Predictive model for hygroscopicity of contents in Guizhi Fuling Capsules / 中国中药杂志

To control the risks of powder caking and capsule shell embrittlement of Guizhi Fuling Capsules, a predictive model for hygroscopicity of contents in Guizhi Fuling Capsules was built. A total of 90 batches of samples, including raw materials, intermediate powders and capsules, were collected during the manufacturing of Guizhi Fuling Capsules. According to the production sequence, 47 batches were used as the calibration set, and the properties of raw materials and the four intermediate powders were comprehensively characterized by the physical fingerprint. Then, the partial least squares(PLS) model was developed with the content hygroscopicity as the response variable. The variable importance in projection(VIP), variance inflation factor(VIF) and regression coefficients were used to screen out potential critical material attributes(pCMAs). As a result, five pCMAs from 54 physical parameters were screened out. Furthermore, different models were built by different combinations of pCMAs, and their predictive robustness of 43 batches was evaluated on the basis of the validation set. Finally, the tap density(D_c) of wet granules obtained from wet granulation and the angle of repose(α) of raw materials were identified as the critical material attributes(CMAs) affecting the hygroscopicity of the contents of Guizhi Fuling Capsules. The prediction model established with the two CMAs as independent variables had an average relative prediction error of 2.68% for samples in the validation set, indicating a good accuracy of prediction. This paper proved the feasibility of predictive modeling toward the control of critical quality attributes of Chinese medicine oral solid dosage(OSD). The combination of the continuous quality improvement, the industrial big data and the process modeling technique paved the way for the intelligent manufacturing of Chinese medicine oral solid preparations.

Exploration of fire needling therapy on coronavirus disease 2019 / 中国针灸

Combined with previous clinical experience in anti-epidemic and acupuncture, the prevention program of fire needling therapy for coronavirus disease 2019 (COVID-19) was drawn out. Fire needling therapy has the effects of clearing heat, removing dampness, replenishing for the deficiency, removing stasis and detoxifying, which is mainly aimed at preventing populations, light and common types cases, and cases in the recovery period. Acupoints of governor vessel, lung meridian, bladder meridian and stomach meridian are mainly used in this program. For the special groups, such as children, elderly and weak, and pregnant women, Shenzhu (GV 12), Danshu (BL 19), Geshu (BL 17), Zhigou (TE 6), etc. are added. It is hoped that fire needling therapy will be applied in the community and square cabin hospitals as an effective supplement to anti-epidemic of traditional Chinese medicine (TCM).

Development and Application of Professional Care APP for Stroke Patients at Home / 中国康复理论与实践

Objective:To develop and evaluate the effect of Professional Care APP for stroke patients at home. Methods:Professional Care APP 1.0 was developed by reviewing literature, analyzing APP function and consulting expert, and combined with the findings at the early stage. And then it was upgraded to APP 2.0 after a 4-week trial in 10 stroke patients at home, which included two parts: patient-side and medical-side. The patient-side provided health education, rehabilitation guidance, medication reminder, online consultation and so on. From December, 2017 to June, 2018, 77 stroke patients in a community in Zhengzhou, China were conveniently selected and randomly divided into control group (n = 39) and intervention group (n = 38). The control group received routine community follow-up, and the intervention group received Professional Care APP 2.0, for 12 weeks. Results:After a 12-week intervention, the level of knowledge and medication compliance was significantly higher in the intervention group than in the control group (t > 4.205, P < 0.001). The score of demand for professional care was significantly lower in the intervention group than in the control group (t = -18.183, P < 0.001). The intervention group made a good evaluation for APP in usefulness, ease of learning, usability, credibility, acceptability and satisfaction. Conclusion:Professional Care APP can meet the professional care needs, and improve the level of knowledge on disease and medication compliance for stroke patients at home. The patients' evaluation for APP is ideal.

Correlative analysis on metatarsalgia and the X-ray measurement indexes under weight-bearing and non-weight-bearing of hallux valgus / 中国骨伤

<p><b>OBJECTIVE</b>To study changes in the radiographic appearance during weight-bearing and non-weigh-bearing in hallux valgus, and to analyse the correlation between the elasticity of plantar soft tissue of hallux valgus and the pain under the metatarsal head.</p><p><b>METHODS</b>From May 2012 to October 2012, 240 feet of 120 patients with hallux valgus were enrolled in the study. The degrees of the pian under the metatarsal head of all the patients were observed. AP and lateral X-ray films of feet were taken on the condition of weight-bearing and non-weight-bearing. So the hallux valgus angle (HVA), the inter-metatarsal angle between the first and second metatarsals (IM1-2), the inter-metatarsal angle between the first and fifth metatarsals (IM1-5), top angle of the medial longitudinal arch (TAOTMLA),and anterior angle of the medial longitudinal arch (AAOTMLA) were measured on the X-ray films. The differences of HVA, IM1-2, IM1-5, TAOTMLA and AAOTMLA between two groups were compared, and the correlation between the changes of IM1-2, IM 1-5, TAOTMLA, AAOTMLA and the degree of the pain under the metatarsal head were analysed.</p><p><b>RESULTS</b>One hundred and forty-eight feet had the pain under the metatarsal head. The IM1-2, IM1-5 and TAOTMLA increased on weight-bearing position compared with those on non-weight-bearing position, but the HVA and AAOTMLA decreased on weight-bearing position compared with those on non-weight-bearing position. There was a moderate relationship between the changes of IM 1-2,IM1-5 and the degree of the hallux valgus deformity, as well as the relationship between the different of IM1-5 and the degree of the pian under the metatarsal head.</p><p><b>CONCLUSION</b>The degree of the collapse of the arch of foot with hallux valgus becomes serious with its deformity increasing. The pain under the metatarsal head of hallux valgus increases with the increased changes of IM 1-2,IM 1-5 and TAOTMLA. Analysis of the X-ray observation indexes of hallux valgus on weight-bearing position and non-weight-bearing position has important significance in evaluating the degree of the collapse of the arch of foot with hallux valgus,preventing and curing the the pain under the metatarsal head.</p>

Diagnosis, treatment and prognosis of neuroendocrine carcinoma of the colorectum / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the diagnosis, treatment and prognosis of colorectal neuroendocrine carcinoma.</p><p><b>METHODS</b>Clinical data of 39 patients with colorectal neuroendocrine carcinoma from Jan 1995 to Jan 2010 were analyzed retrospectively and the related literatures were reviewed.</p><p><b>RESULTS</b>There were 27 males and 12 females. No patients presented endocrinal dysfunction symptoms. Fourteen patients were diagnosed as neuroendocrine cancer by preoperative pathological examination. All the patients received postoperative adjuvant chemotherapy including cis-platinum and etoposide. Twenty-two patients underwent curative resection, while 14 underwent palliative resection and 3 underwent biopsy alone. Of the 36 surgical resection specimens, vascular invasion was found in 27 patients (75.0%) and regional lymph node metastasis was found in 29 patients (80.6%). Length of follow-up ranged from 4 to 67 months. The 1-year, 3-year and 5-year survival rates were 48.2%, 16.5% and 6.8%, respectively. Statistically significant differences in survival were observed and associated with tumor staging, vascular invasion and surgery type (P<0.05), but not related to gender, age, tumor location, or diameter (P>0.05).</p><p><b>CONCLUSIONS</b>Clinical symptoms and signs of colorectal neuroendocrine carcinoma are nonspecific with poor prognosis. Tumor staging, vascular invasion and surgical type have potential impact on survival.</p>

Expression of survivin in invasive pituitary adenoma

To investigate the relationship between survivin expression and invasiveness of pituitary adenoma. A total of 66 patients, on whom trans sphenoidal surgery had been performed between July 2006 and March 2008, were enrolled in our study at the Department of Neurosurgery in Shandong Provincial Hospital and Jinan Central Hospital, Shandong, P. R. China. All patients were divided into the invasion group [n=39], and the non-invasion group [n=27] by assessment of preoperative MRI and intraoperative inspection. Survivin expression was determined by immunohistochemistry. Statistical analysis of survivin expression between the 2 sample groups was accomplished using the chi-square test. Survivin was expressed in 46 [69.7%] of the investigated pituitary adenomas. For invasive pituitary adenoma, survivin staining was positive in 35 [89.7%], only 11 [40.7%] specimens were positive in noninvasive tumors. The chi-square test demonstrated a statistically significant difference in survivin expression between invasive and noninvasive pituitary adenoma [x[2]=14.309, p=0.0002]. Survivin was highly associated with invasive pituitary adenoma, it is likely to serve as a useful tool for confirmation of invasive pituitary adenoma and the gene could be an effective target for pituitary adenoma gene therapy