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Vitamin D deficiency can be a trigger factor for recurrent oral ulcers. This article combining two cases of recurrent oral ulcers in patients with vitamin D deficiency who were cured by active vitamin D supplementation emphasizes that 25-hydroxyvitamin D and other indicators should be screened in patients with recurrent oral ulcers, so as to improve the understanding of the disease and the ability of clinical diagnosis and treatment for it.
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Hyperparathyroidism is a common endocrine disease that seriously affects human health, depending on its etiology, which can be divided into three types: primary, secondary and tertiary. In clinical practice, we found that some primary hyperparathyroidism may be secondary or tertiary hyperparathyroidism caused by insufficient calcium intake and/or vitamin D deficiency/insufficiency, and become a common type of hyperparathyroidism. The daily calcium intake of Chinese people is generally insufficient. Vitamin D can promote the absorption of calcium, but vitamin D deficiency/insufficiency is also a worldwide public health problem. Long-term hypocalcemia will stimulate parathyroid hyperplasia and secrete excessive parathyroid hormone, resulting in parathyroid hyperfunction (pre-hyperparathyroidism) and then secondary hyperparathyroidism, both of which may damage bone and release calcium into blood, leading to diseases of multiple organs and tissues. The detection of bone metabolism indexes such as calcium, magnesium, phosphorus, parathyroid hormone and vitamin D may be helpful for the early diagnosis of pre-hyperparathyroidism and hyperparathyroidism. Supplementation of calcium and vitamin D in early stage can control the development of the disease and change "unpreventable and uncontrollable" into "preventable and controllable" . The health screening of bone metabolism indexes and parathyroid ultrasonography should be advocated, and the prevention and treatment of calcium and/or vitamin D insufficiency associated parathyroid hyperfunction and hyperparathyroidism should be strengthened, so as to greatly improve the bone health, urinary calculus, metastatic vascular calcification and systemic abnormal calcium migration and precipitation in the population.
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With the development of various laboratory testing techniques such as serum calcium and parathyroid hormone (PTH) , a large number of asymptomatic or normocalcemic primary hyperparathyroidism (PHPT) can be diagnosed early. PHPT has become the third most common endocrine disease affecting human health. Currently, most PHPT, especially normocalcemic primary hyperparathyroidism, are not primary diseases and may be related to vitamin D deficiency/insufficiency and/or insufficient calcium supplementation. That is, the relative hypocalcemia caused by long-term vitamin D deficiency/insufficiency and/or insufficient calcium supplementation leads to parathyroid hyperfunction, stimulates parathyroid hyperplasia, and secretes excessive parathyroid hormone to compensate for the regulation of calcium and phosphorus balance. When it is in the initial reversible stage, it can be cured by internal medicine; if it progresses freely, long-term hypocalcemia stimulation will lead to excessive parathyroid hyperplasia and even tumor occurrence with the formation of so-called PHPT and parathyroidectomy has to be performed. Therefore, routine screening of bone mineral density, calcium, magnesium, phosphours, 25-hydroxyvitamin D, parathyroid hormone and other bone metabolism indicators in the physical examination of general population is beneficial to the prevention and treatment of bone metabolism diseases, urinary stones and hyperparathyroidism. At the same time, attention should be paid to identifying the stage of prehyperparathyroidism in which vitamin D deficiency/insufficiency and insufficient calcium supplementation will stimulate parathyroid hyperfunction. Active intervention on prehyperparathyroidism is an effective way to avoid the development of primary hyperparathyroidism.
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OBJECTIVE：To establish quantitative e valuation system of the prophylactic use of antibiotics in orthopedic type Ⅰ incision surgery ，and to provide reference for evaluating the rational prevention use of antibiotics in this type surgery scientifically. METHODS：Based on the Guidelines of Clinical Use of Antimicrobial Agents （2015 edition），drug instructions ，related guidelines and references ，experts from relevant departments jointly discussed and formulated the evaluation criteria for the rationality of the use of antibiotics in type Ⅰ incision in orthopedic surgery. AHP method was used to assign the weights for various indexes of evaluation criteria ；TOPSIS method was used to retrospectively analyze and evaluate the rationality of 120 cases of type Ⅰ incision surgery from 3 orthopedic departments in Peking University People ’s Hospital during Sept. 1st-30th，2019. RESULTS ：Established evaluation system included 4 primary indicators （medication indication ，usage and dosage ，medication timing ，other factors ）and 12 secondary indicators. Among the secondary indicators ，indications，drug selection and timing of preoperative administration were the most important （weights were 0.209，0.140，0.117）. Among 120 cases，30.83％ of drug use were reasonable ，47.50％ were basically reasonable and 21.67％ were unreasonable. Evaluation results obtained by AHP-TOPSIS were consistent with the actual situation. CONCLUSIONS ：The rationality evaluation method of prophylactic use of antibiotics in type Ⅰ incision surgery based on AHP-TOPSIS method can quantitatively evaluate the rationality of drug use by combining multiple indicators. The method is feasible ，operable，and the evaluation results can be quantified ，which has a wide range of application.
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OBJECTIVE：To e stablish a method for simultaneous determination of 7 constituents in Xiao ’er jinqiao granules . METHODS：QAMS method was adopted. The determination was performed on Lubex Kromasil C 18 column with mobile phase consisted of acetonitrile- 0.1％ phosphoric acid solution （gradient elution ）. The detection wavelength was set at 326 nm，the flow rate was 1.0 mL/min. The column temperature was 40 ℃，and sample size was 10 µL. Using chlorogenic acid as the internal reference，the relative correction factors （RCF）of neochlorogenic acid ，cryptochlorogenic acid ，forsythiaside A ，isochlorogenic acid B ，isochlorogenic acid A and isochlorogenic acid C were calculated. The effects of different chromatogram system ， chromatogram column ，the ratio of mobile phase ，flow rate and column temperature on RCF were investigaten. According to the two-point correction method combined with the relative retention time correction of the components to be tested ，the peak location was carried out. The contents of 7 components were determined by QAMS and SCM respectively and then compared. RESULTS： The linear range of neochlorogenic acid ，chlorogenic acid ，cryptochlorogenic acid ，forsythoside A ，isochlorogenic acid B ，isochlorogenic acid A ，isochlorogenic acid C were 9.27-92.70，37.36-373.60，13.02-130.20，7.15-71.50，4.56-45.60，6.32-63.20，14.69-146.90 µg/mL （r≥0.999 7）. The limits of quantification were 1.38，1.41，1.40，1.99，1.10，1.17，1.10 ng，respectively；and the limits of detection were 0.41，0.42，0.42，0.60，0.33，0.35，0.33 ng，respectively. RSDs of precision ，repeatability and stability tests were all less than 2％；average recoveries were 98.28％-99.15％ （RSD＜2.0％ ， n＝9）. RCFs of neochlorogenic acid ， （No.2013LZLY-K61） cryptochlorogenic acid ，forsythiaside A ，isochlorogenic acid B，isochlorogenic acid A and isochlorogenic acid C relative to xinyuliang@stu.cqmu.edu.cn chlorogenic acid were 0.995，1.007，0.580，1.243，1.252 and 1.247，respectively. RSDs of RCFs were all lower than 3％ under different chromatogram conditions. Absolute value of relative error between the relative retention time of components to be tested predicted by two-point correction combined with relative retention time correction and measured value was less than 2％. The contents measured by QAMS were 2.790-3.416， 14.526-17.907，3.763-4.531，1.625-1.982，1.087-1.523，1.434-2.219，3.631-5.078 mg/g；the contents measured by SCM method were 2.811-3.438，14.512-17.893，3.739-4.508，1.656-2.012，1.108-1.544，1.460-2.245，3.597-5.045 mg/g；relative errors of the two methods were within ±2％. CONCLUSIONS ：Two-point correction method combined with relative retention time correction can accurately locate the peaks of each constituent ；established QAMS method is simple ，rapid，accurate and reliable ，it can be used for simultaneous determination of 7 constituents in Xiao ’er jinqiao granules.
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Objective to investigate the effect of berberine on the expression of AQP4 and neuronal injury after focal cerebral ischemia in diabetic rats. Methods Male SD rats were randomly divided into four groups:control(sham surgery),middle cerebral artery occlusion and reperfusion (MCAO/R),MCAO/R treated with vehicle(DMSO),MCAO/R treated with berberine. the transient focal ischemia/reperfusion was induced by in-troducing silicone-coated monofilament nylon suture from the right external carotid artery into the origin of the middle cerebral artery,which was re-moved after 60 min. In group treated with berberine,the rats were injected with berberine before and after suffered from cerebral ischemia. Similarly, in group vehicle,the animals received DMSO vehicle at the same time. the score of neurological behavior was evaluated 24 h after reperfusion. Mean-while,the rats were sacrificed for Nissl staining. to estimate cerebral edema,the wet-dry ratio was measured. the expression of AQP4 in the border of the infarct region in different groups was observed by Western blot. Results Compared with the model group,berberine improved neurological deficits(P < 0.05). Berberine treatment inhibited the neuronal deformation shown by Nissl staining(P < 0.05). Berberine significantly decreased the wet-dry ratio and reduced the expression of AQP4(P < 0.05). Conclusion these results suggested that berberine could induce neuroprotection against ischemic injury by inhibiting the expression of AQP4 in diabetic rats.
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Objective To study the relevance of peripheral blood mononuclear cell (PBMC) IL- 18 level in patients with chronic HBV infection and the activity of chronic hepatitis B as well as the ex- tent of hepatic tissue inflammation. Methods Flow cytometry was applied to measuring IL-18 level in PBMCs isolated from 147 patients with HBV infection; meanwhile, 22 cases with hepatitis B patients or HBV carriers underwent needling biopsy of liver for liver histopathologic examination. Results IL- 18 level was rising step by step in moderate chronic hepatitis, severe chronic hepatitis, chronic serious hepatitis and acute fatal hepatitis. Elevation of IL-18 level was correlative to the activity of hepatic tis- sue inflammation. Conclusion The expression level of IL-18 is different in various HBV infection states, which is correlative to the activity of chronic hepatitis B as well as the extent of hepatic tissue inflammation. Therefore, IL-18 may be used as an important index of evaluating therapeutic effect and prognosis.
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[Objective] To observe the therapeutic effect of wind-dispersing and cold-dispelling, blood-activating and stasis-removing therapy for cold-type urticaria and to explore its possible mechamism. [Methods] Sixty-six cases were allocated to two groups by a simple random sampling method. Group A ( n = 36) was treated with wind-dispersing and cold-dispelling, blood-activating and stasis-removing herbal medicine including Herba Ephedrae, Ramulus Cinnamomi, Herba Schizonepetae, Radix Saposhnikoviae, Semen Armeniacae Amarum, Rhizoma Zingiberis Recens, Fructus Jujubae, Radix Salviae Miltiorrhizae, Radix Angelicae Sinensis, Caulis Spatholobi, Radix Paeoniae Rubra, etc. Group B (n =30) was treated with cetirizine hydrochloride tablets. The two groups were treated for two 20-day courses. One week after treatment, the therapeutic effect and the changes of hemorheological parameters before and after treatment were observed and compared with those in 38 healthy volunteers. [Results] The total effective rate was 80.6% in group A and 63.3% in group B, the difference being significant ( P 0.05) . [ Conclusion] Wind-dispersing and cold-dispelling, blood-activating and stasis-removing therapy is an important method for cold-type urticaria and the selected herbal medicines are effective. Its therapeutic mechanism may be related to the improvement of hemorheological parameters.
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[Objective] To observe the influence of blood-nourishing and wind-expelling therapy on the therapeutic effect of epidermic grafting for vitiligo. [Methods] Sixty-two patients with vitiligo were allocated to group A (n = 32) and group B (n = 30) with simple random method. Group B was treated with epidermic grafting. Group A was treated with oral use of Baibofeng Decoction (mainly composed of Radix Angelicae Sinensis, Caulis Spatholobi, Radix Saposhnikoviae, Fructus Psoraleae, Radix Paeoniae Rubra , Radix Salviae Miltiorrhizae, etc.) 2 weeks after epidermic grafting was performed, one dose every other day, and with external application of Fubu tincture (composed of Fructus Psoraleae, Radix Angelicae Dahuricae, Radix Salviae Miltiorrhizae and Flos Carthami) bid. After treatment, the short-term and long-term therapeutic effect was observed in the two groups. [Results] The cure rate was 83.6% and the effective rate was 93.1% in group A, and respectively 71.0% and 88.5% in group B, the therapeutic effect of group A being better than that of group B (P