Herbal Textual Research on Gei Herba and Its Pharmacological Effect on Cardiovascular and Cerebrovascular Diseases / 中国实验方剂学杂志

Gei Herba is a traditional folk herbal medicine with a variety of functions such as replenishing Qi and invigorating spleen， tonifying blood and nourishing Yin， moistening lung and resolving phlegm， activating blood and alleviating edema， moving Qi， and activating blood. The reports about the pharmacological effects of this herbal medicine have been increasing in recent years. By reviewing the ancient and modern literature about Gei Herba， we systematically organized the name， original plants， nature， taste， and functions of this herbal medicine， and summarized the modern pharmacological studies and clinical applications of Gei Herba in cardiovascular and cerebrovascular diseases. Gei Herba was first recorded in the name of "Dijiao" in the Geng Xin Yu Ce（《庚辛玉册》） written in the Ming Dynasty. It is derived from Geum japonicum var. chinense （Rosaceae） and sometimes confused with Adina rubella （Rubiaceae）. This medicine had numerous synonyms in the local materia medica books. Gei Herba is widely distributed and harvested in summer and autumn， with the dried whole grass used as medicine. The historical records of the nature， taste， meridian tropism， main functions， and indications of Gei Herba are not consistent. It is generally believed that Gei Herba is pungent， bitter， sweet， cool， and has tropism to the liver， spleen， and lung meridians. Based on the effects of tonifying Qi， activating blood， and nourishing Yin， modern pharmacological studies have reported that the extracts of Gei Herba and the tannin phenolic acid compounds and triterpenoids isolated from Gei Herba have therapeutic effects on cardiovascular and cerebrovascular diseases such as hypertension， myocardial ischemia， cerebral ischemia， and vascular dementia. This study provides a reference for discovering the clinical advantages of Gei Herba and developing new drugs.

Quality Difference Analysis of Raw and Steamed Products of Citri Reticulatae Pericarpium Based on Electronic Eye Technique and Chemical Fingerprint / 中国实验方剂学杂志

ObjectiveTo explore the quality differences between steamed products and raw products of Citri Reticulatae Pericarpium（CRP）. MethodThe color of steamed products and raw products of CRP was determined from the perspective of appearance by electronic eye technique， and the quality differences between them was objectively characterized by the luminous value（L*）， yellow-blue value（b*）， red-green value（a*） and total chromatic value（E*ab）. Based on this， ultra-high performance liquid chromatography（UPLC） was used to establish a fingerprint evaluation method with the mobile phase of acetonitrile（A）-0.1% formic acid aqueous solution（B） for gradient elution（0-5 min， 5%A； 5-30 min， 5%-20%A； 30-60 min， 20%-52%A）， detection wavelength at 270 nm， flow rate of 0.3 mL·min-1 and column temperature of 30 ℃. The quality differences between steamed products and raw products of CRP were compared from the perspective of chemical composition， and correlation analysis was used to reveal the correlation between the difference in appearance color and the difference in internal chemical composition. ResultAfter being steamed， L*， b* and E*ab of CRP showed an overall decreasing trend， indicating that the color of the steamed products darkened and deepened from yellow to blue but still tended to be yellow， while a* showed an overall increasing trend， indicating that the color of the steamed products tended to red. A total of 24 peaks were identified in the fingerprint profiles of raw products and steamed products of CRP， and 13 of the main peaks were identified. The precision， stability and repeatability studies showed that compared with the reference peak （peak 14， hesperidin）， the relative standard deviations（RSDs） of the relative peak area and relative retention time of the remaining peaks were<3.0%.The results of chemometric statistical analysis showed that there were some differences between raw products and steamed products of CRP， and 7 main differential components were identified， among which 5-hydroxymaltol（peak 1） and 5-hydroxymethylfurfural（peak 2） were the characteristic components of steamed products. The correlation analysis results showed that， in addition to the above two characteristic components， four components of peak 4， peak 10 （vicenin-2）， peak 23 （tangeretin） and peak 24 （5-demethylnobiletin） also correlated significantly with the color change （E*ab） of the samples （P<0.05， P<0.01）. ConclusionBefore and after steaming， not only the chemical composition changes， but also the color. Comparing the characteristic peaks of chemical composition difference and color difference before and after steaming of CRP， it is found that 5-hydroxymaltol， 5-hydroxymethylfurfural and peak 4 are common characteristic difference components， which can provide a reference for establishing the characteristic quality control method of steamed products， and quickly evaluating the quality difference between raw products and steamed products of CRP.

Expression and clinical significance of B cell ectopic gene 2 in pancreatic cancer tissue / 中华胰腺病杂志

Objective:To investigate the expression of the B cell ectopic gene 2 (BTG2) in the pancreatic cancer tissue and analyze its relationship with the clinicopathological features and prognosis.Methods:46 pairs of pancreatic cancer tissues and corresponding adjacent tissues kept in paraffin in the pathology department, and 9 fresh pancreatic cancer tissues and corresponding adjacent tissues resected by surgery in Department of Pancreatic Surgery of Sinopharm Dongfeng General Hospital from June 2015 to December 2020 were collected. BTG2 gene expression in 46 pairs of pancreatic cancer tissues and corresponding adjacent tissues were detected by immunohistochemical staining, and high and low BTG2 expression groups were divided. BTG2 gene expression in 9 fresh pancreatic cancer tissues and corresponding adjacent tissues were detected by RT-PCR. The correlation between BTG2 protein expression level and clinicopathological features was analyzed. Furthermore, the survival curve and death risk curve were drawn using the Kaplan-Meier method, and the Cox regression hazards model was applied for the univariate and multivariate analysis of the factors affecting the prognosis of pancreatic cancer.Results:29 of 46 (63.04%) pancreatic cancer tissues had high BTG2 expression, and 38(82.61%) of corresponding adjacent tissues had high BTG2 expression; and BTG2 high expression rate of adjacent tissues was significantly higher than that of cancer tissues. Three out of 9 pancreatic cancer tissues were highly differentiated, and six cases had medium-and low differentiation. The BTG2 expression of highly differentiated pancreatic carcinoma was significantly higher than that of moderately and poorly differentiated carcinoma tissues [(0.66±0.07 vs 0.24±0.18); the expression level of adjacent tissues was significantly higher than that of cancer tissues (1.00±0.00 vs 0.38±0.30), and all differences were statistically significant (all P values <0.001). Low BTG2 expression in pancreatic cancer was associated with low tumor differentiation and vascular invasion (all P values <0.05), but was not correlated with tumor location, volume, lymph node metastasis, CA19-9 level and postoperative liver metastasis. The median survival of high BTG2 expression group was significantly longer than that of low BTG2 expression group (525 d vs 266 d, P<0.001). Among patients with survival time ≥300 d, the survival time was significantly higher in the high BTG2 expression group than in the BTG2 low expression group (616±135d vs 426±113 d), and the difference was statistically significant ( P<0.001). Among patients with survival time <300 d, there was no significant difference between BTG2 high and low expression group. The results of the univariate analysis showed that tumor differentiation degree, vascular invasion, BTG2 expression, CA19-9 levels, and postoperative liver metastasis were all associated with the prognosis of pancreatic cancer. The results of the multivariate analysis showed that BTG2 expression level ( HR=2.572, 95% CI1.140-5.802, P=0.023), vascular invasion ( HR=0.023, 95% CI0.072-0.572, P=0.003) and postoperative liver metastasis ( HR=0.240, 95% CI0.102-0.564, P<0.001) were independent risk factors affecting the prognosis of patients with pancreatic cancer. Conclusions:BTG2 expression in pancreatic cancer tissues was significantly lower than that in adjacent tissues, and its low expression was associated with strong aggressiveness, low differentiation degree and poor prognosis of pancreatic cancer. The effect of BTG2 on the prognosis in pancreatic cancer patients was mainly in the long term.

Short term efficacy of laparoscopic assisted transanal total mesorectal excision for low rectal cancer: a prospective, multicenter, case registration study / 中华消化外科杂志

Objective:To investigate the short term efficacy of laparoscopic assisted transanal total mesorectal excision (taTME) for low rectal cancer.Methods:The prospective study was conducted. The clinicopathological data of 80 patients who underwent laparoscopic assisted taTME for low rectal cancer in 8 medical centers，including 27 cases in the First Affiliated Hospital of Jilin University，16 cases in the Daping Hospital of Army Medical University，15 cases in the Beijing Friendship Hospital of Capital Medical University，10 cases in the Peking University Cancer Hospital，7 cases in the Peking Union Medical College Hospital of Chinese Academy of Medical Sciences，2 cases in the Peking University People′s Hospital，2 cases in the Liaoning Cancer Hospital Institute，1 case in the Ruijin Hospital of Shanghai Jiaotong University School of Medicine，from August 2017 to September 2018 were collected. Observation indicators：(1) clinical data of enrolled patients；(2) surgical situations；(3) postoperative histopathological examination；(4)postoperative complications and hospitalization. Measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers and (or) percentages. Results:(1) Clinical data of enrolled patients：a total of 80 patients were selected for eligibility. There were 59 males and 21 females，aged from 53 to 79 years，with a median age of 61 years. (2）Surgical situations：all 80 patients underwent surgery successfully，including 73 cases undergoing low anterior resection，4 cases undergoing Hartmann operation，1 case undergoing intersphincteric and abdominoperineal resection，1 case undergoing other operations and 1 case missing operation information. Nineteen of the 80 patients underwent transabdominal and transanal operations simultaneously. The operation time of 80 patients was 255 minutes (range，211?305 minutes). Of 80 patients，77 cases had the volume of intraoperative blood loss ≤500 mL，3 cases had the volume of intraoperative blood loss >500 mL，44 cases underwent instrumental anastomosis，24 cases underwent manual anastomosis，12 cases were missing anastomosis information，66 cases had specimens been taken out through anus，2 cases had specimens been taken out through Pfannens-tiel incision，10 cases had specimens been taken out through other ways，2 cases were missing the information of specimens removal ways，57 cases underwent preventive stoma，32 cases under-went anal canal indwelling，30 cases underwent free of splenic flexure and 2 cases were converted to open surgery. (3) Postoperative histopathological examination：of 80 patients，68 cases had the integrity of mesorectal specimens with complete，5 cases had the integrity of mesorectal specimens with near complete，1 case had the integrity of mesorectal specimens with not complete，6 cases were missing the information of integrity of mesorectal specimens，1 case had rectal perforation，1 case had positive circumferential margin and 1 case had positive distal margin. The number of lymph node dissected and diameter of tumor were 12(range，9?16) and 3.0 cm(range，1.9?4.0 cm) of 80 patients. Four of 80 patients achieved pathological complete remission. Cases with tumor stage as T0 stage，Tis stage，T1 stage，T2 stage，T3 stage or T4 stage of the pT staging，cases with tumor stage as N0 stage，N1 stage or N2 stage of the pN staging，cases with tumor stage as M0 stage or M1 stage of the pM staging were 4，2，11，24，35，4，55，21，4，75，5 of 80 patients. (4) Postopera-tive complications and hospitalization：8 of 80 patients underwent anastomotic leakage，including 2 cases with grade A anastomotic leakage，4 cases with grade B anastomotic leakage and 2 cases with grade C anastomotic leakage.Seven of 80 patients underwent intestinal obstruction. The 2 cases with grade A anastomotic leakage were improved after symptomatic drug treatment，the 4 cases with grade B anastomotic leakage were improved after treatment with antibiotics or catheter drainage and the 2 cases with grade C anastomotic leakage were improved after operation. The duration of hospital stay of 80 patients was 14 days(range，11?21 days). No patient died during hospitalization.Conclusion:Laparoscopic assisted taTME for low rectal cancer is safe and feasible，which has a good short term efficacy.

Analysis of clinicopathologic features of intraductal papillary neoplasm of the bile duct / 国际外科学杂志

Objective To analysize the clinicopathologyic features of intraductal papillary neoplasm of the bile duct (IPNB),aiming to increase clinic reorganization of it.Methods Nine patients with IPNB were treated at Department of General Surgery,Beijing Friendship Hospital,Capital Medical University from April 2009 to March 2019,including 5 males and 4 females,aged from 53 to 72 years old.All patients' clinical characteristics,diagnostic methods,treatment and prognosis were retrospectively analyzed.All the patients were followed up from 1 to 119 months (medium 31 months).Results The pathologic diagnosis of all the 9 cases were obtained.Seven cases had occured recurrent abdominal painand fever and 2 cases presented painless jaundice.Five patients had single lesion (4 cases at the distal of common bile duct,1 cases at the hilum),whereas 4 cases had multiple lesions (2 cases diffuse lesionsin the biliary tree,2 cases multicentriclesionsin the common bile duct).Eight patients were underwent surgical procedure,including 7 cases of pancreticoduodenectomy and 1 cases radical resection of hilar cholangiocarcinoma.One patient with diffuse lesions was treated by chemotherapy after pathologic diagnosis was confirmed.One was died at 88 months after surgery,others were survival.Conclusions IPNB is a rear disease.The multicentric lesions have more chances to progress to invasive lesions.Different operative approaches should be chosen for different tumor sites and extents.

A retrospective case-control study on postoperative pancreatic fistula about modified invagination pancreaticojejunostomy and mucosa to duct pancreaticojejunostomy / 国际外科学杂志

Objective To compare clinical outcomes between modified invagination pancreaticojejunostomyandmucosa (MIP) to mucosa duct pancreaticojejunostomy(MDP) in pancreaticoduodenectomy.Methods In Department of General Surgery,Beijing Friendship Hospital Capital Medical University,from Jan.2013 to Jan.2019,there were 222 cases performed pancreaticoduodenectomy,with MIP or MDP.According to the operation methods,by matching the sex and year decads,all patients were divided into MIP group (n =111) and MDP group (n =111).The incidence of pancreatic fistula in two groups was observed.The software of SPSS 20.0 was adopted for statistical analysis.Results There was no perioperative death in both groups.The mean operative time of MIP group was significant shorter than that of the MDP group [(212.8 ± 62.4) min vs (231.5 ±51.9) min,P =0.016].However,there were no significant differences in blood loss,blood transfusion,bowel fnnction recovery and liquid diet time.There was no grade C pancreatic fistula in MIP group,but 2 cases in MDP group.There were no significant differences in incidence and classification of pancreatic fistula between two groups.Conclusions There were no significant differences in clinical outcomes between MIP and MDP.The MIP is more easier to performed,so it is of certain spreading value.However,the further evidence need more prospective controlled study.

Incidence and risk factors for anastomotic leakage after anterior resection for rectal cancer / 中华胃肠外科杂志

Objective@#To assess the incidence and independent risk factors for clinical anastomotic leakage (AL) in patients undergoing anterior resection (AR) or low anterior resection, (LAR) for rectal cancer.@*Methods@#This was a retrospective case-control study of 550 patients with rectal cancer who underwent AR or LAR from April 2007 to March 2017 in Beijing Friendship Hospital, Capital Medical University. The relationship between the incidence of AL and clinicopathological manifestations was analyzed by Chi-squared test and Fisher exact test, and the independent risk factors of AL were analyzed using logistic regression analysis. AL is defined as a defect (including necrosis or abscess formation) of the intestinal wall at the anastomotic site, leading to a communication between the intra- and extra-luminal compartments. AL can be divided into three grades. Grade A anastomotic leakage results in no change in the management of patients, whereas grade B leakage requires active therapeutic intervention but is manageable without re-laparotomy. Grade C anastomotic leakage requires re-laparotomy.@*Results@#AL was noted in 32 (5.8%) of 550 patients with rectal cancer who underwent AR or LAR, including 15 (46.9%) , 4 (12.5%) , and 13 patients (40.6%) with Grades A, B, and C, respectively. Five patients (0.9%, 5/550) died peri-operatively. AL- and non-AL-related deaths occurred in 3 (9.4%, 3/32, all cases were Grade C) and 2 patients (0.4%, 2/518) , respectively, with the two mortality rates being significant difference (P = 0.002) . Chi-squared test or Fisher exact test showed that the incidence of AL was associated with neoadjuvant chemoradiotherapy (P = 0.011) , intraoperative bleeding (≥100 ml) (χ2 = 11.980, P = 0.001) , and tension-reducing suture of anastomosis (P = 0.015) . The results of logistic regression analysis showed that the independent risk factors of AL were neoadjuvant chemoradiotherapy (OR = 2.402, 95%CI: 1.004 - 5.749, P = 0.049) , intraoperative bleeding (≥100 ml) (OR = 2.971, 95%CI: 1.269 - 6.957, P = 0.012) and tension-reducing suture of anastomosis (OR = 2.304, 95%CI: 1.008 - 5.263, P = 0.048) .@*Conclusion@#The incidence of AL in patients undergoing AR for rectal cancer is 5.8%. The high-risk factors for AL are neoadjuvant chemoradiotherapy, intraoperative bleeding (≥100 ml) , and tension-reducing suture of anastomosis. Patients with these three risk factors have a high risk of AL rate, and a defunctioning stoma should be performed.

Clinical analysis on day surgery of laparoscopic cholecystectomy and common bile duct exploration through cystic duct / 国际外科学杂志

Objective To investigate the safety and feasibility of laparoscopic common bile duct exploration through cystic duct while cholecystectomy by means of day surgery. Methods The data of69 patients who received day surgery of laparoscopic cholecystectomy and intraoperative transcystic biliary duct exploration from January 2015 to January 2018 in Beijing Friendship Hospital, Capital Medical University were analyzed. Preoperative symptoms and signs, laboratory examinations, imaging examinations, intraoperative exploration results, operation time, postoperative time, hospitalization expenses, as well as short time follow-up data were analyzed retrospectively. Results Sixty-nine cases of day surgery were iniolled.21.7％(15/69) were indicated in bile duct exploration according to medical history, and 33.3％ (23/69) simply because of abnormal blood examination which all showed elevated gamma-glutamyl transferase and 5.8％(4/69) only for positive imaging results. In the surgery, 24.6％(17/69) found bile duct stones, and 10.1％ (7/69) found sand-like stones or floccule in the biliary tract exploration, while negative exploration in 65, 2％(45/69). The operation time ranged from 41 to 169(median 111) minutes. No patient placed drainage tube in the surgery. Only 1 patient discharged at the first day after surgery because that nausea and vomiting led to a conversion to be hospitalized. The other patients discharged from the hospital in 1.4 to 8.3 (median 2.8) hours after the surgery; hospitalization costs 7 820 to 16 285 (Median 13 619) yuan. Telephone follow-up found no serious complications 3 days after operation, and1 patient complainted low grade fever 7 days after discharge due to gallbladder fossa fluid was cured by antibiotics. No residual stone was detected by ultrasound examination 3-month after surgery in follow-up cases. Conclusions As a practice of enhanced recovery after surgery concept, laparoscopic cholecystectomy and intraoperative transcystic bile duct exploration by means of day surgery is safe and feasible in experienced medical center. It could be safe when patients are strictly screened, although no effective method to predict the result of bile duct exploration by now.

Clinicopathological features and prognosis analysis of the obstructive colorectal cancer / 中华消化外科杂志

Objective To explore the clinicopathological features and prognosis of the obstructive colorectal cancer (CRC).Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 667 CRC patients who were admitted to the Beijing Friendship Hospital Affiliated to Capital Medical University between January 2013 and December 2015 were collected.The diagnosis and treatment of CRC patients were based on colon cancer and rectal cancer clinical practice guidelines in oncology(Version 2013) of the National Comprehensive Cancer Network (NCCN) and the 7th edition of the American Joint Committee on Cancer (AJCC) cancer staging manual and the future of TNM.CRC and clinical staging were confirmed by colonoscopy,biopsy pathology and CT or MRI examination.Patients selected laparoscopic surgery or open surgery according to their conditions,and then selectively underwent postoperative adjuvant therapy based on the results of pathological examination.Observation indicators:(1) diagnosis and treatment;(2) clinicopathological features;(3) prognosis.Follow-up using outpatient examination and telephone interview was performed to detect postoperative overall and tumor-free survivals up to April,2017.Measurement data with normal distribution were represented as (x)±s and comparison between groups was analyzed using the t test.Count data were described as case and percentage,comparisons between groups were evaluated with the chi-square test.Ordinal data were analyzed using the nonparametric test.Results (1) Diagnosis and treatment:tumor locations of 677 patients:tumors located in the right hemicolon,left hemicolon and rectum were respectively detected in 213,312 and 142 patients.Preoperative clinical staging:3,47,300,298 and 19 patients were respectively detected in stage 0,Ⅰ,Ⅱ,Ⅲ and Ⅳ.Ninety-nine patients were complicated with intestinal obstruction,with an obstructive rate of 14.84％ (99/667),and 568 patients didn't have intestinal obstruction.Treatments of 667 patients:① Preoperative adjuvant treatment:17 non-obstructive CRC patients underwent preoperative adjuvant treatments and 650 didn't undergo preoperative adjuvant treatment.② Surgical treatment:389 and 278 patients underwent respectively open and laparoscopic surgeries,and 588 received radical resection and 79 received non-radical resection.(2) Clinicopathological features:of 99 obstructive CRC patients,tumors located in the right hemicolon,left hemicolon and rectum were respectively detected in 26,61 and 12 patients.Eighteen and 81 patients underwent respectively laparoscopic and open surgeries,including 21 with low-differentiated tumors,61 with moderate-differentiated tumors and 17 with high-differentiated tumors;71 patients received radical resection,with a number of lymph node dissected of 12±9,and 37,20 and 14 were respectively detected in stage N0,N1 and N2.Of 568 non-obstructive CRC patients,tumors located in the right hemicolon,left hemicolon and rectum were respectively detected in 187,251 and 130 patients.Two hundred and sixty and 308 patients underwent respectively laparoscopic and open surgeries,including 38 with low-differentiated tumors,420 with moderate-differentiated tumors and 110 with high-differentiated tumors;517 patients received radical resection,with a number of lymph node dissected of 15±8,and 338,155 and 24 were respectively detected in stage N0,N1 and N2.There were statistically significant differences in above indicators between obstructive CRC and non-obstructive CRC patients(x2=11.234,46.505,30.088,Z=-2.782,t=2.942,Z=-2.892,P＜0.05).(3) Prognosis:of 667 patients,584 were followed up for 18-52 months,with a median time of 36 months,including 88 with obstructive CRC (1,5,23,28 and 31patients were respectively in stage 0,Ⅰ,Ⅱ,Ⅲ and Ⅳ) and 469 with non-obstructive CRC (5,62,212,116 and 101 patients were respectively in stage 0,Ⅰ,Ⅱ,Ⅲ and Ⅳ).During the follow-up,56 obstructive CRC patients survived,including 1 in stage 0,4 in stage Ⅰ,15 in stage Ⅱ,17 in stage Ⅲ and 19 in stage Ⅳ,with an overall survival rate of 63.64％ (56/88),and overall survival rates in stage 0,Ⅰ,Ⅱ,Ⅲ and Ⅳ were respectively 1/1,4/5,65.22％(15/23),60.71％(17/28) and 61.29％ (19/31);38 had tumor-free survival,including 1 in stage 0,4 in stage Ⅰ,15 in stage Ⅱ,13 in stage Ⅲ and 5 in stage Ⅳ,with a tumor-free survival rate of 43.18％(38/88),and tumor-free survival rates in stage 0,Ⅰ,Ⅱ,Ⅲ and Ⅳ were respectively 1/1,4/5,65.22％ (15/23),46.43％ (13/28),16.13％ (5/31).Four hundred and forty-three non-obstructive CRC patients survived,including 5 in stage 0,58 in stage Ⅰ,181 in stage Ⅱ,106 in stage Ⅲ and 93 in stage Ⅳ,with an overall survival rate of 89.31％(443/496),and overall survival rates in stage 0,Ⅰ,Ⅱ,Ⅲ and Ⅳ were respectively 5/5,93.55％ (58/62),85.38％ (181/212),91.38％ (106/116) and 92.08％ (93/101);384patients had tumor-free survival,including 5 in stage 0,52 in stage Ⅰ,166 in stage Ⅱ,94 in stage Ⅲ and 67 in stage Ⅳ,with a tumor-free survival rate of 77.42％ (384/496),and tumor-free survival rates in stage 0,Ⅰ,Ⅱ,Ⅲ and Ⅳ were respectively 5/5,83.87％ (52/62),78.30％ (166/212),81.03％ (94/116) and 66.34％ (67/101).There were statistically significant differences in overall survival rate and tumor-free survival rate between obstructive CRC and non-obstructive CRC patients (x2 =39.626,43.707,P＜ 0.05).The subgroup analysis:there were statistically significant differences in stage Ⅱ,Ⅲ and Ⅳ overall survival rates between obstructive CRC and non-obstructive CRC patients (x2 =6.092,17.027,11.268,P＜0.05) and in stage Ⅲ and Ⅳ tumor-free survival rates (x2 =14.148,24.116,P＜ 0.05).Conclusion The obstructive CRC commonly locates in the left hemicolon,with complex clinicopathological features and low-differentiated tumors,meanwhile,there are lower radical rate and poor prognosis.

Analysis of value of laparoscopic hepatectomy in the treatment of hepatic hemangioma / 中国综合临床

Objective To explore the clinical value of laparoscopic hepatectomy for the treatment of hepatic hemangioma.Methods Clinical data of forty-six patients treated with hepatic hemangioma hepatectomy in Dongfeng Hospital Affiliated to Hubei University of Medicine from February 2014 to February 2017 were collected.The patients were divided into the laparoscopic hepatectomy group (LH group 26 cases) and the open hepatectomy (OH group 20 cases) by retrospective descriptive study.The operation time,hepatectomy time,intraoperative blood loss,postoperative complications,postoperative liver function recovery time,hospitalization time,total hospitalization cost,number of residual tumor tissues and follow-up recurrence rate of the two groups were compared.Results The length of incision in the laparoscopic hepatectomy group was significantly lower than that in the open hepatectomy group ((5.41±0.53) cm vs.(19.72±1.26) cm,t=52.335,P=0.000),the intraoperative blood loss,operation time,exhaust time,indwelling drainage time,first postoperative feeding time and postoperative hospitalization time in the LH group were significantly lower than those in the OH group ((572.23±16.92) ml vs.(911.75±19.41) ml,(149.52±18.14) min vs.(171.47±21.35) min,(2.84±0.63) d vs.(3.46±0.57) d,(5.74±3.380) d vs.(10.62±3.59) d,(2.08±0.52) d vs.(3.10±0.61) d,(8.91±2.16) d vs.(14.84±2.09) d,t=63.287,3.767,3.447,4.725,6.117,9.360,P<0.05);in the LH group,liver function recovery index alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were significantly lower than those in the OH group ((45.73±2.16) U / L) vs.(149.29±3.44) U/L,(47.32±1.89) U/L vs.(50.60±3.53) U / L,t=124.985,4.051,P<0.05).Conclusion Laparoscopic hepatectomy for patients with hepatic hemangioma is characterized by less trauma,quicker recovery and higher safety.

From traditional population-based approach to individualized precision medicine: the interpretation of update on The AJCC Colorectal Cancer Staging System, Eighth Edition / 中华外科杂志

The eighth edition of cancer staging system published by AJCC will be implemented all over the world in January 1, 2018. In addition to strengthening the traditional TNM staging system, the introduction of new molecular markers, is a major advance in the eighth edition, and is expected to play a more valuable role in the"individualized" clinical practice. The most important update in the eighth edition of AJCC colorectal cancer staging system is"non-anatomic" prognostic and predictive evaluation system based on the molecular detection. The system is useful for better understanding the pathogenesis of colorectal cancer, and guide clinicians to provide individualized treatment for the patients even in the same stage of colorectal cancer.

Improvement of prognostic and predictive network of colorectal cancer based upon the 8th edition of AJCC colorectal cancer staging system / 中华胃肠外科杂志

The 8th edition of AJCC cancer staging system will be launched all over the world in January 1, 2018. The major advances in the 8th edition are the introduction of non-anatomic prognostic and predictive factors supported by I(-II( grade evidence based on histopathology and molecular biology, and the improvement of prognostic assessment system based on these factors, including CEA level, cancer retraction score, circumference margin, lymphatic invasion, peripheral nerve invasion, microsatellite instability, KRAS/NRAS gene mutation and BRAF gene mutation. In the background of evidence-based medicine and precise medicine, combination of anatomic staging and non-anatomic classification system is very important for establishing and improving the prognostic and predictive assessment system of colorectal cancer. This will help to assess colorectal cancer staging and grouping much better, evaluate the prognosis, predict individualized efficacy, and promote clinical practice of colorectal cancer from traditional population-based diagnosis and treatment to the precise individualized care.

Changes of amplitude integrated electroencephalogram during brain development in premature / 中华实用儿科临床杂志

Objective To explore the changes of amplitude integrated electroencephalogram (aEEG) during brain development in premature.Methods One hundred and forty-eight premature (gestational age 28-36 weeks) were selected.According to their gestational ages,148 premature were divided into 28-30 weeks group(40 cases),with 21 male,19 female;＞30-33 weeks group (49 cases),with 25 male,24 female;＞33-36 weeks group (59 cases),33 male,26 female.At the same time,40 cases of gestational age 37-40 weeks full-term newborns were selected as control group,with 23 male,17 female.Olympic CFM 6000 cerebral function monitor(produced by the American Natus company) was used to detect the changes of their aEEG,and analysis of the changes of aEEG were conducted.The first monitor was performed 3 days after birth,then once a week,monitoring for 2 hours each time,till the premature were discharged from hospital.The average of the monitoring data was obtained as a result for the analysis,and data analysis was conducted by using SAS 9.0 statistical software.Results The sleep-wake cycle continuity voltage positive rate and cycle occurrence rate of the 28-30 weeks,＞ 30-33 weeks,＞ 33-36 weeks premature were significantly lower than those of the 37-40 weeks full-term newborns (all P ＜ 0.05).The 28-30 weeks,＞ 30-33 weeks,＞ 33-36 weeks premature spectrun lower bound voltage value of quiet sleep cycle and activity sleep cycle were significantly lower than those of the 37-40 weeks full-term newborns (all P ＜ 0.05).The 28-30 weeks,＞ 30-33 weeks,＞ 33-36 weeks premature spectrum width of quiet sleep cycle and activity sleep cycle were significantly wider than the 37-40 weeks full-term newborns (F =13.444,11.982,all P ＜ 0.05).The 28-30 weeks,＞ 30-33 weeks,＞ 33-36 weeks premature total duration of sleep cycle were significantly higher than the 37-40 weeks full-term newborns (F =12.451,P ＜ 0.05).Conclusions With the increase of gestational age,premature brain development becomes gradually mature,and aEEG can reflect the degree of premature brain development to some extent.

Neurological and cerebrospinal fluid interleukin-6 effects of butylphthalide for treating of brain hemorrhage / 中国综合临床

Objective To investigate the neurological and cerebrospinal fluid interleukin-6 effects of butylphthalide on brain hemorrhage.Methods Ninety cerebral hemorrhage patients in principle based on a random draw were equally divided into the treatment group (45 cases) and the control group (45 cases).Two groups were given basic treatment, the control group were treated with nimodipine tablets adjuvant therapy, the treatment group were treated with butylphthalide soft capsules adjuvant therapy, all patients were treated for 30 days.Results After treatment, the national institutes of health stroke scale (NIHSS) score was shown significant downward trend in the two groups((9.45±0.44) to (2.09±0.45) scores;(9.44±0.21) to (4.58±0.65) scores) and compared with pre-treatment differences were significant (t=16.983, P=0.000;t =8.112, P =0.000), and the NIHHS score in treatment group was significantly lower than in control group(P =0.000).The mini-mental state examination (MMSE) score and activities of daily living (ADL) scores were shown significant upward trend in the two groups,compared with pre-treatment differences were significant(P ＜0.05).MMSE score(26.98±3.91) and ADL scores(34.29±6.42) scores in the treatment group were significantly lower in the control group((23.09±5.33) scores, (30.28±5.33)scores) after treatment(t =6.498, P =0.000;t =8.123, P =0.000).After treatment, the values cerebrospinal fluid interleukin-6 (IL-6) expression in the two groups were significantly reduced (P ＜ 0.05), while the value of cerebrospinal fluid IL-6 expression in the treatment group were significantly lower than the control group ((45.38 ± 13.02) ng/L vs (122.87± 17.42) ng/L, t =18.334, P =0.000).The adverse reactions of the two groups were mild, and were significantly improved after symptomatic treatment.Conclusion Butylphthalide adjuvant treatment of cerebral hemorrhage can improve nerve function, cognitive function and activities of daily living, its safety is also better.It plays its role may related to effectively reduce the IL-6 expression.

Improving effect of the ginsenoside hydrolysis product DS-1227 on scopolamine-induced learning and memory impairment in mice / 中国比较医学杂志

Objective The aim of this experiment was to study the improving effects of a ginsenoside hydrolysis product DS-1227 on scopolamine-induced learning and memory impairment in mice.Methods Sixty healthy 5-6-week old male ICR mice (body weight 22 ±2 g) were randomly divided into control group, model group, three DS-1227 groups (25 mg/kg, 50 mg/kg, 100 mg/kg), and positive control group (0.3 mg/kg).Fourteen days after oral administration of DS-1227, an open-field test was conduct to determine the mouse locomotor activity.Fifteen days after oral administration of DS-1227, all experimental animals were intraperitoneally administered scopolamine (0.75 mg/kg) and the mice of control group received the same volume of saline.In addition to scopolamine, the mice of positive control group received intraperitoneal injection of physostigmine in a dose of 0.3 mg/kg.Twenty minutes after completion of all the drug administration, object recognition test and Morris water maze test were conducted to evaluate the learning and memory abilities of the mice.Results DS-1227 had no significant effect on locomotor activity of the mice.Scopolamine obviously decreased the discrimination indexes in object recognition test, and prolonged the escape latency of water maze place navigation test.While 25 mg/kg, 50 mg/kg, 100 mg/kg of DS-1227 increased the discrimination indexes and decreased the escape latency of place navigation in the mice.Conclusion DS-1227 can improve the learning and memory impairment induced by scopolamine in mice.

Improving effects of dammarane sapogenins on sleep interruption-induced learning and memory impairment in mice / 中国比较医学杂志

Objective To study the effects of dammarane sapogenins ( DS-1226 ) on sleep interruption-induced learning and memory impairment in mice.Methods 130 SPF healthy 5 -6-week old male ICR mice were randomly divided into control, model, DS-1226 low dose, DS-1226 medium dose and DS-1226 high dose groups.The behavioral alterations in open field (OF), Morris water maze (MWM) and step-through (ST) tests were detected at 15 days after rotating drum-induced sleep interruption ( SI) .Results The total distance, movement speed, total duration of movement were increased in OF test ( P<0.05, vs.the model group) after treatment.The latency of place navigation was increased from day 5 in the MWM test after 15 d sleep interruption, and the number of crossing in the target quadrant and the percent distance in target quadrant were decreased after 15 d sleep interruption ( P <0.05, vs.the control group), while the latency of place navigation was decreased, and the percent distance in target quadrant and percent time in target quadrant after high dose DS-1226 oral administration ( P<0.05, vs.the model group) were increased.Error times, distance in dark chamber, time in dark chamber and immobility time in dark chamber were increased in training of step through test ( P<0.05, vs.the control group);while these indexes were decreased after DS-1226 oral administration ( P<0.05, vs.the model group) .But there was no significant difference in the step through testing course.Conclusions The results show that orally administrated DS-1226 can ameliorate SI-induced learning and memory impairment, and there is a significant dosage-effect relationship.

Effects of chronic restraint stress on learning and memory in SD and Wistar rats / 中国实验动物学报

Objective To investigate the effects of chronic restraint stress on learning and memory in Wistar and Sprague-Dawley (SD) rats.Methods Healthy adult male Wistar rats (n=6) and Sprague-Dawley rats (n=6) were subjected to restraint stress 10 h daily for 28 days.After that, all rats were tested for recognition memory by novel object recognition test , and spatial memory and working memory by Morris water maze test .Results After restraint for 10 h daily for 28 days, the restraint rats of the two strains demonstrated lower discrimination index (DI)than the control group, but on-ly SD rats showed significant difference ( P<0.05 ) .The restraint SD rats showed higher escape latency than the control rats, and on the 5th day the difference became significant (P<0.05), and there was no significant difference between Wistar restraint and control rats .The working memory test showed that restraint SD rats exibited longer escape latency than the control rats (P<0.05), while Wistar rats didn’t show significant difference between the two groups .Conclusions The results of this study demonstrate that the impairments of learning and memory in SD rats subjected to restraint 10 hour per day for 28 days are more serious than that in the Wistar rats .Therefore , SD rats may be a better choice as an animal model to study the effects of chronic restraint stress on learning and memory impairment .

Study on absorption ingredients of yuanhuzhitong pill by everted intestinal sac method / 中国中药杂志

<p><b>OBJECTIVE</b>To establish an everted intestinal sac method for determining absorption ingredients of yuanhuzhitong pill and study absorption characteristics of major chemical constituents of yuanhuzhitong pill.</p><p><b>METHOD</b>The everted intestinal sac model was adopted. Intestinal sac fluid samples at different time points after administration of three concentrations of Yuanhuzhitong pill were collected and determined by HPLC. The accumulative absorbed doses of active constituents were calculated, while the proportion between samples of yuanhuzhitong pill and absorption ingredients was compared.</p><p><b>RESULT</b>Eight ingredients of Yuanhuzhitong pill can be detected in intestinal sac, they are protopine, palmatine, coptisine, imperatorin, berberine, byakangelicin, alpha-allocryptopine and tetrahydropalmatine. The absorption rate constants (Ka) of eight constituents increased in jejunum and ileum with the increase in concentration of Yuanhuzhitong pill extracts (P < 0. 05), indicating a passive absorption.</p><p><b>CONCLUSION</b>As ingredients are selectively absorbed in intestinal sac, the everted intestinal sac method is selected to assess the intestinal absorption characteristics of ingredients of Yuanhuzhitong prescription.</p>

Advance of pharmacological studies on Valeriana jatamansi / 中国中药杂志

As a traditional Chinese medicine, Valeriana jatamansi has a long history of application in China. It is widely distributed and commonly adopted by many ethnic groups. In particular, its roots have a wide range of medicinal value. With the increasingly more attention on it from domestic and foreign researchers, there have been more and more studies on its pharmacological activity and mechanism. This essay summarizes domestic and foreign reports on its pharmacological activity and mechanism.

Study on feasibility of cutting process of fresh Angelica sinensis Radix / 中国中药杂志

<p><b>OBJECTIVE</b>To study on the feasibility of cutting process of fresh Angelica sinensis.</p><p><b>METHOD</b>Qualitative and quantitative chemical analysis methods were used to evaluate the quality of different cutting processed A. sinensis.</p><p><b>RESULT</b>The contents of ligustilide and ferulic acid in the fresh cutting processed were both lower than the traditional cutting process, and the similarity of fingerprints of two different cutting processed A. sinensis were basically above 90%.</p><p><b>CONCLUSION</b>The method of cutting process of fresh A. sinensis was not suitable apparently, and the effect on clinical application of these two different cutting processed A. sinensis need more study.</p>