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@#Objective To compare the clinical effects of coronary artery bypass grafting (CABG) via the left anterior small thoracotomy (LAST) versus lower-end sternal splitting (LESS) approach in the treatment of coronary heart disease. Methods The patients who underwent LAST CABG in Tianjin Chest Hospital from October 2015 to December 2020 were allocated to an observation group (LAST group), and the patients who underwent LESS CABG at the same period were allocated to a LESS group. Propensity score matching method was applied with a ratio of 1∶1. The baseline data, perioperative data and grafts data were compared between the two groups after matching. Results Before matching, there were 110 patients in the LAST group, and 206 patients in the LESS group. After matching, there were 110 patients in each group. In the LAST group, there were 83 males and 27 females with an average age of 60.6±8.3 years. In the LESS group, there were 80 males and 30 females with an average age of 61.0±9.6 years. There was no statistical difference in baseline data between the two groups after matching (P>0.05). The hospital stay time (t=2.255, P=0.025) and ventilator using time (t=−2.229, P=0.027) in the LAST group were significantly shorter than those in the LESS group. There were no statistical differences between the two groups in the postoperative hospital stay time, ICU stay time, postoperative left ventricular ejection fraction, postoperative left ventricular end-diastolic diameter, average number of grafts, secondary intubation, secondary thoracotomy, postoperative wound infection, sternal complications, postoperative atrial fibrillation, postoperative pulmonary infection or main adverse cardiovascular and cerebrovascular events (P>0.05). There was no statistical difference in the distribution of target vessels in the anterior descending branch, diagonal branch or posterior descending branch between the two groups (P>0.05). The grafts of the LAST group were significantly more than those of the LESS group in the area of obtuse marginal branch and posterior ventricular branch, and the grafts of the LESS group were significantly more than those of the LAST group in the area of right coronary artery (P<0.05). Post-operative computerized tomography angiography indicated that 1 patient in the LAST group had obtuse marginal branch vein bridge vessel occlusion, and the bridge vessels in the other patients were unobstructed. Conclusion Minimally invasive CABG via both LAST and LESS approaches is safe and effective. LAST approach can achieve complete revascularization for multi-vessel lesions, and it is safe and reliable, with the advantages of less trauma and aesthetic appearance. However, it requires a certain learning curve of surgical techniques and certain surgical indications.
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OBJECTIVE:To study transfer rate of asperosaponinⅥ in standard decoction of Dipsacus asper decoction pieces. METHODS:The content of asperosaponin Ⅵ in Dipsacus asper decoction pieces and its standard decoction was determined by HPLC. The determination was performed on SinoChrom ODS-AP with mobile phase consisted of acetonitrile-water(30∶70,V/V)at the flow rate of 1.0 mL/min. The detection wavelength was set at 212 nm,and column temperature was 30℃. The sample size was 10 μL. By the ingredients content obtained,the transfer rate of asperosaponin Ⅵ was calculated during decoction piece to standard decoction. RESULTS:The linear range of asperosaponin Ⅵ was 0.484-4.84 μ g(r＝0.999 9). RSDs of precision,stability and reproducibility tests were all lower than 2%. The limits of quantification and detection were 0.3 and 0.1 μ g,respectively. The average recoveries in D. asper decoction pieces and standard decoction were 95.13% -100.22%(RSD＝1.78%,n＝6), 97.07%-100.08%(RSD＝0.98%,n＝6). RSD of durability test was lower than 1%.The transfer rate of asperosaponin Ⅵ in standard decoction of D. asper decoction pieces ranged 26.3%-49.5%. CONCLUSIONS:The method is simple,accurate,precise, stable,reproducible and durable,and can be used for transfer rate of asperosaponin Ⅵ in standard decoction of D. asper decoction pieces.
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OBJECTIVE:To establish the quality standard for Gentiana scabra dispensing granule. METHODS:TLC was ad-opted to identify G. scabra in the preparation;HPLC was adopted to determine the content of gentiopicroside in the preparation:the column was Dionex C18 with mobile phase of methanol- water(25∶75,V/V)at a flow rate of 1.0 ml/min,the detection wave-length was 270 nm,column temperature was 30 ℃,the injection volume was 10 μl. RESULTS:TLC showed clear spots and good separation. The linear range of gentiopicroside injection volume was 0.302 6-3.026 μg (r=0.999 9);RSDs of precision,stability and reproducibility tests were lower than 2%;recovery was 98.27%-99.56%(RSD=0.68%,n=6). CONCLUSIONS:The estab-lished standard can be used for the quality control of Gentiana scabra dispensing granule.
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ObjectiveTo establish an HPLC analytic method for amygdalin inKuxingrenFormula Granules and HPLC characteristic chromatogram.MethodsRP-HPLC method was adopted. The determination was performed on Dionex C18 column (4.6 mm×250 mm, 5μm) with acetonitrile-0.1% phosphoric acid solution (8:92) at the flow rate of 0.6 mL/min. The detection wavelength was set at 207 nm and sample size was 10μL. The column temperature was 30℃. The peak of amygdalin was set as refernce, and 10 batches of samples were analyzed. TCM Chromatogram Fingerprint Similarity Evaluation System (2004 A) was adopted to evaluate similatity.Results The linear equation of amygdalin wasY=6.176×10-7X?3.058×10-3, with a good linear relationship in the range of 0.122 5–1.225μg (r= 0.999 8). The average recovery rate was 98.75% (RSD=1.30%). There were 6 common peaks in the characteristic chromatogram ofKuxingrenFormula Granules, and the similarity of 10 batches of samples was higher than 0.981. ConclusionThe HPLC method is simple, accurate and reproducible, which can be used for the quality control of Kuxingren Granules.
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OBJECTIVE:To establish the quality standard of Fructus arctii concentrated granules. METHODS:TLC was con-ducted for the qualitative identification and HPLC was used for the content determination of arctiin in F. arctii concentrated gran-ules. The determination was performed on Dionex C18 column with mobile phase consisted of methanol-water(40∶60,V/V) at the flow rate of 1.0 ml/min. The detection wavelength was set at 280 nm,and the column temperature was 30 ℃. The samples size was 10 μl. RESULTS:TLC spectrum showed that the spots of F. arctii concentrated granules and arctiin reference medicinal material had the same color;the linear range of arctiin was 0.5-12.5 μg(r=0.999 8)with the average recovery of 98.41%(RSD=0.81%, n=9). The RSDs of precision,stability,repeatability tests were no more than 1.0%. CONCLUSIONS:The method is feasible and reproducible,and can effectively control the quality of F. arctii concentrated granules.
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A new flavonoid glucoside was isolated from the aerial parts of Alhagi pseudoalhaki (M. B. )Desv.. Onthe basis of spectral data and chemical reaction,it was elucidated to be syringetin-3-O-?-D-glucoside- Moreover,fourteen known compounds have been isolated and identified as Psitosterol, stigmasterol,kaempferol,rhamnetin, ombuine, isorhamnetin, tamarixetin, kaempferol-3-O-?-D-(6″-O-p-coumaroyl )-glucoside, isoquercitrin, D-3-O-methylinositol, 1-O-?-D-methyl-glucoside, isoswertianolin, isorhamnetin-3-O-?-D-rutinoside,and tyramine. These compounds were isolated for the first time from the aerial parts of A. pseudoalhagl.
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OBJECTIVE: To study the discharge medication of tuberculosis inpatients of our hospital for the references of clinical medication. METHODS: The statistics on the quantity of drugs and the amount of money in discharge medication of the tuberculosis patients in our hospital in 2004 was conducted by defined daily dose method,and medication frequency and daily medication sum were computed and the associated data were analyzed as well. RESULTS: The quantity of drugs and the amount of money of the tuberculosis inpatients with medical insurance in discharge medication were less than those without. In addition to first class antituberculosis drugs, the medication frequencies of pasiniazide, rifapentine, ofloxacin and prothionamide were also high;4 agents consisted combined regimen was the chief form of drug combination;Liver protectants were the chief adjunctive therapy. CONCLUSIONS: Medical insurance policy has significant effect on during of administration and consumption sum in discharge medication. Attention should be paid to drug resistance and dependence in the discharge medication of tuberculosis patients.