Pharmaceutical cocrystals is an advanced technology to improve the physicochemical and biological properties of drugs. However, there are few studies on the in vivo metabolism of pharmaceutical cocrystals. In this study, the pharmacokinetics of wogonin cocrystal in normal rats was further studied on the basis of the previous preparation of wogonin-aloperine cocrystal. Firstly, an ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method was established for simultaneous determination of wogonin and its metabolite wogonoside in rat plasma, and to investigate the methodology. The method was applied to the pharmacokinetic study of wogonin-aloperine cocrystal (Wog-Alop) in rats. The results showed that wogonin and its metabolite wogonoside had a good linear relationship in the range of 1-800 ng·mL^-1, and the precision, accuracy, matrix effect and stability in this range met the requirements of biological analysis. Compared with direct administration of wogonin, the C_max of wogonin and its metabolite in rats increased to 7.44-fold and 9.15-fold, AUC_0-t increased to 1.67-fold and 3.72-fold, and oral bioavailability of wogonin increased to 187.66% after cocrystal administration. Wog-Alop cocrystal can significantly improve the C_max, AUC, and oral bioavailability of wogonin and its metabolite, which provides a new perspective for the clinical application of wogonin. This study was approved by the Experimental Animal Ethics Review Committee of Beijing University of Chinese Medicine (approval number: BUCM-2023032307-1148).

To comprehensively evaluate the quality of commercial Ginseng Radix et Rhizoma Rubra, 43 batches of commercial Ginseng Radix et Rhizoma Rubra were collected to determine the content of nine ginsenosides Rg_1, Re, Rb_1, Rk_3, Rh_4, 20(S)-Rg_3, 20(R)-Rg_3, Rk_1, and Rg_5 by high performance liquid chromatography(HPLC). The quality of the commercial Ginseng Radix et Rhizoma Rubra was evaluated by correlation analysis, principal component analysis, factor analysis, analysis of variance(ANOVA), and cluster heatmap analysis. The content determination indicated that the content of common ginsenosides in commercial Ginseng Radix et Rhizoma Rubra were higher while that of rare ginsenosides were lower. Multivariate statistical analysis revealed that ginsenosides Rg_1 and Rb_1 were significantly positively correlated with rare ginsenosides, and Rg_1, Rb_1 and rare ginsenosides played an important role in evaluating the quality of commercial Ginseng Radix et Rhizoma Rubra. In combination with the processing principle and current quality situation of Ginseng Radix et Rhizoma Rubra, it is recommended to improve the content limit of Rb_1 in the existing quality standards.
Panax ; Ginsenosides/analysis* ; Rhizome/chemistry* ; Plant Roots/chemistry* ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal

Objective To explore the causes and characteristics of medical disputes caused by death after cardiac surgery and to analyze the pathological changes after cardiac surgery and the key points of forensic anatomy, thus to provide pathological evidence for clinical diagnosis and treatment of cardiac surgery and judicial appraisal as well as reference for the prevention of medical disputes in such cases. Methods Forensic pathological cases of medical disputes caused by death after cardiac surgery which were accepted by the Center for Medicolegal Expertise of Sun Yat-Sen University from 2013 to 2018 were analyzed retrospectively from aspects such as causes of death, pathological diagnosis, surgery condition, medical misconduct, and so on. Results The causes of death after cardiac surgery of 43 patients were abnormal operation, low cardiac output syndrome, postoperative infection, postoperative thrombosis, and other diseases. Among the 43 cases, there were 18 cases without medical fault while 25 cases had medical fault. Conclusion The medical disputes caused by death after cardiac surgery are closely related to the operative technique and postoperative complications. The causes of medical faults include defects in diagnosis and treatment technique, as well as unfulfillment of duty of care.
Cardiac Surgical Procedures/adverse effects* ; Dissent and Disputes ; Forensic Medicine ; Forensic Pathology ; Humans ; Retrospective Studies

To observe therapeutic effect of continuous rehabilitation exercise combined low‐frequency e‐lectrical stimulation on patients with low extremity dysfunction after ischemic stroke and its influence on patients＇lower extremity muscle strength and neurological motor function .Methods : A total of 94 patients with lower ex‐tremity dysfunction after ischemic stroke were randomly and equally divided into electrical stimulation group (re‐ceived low frequency electrical stimulation ) and combined treatment group (received continuous rehabilitation exer‐cise based on electrical stimulation group ).Therapeutic effect after three‐month treatment , lower extremity muscle strength and neurological motor function before and after treatment were evaluated , compared and analyzed be‐tween two groups .Results : After treatment , total effective rate of combined treatment group was significantly higher than that of electrical stimulation group (87. 23% vs.68.09%, P＝0.026).Compared with electrical stimu‐lation group after treatment , there was significant reduction in lower extremity muscle strength score [ (1.96 ± 0.45) scores vs .(1. 43 ± 0. 41) scores] , significant rise in scores of Fugl‐Meyer movement scale [FMMS , (24. 54 ± 3.76) scores vs.(29. 98 ± 3. 82) scores] , Barthel index of activities of daily living (ADL ) [BI , (69. 02 ± 6.29 ) scores vs .(79. 46 ± 6. 35 ) scores] , Berg balance scale [BBS , (44.56 ± 5.71 ) scores vs .(52.14 ± 5.79 ) scores] , Holden walking function [ (3.92 ± 0. 46) scores vs .(4.61 ± 0.49) scores] and Tinetti gait analysis [ (6. 57 ± 1.13) scores vs .(8. 06 ± 1. 24) scores] in combined treatment group , P＝0.001 all.Conclusion : Continuous rehabilitation exercise combined low frequency electrical stimulation can significantly enhance lower extremity muscle strength , improve neurological motor function , improve ADL in patients with lower extremity dysfunction after ischemic stroke , which is worth extending .

Objective To detect and analyze of residual ethanol in abandoned flaps after laser subepithelial keratomileusis (LASEK) with ethanol infiltration methods.Methods Together 20 patients (40 eyes) undergoing LASEK were recruited in the study.After infiltrated with 20％ ethanol and rinsed in equilibration solution,the corneal epithelial free flap was isolated and removed in time for sealing,and then procedures were continuously completed.Finally,observation of the skin flap production,postoperative irritation symptoms,epithelial healing,visual recovery and postoperative haze situation was performed,and then the amount of ethanol in the epithelial flap was measured.Results There was no failure in making the intact corneal flaps.The sensory score of postoperative irritation was 2.52 ± 1.46.Neonatal epithelial with 1 grade was observed in 32 eyes,2 grade in 8 eyes 5 days after surgery,while corneal haze with 0.5 grade was occurred in 3 eyes,1 grade in 2 eyes 12 weeks after surgery.There were ethanol residues in corneal epithelium in the abandoned flaps,with the amount of ethanol residues of (0.205 2 ± 0.041 0) μL in each flap.Conclusion It is found that a certain amount of ethanol residue in the corneal epithelium after LASEK with ethanol infiltration equilibration solution rinse,which may be one reason of the corneal irritation symptoms and corneal haze.

Objective:To observe the effect of electroacupuncture (EA) on the expressions of acetylcholine (ACh) and mucin 5AC (MUC5AC) in the lungs of rats with chronic obstructive pulmonary disease (COPD),and explore the mechanism of EA in treating COPD.Methods:Thirty Sprague-Dawley (SD) rats were randomly divided into a control group,a COPD group,and an EA group,with 10 rats in each group.The control group was a group of normal rats.The COPD rat model was induced by cigarette smoke combined with lipopolysaccharide (LPS).The COPD rats were treated with EA at bilateral Feishu (BL 13) and Zusanli (ST 36) in the EA group,30 min each time,once a day,successively for 14 d.The lung function was tested.The contents of ACh and MUC5AC in lungs and bronchoalveolar lavage fluid (BALF) were detected by enzyme-linked immunosorbent assay (ELISA).Pearson method was used to analyze the correlation between pulmonary function and the content of MUC5AC in lungs.The mRNA and protein expressions of MUC5AC in lung tissues were detected by real-time polymerase chain reaction (RT-PCR) and Western blot (WB),respectively.The immune response of MUC5AC was observed by immunohistochemistry.Results:Eight rats were left in each group,and the other two died.Compared with the control group,the total airway resistance (Raw) increased significantly and dynamic compliance (Cdyn) decreased significantly in the COPD group (P＜0.01);compared with the COPD group,the Raw level declined significantly and Cdyn increased significantly in the EA group (P＜0.01).The contents of ACh and MUC5AC in the lungs and BALF were remarkably higher in the COPD group compared with those in the control group (P＜0.01,P＜0.001);compared with the COPD group,the contents of ACh and MUC5AC were significantly lower in the EA group (P＜0.05,P＜0.001).There was a negative correlation between MUC5AC content and lung function (P＜0.001).The mRNA and protein expressions of MUC5AC in the lungs were significantly higher in the COPD group than in the control group (P＜0.001);compared with the COPD group,the expressions were significantly lower in the EA group (P＜0.01).Compared with the control group,the immune response of MUC5AC in the airway epithelium significantly increased in the COPD group (P＜0.001);the immune response of MUC5AC was significantly lower in the EA group compared with that in the COPD group (P＜0.001).Conclusion:EA treatment can improve the lung function of COPD rats,which may be related to its effect in the down-regulation of ACh and MUC5AC contents in the lungs as well as the inhibition of mucus hypersecretion.

Objective This experiment aimed to find out the feasibility of applying 3D printing technology to anato-my education. Methods We constructed 3D printed skull using a cadaveric skull as template.26 participants were recruited from Peking Union Medical College. All participants studied cranial anatomy with 3D printed skulls as teaching materials,and then assessed practicability of 3D printed skulls by subjective assessment questionnaires. Results 57% participants considered that 3D printed skulls can present defined cranial anatomical structures.More than 90% participants agreed that 3D printed models helped spatial comprehension and study of anatomy.88% par-ticipants suggested 3D printing can solve the problem of ethics.84% participants agreed to apply 3D printed models into cranial anatomy education. Conclusions The efficacy of 3D printing had been confirmed in anatomical educa-tion. Further application of 3D printing technology in medical education needs carrying out.

Objective This experiment aimed to find out the feasibility of applying 3D printing technology to anato-my education. Methods We constructed 3D printed skull using a cadaveric skull as template.26 participants were recruited from Peking Union Medical College. All participants studied cranial anatomy with 3D printed skulls as teaching materials,and then assessed practicability of 3D printed skulls by subjective assessment questionnaires. Results 57% participants considered that 3D printed skulls can present defined cranial anatomical structures.More than 90% participants agreed that 3D printed models helped spatial comprehension and study of anatomy.88% par-ticipants suggested 3D printing can solve the problem of ethics.84% participants agreed to apply 3D printed models into cranial anatomy education. Conclusions The efficacy of 3D printing had been confirmed in anatomical educa-tion. Further application of 3D printing technology in medical education needs carrying out.

Objective To investigate the standard prescription in patients with stable chronic obstructive pulmonary disease (COPD) and to provide a reference for rational drug use. Methods A total of 157 patients with COPD in our hospital were included into the study from June 2016 to January 2017. Of patients, there were 3 patients with mild airflow limitation, 18 patients with moderate airflow limitation, 39 patients with severe airflow limitation and 97 patients with extremely severe airflow limitation. The self-made questionnaire was used to understand the basic situation, complications and irrational drug use. Results Most severe and extremely severe COPD patients were male, and most of them combined with high blood pressure and cardiovascular disease. Of the 157 patients, 12 cases with moderate airflow limitation used inhaled therapy of corticosteroids/bronchodilator medications, 45 cases combined with pneumocardial disease used compound methoxyphenamine, 26 cases used leukotriene receptor antagonist, 14 cases used antibiotics for no obvious infection symptom and 11 cases used systemic corticosteroids in stable COPD. All of them belong to rational drug use. Conclusion There are some unreasonable situations of drug using in patients with stable COPD. The medical staff should strictly control indications, strengthen the education for drug use, guide rational drug use and avoid the occurrence of adverse consequences.