OBJECTIVE To study the effect of different proportion compatibility of Astragali Radix and Chuanxiong Rhizoma on the extraction kinetics of flavonoids. METHODS The content determination method of flavonoids(with rutin as the control substance) was established, and the concentrations of flavonoids in the extracts of Astragali Radix membranicum and Chuanxiong Rhizoma in different proportions(1∶1, 1∶2, 1∶3, 1∶4, 1∶5, 2∶1, 3∶1, 4∶1, 5∶1) were determined dynamically within 2 h, respectively. The extraction kinetics model was established according to Feck's first diffusion law. The extraction rate constant was calculated and the difference of dissolution kinetics was compared. RESULTS The compatibility of different proportions of Astragali Radix and Chuanxiong Rhizoma had significant effects on the extraction rate and concentration of flavonoids. The extraction kinetics models of flavonoids were consistent with the characteristics of the first-order kinetic equation. The extraction rate was the fastest when Astragali Radix ∶ Chuanxiong Rhizoma was 3∶1, the extraction rate was the slowest when Chuanxiong Rhizoma∶ Astragali Radix was 2∶1. The equilibrium concentration of flavonoids was the highest when Chuanxiong Rhizoma∶ Astragali Radix was 3∶1, when the ratio of Astragali Radix∶Chuanxiong Rhizoma was 5∶1, it was the lowest. CONCLUSION The compatibility of different proportions of Astragali Radix and Chuanxiong Rhizoma has a significant effect on the extraction rate and concentration of flavonoids.

Objective:To evaluate the efficacy and safety of modified Atkins diet (MAD) in treating global growth retardation (GDD).Methods:A prospective multicenter clinical controlled study was conducted.The children were included from 8 departments of children′s rehabilitation in Henan Province from July 2017 to October 2017.A total of 154 children who met the inclusion criteria were randomly assigned into the routine treatment group (88 cases) and MAD therapy group (66 cases). A total of 62 children in MAD therapy group and 59 children in routine treatment group completed the study for 15 months.The routine treatment group was provided comprehensive rehabilitation training, and the MAD therapy group was given MAD treatment on the basis of rehabilitation training.Two-way repeated-measures ANOVA was used to compare the differences among datas at different time points. Results:After 3 months, there were significant differences in the scores of the Chinese Version of Urban Infant-Toddler Social and Emotional Assessment (CITSEA)/Achenbach Children′s Behavior Scale (CBCL) between the 2 groups (all P<0.05). Significant improvement was seen in the MAD group.After 6 months, the MAD therapy group had significantly higher scores on the Gesell Developmental Scale for language and social behavior than the routine treatment group (all P<0.05). After 9 months, the scores of the children in the MAD therapy group were better than those in the routine treatment group in the Gesell Developmental Scale adaptive energy area and the infant-junior high school student social life scale (S-M scale), and the differences were statistically significant (all P<0.05). After 15 months, the fine motor in the MAD therapy group was better than that in the routine treatment group ( P<0.05). At the early stage of MAD therapy, 28 patients showed mild adverse reactions that were reversed after symptomatic treatment.No severe adverse reactions were observed. Conclusions:MAD therapy can improve the neuro-development, emotional and social behaviors, and adaptive behaviors with no severe adverse effects.

Objective To establish a method for the simultaneous determination of Forsythoside A, Phillyrin, (R,S)-Epigoitrin, Chlorgenic Acid and Isochlorogenic Acid A by HPLC, and test 16 batches of samples from 14 manufacturers. Methods The test was performed on Kinetex EVO C18 column (150 mm × 4.6 mm, 5 μm) with the column temperature at 35 ℃ . The gradient elution was adopted with the mobile phase of acetonitrile and 0.3% phosphoric acid aqucous at a flow rate of 1.0 ml/min. The detection wavelength of (R,S)-Epigoitrin and Phillyrin were set as 236 nm, the detection wavelength of Forsythoside A, Cholorogenic Acid and Isochlorogenic Acid A were set as 327 nm. Results The good linear relationships were displayed within the linear range of 0.050 45-2.018 00 μg for Forsythoside A (r=0.999 9), 0.018 21-0.728 40 μg for Phillyrin (r=0.999 9), 0.010 16-0.406 40 μg for (R,S)-Epigoitrin (r=0.999 9), 0.006 60-0.263 90 μg for Cholorogenic Acid (r=0.999 9) and 0.0040 44~0.161 76 μg for Isochlorogenic Acid A ( r=0.999 5). The RSDs of reproducibility and stability tests were lower than 2%; recoveries were 97.01%, 98.28%, 99.35% and 96.21%, RSD were 3.19%, 1.19%, 0.81%, 2.88% and 2.96%. The content ranges of Forsythoside A, Phillyrin, (R,S)-Epigoitrin, Chlorgenic Acid and Isochlorogenic Acid A from 16 batches of samples from 14 manufacturers were 0.057 43-1.508 71 mg/g, 0.017 72-0.350 15 mg/g, 0.005 68-0.177 13 mg/g, 0.007 53-0.226 33 mg/g and 0.00308-0.11908 mg/g. Conclusions The established method is simple and accurate, and has a good repeatability. It can be used for the quality analysis of Forsythoside A, Phillyrin, (R,S)-Epigoitrin, Chlorgenic Acid and Isochlorogenic Acid A. The content of the tested chemical components from 16 batches of samples from 14 manufacturers have significant differences which indicate that a reinforcement of the quality control is needed.

Objective To investigate the distribution characteristics of the gut microbiome in infants with different delivery mode and feeding pattern at six weeks of life.Methods A total of 60 infants delivered between June and September in 2017 at Peking University First Hospital were recruited.According to delivery modes and feeding patterns,they were respectively divided into two groups,which were vaginal delivery (n=42)and cesarean delivery (n=18) groups,and exclusively breastfeeding (n=40) and mixed-feeding (n=20) groups.Stool samples of all subjects were collected at six weeks after birth.The V3-V4 region of 16s rRNA gene was sequenced on Illumina Hiseq 2500 platform,and the results were analyzed with SILVA database and QIIME software.Independent samples t-test or Mann-Whitney U test was used for statistical analysis.Results (1)Eight bacterial phyla and 146 genera were identified in the 60 stool samples.Firmicutes,Proteobacteria,Actinobacteria and Bacteroidetes were four dominant phyla,and Bifidobacterium,Clostridium,Klebsiella,Bacteroides,Streptococcus,Escherichia-Shigella,Veillonella and Faecalibacterium were the top eight most abundant genera.(2) At the phyla level,the vaginal delivery group was characterized with reduced Firmicutes (0.56 ± 0.1 0 vs 0.42± 0.20,t=2.94,P＜0.05) and increased Actinobacteria and Bacteroidetes [0.04 (0.01-0.11)vs 0.20 (0.05-0.36),U=223,P＜0.05;0.05 (0.01-0.23) vs 0.09 (0.02-0.29),U=315,P＜0.05] as compared with the cesarean delivery group.However,there was no significant difference in the four dominant phyla between exclusively breastfeeding and mixed-feeding groups (all P＞0.05).At the genus level,the relative abundance of Bifidobacterium was higher in the vaginal delivery group than in the cesarean delivery group [0.19 (0.02-0.36) vs 0.01 (0.00-0.07),U=210,P＜0.01].Similarly,there was no significant difference in the eight dominant genus between exclusively breastfeeding and mixed-feeding groups(all P＞0.05).(3) The vaginal delivery group showed significantly lower Shannon and Simpson indexes than the cesarean delivery group [4.26 (3.61-5.52) vs 5.48± 1.19,U=227,P＜0.05;0.86±0.08 vs 0.94 (0.92-0.97),U=194,P＜0.05],while no significance was found in operational taxonomic unit (OTU) number and Chaol index (all P＞0.05).However,there was no significant difference in OTU number,Chaol,Shannon or Simpson index between the exclusively breastfeeding and the mixed-feeding groups (all P＞0.05).Conclusion The early infancy is a critical period for the establishment of gut microbiome.Significant differences in the composition and diversity of gut microbiota are found between infants born vaginally and abdominally,but not in infants with different feeding patterns.

Objective: To optimize the preparation process for Haoqin-Huaban granules so as to provide experimental basis for the development and utilization of the compound. Methods: Taking the extraction rate of gentiopicroside from Gentiana macrophylla Pall as the observation index, L₉(3⁴)orthogonal test was used to investigate the amount of water, extraction time, and extraction frequency for optimizing the water extracting technology of the Haoqin-Huaban granules. Then the dry paste was used for the raw material, the ratio of the diluent (dextrin) and the concentration and dosage of the binder (ethanol) were investigated by single factor, and the particles were prepared. Results: The optimum water extraction process was A2B2C3, which indicated that the prescribed medicinal materials with 8 times water were extracted 1 h for 3 times. The extract was concentrated into paste, vacuum drying, pulverizing, mixing according to the ratio of 5:1, with ethanol, made of soft material, pelletizing, drying at 60 ℃ for granulation, in order to make Haoqin-Huaban granules. Conclusions The preparation process is reasonable and feasible, which provides experimental basis for the industrial production of Haoqin-Huaban granules.

Background:Mortality outcomes in trials of low-dose computed tomography (CT) screening for lung cancer are inconsistent.This study aimed to evaluate whether CT screening in urban areas of China could reduce lung cancer mortality and to investigate the factors that associate with the screening effect.Methods:A decision tree model with three scenarios (low-dose CT screening,chest X-ray screening,and no screening) was developed to compare screening results in a simulated Chinese urban cohort (100,000 smokers aged 45-80 years).Data of participant characteristics were obtained from national registries and epidemiological surveys for estimating lung cancer prevalence.The selection of other tree variables such as sensitivities and specificities of low-dose CT and chest X-ray screening were based on literature research.Differences in lung cancer mortality (primary outcome),false diagnoses,and deaths due to false diagnosis were calculated.Sensitivity analyses were performed to identify the factors that associate with the screening results and to ascertain worst and optimal screening effects considering possible ranges of the variables.Results:Among the 100,000 subjects,there were 448,541,and 591 lung cancer deaths in the low-dose CT,chest X-ray,and no screening scenarios,respectively (17.2％ reduction in low-dose CT screening over chest X-ray screening and 24.2％ over no screening).The costs of the two screening scenarios were 9387 and 2497 false diagnoses and 7 and 2 deaths due to false diagnosis among the 100,000 persons,respectively.The factors that most influenced death reduction with low-dose CT screening over no screening were lung cancer prevalence in the screened cohort,low dose CT sensitivity,and proportion of early-stage cancers among low-dose CT detected lung cancers.Considering all possibilities,reduction in deaths (relative numbers) with low-dose CT screening in the worst and optimal cases were 16 (5.4％) and 288 (40.2％) over no screening,respectively.Conclusions:In terms of mortality outcomes,our findings favor conducting low-dose CT screening in urban China.However,approaches to reducing false diagnoses and optimizing important screening conditions such as enrollment criteria for screening are highly needed.

Objective To evaluate the efficiency of rotational atherectomy (RA) with drug-eluting stents (DES) by intravascular ultrasound (IVUS) for elderly patients with heavily calcified lesions. Methods Thirteen patients aged above 70 years with heavily calcified coronary artery having underwent the treatment of RA and DES by IVUS were enrolled. The levels of troponin T, creatine kinase isozyme-MB and creatinine were detected before and after operation.The levels of minimus lumen diameter, diameter stenosis rate, effective area of the lumen before and after operation were compared. The immediate success rate was evaluated and the follow-up results were recorded. Results Thirteen patients in accordance with angiography and IVUS examination were confirmed as severe calcification. The levels of troponin T, creatine kinase isozyme-MB and creatinine detected before and after operation had no significantly differences (P>0.05). The levels of minimus lumen diameter, diameter stenosis rate and effective area of the lumen before and after operation had significant differences:(2.06 ± 0.38) mm vs. (3.98 ± 0.76) mm, (73.26 ± 7.02)%vs. (17.00 ± 3.34)%, (4.53 ± 1.50) mm2 vs. (12.54 ± 6.19) mm2, P<0.01. The rate of left anterior descending artery, circumflex artery and right coronary artery calcification was 10/13, 0 and 1/13. All patients′operation was successful. Followed up for (14.6 ± 3.4) months, no patients had angina and myocardial infarction, or required target vessel revascularization. Conclusions RA with DES by IVUS can be safely used in elderly patients with severely calcified coronary artery disease, and can improve the success rate of intervention operation.

Objective To analyze the value of plane QRS-T angle on prediction of malignant ventricular arrhythmia (MVA) occurred after emergency percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods The clinical data of 418 patients with STEMI who underwent PCI within 12 h of symptom onset were retrospectively analyzed, and the patients were divided into plane QRS-T angle ≤ 90° group (324 cases) and plane QRS-T angle>90° group (94 cases) according to the plane QRS-T angle after PCI. The clinical data were compared between 2 groups. Results Compared with patients in plane QRS-T angle ≤ 90° group, patients in plane QRS-T angle > 90° group was older: (67.4 ± 11.8) years vs. (63.6 ± 12.0) years, QTc interval was longer: (438.60 ± 34.97) ms vs. (425.24 ± 25.49) ms, rate of left ventricular ejection fraction (LVEF) <45% was higher: 57.4% (54/94) vs. 35.8% (116/324), rate of using of beta-blockers was less: 74.5% (70/94) vs. 84.9% (275/324), but the incidences of hypertension and MVA were higher:79.8%(75/94) vs. 64.5%(209/324) and 10.6%(10/94) vs. 1.2%(4/324), and there were statistical differences (P<0.01 or<0.05). Logistic regression analysis showed that plane QRS-T angle >90° was an independent risk factor of MVA after PCI in STEMI patients (OR = 9.640, P =0.001), and using of beta-blockers was a protective factor (OR = 0.266, P = 0.028). Conclusions Plane QRS-T angle>90° is an independent risk factor of MVA after PCI in STEMI patients, while the use of beta-blockers is a protective factor. Paients with STEMI after PCI should be alert to the occurrence of MVA in the condition of plane QRS-T angle>90° and not taking beta-blockers.

Objective To compare the effects of exogenous enzymes on the degradation of adhesive-dentin interface.Methods Forty molars were sectioned to expose the middle-coronal dentin surface and randomly divided into two adhesive systems:an etch-and-rinse adhesive Adper Single Bond 2 and a self-etching adhesive G-Bond.After composite building up,the specimens were then randomly assigned to four groups(n=5 for each group) as follows:group 1,24 h of water storage(the control group);group 2,six months of water storage;group 3,twelve weeks storage in artificial saliva containing clostridium histolyticum collagenase;group 4,twelve weeks storage in artificial saliva containing cholesterolesterase.The microtensile bond strengths(MTBS) were then tested.The failure modes and nanoleakage were analyzed.Results After aging treatments,the three aging groups showed significantly lower MTBS compared with the control group in both adhesive systems(P＜0.05).For etch-and-rinse adhesive Adper Single Bond 2,the MTBS of group 3([19.6±3.5] MPa) was lower than that of group 2([23.4±4.2] MPa) and group 4([24.2±4.2] MPa) (P＜0.05).For self-etching adhesive G-Bond,there was no difference on MTBS among different aging groups (P＞0.05).SEM observation showed that,compared with the control group,water storage(group 2) and the exogenous enzymes(group 3 and 4) increased the nanoleakage expression(silver deposition) of both adhesive systems.Adhesive failure was the predominant fracture modes in all groups.Conclusions Storage in artificial saliva containing clostridium histolyticum collagenase or cholesterol esterase could be used to accelerate the degradation process of adhesive-dentine interface.