Predictive model of curative effect of mite subcutaneous immunotherapy in 5-18 years of age patients with allergic asthma / 中华儿科杂志

Objective: To analyze the factors affecting the efficacy of mite subcutaneous immunotherapy (SCIT) in allergic asthma patients aged 5-18 years, and to find the best predictive model for the curative effect. Methods: The data of 688 patients aged 5-18 years with allergic asthma who completed more than 3 years of mite SCIT from December 2006 to November 2021 in the Department of Respiratory Medicine, Children's Hospital Affiliated to Nanjing Medical University were retrospectively analyzed. Male, results of skin prick test (SPT), age, daily medication score (DMS), visual analogue scale (VAS) score, and enrollment season were defined as independent variables. R language models, including Logistic regression model, random forest model and extreme gradient boosting (XGboost) model, were used to analyze the impact of these independent variables on the outcomes. The receiver operating characteristic curve was applied to compare the predictive ability of the models. Hypothesis testing of the area under curve (AUC) of the 3 models was performed using DeLong test. Results: There were 435 males and 253 females in the 688 patients. There were 349 patients aged 5-<8 years, 240 patients aged 8-<11 years, and 99 patients aged 11-18 years. SPT showed that 429 cases (62.4%) were only allergic to mite, and 259 cases (37.7%) were also allergic to other allergens. According to the efficacy after 3 years of SCIT, 351 cases (51.0%) discontinued the treatment and 337 cases (49.0%) required continued treatment. The DMS was 4 (3, 6) at initiation, 3 (2, 5) at 3 months, 3 (2, 5) at 4 months, 2 (1, 3) at 12 months, and 0 (0, 1) at 3 years of SCIT treatment. The VAS was 3.5 (2.5, 5.2) at initiation, 3.2 (2.2, 4.8) at 3 months, 2.6 (1.4, 4.1) at 4 months, 1.0 (0.6, 1.8) at 12 months, and 0.5 (0, 1.2) at 3 years of treatment. At 3, 4, and 12 months, the rate of decline in DMS was 0 (0, 20%), 16.7% (0, 33.3%), and 50.0% (31.0%, 75.0%), respectively; and the VAS decreased by 7.1% (3.2%,13.8%), 27.6% (16.7%,44.4%), and 70.2% (56.1%, 82.3%), respectively. Regarding the enrollment season, 99 cases were in spring, 230 cases in summer, 171 cases in autumn, and 188 cases in winter. The R language Logistic regression model found that DMS>3 points at 3 months (OR=-3.5, 95%CI:-4.3--2.7, P<0.01), male (OR=-1.7, 95%CI:-2.3--1.0), P<0.01), DMS decline rate>16.7% at 4 months (OR=-1.6, 95%CI:-2.3--0.8, P<0.01) and DMS decline rate>0 at 3 months (OR=-0.7, 95%CI:-1.3--0.2, P<0.05) had higher possibility of drug discontinuation; whereas, the decline rate of DMS at 12 months>50.0% (OR=0.7, 95%CI: 0.1-1.3, P<0.05), VAS at 12 months>1.0 points (OR=0.9, 95%CI: 0.3-1.6, P<0.05), and initial VAS<4.0 points (OR=1.0, 95%CI: 0.4-1.6, P<0.01) had lower possibility of drug discontinuation. Both the random forest model and the XGboost model showed that DMS>3 points at 3 months (mean decrease accuracy=30.9, importance=0.45) had the greatest impact on drug discontinuation. The AUC of the random forest model was the largest at 0.900, with an accuracy of 78.2% and a sensitivity of 84.5%. Logistic regression model had AUC of 0.891, accuracy of 80.0%, and sensitivity of 80.0%; XGboost model had AUC of 0.886, accuracy of 76.9%, and sensitivity of 84.5%. The AUC of the pairwise comparison model by DeLong test found that all three models could be used for the prediction of this data set (all P>0.05). Conclusions: The more drugs used to control the primary disease, and the more careful reduction of the control medicine after starting SCIT treatment, the more favorable it is to stop all drugs after 3 years. The random forest model is the best predictive model for the efficacy of mite SCIT in asthmatic children.

Effect of lupeol on invasion and metastasis of human hepatoma HepG2 and SK-HEP-1 cells and its mechanism / 中国中药杂志

Epithelial-mesenchymal transformation(EMT) exists in embryonic development and is closely related to cell migration and invasion. The increased EMT level in tumors showed that E-cadherin was replaced by N-cadherin, and the expression of interstitial markers such as α-SMA and vimentin was up-regulated. It has been reported that lupeol can reduce the expression of matrix metalloproteinase-2(MMP-2), matrix metalloproteinase-9(MMP-9) and N-cadherin to inhibit the metastasis of osteoma cells. However lupeol has been less studied in liver cancer. Therefore, this paper investigated the effect of lupanol on invasion and metastasis of human hepatoma cell line HepG2 and SK-HEP-1 and its possible mechanism. MTT assay and Annexin V/PI double staining were used to investigate the effect of lupeol on activity and apoptosis of HepG2 cells and SK-HEP-1 cells. Moreover, the effect of lupeol on the invasion of HepG2 cells and SK-HEP-1 cells were evaluated by Transwell assay. The expressions of E-cadherin, N-cadherin, α-SMA, vimentin and MMP-9 were measured by Western blot. The model of subcutaneous transplantation of nude mice and the lung metastasis model of H22 hepatocellular carcinoma cells were established to evaluate the efficacy of lupeol in vivo on tumor growth and lung metastasis by HE staining combined with immunohistochemical assay. The results showed that lupeol inhibited the activity and invasion of HepG2 cells and SK-HEP-1 cells in a dose-dependent manner and induced apoptosis. Western blot showed that the expression of E-cadherin, a landmark protein for EMT, was induced by lupeol, and the expressions of N-cadherin, α-SMA, vimentin and MMP-9 were decreased. In vivo experiments showed that lupeol inhibited tumor growth in mice bearing xenograft. In addition, immunohistochemical experiments confirmed that lupeol could up-regulate the expression of E-cadherin in tumor tissues of nude mice, reduce the expression of N-cadherin, and inhibit the metastasis of liver cancer H22 cells in the lungs of mice. The above results indicated that the mechanism of lupeol inhibiting the invasion and metastasis of HCC cells may be related to the regulation of EMT process.

Study on synergistic anti-tumor effect of Shuangdan Capsules combined with 5-FU on hepatocellular carcinoma cells Huh-7 and xenograft mice / 中国中药杂志

This paper discussed the synergistic anti-tumor effect of Shuangdan Capsules combined with 5-fluorouracil(5-FU) on human liver cancer cell line Huh-7 and tumor bearing mice. The effects of Shuangdan Capsules combined with 5-FU on the activity and vascular endothelial growth factor(VEGF) receptor protein expression of Huh-7 cells were investigated, and the effects of drug combination on tube formation of HUVEC cell were also verified. In addition, the mice model of Huh-7 was established to observe the anti-tumor effect of drug combination and the distribution of tumor blood flow in tumor bearing mice by using molecular imaging. HPLC analysis showed that Shuangdan Capsules mainly consisted of danshensusodium, protocatechuic aldehyde, paeoniflorin, rosmarinic acid, alkannic acid, salvianolic acid B, and paeonol. In MTT experiment, the inhibition rate of Shuangdan Capsules(20 mg·L~(-1)) and 5-FU(1 μmol·L~(-1)) on Huh-7 cells was 60%, and the CI value was 0.59, suggesting that these two drugs had synergistic anti-hepatoma cells effect. The expression of VEGF receptor in Huh-7 cells was inhibited by the combination of these two drugs. In addition, the process of HUVEC was slow, and the number, length and area of the lumen branches decreased significantly. In vivo, Shuangdan Capsules combined with 5-FU inhibited the growth and prolongation of survival of Huh-7 cells in subcutaneous transplanted tumor nude mice; serum expression of CD31 and VEGF in nude mice were decreased, while caspase-3 was increased. Meanwhile, the drug combination significantly inhibited the expressions of MMP2 and VEGF in tumor tissues. Ultrasound showed that Shuangdan Capsules combined with 5-FU also inhibited tumor angiogenesis and reduced blood flow of tumor tissue. The results showed that Shuangdan Capsules combined with 5-FU may inhibit tumor angiogenesis by inhibiting VEGF and MMP2 expressions, thereby blocking tumor growth.

Preparation and Quality Evaluation of Magnolol Nano-crystal Suspension / 中国药房

OBJECTIVE： To prepare Magnolol nano-crystal suspension （MAG-NS）， and to conduct quality evaluation. METHODS： The preparation technology of MAG-NS was optimized by central composite design-response surface methodology with OD value of particle size and polydispersity coefficient as evaluation indexes， using volume ratio of organic phase to water phase， ratio of excipient to drug， concentration of magnolol as factors and conduct validation tests. The quality of MAG-NS prepared optimal technology was evaluated. RESULTS： Optimized technology included that the volume ratio of organic phase to water phase was 1 ∶ 5， mass ratio of excipient to drug was 4 ∶ 1， concentration of magnolol was 2 mg/mL. In 3 times of validation tests， average OD value was 0.940 0 （RSD＝0.08％）， relative error of which to predicted value 0.977 7 was 3.86％. magnolol nano-crystals of MAG-NS prepared by the optimal technology were spherical， uniform in size， smooth in surface， with particle size of （34.88±0.33） nm， polydispersity coefficient of 0.032±0.001 and drug loading amount of （17.83±0.92）％. CONCLUSIONS： Established preparation method is simple and feasible. Prepared MAG-NS is in line with quality requirements. It can provide reference for further development and utilization of MAG-NS.

Beneficial effects of nanosuspensions of honokiol in mice on high fat diet through suppression of hepatic gluconeogenesis / 药学学报

To investigate the potential hypoglycemic effect of nanosuspensions of honokiol and explore the underlying mechanisms, a high fat diet (HFD) was studied in C57BL/6J mice divided into five groups: normal diet (ND), HFD, HFD/honokiol-sodium carboxymethyl cellulose (CMC-Na) (Hono-CMC, 100 mg·kg-1), HFD/honokiol- Nano (Hono-Nano, 80 mg·kg-1), HFD/metformin (HFD/Met, 200 mg·kg-1). Fasting blood glucose (FBG) and body weights (BW) of mice were measured every seven days. After 30-day treatment, an oral glucose tolerance test (OGTT) was performed, and blood and tissue samples were collected for analysis. All animal experiments were approved by the Research Animal Care Committee of Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine. The data showed Hono-Nano and metformin reduced FBG, BW, and markedly improved OGTT of mice compared to HFD group (P<0.05). Hono-CMC produced nonsignificant impact on FBG, BW of mice, while OGTT of mice was improved by Hono-CMC (P<0.05). Meanwhile, none of these treated groups showed significant effects on regulating serum insulin levels, but all of them exhibited decreased serum glucagon levels notably compared to the HFD group (P<0.05). Western blot analysis revealed that honokiol up-regulated levels of p-AMPK and p-FOXO1 in liver tissue of HFD mice (P<0.05), which resulted in activation of AMPK and inhibition of FOXO1. Moreover, the expression of PEPCK (a key enzyme of gluconeogenesis) was decreased by honokiol (P<0.05). Taken together, our findings demonstrate that nanosuspension of honokiol is more effective than CMC-Na-suspension of honokiol on blood glucose controlling in HFD mice. The hypoglycemic effects of honokiol might rely on suppressing hepatic gluconeogenesis via activating AMPK and inhibiting FOXO1.

Presenilins in dilated cardiomyopathy: An update / 第二军医大学学报

Presenilin (PS) is a transmembrane protein identified in familial early-onset Alzheimer disease, and it is mainly expressed in cell membranes and organelle membranes. As an important catalytic core of the γ-secretase multimeric enzyme complex, PS has been implicated in regulating various proteins. Recent researches have shown that mutations in PS are identified in the familial dilated cardiomyopathy, and the PS gene plays an important role in cardiac formation and regulation of calcium homeostasis in myocardial cells. In this review, we summarized the function of PS in heart and the mechanisms underlying the effects of PS on calcium homeostasis, such as amyloid β protein (Aβ), 1,4,5-inositol trisphosphate receptors, ryanodine receptors and PS as endoplasmic reticulum (ER) Ca2+ leak channels, hoping to provide a theoretical basis for the therapy of dilated cardiomyopathy.

Application of early warning model based on decision tree for medical equipment quantity and quality / 医疗卫生装备

Objective To propose a decision tree-based early warning model so as to predict the medical equipment quantity and quality under special conditions to quantize maintenance and detection staffs allocation,components supply,emergency planning and etc.Methods A data set was established based on the verification report,data on performance parameters detection and daily management log,and then underwent pretreatment.A decision tree came into being with the algorithms of ID3,CHAID and etc.The data rule corresponding to the decision tree was transformed into a series of early warning information.The model was verified by applying it to medical equipment usage management.Results The decision tree developed was applied to analyzing a vehicle-mounted water purifying device maintenance and usage records in some logistics support vehicle,and it's found the main factors contributing to the failures included migration distance along non-paved road,ambient temperature and service time.Conclusion The decision tree-based early warning model for medical equipment quantity and quality gains high feasibility and practical values.

Relationship between hepatic drug-metabolizing enzymes CYP450 and traditional Chinese medicine-induced hepatotoxicity / 中国中药杂志

In recent years, with the emergence of new methods and technologies in traditional Chinese medicines metabolism, the relationship between medicine metabolism and cytochrome P450 has gradually been revealed. The research on P450 drug metabolizing enzymes can be used to predict the side effects of traditional Chinese medicines and explore the relationship between compatibility of medicines and toxicity reducing and efficacy enhancing. This paper aims to summarize the progress of CYP450 research, the mechanism of hepatic drug-metabolizing enzymes in the process of drug-metabolism and the relationship between CYP450 and medicine hepatotoxicity. Furthermore, we set out the regulation effects of typical traditional Chinese medicines on CYP450 to provide a reliable basis for the rational use of Chinese medicines.

Protective effect of protocatechuic acid on midbrain dopaminergic neurons injured by 1-methyl-4-phenylpyridinium / 中草药

Objective: To investigate the effects of protocatechuic acid (PCA) on the midbrain dopaminergic neurons injured by 1-methyl-4-phenylpyridinium (MPP+). Methods: Midbrain neuron cells from KM mice pregnant 14 d were used in this experiment, and divided into control group, model group, low-, mid-, and high-dose (0.05, 0.1, and 0.5 mmol/L) groups. MTT method was used to determine the neuronal survival rate. The activity of lactate dehydrogenase (LDH) in culture, content of intracellular reactive oxygen species (ROS), activity of mitochondrial complex I, and mitochondrial membrane potential were further determined. Results: PCA can enhance the viability of dopaminergic neurons damaged by MPP+, reduce the release of LDH and the generation of ROS, increase the activity of the mitochondrial complex Ι, and prevent the reduction of mitochondrial membrane potential. Conclusion: PCA has the neroprotective effects against MPP+-induced damage of midbrain dopaminergic neurons.

Advances in study on applicability of drug metabolism model in zebrafish / 中草药

According to relative research and foreign references, we summarized the experimental method, drug metabolism type, and applicability of drug metabolism model in zebrafish. Zebrafish successfully simulated the mammals in phase I metabolism, phase II metabolism, intestinal bacteria metabolism, and multiway in vivo metabolism. Zebrafish is suitable for in vivo metabolism of trace monomeric compounds and their combinations, and is benefit for the efficient enrichment of metabolites in simple way. It has the advantages of simplity, high efficiency, low cost, and less amount of compound (a few mg) etc. It is a very prospect organisms model for early and rapid prediction of in vivo metabolism of trace elements.

Preventive Effect of Jie-Gu-Tang on Osteoporosis Model Using Zebrafish Induced by Prednisolone / 世界科学技术-中医药现代化

Prednisolone-induced zebrafish osteoporosis model was used to explore the bone-strengthening effect of Jie-Gu-Tang (JGT). Zebrafish larvae of 5 days post fertilization (d.p.f.) were co-exposed with 25 μmol·L-1 pred-nisolone and a series of JGT solutions with a range of concentrations (0.025, 0.25, 2.5, 25 and 100 mg crude herb per liter). The 25 μmol·L-1 prednisolone was selected as the model group. Etidronate disodium (15 and 30 mg·mL-1) with 25 μmol·L-1 prednisolone was used as the positive group. And 0.5% DMSO was used as the vehicle control group. All groups were incubated in 24-well plates (28.5℃) until 10 d.p.f. Zebrafish skeleton at 10 d.p.f. was anes-thetized and fixed for staining with alizarin red. Quantitative analysis of the stained area was performed by microscop-ic inspection and digital imaging methods to reflect the amount of zebrafish head skeleton mineralization. The results showed that prednisolone group at 25 μmol·L-1 concentration can obviously decrease the staining area and the stain-ing optical density values when compared with the vehicle control group (0.5% DMSO). Compared with the model group, both etidronate disodium (15 and 30 mg·mL-1) and JGT (2.5, 25 and 100 mg crude herb per liter) can in-crease the mineralized matrix and integrated optical density (IOD) of zebrafish head skeleton significantly with dose-effect relationship. It was concluded that zebrafish osteoporosis model was successfully used in the evaluation on bone loss prevention and bone formation promotion of JGT, which provided basis for the reliability and reasonability of zebrafish model.

Research progresses of the PARP inhibitors for the treatment of cancer / 药学学报

The poly(ADP-ribose) polymerases (PARPs) is an important group of enzymes in DNA repair pathways, especially the base excision repair (BER) for DNA single-strand breaks (SSBs) repair. Inhibition of PARP in DNA repair-defective tumors (like those with BRAC1/2 mutations) can lead to cell death and genomic instability, what is so called "synthetic lethality". Currently, PARP inhibitors combined with cytotoxic chemotherapeutic agents in the treatment of BRCA-1/2 deficient cancers are in the clinical development. In this review, we will be focused on the development of combination application of PARP inhibitors with other anticancer agents in clinical trials.

Commentary on "Group and organization: a dimension of collaboration of anthropology and epidemiology" by Song LM and Wang N / 中华流行病学杂志

Epidemiology,as the study of occurrence and distribution of diseases or health events in specified populations and the application of the study to control health problems,is not just a method to study determinants of diseases at individual level through analysis of mass data based on individuals.To achieve the aims on the control of health problems in specified populations,Epidemiology should be public health-oriented to reduce incidence,prevalence and mortality,and should include study on determinants at the population level.Interdisplinarity and systems science will facilitate the breakthrough in improving health of the populations.

Studies on sustained release solid dispersion of tripterine carried by HPMC-stearic acid / 中国中药杂志

<p><b>OBJECTIVE</b>To prepare the sustained release solid dispersion of tripterine, using HPMC-stearic acid with the intention of improving drug dissolution and controlling drug releases moderate, so that the drug performances lower toxicity.</p><p><b>METHOD</b>Tripterine sustained release solid dispersions was prepared by the solvent method with different weight ratios of HPMC-stearic acid and tripterine, which were dissolved in 95% ethanol. And in vitro dissolution experiment was conducted. Differential scanning calorimetry, scanning electron microscopy and X-ray powder diffraction can prove the formation of solid dispersions.</p><p><b>RESULT</b>The ideal tripterine sustained release solid dispersions were prepared under the condition as follows, the weight ratio of tripterine and HPMC-stearic acid was 1: 10, and the release rate of drug can keep moderate and controllable. In vitro cumulative release of tripterine sustained release solid dispersion is up to more than 90% after 8 h, and the tripterine exist as amorphous in the solid dispersion.</p><p><b>CONCLUSION</b>The sustained release solid dispersion of tripterine, carried by HPMC-stearic acid, can improve the release of tripterine effectively and controls the release rate keep moderate and controllable, and the preparation process is simple, which has potential applications.</p>

Response surface method optimize of nano-silica solid dispersion technology assistant enzymatic hydrolysis preparation genistein / 药学学报

This article reports that nano-silica solid dispersion technology was used to raise genistein efficiency through increasing the enzymatic hydrolysis rate. Firstly, genistin-nano-silica solid dispersion was prepared by solvent method. And differential scanning calorimetry (DSC) and transmission electron microscopy (TEM) were used to verify the formation of solid dispersion, then enzymatic hydrolysis of solid dispersion was done by snailase to get genistein. With the conversion of genistein as criteria, single factor experiments were used to study the different factors affecting enzymatic hydrolysis of genistin and its solid dispersion. And then, response surface method was used to optimize of nano-silica solid dispersion technology assistant enzymatic hydrolysis. The optimum condition to get genistein through enzymatic hydrolysis of genistin-nano-silica solid dispersion was pH 7.1, temperature 52.2 degrees C, enzyme concentration 5.0 mg x mL(-1) and reaction time 7 h. Under this condition, the conversion of genistein was (93.47 +/- 2.40)%. Comparing with that without forming the genistin-nano-silica solid dispersion, the conversion increased 2.62 fold. At the same time, the product of hydrolysis was purified to get pure genistein. The method of enzymatic hydrolysis of genistin-nano-silica solid dispersion by snailase to obtain genistein is simple, efficiency and suitable for the modern scale production.

A study on seroprevalence of anti-HAV IgG in adults of 4 cities in China / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the seroprevalence of anti-HAV IgG in adults of 4 cities in China.</p><p><b>METHODS</b>Serum samples were collected from 2390 local residents aged between 20 to 88 years from Beijing, Shanghai, Wuhan and Guangzhou. The anti-HAV IgG in sera was detected with a microparticle enzyme immunoassay (MEIA).</p><p><b>RESULTS</b>The anti-HAV IgG seroprevalence in female of 30 to 39 years in Beijing (64.58%, 62/96) was higher than that in male (45.57% 36/79)) (x(2) = 6.358, P = 0.012). It increased with age in adults of Beijing and Guangzhou. The rates were 54.22 % (90/166), 56.00% (98/175) and 67.18% (88/131) for the 20-, 30- and 40-49 age groups in Beijing (x(2) = 4.76, P = 0.03); and 52.83% (56/106), 52.50% (63/120), 82.46% (94/114), 89.80% (88/98) and 96.77% (60/62) for the 20-, 30-, 40-, 50- and 60-88 age groups in Guangzhou, respectively (x(2) = 72.58, P less than 0.01). This trend was not found in Shanghai and Wuhan (x2 = 0.96, 2.99; P = 0.33, 0.08 respectively). The seroprevalence rates of anti-HAV IgG in the 20 to 39 age group of Beijing, Shanghai, Guangzhou and Wuhan were 55.13% (188/341), 63.93% (429/671), 52.65% (119/226) and 78.37% (308/393), respectively.</p><p><b>CONCLUSION</b>The seroprevalence rates of anti-HAV IgG in young adults aged 20 to 39 years of the four cities are relatively low, and HAV vaccination should be suggested for the susceptible population of this age group in China.</p>

Association between expressions of HSP70, HSP90 and efficacy of chemotherapy in colorectal cancer patients with unresectable liver metastasis / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the association between expressions of HSP70, HSP90 and efficacy of chemotherapy in colorectal cancer patients with unresectable liver metastasis.</p><p><b>METHODS</b>Data of 52 colorectal cancer cases, whose primary colorectal focuses were resected but hepatic metastatic tumors were unresectable, were reviewed retrospectively. All the patients underwent FOLFOX4 regimen well. Immunohistochemistry assay was applied to determine the expressions of HSP70 and HSP90 in primary focus tissues. The number and size of hepatic metastatic tumors pre- and post-chemotherapy were compared by CT scanning.</p><p><b>RESULTS</b>Partial remission(PR) rate was 33.3% in cases with up-regulated expression of HSP70, while 64.5% in cases with down-regulated expression of HSP70, whose difference was significant. PR rate was 50% in cases with up-regulated expression of HSP90, and 53.1% in the others with down-regulated expression of HSP90, whose difference was not significant.</p><p><b>CONCLUSIONS</b>FOLFOX4 regimen has advantages in cases with lower HSP70 expression over those with higher HSP70 expression. HSP90 expression level is not associated with the efficacy of FOLFOX4 regimen.</p>

Treatment of congenital hypertrophic pyloric stenosis with endoscopic pyloromyotomy / 中华儿科杂志

<p><b>OBJECTIVE</b>To evaluate the effect of the treatment of congenital hypertrophic pyloric stenosis (CHPS) with endoscopic pyloromyotomy.</p><p><b>METHOD</b>Nine consecutive infants (7 boys, 2 girls; age range 26 - 70 days; weight range 2.65 - 6.10 kg), with a diagnosis of CHPS according to typical clinical manifestations, transabdominal ultrasound (US), gastroenterography and gastroscope. All the cases had accompanying malnutrition, anaemia, metabolic alkalosis, and some were complicated with congenital heart disease. In gastroscope operating room, all the patients were given pentobarbital and midazolam intravenously. A gastroscope with an outer diameter of 5.9 mm was passed through mouth, stomach, pylorus to the descending segment of duodenum. Under gastroscopy, two incisions were made along the anterior and posterior wall of pylorus from the duodenal bulb to the antrum by using endoscopic electrosurgical needle knife and an arch sphincter sarcosome. Incisions were deepened by 2 to 3 procedures until the longitudinal muscle was exposed, about 2 to 4 mm according to transabdominal US performed before operation. The incision depth was 2 - 3 mm if pylorus wall was 4 - 6 mm in thickness; or 3 - 4 mm when the wall was thicker than 6 mm.</p><p><b>RESULT</b>The endoscope was easily passed through the pylorus to the duodenum post-operation. The transabdominal US and gastroenterography showed that liquid easily flew through pylorus. All patients were able to have regular feeding about 2 to 10 hours after the operation. Vomiting in all patients was significantly decreased in frequency and amount, and in 8 infants vomiting stopped within 1 week, in one case it did not stop until 1 month after the treatment. Some cases showed slight adverse reaction, no perforation or massive haemorrhage in stomach or intestines occurred in any of the patients during and post-operation. Eight infants were doing well at follow-up (range 2 to 9 months). One girl had recurred vomiting at normal feeding after a period of 1 month postoperation without vomiting. This case was cured by second endoscopic pyloromyotomy.</p><p><b>CONCLUSIONS</b>Endoscopic pyloromyotomy is effective, safe, simple, and offers several advantages: no need for open-abdomen surgery, feeding can be initiated rapidly.</p>

The standard of quality control of Yiqi Zhixue Granule / 中成药

AIM:To improve the standard of quality control of Yiqi Zhixue Granule(Radix Codonopsis,Radix Astragali,Rhizoma Atractylodis macrocephalae,etc.) METHODS: In the prescription,both Radix codonopsis and Radix Astragali were identified by HPLC.Folium mahoniae was distinguished by TLC.Rhizoma Bletillae was authenticated by microscope.Morever,RP-HPLC method was adopted to determine the astragaloside content in the productions,using a column of C_(18),the column temperature was at 35(?C),acetonitrile-water(32∶68) as a mobile phase,he flow rate was 1.0 mL/min,and ELSD as detection in which the tube temperature was set at 102(?C) and the air flow was at 2.8 mL/min,the impactor was chosen off. RESULTS: The established identification methods were simple and proper,reflecting a good specificity,while the determination method was accurate and reliable,which showed the recovery of 97.95%,RSD=2.21%(n=9),the intermediate precision of RSD=2.67%(n=3),the robustness of RSD=3.67%(n=3) between columns,and the LOQ of 0.539 2 ?g,RSD=2.92%(n=5). CONCLUSION: The improved standard of quality control of Yiqi Zhixue Granule is not only practical but capable of effectively controlling the quality of the medicine as well.