Surgery for biliary tract cancer (BTC) is characterized by technical difficulty, high morbidity, and poor prognosis. Establishing the surgical standards for BTC is crucial for a better quality of medical care, prolonged survival, and improved prognosis. The surgical standards for BTC consist of preoperative evaluation, preoperative management, and surgical procedures. In preoperative evaluation and management, the fashions of preoperative biliary drainage and the strategies for liver remnant enlargement remain controversial. In surgical procedures, the appropriate extent of liver resection, the management of bile duct margins, the indication of vascular resection and reconstruction, and the extent of lymphadenectomy remain debated. More insights into these controversies contribute to better surgical standards.

Abstract Allergic diseases can occur in all systems of the body, covering the whole life cycle, from children to adults and to old age, can be lifelong onset and even fatal in severe cases. Children account for the largest proportion of the victims of allergic disease, Children s allergies start from scratch, ranging from mild to severe, from less to more, from single to multiple systems and systemic performance, so the prevention and treatment of allergic diseases in children is of great importance, which can not only prevent high risk allergic conditions from developing into allergic diseases, but also further block the process of allergy. At present, there is no consensus on the management system of allergic children in kindergartens and primary schools. The "Consensus on Allergy Management and Prevention in Kindergartens and Primary Schools", which includes the organizational structure, system construction and management of allergic children, provides evidence informed recommendations for the long term comprehensive management of allergic children in kindergartens and primary schools, and provides a basis for the establishment of the prevention system for allergic children.

OBJECTIVE To establish the met hod for the purific ation of test sample of Banxialu granules ，and to determine the contents of 4 ephedrine components such as ephedrine ，pseudoephedrine，norpseudoephedrine and methylephedrine. METHODS Three batches of Banxialu granules were extracted with methanol（containing 1％formic acid ）and pretreated with QuEChERS method of N-propyl ethylenediamine adsorbent （PSA）and octadecyl bonded silica gel adsorbent （C18）. Ultra high performance liquid chromatography tandem triple quadrupole mass spectrometry （UHPLC-MS/MS）was adopted. The separation was performed on an Agilent XDB-C 18 column with 5 mmol/L ammonium acetate solution （containing 0.1％ formic acid ）-acetonitrile as mobile phase（gradient elution ）at the flow rate of 0.40 mL/min. The column temperature was set at 30 ℃，and sample size was 2 μL. The electrospray ionization source was adopted ，and positive ion scanning was performed in multiple reaction monitoring mode. The ion pairs used for quantitative analysis were m/z 166.2→148.1（ephedrine，pseudoephedrine），m/z 152.2→134.1（norpseudoephedrine）， m/z 180.2→162.2（methylephedrine）. RESULTS The solution obtained by QuEChERS purification method was clear and nearly colorless. The linear ranges of ephedrine ， pseudoephedrine， norpseudoephedrine and methylephedrine were 1.38-206.82， 1.41-212.13，1.29-19.34，1.99-59.83 ng/mL（r＞0.99）. The limits of detection were 0.41，0.42，0.39 and 0.60 ng/mL. The limits of quantitation were 1.38 ，1.41 ，1.29 and 1.99 ng/mL，respectively. RSDs of precision ，stability（48 h）and repeatability tests were all lower than 2％. The average recoveries were 95.75％-100.87％（RSD＜2％，n＝9）. The contents of above 4 ephedrine components were 20.62-26.02，20.96-24.90，2.26-2.63，5.36-6.32 μg/g， respectively. CONCLUSIONS Established method is simple ，rapid，sensitive and suitable for simultaneous determination of 4 ephedrine components in Banxialu granules.

Cadaver ; Foramen Ovale ; Humans ; Punctures ; Robotics ; Tomography, X-Ray Computed

Objective:To evaluate the effectiveness and safety of intravenous infusion of tranexamic acid combined with local infiltration in reducing the perioperative bleeding of prosthetic replacement surgery after massive tumor resection around the knee joint.Methods:Retrospective analysethe patients treated in our hospital from December 2014 to November 2018 underwent tumor resection and prothesis replacement surgery for tumors around the knee, according to whether intravenous infusion of tranexamic acid combined local infiltration of tranexamic acid in the incision was divided into tranexamic acid group and control group. Statistical analysis of postoperative drainage volume, total blood loss, number of blood transfusion, hemoglobin and fibrinogen level in 3 days after surgery, drug-related side effects, wound complications. The differences between the measurement data of the two groups used independent sample t test to compare; the comparison between the count data groups was by χ2 test. Results:In all 116 patients, preoperative intravenous infusion of tranexamic acid combined with intraoperative local infiltration of tranexamic acid in 26 patients, 90 cases in control group; 39 of the replacement required preoperative chemotherapy, There were 8 cases in the tranexamic acid group. In the tranexamic acid group, there were 23 cases (88.46%) in the distal femur and 3 cases (11.54%) in the proximal tibia, and 59 cases (65.56%) in the proximal femur in control group, and 31 cases (34.44%) of the proximal tibia. The length of the osteotomy is similar, the control group is 14.01±3.26 cm, and the tranexamic acid group is 15.21±4.69 cm. The operation time in control group was 2.57 h, and the tranexamic acid group was 2.34 h. Bleeding volume: the bleeding in control group was 613.33±212.76 ml, and the tranexamic acid group was 440.39±208.48 ml ( t=3.636, P=0.002). There were 54 patients (60%) had blood transfusion in control group, and 15 patients (57.69%) in the tranexamic acid group. There was a significant difference between two groups ( χ2=4.771, P=0.029). The total drainage volume was 623.92±316.87 ml in control group, 468.08±220.74 ml in tranexamic acid group ( t=2.328, P=0.022); estimated total blood loss index: 440.47±194.23 ml in control group, tranexamic acid group: 236.75±116.56 ml ( t=5.046, P=0.000); hemoglobin level in 3 d after surgery, control group: 84.29±11.21 g/L, tranexamic acid group: 92.12±13.66 g/L ( t=-2.951, P=0.004), perioperative blood loss: 866.14±418.68 ml in control group, 586.75±409.93 ml in the tranexamic acid group ( t=2.985, P=0.003). There were significant differences between two groups. All patients were rechecked for coagulation function within 3 days after surgery. The PT time of the patients in the tranexamic acid group was 15.01±1.01 s at 3 d, which is 14.88±0.85 s in control group, and the APTT was 41.18±4.61 s in tranexamic acid group, but approximately 40.77±4.63 s in control group, fibrinogen was 3.26±0.66 g/L and 3.31±1.20 g/L in control group, there is no significant difference between two groups. Conclusion:Local infiltration of tranexamic acid intravenous infusion of tranexamic acid during surgery can significantly reduce the perioperative bleeding volume of limb salvage surgery aroundknee joint and reduce allogeneic blood transfusion.

Objective To extract Xinjiang Uyghur medicine image features and analyze the features; To investigate the image classification effect of the researched features; To find the suitable features for Xinjiang Uyghur medicine image classification; To lay the foundation for content-based medical image retrieval system of Xinjiang Uyghur medicine images.Methods The flowers and leaves of Xinjiang Uyghur medicine were treated as the research objects. First, images were under preprocessing. Then color and textural features were extracted as original features and statistics method was used to analyze the features. Maximum classification distance was used to analyze the main features obtained from image classification. At last, the classification ability of features was evaluated by Bayes discriminant analysis.Results Color and textural features were selected and classified. The correct classification rate of flower images was 85% and the correct classification rate of leaf images was 62%. The classification effect of flower images used by selected features was better than classification effect of original feature.Conclusion Compared with the classification of original features, the classification accuracy of flower medicine is higher through selected features. This research can lay a certain foundation for the further researches on Xinjiang Uyghur medicine images and the improvement of feature extraction methods.

Breathing gas carries important physiological information. Technology for detection of breathing gas has become a research focus because of the advantages of nondestructive sampling and convenient operation. Proton transfer reaction mass spectrometry (PTR-MS) plays an irreplaceable role because of the advantages of high sensitivity, fast response and good specificity. In this paper, the principle of PTR-MS is introduced first, followed by research progress of PTR-MS in the field of breathing gas detection. Factors influencing the test results are analyzed. Finally, future prospects of development for PTR-MS in the field of breathing gas detection are discussed.
Gases ; isolation & purification ; Mass Spectrometry ; methods ; Protons

Image feature extraction is an important part of image processing and it is an important field of research and application of image processing technology. Uygur medicine is one of Chinese traditional medicine and researchers pay more attention to it. But large amounts of Uygur medicine data have not been fully utilized. In this study, we extracted the image color histogram feature of herbal and zooid medicine of Xinjiang Uygur. First, we did preprocessing, including image color enhancement, size normalizition and color space transformation. Then we extracted color histogram feature and analyzed them with statistical method. And finally, we evaluated the classification ability of features by Bayes discriminant analysis. Experimental results showed that high accuracy for Uygur medicine image classification was obtained by using color histogram feature. This study would have a certain help for the content-based medical image retrieval for Xinjiang Uygur medicine.
Bayes Theorem ; Color ; Discriminant Analysis ; Drugs, Chinese Herbal ; analysis ; Medicine, Chinese Traditional

The crystal form of solid substance had intrinsic correlation with its three dimensional crystal morphology. Based on the characterization of the three dimensional crystal morphology of clopidogrel bisulfate, this research is to establish a model based on the three dimensional morphological parameters. The granular samples composed of polymorphs of clopidogrel bisulfate and microcrystalline cellulose (MCC) were scanned by synchrotron radiation X-ray microscopic CT technology (SR-microCT) and the three dimensional structural models for which were constructed. Seven groups of three dimensional morphological parameters were calculated. Finally, the mathematical model was established with the multi-layer perception (MLP) artificial neutral network methods to identify and predict the polymorphs of clopidogrel bisulfate. The success rate of the model prediction for the polymorphs of clopidogrel bisulfate was 92.7% and the area under the ROC curve was 96.2%. The polymorphs of drugs could be identified and predicted through the numerical description of the three dimensional morphology. The volume, number of the vertices and the surface area were the major determinants for the identification of the polymorphs of clopidogrel bisulfate.
Crystallization ; Neural Networks (Computer) ; Platelet Aggregation Inhibitors ; chemistry ; ROC Curve ; Radiographic Image Interpretation, Computer-Assisted ; Synchrotrons ; Ticlopidine ; analogs & derivatives ; chemistry ; Tomography, X-Ray Computed

Objective To investigate the analgesic effects of parecoxib sodium combined with patient controlled epidural analgesia (PCEA) after orthopedic subarachnoid block anesthesia surgery.Methods Two hundred patients undergone orthopedic subarachnoid block anesthesia surgery were randomly and equally divided into two groups:Group P (treated intravenously with 40 mg parecoxib sodium combined with PCEA at the end of operation) and Group C ( treated intravenously with 0.5 g tramadol combined with PCEA at the end of operation).The visual analog scale (VAS) was performed at 6,12,24,48 and 72 hours postoperatively in two groups.Meanwhile,the press frequency of analgesic pump,effective frequency,side effects and satisfaction degree were recorded. Results The VAS sore of Group P was lower than that of Group C at 6,12,24,48 and 72 hours postoperatively ( P ＜ 0.05 ).Group P showed a less number in aspects of the press frequency of analgesic pump,effective frequency,and side effects at 12 and 24 hours,but a higher satisfactory degree,compared with Group C (P ＜0.05). Conclusion Combined use of parecoxib sodium and PCEA can exert a better analgesic effect and have a low incidence rate of side effects following orthopedic subarachnoid block anesthesia.