ObjectiveTen Chinese patent medicines for stable angina pectoris with qi stagnation and blood stasis were comprehensively evaluated， with the aim of providing reference for optimizing the drug list of medical institutions and promoting rational drug utilization. MethodAccording to the Expert Consensus on the Selection of Chinese Patent Medicines in Medical Institutions 2022， an evaluation framework of "6+1" dimensions was established for comprehensive evaluation of the drugs based on the indicators in three levels. ResultThe evaluation results showed that Compound Danshen dripping pills， Shexiang Baoxin pills， Di'ao Xinxuekang capsules， and Xuefu Zhuyu capsules were strongly recommended for stable angina pectoris with Qi stagnation and blood stasis， with the scores of 78.5， 76， 72， and 70.8， respectively. Suxiao Jiuxin pills， Xinkeshu Tablets， Guanxin Danshen Dripping pills， and Yindan Xinnaotong soft capsules were weakly recommended， with the scores of 68.5， 65.5， 60.5， and 60.5 respectively. Lemai pills and Yangxin Dawayimixike migao were not recommended for the time being due to their low scores （50.5 and 48.8， respectively）. There is a lack of research on special populations， pharmacokinetic parameters， post-marketing re-evaluation， and economics of the medicines. ConclusionWith the updating of Chinese patent medicines， real-world research data are needed to enhance the evidence-based support. This evaluation can only reflect the comprehensive situation at a certain stage， and dynamic evaluation remains to be carried out to provide support for decision makers.

Objective:Laparoscopic surgery for cervical cancer has the advantages of little blood loss and rapid recovery,but its therapeutic effect is still controversial.This study aims to analyze the surgical procedure and clinical efficacy of tumor-free laparoscopic radical hysterectomy without a uterine manipulator for early-stage cervical cancer,and to explore the indications of laparoscopic surgery for cervical cancer. Methods:This study was a retrospective study.The data of patients who underwent radical hysterectomy for early-stage cervical cancer admitted to Hunan Provincial Maternal and Child Health Care Hospital from July 2019 to December 2021 were collected.According to 2018 the International Federation of Gynecology and Obstetrics(FIGO)clinical staging,all patients were in IA1 with lymphovascular invasion,IA2,and IB1 stage.Among them,45 patients underwent tumor-free laparoscopic radical hysterectomy without a uterine manipulator(laparoscopy group)and 16 patients underwent open surgery(open surgery group).Patients were followed up for 12-41 months.The differences between the 2 groups in terms of operative time,bleeding volume,extent of surgical resection,surgical complications,and prognosis were compared and analyzed. Results:Compared to the open surgery group,the laparoscopy group had significantly shorter operation time and less intraoperative blood loss(both P＜0.001).There were no significant differences between the 2 groups in terms of the length of excised uterosacral ligaments,cardinal ligaments,vagina,and the number of excised lymph nodes(all P＞0.05).The incidence of postoperative complications did not differ significantly between the groups(P＞0.05).No death or recurrence occurred in the 2 groups during the follow-up period.The overall survival rate and disease-free survival rate were both 100%. Conclusion:For early-stage cervical cancer with a diameter≤2 cm,tumor-free laparoscopic radical hysterectomy without a uterine manipulator is safe and feasible,and the short-term outcomes is no less than that of open surgery.

The clinical data of 120 patients admitted to our hospital with renal stones treated by flexible ureteroscopy (FURS) and the imaging-related data measured by virtual reality technology were retrospectively analysed. The results of the univariate analysis showed that stone surface area (S), renal pelvis volume (P), length of calyces funnel (L), pelvic calyceal height (H) and essence of stone (E) were closely related to stone-free rate. The H. L.P.E.S. score was constructed to predict stone-free rate after FURS based on the above factors, and the area under the receiver aperating characteristic curve for the H. L.P.E.S. and S. O.L.V.E. scoring systems was 0.921 and 0.754 respectively.The H. L.P.E.S. scoring system has higher predictive value.

Objective:To study the effect of hepatitis B virus X protein (HBx) expression level on migration and invasion of zonula occludens protein-1 (ZO-1) in HepG2 liver cancer cells.Methods:Liver cancer cells were transfected with HBV full gene plasmid (pcDNA3.1-HBV1. 1 or pcDNA3.1-HBV1.3), empty plasmid (pcDNA3.1) and HBV-encoded protein plasmids (pHBc, pHBs, pHBp and pHBx), respectively. Western blot and RT-PCR were used to detect ZO1 protein and mRNA levels. Immunoprecipitation was used to detect transfected pHBx. Western blot was used to detect ZO1 ubiquitination levels. Transwell chambers were used to assess cell migration and invasion. Cell proliferation and lactate dehydrogenase assay was used to detect siRNA transfecting targeting ZO1. Flow cytometry was used to detect cell apoptosis and cycle. The data was compared between two and multiple groups by using an independent sample t-test and one-way analysis of variance.Results:Compared with the empty plasmid, ZO1 protein level in HepG2 cells after transiently transfected with pHBV1.1 and pHBV1.3 was decreased by 42.99% ± 6.8% and 55.0% 5 ± 4.56%, respectively, and their mRNA levels did not change significantly. ZO1 protein level in Huh7 cells was decreased by 17.46% ± 4.94% and 47.53% ± 3.38%, respectively. ZO1 protein level after transfection with pHBx was decreased by 47.02% ± 3.4%, while the ZO1 protein level after transfection with pHBc, pHBs and pHBp did not change significantly. ZO1 mRNA level was unaffected with pHBx transfection. ZO1 ubiquitin level and cell migration and invasion ability in HepG2 cells was significantly increased with transfected pHBx. HepG2 cells proliferation, apoptosis and cycle after transfection with ZO1-targeted siRNA did not change significantly, but the migration and invasion ability were significantly increased.Conclusion:HBx can increase the migration and invasion of liver cancer cells by promoting the ubiquitination and degradation of ZO1 protein level.

OBJECTIVE: To investigate the interventional effect of the Chinese herbal preparation Xi Fu Pai Chen(XFPC) on pulmonary inflammation and fibrosis in rats with silicosis. METHODS: A total of 144 adult specific pathogen free male SD rats were randomly divided into 6 groups: blank control group, silicosis model group, drug administration control group and groups of low-dose,medium-dose and high-dose XFPC, with 24 rats in each group. Lung silicosis model was established by single inhalation tracheal instillation method, which was treated with 50.0 g/L silica suspension, in groups except in the blank control group. On the 7 th day of modeling, the rats in the drug administration control group were orally given tetrandrine(5 mg/kg body weight), while those in the low-, medium-and high-dose groups were given 43, 86 and 192 g/L of XFPC by atomization inhalation once a day for 20 minutes, 5 days a week for 4 weeks. At the end of drug administration, the histopathological changes of the lung were observed. The number and classification of cells in bronchoalveolar lavage fluid(BALF)were examined, and the levels of malondialdehyde(MDA) and interferon-gamma(IFN-γ) in BALF were measured by enzyme-linked immunosorbent assay. RESULTS: On the 7 th day after modeling, the body weight in the drug administration control group and XFPC high-dose group decreased compared with the blank control group(P<0.05). On the 35 th day after modeling, the body weights of rats in the other 5 groups were lower than that in the blank control group(P<0.05). The pathological changes of lung tissue(infiltration of inflammatory cells, fibrosis and size of silicon nodule) in drug administration control group and XFPC low-dose group were better than those in silicosis model group by naked eyes and under light microscope. The lung coefficient, the proportion of neutrophils and the level of MDA and IFN-γ in BALF of the drug administration control group and XFPC low-dose group decreased(P<0.05), and the proportion of macrophages in BALF increased(P<0.05) compared with the silicosis model group. There was no significant difference in lung coefficients and the relevant indices of BALF between XFPC medium-, high-dose groups and silicosis model group(P>0.05). CONCLUSION: Low dosage XFPC can improve pulmonary fibrosis and inflammation in rats with silicosis, and its mechanism of action may be related to reducing the levels of IFN-γ and MDA in BALF.

Objective To explore the clinical application effect of multiple end-to-side anastomosis in free anterolateral thigh perforator flap transplantation.Methods From January,2013 to October,2017,29 cases were applied the technology of multiple end-to-side anastomosis to the same recipient vessel in anterolateral thigh perforator flap transplantation for wound repair.Fifteen cases treated with multiple end-to-side anastomosis on flap arteries,and 2-3 arteries were anastomosed,with the average of 2.13.Nine cases were treated with venous multiple end-to-side anastomosis,and 2-4 veins were anastomosed,with the average of 3.11.Five cases treated with arterial and venous multiple end-to-side anastomosis,and 4-6 vessels were anastomosed,with the average of 5.20.Distribution of wounds:10 cases with hands and wrists wounded,15 cases with forearms and elbow joints wounded,and 4 cases with lower legs and feet wounded.The soft tissue defect size was 5 cm×13 cm-11 cm×27 cm,and the flap area was 6 cm× 15 cm-12 cm×29 cm.Postoperative followed-up was performed every 3-6 months to review flap survival.Results All flaps of 29 cases survived.Venous congestion occurred in 2 flaps within 48 h after the operation,among which,1 was overcomed after released the dressing and sutures,and the other underwent surgical exploration.The venous end-to-side anastomotic stomas were unobstructed,and hematoma was formed.After the hematoma compression was removed,circulation was recovered and the flap survived.With followed-up for 6 months to 2.5 years,both donor site and recipient site of the flaps healed well and the injured distal limbs had no hemodynamic disorder.Conclusion The application of multiple end-to-side anastomosis to the same recipient vessel for free transplantation of anterolateral thigh perforator flaps is safe and reliable.

Objective To compare the renal toxicity of vancomycin with continuous infusion vs intermittent infusion. Methods The databases of EMBASE,PUBMED,the Cochrane Register of Controlled Trials,CBM,CNKI and WanFang were searched.The Cochrane Revman5.2 software was used for Meta-analysis.Results Two RCTs and eight observational studies were included in the systematic literature search with total of 1 764 patients.1 037 patients received vancomycin with continuous infusion while 727 patients with intermittent infusion.The Meta-analysis indicated that there was no significant difference in renal toxicity between continuous infusion group and intermittent infusion group(P>0.05).Conclusion Vanco-mycin continuous infusion cannot effectively reduce the incidence of renal toxicity.

Objective To evaluate the association between the decrease of the perioperative serum carcinoembryonic antigen (CEA) level during perioperative period and the prognosis in patients with colon cancer after a curative resection.Methods Retrospective analysis was conducted to evaluate the relationship between preoperative serum CEA level and different clinicopathologic features in 605 cases who underwent a curative resection for colon cancer from January 2006 to April 2011.According to the preoperative serum CEA level,the patients were divided into two groups:≤5 ng/ml and ＞5 ng/ml group.The critical value of the CEA decreasing rate in preoperative serum CEA ＞ 5 ng/ml group was calculated,and the relationship between this critical value and survival rate was then analyzed.Univariate and multivariate models were used to detect the risk factors of overall survival rate (OS) and disease free survival (DFS) in preoperative serum CEA ＞ 5 ng/ml patients.Results The preoperative serum CEA levels were significantly associated with lymphatic invasion (x2 =14.122,P＜0.001),T stages (x2 =40.153,P ＜0.001),N stages (x2 =22.721,P ＜0.001) and pathological stages (x2 =38.576,P ＜ 0.001),except for sex (x2 =0.453,P =0.501),age (x2 =0.195,P =0.659) and histological stages (x2 =6.135,P =0.112).The critical values of CEA decreasing rate for OS and DFS were 48.95％ and 50.81％ in preoperative serum CEA ＞5 ng/ml group respectively.There were significant differences of 5-year OS (31.37％ vs.76.63％,x2 =43.235,P ＜ 0.001) and 5-year DFS (27.69％ vs.72.10％,x2 =55.561,P ＜0.001) between patients after operation whose CEA decreasing rate were lower than critical value and those whose were higher.Univariate analysis showed that the decreasing rate of CEA was an influence factor for OS (x2 =43.235,P ＜ 0.001) and DFS (x2 =55.561,P ＜ 0.001) of preoperative serum CEA ＞ 5 ng/ml patients.The N stages and pathological stages were both related to OS (x2 =14.683,P＜0.001;x2 =12.295,P＜0.001) and DFS (x2 =16.212,P＜0.001;x2 =13.704,P＜0.001)respectively.Multivariate model showed that the decreasing rate of CEA level and N stages were both associated withOS (x2=18.885,P＜0.001;x2 =7.523,P＜0.001) and DFS (x2 =19.275,P＜0.001;x2 =6.997,P ＜ 0.001) of preoperative serum CEA ＞ 5 ng/ml patients.Conclusion A high decreasing rate of serum CEA level after operation in colon cancer patients who have high CEA levels before the curative resection can be a protective factor for prognosis,especially when the decreasing rate is higher than the critical value.

Objective To analyze the correlation between postoperative systemic inflammatory response syndrome (SIRS) and calculi composition following flexible ureteroscopy (f-URS) lithotripsy.Methods The clinical data of 1 130 patients with kidney stones treated with f-URS lithotripsy in the department of urology surgery of our hospital from November 2013 to August 2016 were collected to analyze the correlation between postoperative SIRS occurrence and calculi composition.Results The compositions of urinary stones were mainly calcium oxalate monohydrate(67.7 ％),carbonate apatite (14.7 ％),anhydrous uric acid (6.4 ％),six magnesium ammonium phosphate (6.2 ％) and calcium oxalate dihydrate (3.2 ％).Only six magnesium ammonium phosphate was related to the development of SIRS(P＜0.01).Conclusion Six magnesium ammonium phosphate has a correlation with the development of SIRS following f-URS lithotripsy,and the results of stone compositions analysis can help to prevent the occurrence of SIRS after f-URS lithotripsy.

ObjectiveTo investigate the effect of therapeutic endoscopic retrograde cholangiopancreatography (ERCP) on liver function and treatment outcome in patients with pancreaticobiliary diseases. MethodsA total of 397 patients with pancreaticobiliary diseases who underwent ERCP with an electronic duodenoscope in Beijing Chuiyangliu Hospital from January 2005 to July 2015, were enrolled. According to the type of disease, they were divided into benign obstruction group (109 patients), malignant obstruction group (47 patients), pancreatitis group (27 patients), foreign body obstruction group (127 patients), simple cholangitis group (19 patients), biliary fistula group (15 patients), juxta-ampullary duodenal diverticula group (29 patients), and liver transplantation group (24 patients). Liver function parameters including alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), γ-glutamyl transpeptidase (GGT), and total bilirubin (TBil) were measured at 1 day before ERCP and at 4 weeks after ERCP. The therapeutic effect was evaluated at 1 month after ERCP. The paired t-test was used for comparison of continuous data before and after treatment within one group, an analysis of variance was used for comparison between multiple groups, and the chi-square test was used for comparison of categorical data between groups. ResultsAfter ERCP, all the patients showed significant improvements in ALT, AST, ALP, GGT, and TBil, suggesting that ERCP significantly improved the subjects′ liver function (all P＜0.05). The evaluation of therapeutic effect showed that after ERCP, all the groups showed significant remission of symptoms; all the patients in the simple cholangitis group were cured, while those in the liver transplantation group and malignant obstruction group only achieved certain improvements. ConclusionTherapeutic ERCP can significantly improve the patients′ liver function. However, as for patients with liver transplantation and pancreaticobiliary tumors, laparoscopic surgery should be performed in combination with ERCP.