rostral inner side, 1 case in the rostral lateral and inner side, and 1 case in rostral lateral side. The neurological deficits included weakness in 4 cases, contralateral sensory deficit in 1 case, and ataxia in 2 cases. All 5 patients presented with symptom of RLS at or soon after the onset of infarction and 4 patients experienced uncomfortable sensations in the paralyzed limbs contralateral to the ischemic lesion. Their neurological deficits improved significantly 2 weeks later, but the symptoms of RLS did not resolve. Among them, 3/5 patients were treated with dopaminergic drugs. At the end of the follow-up, RLS symptom eventually resolved in 3 patients but persisted in two. The IRLS-RS, NIHSS and mRS scores were significantly lower at the onset than those at the last follow-up (P=0.035, 0.024 and 0.049, respectively). However, there was no significant difference in the ERS, HDS and HAS scores (P=0.477, 0.226 and 0.778, respectively).Conclusion: RLS can be an onset manifestation of pontine infarction, clinicians should be aware of this potential symptom. RLS usually occurs in the paralyzed limbs contralateral to the infarction lesion. The pathogenesis still needs further investigation.

Objective: Pontine infarction is a common type of stroke in the cerebral deep structures, resulting from occlusion of small penetrating arteries, may manifest as hemi-paralysis, hemi-sensory deficit, ataxia, vertigo, and bulbar dysfunction, but patients presenting with restless legs syndrome (RLS) are extremely rare. Herein, we reported five cases with RLS as a major manifestation of pontine infarction.Methods: Five cases of pontine infarction related RLS were collected from July 2013 to February 2016. The diagnosis of RLS was made according to criteria established by the International RLS Study Group (IRLSSG) in 2003. Neurological functions were assessed according to the National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS). Severity of RLS was based on the International RLS Rating Scale (IRLS-RS). Sleep quality was assessed by Epworth Rating Scale (ERS), and individual emotional and psychological states were assessed by Hamilton Depression Scale (HDS) and Hamilton Anxiety Scale (HAS).Results: The laboratory data at the onset including hemoglobin, serum concentration of homocysteine, blood urea nitrogen (BUN), creatinine, electrolytes, and thyroid hormones were normal. The electroencephalogram (EEG), lower-extremity somatosensory evoked potential (SEP), and nerve conduction velocity (NCV) in four limbs were normal. The average period of follow-up was 34.60 ± 12.76 months. The MRI examination showed acute or subacute pontine infarction lesions, 3 cases in the rostral inner side, 1 case in the rostral lateral and inner side, and 1 case in rostral lateral side. The neurological deficits included weakness in 4 cases, contralateral sensory deficit in 1 case, and ataxia in 2 cases. All 5 patients presented with symptom of RLS at or soon after the onset of infarction and 4 patients experienced uncomfortable sensations in the paralyzed limbs contralateral to the ischemic lesion. Their neurological deficits improved significantly 2 weeks later, but the symptoms of RLS did not resolve. Among them, 3/5 patients were treated with dopaminergic drugs. At the end of the follow-up, RLS symptom eventually resolved in 3 patients but persisted in two. The IRLS-RS, NIHSS and mRS scores were significantly lower at the onset than those at the last follow-up (P=0.035, 0.024 and 0.049, respectively). However, there was no significant difference in the ERS, HDS and HAS scores (P=0.477, 0.226 and 0.778, respectively).Conclusion: RLS can be an onset manifestation of pontine infarction, clinicians should be aware of this potential symptom. RLS usually occurs in the paralyzed limbs contralateral to the infarction lesion. The pathogenesis still needs further investigation.

To establish an HPLC-MS/MS method for the analysis of quercetin, kaempferid and isorhamnetin in rats plasma and study its pharmamacokinetics after an intragastrical administration of Hippophae rhamnoides extracts. Five healthy male Sprague-Dawley (SD) rats were given single doses of H. rhamnoides extracts (quercetin 26.35 mg x kg(-1), kaempferid 4.040 mg x kg(-1), isorhamnetin 31.37 mg x kg(-1)), and then their orbital sinus blood samples were collected at different time points. The drug plasma concentration of the three flavonoids was determined by HPLC-MS/MS method. After that, the main pharmacokinetics parameters were calculated by using Kinetica 5. 0. 11 software. The methodological test showed that the linear concentration ranges of quercetin, kaempferid and isorhamnetin were 7.500-600.0 μg x L(-1) (R2 = 0.998 5), 1.000-80.00 μg x L(-1) (R2 = 0.998 5 ) and 10.00-800.0 μg x L(-1) (R2 = 0.998 0), respectively. The inner and inter-days precisions were both less than 14.0%. The plasma samples showed a good stability and consistency with the requirement of biological sample analysis after the samples were frozen once and placed at - 20 degrees C for 15 d and room temperature for 6 h and the treated analytes were placed at -20 degrees C for 24 h. For quercetin, the pharmacokinetic parameter t(½β), AUC(0-∞), MRT(0.∞), C.(max) and T(max) were (113.3 ± 19.37) min, (12 542.14 ± 3 504.05) μg x h x L(-1), (119.6 ± 13.29) h, (164.6 ± 27.33) μg x L(-1) and (5.199 ± 0.840 3) h, respectively. For kaempferid, the pharmacokinetic parameters t(½β), AUC(0-t), MRT(0-∞), C(max) and T(max) were (79.85 ± 17.15) min, (934.51 ± 94.59) μg x h x L(-1), (81.50 ± 13.75) h, (80.15 ± 14.24) μg x L(-1) and (3.827 ± 0.902 7) h, respectively. For isorhamnetin, the pharmacokinetic parameters t1,2,, AUC(0-t), MRT(0-∞), C(max) and T(max) were (118.3 ± 20.73) min, (26 067.77 ± 4 124.60) μg x h x L(-1), (129.0 ± 16.30) h, (269.6 ± 29.32) μg x L(-1) and (6.513 ± 1.450) h, respectively. The HPLC-MS/MS analysis method established in this study was proved to be sensitive and accurate and could be applied in the pharmacokinetic study of quercetin, kaempferid and isorhamnetin in rat plasma.
Animals ; Chromatography, High Pressure Liquid ; methods ; Drugs, Chinese Herbal ; analysis ; pharmacokinetics ; Hippophae ; chemistry ; Kaempferols ; blood ; pharmacokinetics ; Male ; Quercetin ; analogs & derivatives ; blood ; pharmacokinetics ; Rats ; Rats, Sprague-Dawley ; Tandem Mass Spectrometry ; methods

Objective To systematically assess the efficiency of colonoscopy screening for the asymptomatic elderly.Methods A search was performed to identify studies related to colonoscopy screening for the aged in Pubmed and Embase.The key words used for the search included colorectal neoplasm, adenoma, screening, elderly, and colonoscopy.The detection rate of colorectal adenomas, advanced adenomas,colorectal cancer in the elderly and non-elderly were extracted.The studies were evaluated and analyzed by software RevMan 5.3.Results Twelve studies involving 312 111 cases were included(25 107 elderly and 287 004 non-elderly).The total AADR of the elderly was 9.97％ ,ADR was 11.33％ ,while CRC detection rate Was 1.79％.The meta-analysis showed that there were significant differences in the AADR(RR =1.57,95％ CI: 1.51-1.64), ADR(RR =1.22, 95％ CI: 1.19-1.25) and CRC detection rate(RR =2.6,95％ CI:2.34-2.90) between the elderly and the younger patients (P ＜ 0.000 01).The detection rate of AADR,ADR, CRC in the elderly were significantly higher than the non-elderly.Conclusion The elderly have higher AADR and CRC detection rate than the younger.But further studies are needed because life expectancy and complications are factors that need to be considered for screening.

OBJECTIVESymptomatic predictors of influenza could assess risks and improve decisions about isolation and outpatient treatment. To develop such predictors, we undertook a prospective analysis of pandemic (H1N1) 2009 and seasonal influenza (H3N2) in patients attending fever clinics.

METHODSFrom 1 May 2009 to 1 January 2010, all adult patients admitted to fever clinics for suspected influenza, confirmed by real time RT-PCR, were enrolled. Predictors of influenza virus infection were selected with logistic regression models. Measures of sensitivity, specificity, positive and negative likelihood ratios (LRs) were calculated to identify the best predictors.

RESULTSThe clinical features and routine blood test results of influenza (H1N1) 2009 and seasonal influenza were similar. The positive and negative LRs of current US CDC influenza-like illness (ILI) criteria were modest in predicting influenza infection. Our modified clinic predictors improved the ability of the positive and negative LRs to recognize pandemic (H1N1) 2009 and seasonal influenza. The revised criteria are: fever >38 °C accompanied by at least one of the following-cough, arthralgia or relative lymphopenia.

CONCLUSIONPatients with symptoms and signs that meet the new criteria are likely to have influenza and timely antiviral therapy may be appropriate. In addition, physicians should ascertain if influenza is circulating within the community or if there is a contact history of influenza and combine this information with the newly developed criteria to clinically diagnose influenza.

Adult ; China ; epidemiology ; Female ; Humans ; Influenza A Virus, H1N1 Subtype ; Influenza A Virus, H3N2 Subtype ; Influenza, Human ; diagnosis ; epidemiology ; virology ; Logistic Models ; Male ; Multivariate Analysis ; Pandemics ; Predictive Value of Tests ; Prospective Studies ; Young Adult

OBJECTIVE: To Discuss nasolabial pedicle flap in the repair of facial malignant asal nasi resection defect after clinical practicality and feasibility. METHOD: Eleven cases of patients with asal nasi surgery in patients with malignant tumor resection. And in accordance with the characteristics of the blood supply of the nasolabial fold area and the size of design defects to be repaired region length. angle and size, design nasolabial flaps pedicled flap face. Go through the nasal alar defect repair defects. RESULT: All patients were I wound healing, skins all survived, good blood circulation, good color and no obvious scar area. One year postoperative follow-up to 5 years without recurrence of the tumor, the effect of external nose satisfied with the cosmetic restoration. CONCLUSION The nasolabial flap pedicled facial blood rich and easy to survive, organizations can provide sufficient volume to the repair of larger nasal defects, vascular pedicle length, the transfer of a flexible, easy to operate and no obvious scar area. Nasolabial pedicle flap to repair the face of larger asal nasi defects after resection of malignant tumors can choose the best skin.
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Nose ; surgery ; Nose Neoplasms ; surgery ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; Surgical Flaps

OBJECTIVEThe aim of this investigation was to study the expression of collagen type II in the cartilage of mandibular condyle following asymmetric inter-maxillary traction.

METHODSTwo hundred and twenty SD rats were used in this study (one hundred and four rats loading 0.39 N elastic force, another one hundred and four rats loading 1.18 N elastic force, while twelve rats for control). The extra-joint device was fixed on the right side by surgery. Half of the experimental group was killed at 3, 7, 14, 28 days. The devices were removed at the 28th day in the rest rats, and the rats were sacrificed at 3, 7, 14, 28 days after removing the device. The type II collagen expression levels of all the joints were measured using immunohistochemical techniques.

RESULTSThe positive expression of the type II collagen was mainly observed in the cytoplasm of chondrocyte, especially in maturative and hypertrophic layer. The expression intensity was different in different stages and different sides. Both of the two experimental groups showed the same tendency, while the changes in the light force group were more obviously than the heavy force group. In the right side (force-loading side), the type II collagen expression decreased at the early force-loading period. After the device was removed, the expressions increased immediately but then reach the lowest level. The expression almost recovered to normal level at the end of experiment. In the left side (none force-loading side), the expression remained increasing after force-loading and reached the peak at the 14th day.

CONCLUSIONThese results suggest that even in the adult individuals, the chondrocyte showed reaction to the mechanical force by altering type II collagen expression patterns and it may be the cause of the cartilage remolding after asymmetric inter-maxillary traction. A forward elastic force showed a depressant effect in matrix synthesis, and heavy force had stronger effect. But the rotation of condyle accelerated the matrix synthesis.

Animals ; Cartilage ; Chondrocytes ; Collagen Type II ; Mandibular Condyle ; Rats ; Rats, Sprague-Dawley ; Traction