OBJECTIVE To establish HPLC characteristic chro matogram of Jianpi yifei biyan prescription standard decoction ， to select the quality control index components and determine their contents. METHODS HPLC method combined with Similarity Evaluation System of TCM Chromatographic Fingerprint （2004 edition）were used to establish the characteristic chromatogram of 10 batches of Jianpi yifei biyan prescription standard decoction ；the similarity evaluation and common peaks identification were also carried out. Using common peak area of characteristic chromatogram as variables ，SPSS 26.0 software and SIMCA 14.1 software were used to perfor m cluster analysis （CA），principal component analysis （PCA） and orthogonal partial least squares-discriminant analysis （OPLS-DA）；differential components with variable important i n pro jection（VIP）value greater than 1.5 were screened；the contents of cimifugin and differential components were determined by the same method. RESULTS A total of 24 common characteristic peaks were identified ， and the similarities of 10 batches of samples were higher than 0.960；eight characteristic peaks were identified by comparison with reference substance. CA and PCA results revealed that the samples were classified into 3 categories.OPLS-DA analysis showed that 3 components with VIP value greater than 1.5， which were prim-O-glucosylcimifugin （peak 2），calycosin 7-O-β-D-glucopyranoside （peak 4） and 5-O-methylvisammioside （peak 6） in descending order. The linear ranges of prim- O- glucosylcimifugin，calycosin 7-O-β-D-glucopyranoside，cimifugin and 5-O-methylvisammioside were 0.010 7-0.213 0，0.007 8- 0.156 0，0.008 0-0.160 0，0.009 8-0.195 0 μg（r＞0.999），respectively. RSD values of precision ，repeatability and stability tests （24 h） were all less than 2％. Average recoveries were 105.98％（RSD＝1.75％，n＝6），98.06％（RSD＝3.87％，n＝6），96.38％（RSD＝ 4.03％ ，n＝6） and 104.17％（RSD＝1.27％ ，n＝6）. The contents of the above 4 components in 10 batches of samples were 12.12-18.87，3.86-6.40，3.10-4.27 and 11.17-15.79 μ g/mL，respectively. CONCLUSIONS The established HPLC characteristic chromatographic method is stable and feasible ，it can be used for the quality control of Jianpi yifei biyan prescription standard decoction. Prim- O-glucosylcimifugin，calycosin 7-O-β-D-glucopyranoside，cimifugin and 5-O-methylvisammioside can be used as the index components for quality control of the standard decoction.

Objective:To determine the seroprevalence of celiac disease in susceptible population, and to analyze the relationship between demographic characteristics, dietary habits, lifestyle and serological positivity so as to provide guidance for the prevention and treatment of celiac disease in Southern China.Methods:A total of 1 273 individuals who participated in Guangdong Province Health Screening Program in 2015, were selected as serologically positive subjects of celiac disease, including people with irritable bowel syndrome, colitis, diarrhea, anemia, low BMI, short stature, type 1 diabetes mellitus (T1DM), rheumatoid arthritis (RA), ankylosing spondylitis, psoriasis and bristol grade=6 or 7. All subjects were tested for serum IgA anti-tissue transglutaminase antibodies (TTGA), IgA antibodies against deamidated gliadin peptides(DGPA) and IgG against deamidated gliadin peptides (DGPG). Dietary habits, lifestyle and demographic characteristics were compared in subgroups.Results:The seroprevalence of celiac disease in susceptible population was 0.94% (95% CI 0.54%-1.64%) including 0.08% (1/1 273) for TTGA, 0.47% (6/1 273) for DGPA, and 0.39% (5/1 273) for DGPG. The seropositive rate was 3.6% (1/28) in patients with psoriasis, 2.1% (2/95) in the low BMI group, 1.9% (1/53) in T1DM group, 1.8% (3/169) in diarrhea group and 1.1% (5/463) in RA group. No significant difference was found in age, gender, high carbohydrate diet or lifestyle between the negative and the positive subjects. Conclusions:In Southern China, the seropositive rate of celiac disease is 0.94% in susceptible population, which prompts an urgent need of serological screening for early diagnosis.

Objective:To investigate the effect of bilateral repetitive transcranial magnetic stimulation (rTMS) on the pre-attentive processing of methamphetamine addicts.Methods:Forty methamphetamine addicts were screened and equally divided into the intervention group and the control group by random number table method.The intervention group was treated with bilateral simultaneous stimulation with 10 Hz on the left DLPFC and 1 Hz on the right DLPFC with 7 days of continuous intervention.The same scheme was used to intervene the control group, but with pseudo-stimulation. The changes of amplitude and latency of mismatch negative wave(MMN) before and after intervention were compared. SPSS 24.0 software was used for statistical analysis. Independent sample t-test was used for inter group comparison, and paired sample t-test was used for intra group comparison before and after intervention. Results:Before rTMS, there were no significant differences in MMN(F3, Fz, F4) amplitude (intervention group: (-0.90±0.28)μV, (-0.98±0.19)μV, (-0.96±0.19)μV; control group: (-0.92±0.21)μV, (-0.89±0.20)μV, (-0.94±0.16)μV)and latency(intervention group: (184.16±33.07)ms, (179.20±25.35)ms, (184.95±28.22)ms; control group: (184.91±26.96)ms, (180.99±25.29)ms, (181.55±23.19)ms) between the two groups (all P>0.05). After the intervention, there were significant differences in MMN(Fz, F4) amplitude(intervention group: (-1.38±0.16)μV, (-1.17±0.19)μV; control group: (-0.91±0.17) μV, (-0.99±0.16)μV) between the two groups (both P<0.01), but there were no significant differences in MMN (F3) amplitude(intervention group: (-1.01±0.59)μV; control group: (-0.80±0.50)μV), and in MMN (F3, Fz, F4) latency(intervention group: (177.38±26.45)ms, (172.17±23.87)ms, (179.84±23.60)ms; control group: (182.08±24.95)ms, (177.94±21.30)ms, (179.18±21.62)ms)between the two groups (all P>0.05). There were statistically significant differences in MMN( Fz, F4) amplitude (before-intervention: (-0.98±0.19)μV, (-0.96±0.19)μV; after-intervention: (-1.38±0.16)μV, (-1.17±0.19)μV)before and after intervention in the intervention group (both P<0.05), but there was no significant difference in MMN(F3) amplitude(before-intervention: (-0.90±0.28)μV; after-intervention: (-1.01±0.59)μV)before and after intervention in the intervention group ( P>0.05), and there were statistically significant differences in MMN(F3, Fz, F4) latency (before-intervention: (184.16±33.07)ms, (179.20±25.35)ms, (184.95±28.22)ms; after-intervention: (177.38±26.45)ms, (172.17±23.87)ms, (179.84±23.60)ms)before and after intervention in the intervention group(all P<0.05). After pseudo-stimulation, there were no statistically significant differences in MMN( F3, Fz, F4) amplitude(before-intervention: (-0.92±0.21)μV, (-0.89±0.20)μV, (-0.94±0.16)μV; after-intervention: (-0.80±0.50)μV, (-0.91±0.17)μV, (-0.99±0.16)μV)and latency (before-intervention: (184.91±26.96)ms, (180.99±25.29)ms, (181.55±23.19)ms; after-intervention: (182.08±24.95)ms, (177.94±21.30)ms, (179.18±21.62)ms) before and after intervention in the control group (all P>0.05). Conclusion:After repeated transcranial magnetic stimulation, the pre-attentive processing of the intervention group is improved, which shows that bilateral simultaneous stimulation of the rTMS program is effective.

Objective:To evaluate the efficacy of ultrasound-guided adductor canal approach to nerve block using one-puncture four-point technique for analgesia after total knee arthroplasty (TKA).Methods:Sixty patients of both sexes, aged 65-80 yr, with body mass index of 18-27 kg/m 2, of American Society of Anesthesiologists physical status Ⅱor Ⅲ, scheduled for elective unilateral TKA under general anesthesia, were enrolled in this study.Peripheral nerve block was performed for postoperative analgesia under ultrasound guidance.All the patients were allocated into 2 groups ( n=30 each) using a random number table method: adductor canal block combined with posterior approach to sciatic nerve block group (group ASB) and adductor canal approach to nerve block using one-puncture four-point technique including sciatic nerve, medial vastus muscle nerve, saphenous nerve, anterior femoral cutaneous nerve at adductor canal level group (group ANSB). When visual analogue scale score ≥4 during postoperative movement, ketorolac tromethamine 0.6 mg/kg was intravenously injected as rescue analgesic. The muscle strength of quadriceps on the affected side, range of knee joint motion and rate of the ability to walk for 10 m using the walker were recorded at 2, 8, 24 and 48 h after surgery.The consumption of analgesics for rescue analgesia, manipulation completion time, length of hospital stay and patients′ satisfaction score were recorded within 48 h after surgery. Results:Compared with group ASB, the consumption of ketorolac tromethamine was significantly reduced, manipulation completion time and length of hospital stay were shortened, patients′ satisfaction scores were increased, and the range of knee joint motion and rate of the ability to walk for 10 m using the walker were increased at 2, 8, 24 and 48 h after surgery in group ANSB ( P<0.05). There was no significant difference in muscle strength of quadriceps between two groups ( P>0.05). Conclusion:Ultrasound-guided adductor canal approach to nerve block using one-puncture four-point technique provides better efficacy than adductor canal block combined with posterior approach to sciatic nerve block when used for analgesia after TKA.

Patients with coronary heart disease have recurrent cardiovascular events after systemic treatment is often one of the leading factors increasing the death and hospitalization rates, thereby adding to the economic burden of society. According to foreign and domestic reports, poor compliance of cardiac rehabilitation in patients with coronary heart disease is a common problem at present. Therefore, in the rehabilitation of patients with coronary heart disease, Improving cardiac rehabilitation compliance is important in regaining health and cost saving during coronary heart disease recovery treatment. This study summarized the status and influence factors of cardiac rehabilitation compliance among foreign and domestic coronary heart disease patients and the interventions recommended for improving cardiac rehabilitation compliance.

Objective To compare of the application of tracheal intubation guided by Lightwand,Shikani optical stylet,or Macintosh. Methods Ninety ASA Ⅰ~Ⅱ patients undergoing elective general anesthesia were randomly divided into three groups(n = 30):Macintosh group(group M),Lightwand group(group L)and Shi-kani optical stylet group(group S). MAP and HR were recorded at the time of entering the operating room(T1), before intubation(T2),at the immediate time of intubation(T3),3 mins(T4)and 5 mins after intubation(T5). The intubation duration,the first intubation success rate,the number of intubation,and the incidence of complications including sore throat were observed. Results As compared with T1,MAP and HR decreased significantly at T2in the three groups(P<0.05). As compared with T2,HR increased in group L and MAP and HR increased in group S at T3(P<0.05). As compared with group M,MAP and HR at T4and T5were lower in groups L and S(P<0.05). The first intubation time was obviously shorter in group L than in other groups(P<0.05). The incidence of compli-cations was lower in group S(P < 0.05). The first success rate of intubation,the intubation times and the inci-dence of airway complications did not differ significantly among the three groups.(P > 0.05). Conclusions As compared with Macintosh,Lightwand and Shikani optical stylet have less influence on hemodynamic parameters. Lightwand needs shorter intubation time,Shikani optical stylet has the lowest rate of sore throat.

Objective To investigate the predictive value of baseline neutrophil-to-lymphocyte ratio (NLR) in the curative effect and prognosis of breast cancer patients treated with neoadjuvant chemotherapy.Methods The clinical data of 304 breast cancer patients received neoadjuvant chemotherapy in Beijing Cancer Hospital during 2010 were retrospectively analyzed.The correlations of baseline NLR with clinicopathological parameters of breast cancer patients were analyzed by Wilcox or Kruskal-Wallis tests,and the correlation of NLR with pathologic complete response (pCR) after neoadjuvant chemotherapy was analyzed by the binary logistic regression.The effect of clinic pathological parameters on the disease-free survival(DFS) of the patients was evaluated by the univariable and muhivariable Cox regression models.Results The medians of NLR in pCR + patients (n =62) and pCR-patients (n =242) were 1.76 and 1.72,respectively,and there was no significant difference between themn (P ＞ 0.05).Multivariate analysis indicated that the TNM stage (P ＜ 0.05) and pCR (P ＜ 0.05) were the independent risk factors influencing the prognosis of breast cancer patients.There was no significant correlation between NLR and 5-year DFS (HR=0.842,95％CI=0.566-1.255,P＞0.05).Condusion NLR lacks the predictive value in the curative effect and prognosis of breast cancer patients treated with neoadjuvant chemotherapy,while TNM stage and pCR are the independent risk factors influencing the prognosis of breast cancer patients.

Objective To compare the display effect of contrast enhanced MR angiography (CE-MRA) and CTA in evaluating blood supply of early stage cervical cancer.Methods CE-MRA and CTA before the operation of 30 patients with pathologically confirmed early stage cervical cancer were analyzed retrospectively.The origins and continuity of bilateral uterine arteries and the conspicuity of bilateral decending branch of uterine arteries between CE-MRA and CTA were evaluated.Results Fifty uterine arteries could classify as origins clearly visible and vessels clearly visible without discontinuity,5 uterine arteries as origins clearly visible but vessels unclearly visible on both CEMRA and CTA.Both CE-MRA and CTA were conformed well in evaluating the origin and continuity of uterine arteries (Kappa=0.80,P＜0.05).The conspicuity of decending branches for CE-MRA was 55.00％ (33/60),which was lower than that of CTA (73.33％ [44/60]),which had statistically significant difference between CE-MRA and CTA (x2 26.22,P＜0.01).Conclusion For early stage cervical cancer,CE-MRA and CTA can both provide a good performance in evaluating the origin and continuity of uterine arteries,CTA reveals advantage over CE MRA in detecting conspicuity of decending branch of uterine arteries.

Objective To establish the Logistic regression model by reporting and data system version 2 (PI-RADS v2)and prostate specific antigen (PSA),and to evaluate the diagnostic efficiency in transition zone prostate cancer (PCa).Methods MRI and PSA data of 33 patients with PCa and 54 patients with non-PCa confirmed by pathology were analyzed retrospectively.The PI-RADS v2 was used to evaluate the risk of 2 groups (from low to high as 1 to 5 points).Total PSA (t-PSA),free to total PSA ratio (f-PSA/t-PSA),PSA density (PSAD) and PI-RADS v2 scores were compared between 2 groups.The Logistic regression models were established with parameters which were significantly different between 2 groups.The Logistic regression was divide into three protocols:PI-RADS v2-+ t-PSA (A),PI-RADS v2 + f-PSA/t-PSA (B),PI-RADS v2+PSAD (C).The ROC curves were constructed by the new parameters Logit (P) and PI-RADS v2 scores for assessing the diagnostic efficiency.Results The t-PSA,f-PSA/t-PSA,PSAD and PI-RADS v2 scores had significant differences between the 2 groups (all P＜0.01).Predictive multivariate model of A,B,C was established as Logit (P)=-8.682+1.507 PI-RADS v2+0.234 t-PSA (x2=65.993,P＜0.01),Logit(P)=-5.425+1.906 PI-RADS v2 13.921 f-PSA/t-PSA (x2 =65.993,P＜0.01),Logit(P)=-7.534+1.045 PI-RADS v2+13.318 PSAD (x2 =74.036,P＜0.01),their area underthe curve (0.945,0.919,0.960) were all higher than that of PI-RADS v2 score (0.861,all P ＜0.01).The protocol C had the best diagnostic efficiency,and the sensitivity and specificity were 87.88 ％ and 92.59 ％.The sensitivity and specificity of PI-RADS v2 score were 87.88％ and 77.78％.Conclusion The diagnostic efficiency of the Logistic regression model which includes the PI-RADS v2 score and PSA are superior to the PI-RADS v2 score alone for transition zone PCa,which can provide a reliable basis for patients whether need biopsy or not.

Objective To explore the feasibility of intravoxel incoherent motion DWI (IVIM-DWI) in differential diagnosis of hepatocellular carcinoma (HCC) and focal nodular hyperplasia (FNH).Methods A total of 407 patients with clinically-suspected HCC or FNH underwent conventional and dynamic enhanced MRI and IVIM-DWI,60 patients (40 cases of HCC,20 cases of FNH) were enrolled.Parameters of ADC,slow apparent diffusion coefficient (D),fast apparent diffusion coefficient (D*) and fraction of fast apparent diffusion coefficient (f) were obtained by monoexponential model and biexponential model respectively.Results The values of ADC,D,D* and f in FNH group were (1.60±-0.25) × 10-3mm2/s,(1.12±0.17)×10-3mm2/s,(44.89±18.23)× 10-3 mm2/s and (34.80 ± 9.68)％,and those in HCC group were (1.32 ± 0.21) × 10-3 mm2/s,(0.82±-0.21) × 10-3mm2/s,(49.82±20.11) × 10 3mm2/s and (28.72±13.84) ％,respectively.Significant inter-group differences were observed in ADC and D (both P＜0.001),however,there were no significant differences in D* and f (both P＞0.05).The areas under the ROC curve of D were 0.90,and taking D=0.96 × 10-3 mm2/s as cut-off value,the sensitivity and specificity of D in diagnosis of HCC were 84.44％ and 90.02％.Conclusion IVIM-DWI is useful to distinguish FNH from HCC,and the D value in biexponential model has the best diagnostic efficacy for differentiations.