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This study used the zebrafish model to explore the hepatotoxicity of Rhododendri Mollis Flos(RMF). The mortality was calculated according to the number of the survival of zebrafish larvae 4 days after fertilization under different concentration of RMF, and the dose-toxicity curve was fitted to preliminarily evaluate the toxicity of RMF. The liver phenotypes under the sublethal concentration of RMF in the treatment group and the blank control group were observed by hematoxylin-eosin(HE) staining and acridine orange(AO) staining. Meanwhile, the activities of alanine aminotransferase(ALT) and aspartate aminotransferase(AST) were determined to confirm the hepatotoxicity of RMF. Real-time quantitative polymerase chain reaction(real-time PCR) and Western blot were used to determine the expressions of genes and proteins in zebrafish larvae. Gas chromatography time-of-flight mass spectrometry(GC-TOF-MS) was used to conduct untargeted metabolomics testing to explore the mechanism. The results showed that the toxicity of RMF to zebrafish larvae was dose-dependent, with 1 100 μg·mL~(-1) of the absolute lethal concentration and 448 μg·mL~(-1) of sublethal concentration. The hepatocyte apoptosis and degeneration appeared in the zebrafish larvae under the sublethal concentration of RMF. The content of ALT and AST in zebrafish larvae at the end of the experiment was significantly increased in a dose-dependent manner. Under the sublethal concentration, the expressions of genes and proteins related to apoptosis in zebrafish larvae were significantly increased as compared with the blank control group. The results of untargeted metabolomics showed that the important metabolites related to the he-patotoxicity of RMF were mainly enriched in alanine, aspartic acid, glutamic acid, and other pathways. In conclusion, it is inferred that RMF has certain hepatotoxicity to zebrafish larvae, and its mechanism may be related to apoptosis.
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Animals , Zebrafish/genetics , Apoptosis , Larva , Chemical and Drug Induced Liver InjuryABSTRACT
@#Objective To investigate the risk factors for postoperative complications Clavien-Dindo classification≥grade Ⅱ after lung cancer surgery. Methods The patients who underwent lung cancer surgery in a multicenter observational study from November 2017 to January 2020 were included. The Clavien-Dindo classification of postoperative complications was analyzed. Logistic regression was used to identify the risk factors for complications≥ gradeⅡ. Results A total of 388 patients were enrolled, including 203 males and 185 females with a mean age of 56.14±10.36 years. The incidence of postoperative complications was 25.52% (99/388) after lung cancer surgery and the incidence of complications≥gradeⅡ was 20.10% (78/388). The five most common postoperative complications were pneumonia (6.96%), prolonged pulmonary air leak (>7 days, 5.67%), incision dehiscence (4.64%), arrhythmia (3.87%), and postoperative pleural effusion (3.35%). Multivariate analysis showed that open surgery [reference: uniportal thoracoscopic surgery, OR=2.18, 95%CI (1.01, 4.70), P=0.047], extended resection [reference: sublobar resection, OR=2.86, 95%CI (1.11, 7.19), P=0.030; reference: lobectomy, OR=2.20, 95%CI (1.10, 4.40), P=0.026] and operative time≥3 h [OR=2.07, 95%CI (1.12, 3.85), P=0.021] were independent risk factors for postoperative complications≥gradeⅡ after lung cancer surgery. Conclusion Surgical approach, extent of resection and operative time are independent influencing factors for postoperative complications≥gradeⅡ after lung cancer surgery.
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The Chinese Journal of Digestive Surgery has been constantly innovating and gradually developing into the top scientific and technological journals in China since its inception in 2002. It has made important contributions to promote the digestive surgery. The journal always adheres to the policy of "focusing on improvement and popularization"，attaches great importance to the quality of the content，and becomes a good partner of surgeons. It has created a high-quality academic platform to promote innovation. Furthermore，it has formed the Elite Group of Chinese Digestive Surgery to provide a broad stage for young talents. Young scholars have cooperated and innovated on this platform，inputting infinite vitality into the journal.
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Objective:To explore the effects of feedback teaching based on dynamic cases on teaching quality of practice nurses in the department of neurosurgery.Methods:A total of 69 practice nurses from the Department of Neurosurgery in the First Affiliated Hospital of Nanjing Medical University were enrolled as the research subjects between January 2019 and August 2020, of which 33 practice nurses between January and October 2019 were selected as the control group and the other 36 practice nurses between November 2019 and August 2020 were selected as the observation group. The control group used routine teaching, while the observation group adopted feedback teaching based on dynamic cases. The assessment scores, practice effect, nursing job satisfaction, and the incidence of nursing errors after teaching were compared between the two groups. SPSS 24.0 was used for Chi-square test and t-test. Results:After teaching, the scores of each assessment (teaching rounds, health education, specialist nursing operations, morning questions, basic operations, and theoretical assessment) in the observation group were significantly higher than those in the control group, and the scores of disease change recognition ability, independent work ability, communication ability and teamwork ability were significantly higher than those in the control group ( P<0.05). After 1 week, 2 weeks, 3 weeks and 4 weeks of teaching, the teaching satisfaction in the observation group was significantly higher than that in the control group ( P<0.05). The total incidence of nursing errors in the observation group 2.78%(1/36) was significantly lower than that in the control group 27.27(9/33)( P<0.05). Conclusion:Feedback teaching based on dynamic cases can effectively improve the teaching quality of practice nurses in the department of neurosurgery, improve nursing job satisfaction, and reduce the risk of nursing errors.
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Objective:To explore the effect of intravascular sodium nitroprusside (SNP) combined with hyaluronidase (HAase) plus urokinase (UK) in treating rat abdominal wall skin flap ischemia caused by HA induced artery embolism, and to compare the difference between thrombolysis with and without addition of sodium nitroprusside.Methods:Forty male Sprague-Dawley rats were injected with 10 μl of hyaluronic acid (HA) into the left inferior epigastric arteries, constructing the superficial epigastricl artery skin flap ischemic model in rats. The rats were randomly divided into four groups: a control group, and experimental groups A, B and C. Control and experimental groups A, B and C were treated with the following solutions 45 minutes after hyaluronic acid injection: physiological saline plus glucose was injected into the rats (control group); hyaluronidase (HAase) plus glucose injection was injected into the rats (experimental group A), hyaluronidase (HAase) plus urokinase (UK) was injected into the rats (experimental group B), hyaluronidase (HAase), urokinase (UK) plus sodium nitroprusside were injected into the rats (experimental group C). The changes of flaps were observed at 0 min, 3 days, 5 days and 7 days after operation. The difference of the area percentage of unperfused flap in the four groups was compared 7 days after operation. This study was carried out from July 2020 to March 2021 in the Medical Laboratory Animal Center of Weifang Medical University.Results:The unperfused area of flaps for the control group, experimental groups A, B and C were (100.00±0.00) %, (44.68±7.90)%, (34.01±8.77)% and (24.12±4.58)%, respectively. In the experimental group C, the scabby necrosis area was smaller than that of the experimental group A ( P<0.05); in the experimental group C, the scabby necrosis area was smaller than that of the experimental group B ( P<0.05); in the experimental group B, the scabby necrosis area was smaller than that of the experimental group A ( P<0.05). HE staining revealed that size and density of the embolus was significantly decreased after the addition of sodium nitroprusside. Conclusions:Sodium nitroprusside combined with hyaluronidase and urokinase can effectively improve the ischemia of the flap caused by HA induced artery embolism, increase the tissue perfusion, and reduce the necrotic area of the flap.
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Objective:To investigate the clinical efficacy of laparoscopic biliopancreatic diversion with duodenal switch (BPD-DS) for obesity.Methods:The retrospective and descriptive study was conducted. The clinical data of 10 patients with obesity who were admitted to the China-Japan Union Hospital Affiliated to Jilin University from September 2019 to January 2020 were collected.There were 7 male and 3 females, aged (32±9)years. Patients underwent laparoscopic BPD-DS. Observation indicators:(1) intraoperative and postoperative situations;(2) follow-up.Follow-up was performed by telephone interview and wechat up to July 2020, to detect complications, physical index, remission of preoperative comorbidity and blood biochemical index at 3 months and 6 months after operation. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Repeated data were analyzed using the repeated ANOVA and pariwise comparison was done using the LSD method. Measurement data with skewed distribution were represented as M(range). Count data were represented as absolute numbers, and comparison between groups was analyzed using the chi-suqare test. Results:(1) Intraoperative and postoperative situations:10 patients underwent successfully laparoscopic BPD-DS, including 1 patient undergoing concomitant cholecystectomy due to gallstone disease. There was no obvious hemorrhage, conversion to open surgery or perioperative death for the 10 patients. The operation time and duration of postoperative hospital stay were (256±28)minutes and 11 days(range, 4-38 days). Two patients had postoperative complications. (2) Follow-up: 10 patients were followed up for 6 months. During the follow-up, 3 patients had increased frequency of defecation, with 3-5 times per day, 7 patients had defecation frequency of 1-2 times per day. Of 10 patients, 4 cases had postoperative cholestasis, 2 cases development to gallstone, and the remaining 4 patients had no abnor-mality. The body weight, body mass index, waist circumference of 10 patients were (139±22)kg, (46±10)kg/m 2,(139±14)cm before operation, (107±19)kg, (35±8)kg/m 2, (118±17)cm at 3 months after operation, and (92±17)kg, (30±6)kg/m 2, (104±12)cm at 6 months after operation, showing significant differences ( F=170.01, 104.42, 120.25, P<0.05). The excess body mass reduc-tion rates at 3, 6 months after operation of 10 patients were 58%±36% and 81%±42%, showing a significant difference ( t=73.00, P<0.05). Of 10 patients, cases with type 2 diabetes, hypertriglyceri-demia, hypercholesteremia, elevated low density lipoprotein cholesterin level, hyperuricemia, hypertension were 5, 4, 6, 8, 9, 9 before operation, cases with complete remission were 4, 2, 5, 5, 1, 1 at 3 months after operation, and cases with complete remission were 5, 3, 4, 6, 7, 5 at 6 months after operation. Cases with partial remission of hypertension were 8 and 4 at 3, 6 months after operation. For 5 patients with type 2 diabetes, the fasting blood glucose and hemoglobin Alc were (11.4±3.1)mmol/L and 9.3%±1.6% before operation, (5.6±1.0)mmol/L and 5.5%±0.5% at 3 months after operation, (4.9±0.5)mmol/L and 4.8%±0.5% at 6 months after operation, showing significant differences ( F=14.55, 39.84, P<0.05). Of 10 patients, the retinal-binding protein, vitamins E, serum iron, serum zinc were normal before operation, cases with deficiency of above indicators were 5, 2, 1, 1 at 3 months after operation and 3, 3, 2, 4 at 6 months after operation. There was no clinical symptoms in patents with nutrient deficiency. Cases with deficiency of vitamins A, hypocalcemia, folic acid deficiency were 2, 2, 0 before operation, 5, 0, 0 at 3 months after operation and 3, 0, 1 at 6 months after operation. No deficiency of vitamins D, vitamins B12, ferritin or anemia occurred to the 10 patients. Conclusion:Laparoscopic BPD-DS is safe and effective for obesity.
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Objective:To investigate the application value of 'N' shaped Trocar placement in Da Vinci robotic bariatric and metabolic surgery.Methods:The retrospective and descriptive study was conducted. The clinical data of 69 patients who underwent Da Vinci robotic bariatric and metabolic surgery in the China-Japan Union Hospital of Jilin University from March to October 2020 were collected. There were 18 males and 51 females, aged from 12 to 67 years, with a median age of 34 years. The surgery was performed with the 'N' shaped Trocar placement by the same team of surgeons. The Da Vinci robotic sleeve gastrectomy, Da Vinci robotic single-anastomosis duodenal-ileal bypass with sleeve gastrectomy or Da Vinci robotic biliopancreatic diversion with duodenal switch was selected according to the patient's condition. Observation indicators: (1) surgical and post-operative conditions; (2) follow-up. Follow-up using the outpatient examination, telephone interview and WeChat to detect the body weight, body mass index, fasting blood glucose, glycosylated hemoglobin, total cholesterol, Trocar-related complications of patients at postoperative 3 months. The follow-up was up to November 2020. Measurement data with normal distribution were represented as Mean± SD, and comparison of general data before and after surgery was analyzed using the paired t test. Measurement data with skewed distribution were represented as M (range). Count data were described as absolute numbers. Results:(1) Surgical and postoperative conditions: of the 69 patients, 34 cases received Da Vinci robotic sleeve gastrectomy, 34 cases received Da Vinci robotic single-anastomosis duodenal-ileal bypass with sleeve gastrectomy, and 1 case received Da Vinci robotic biliopancreatic diversion with duodenal switch. There was no conversion to open surgery or laparoscopic surgery. The operation time of 69 patients was (161±52)minutes, and the volume of intraoperative blood loss was 30 mL(range, 10-100 mL). Two of 69 patients had post-operative complications. One of them with postoperative abdominal hemorrhage was cured after symptomatic treatment and discharged on the 10th day after surgery. The other one patient with postoperative peritoneal effusion was cured and discharged from hospital after puncture drainage and symptomatic treatment. No Trocar-related complication such as Trocar foramen bleeding and Trocar foramen hernia occurred in the 69 patients. The duration of postoperative hospital stay of 69 patients was (6±3)days. (2) Follow-up: 47 of 69 patients were followed up for 3 months. The body mass, body mass index, fasting blood glucose, glycosylated hemoglobin, and total cholesterol were (86±19)kg, (30±5)kg/m 2, (5.2±0.7)mmol/L, 5.3%±0.6%, (4.3±1.3)mmol/L at postoperative 3 months, which had significant differences compared with the preoperative indicators ( t=6.101, 8.261, 2.973, 2.567, 2.098, P<0.05). All the 47 patients had no Trocar-related complications during the follow-up. Conclusion:The 'N' shaped Trocar placement method is safe and feasible in the Da Vinci robotic bariatric and metabolic surgery, with good efficacy.
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In this study, data of amino acids of Cordyceps samples from Qinghai and Tibet was analyzed with self-organizing map neural network. A model of XY-Fused network was established with the content of 8 major amino acids and total amino acids for the identification of geographical origins of Cordyceps from Qinghai and Tibet. It had the prediction accuracy of 83.3% for the test set. In addition, data mining indicated that methionine was a special kind of amino acid in Cordyceps which could serve as a marker to identify its geographical origins. On this basis, the content ratio of methionine to total amino acids was proposed to be a quantifiable indicator to distinguish Cordyceps from Qinghai and Tibet.
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Amino Acids , Cordyceps/genetics , Geography , Neural Networks, Computer , TibetABSTRACT
With the increasing incidence of hepatobiliary diseases, it is particularly important to understand the role of molecular, cellular and physiological factors in the clinical diagnosis and treatment with traditional Chinese medicine(TCM) in the development of liver disease. Appropriate animal models can help us identify the possible mechanisms of relevant diseases. Danio rerio(zebrafish) model was traditionally used to study embryonic development, and has been gradually used in screening and evaluation of liver diseases and relevant drug in recent years. Zebrafish embryos develop rapidly and the digestive organs of 5-day-old juvenile fish are all mature. At this stage, they may develop hepatobiliary diseases induced by developmental defects or compounds. Zebrafish liver is similar to human liver in cell composition, function, signal transduction, response to injury and cell process mediating liver disease. Furthermore, due to the high conservation of genes and proteins between humans and zebrafish, zebrafish becomes an alternative system for studying basic mechanisms of liver disease. Therefore, genetic screening could be performed to identify new genes involving specific disease processes, and chemical screening could be made for drugs in specific processes. This paper briefly introduced the experimental properties of zebrafish as model system, emphasized the study progress of zebrafish models for pathological mechanism of liver diseases, especially fatty liver, and drug screening and evaluation, so as to provide ideas and techniques for the future liver toxicity assessment of TCM.
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Animals , Humans , Drug Evaluation, Preclinical , Liver , Liver Diseases/genetics , Medicine, Chinese Traditional , Zebrafish/geneticsABSTRACT
Metallomics is a frontier interdisciplinary subject at its vigorous development stage. Its goal is to systematically study the content, distribution, chemical species, structural characteristics and functions of metal elements in biological system. It is also a comprehensive discipline to study the existing state and function of free or complex metal elements in life. Metallomics is an ideal tool to study the biological behavior of inorganic elements, which can be used to solve many problems in the research of mineral Chinese medicine(MCM). It provides a strong theoretical basis and technical support for the research of MCM. Its theory and methods provide re-ference and enlightenment for the in-depth study of MCM, and also provide new ideas and open up new ways for the research of MCM. The application of metallomics theory and methods in the research of MCM is of great significance to reveal the material basis and mec-hanism of MCM, promote the process of basic research on MCM, fully exploit and utilize medicinal mineral resources and carry forward the traditional MCM treasure in China. In this paper, we introduced the concept, academic development, research content and research methods of metallomics, and discussed the application prospects of metallomics in the analysis of inorganic element composition characteristics and quality control, material basis and mechanism of MCM, so as to provide reference for further researches on MCM.
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China , Drugs, Chinese Herbal , Medicine, Chinese Traditional , Minerals , Quality ControlABSTRACT
Purpose@#The prognosis of nasopharyngeal carcinoma (NPC) patients with parotid lymph node (PLN) metastasis remains unclear. This study was performed to investigate the prognostic significance and optimal staging category of PLN metastasis and develop a nomogram for estimating individual risk. @*Materials and Methods@#Clinical data of 7,084 non-metastatic NPC patients were retrospectively reviewed. Overall survival (OS) was the primary endpoint. A nomogram was established based on the Cox proportional hazards regression model. The accuracy and calibration ability of this nomogram was evaluated by C-index and calibration curves with bootstrap validation.ResultTotally, 164/7,084 NPC patients (2.3%) presented with PLNs. Multivariate analyses showed that PLN metastasis was a negative prognostic factor for OS, progression-free survival (PFS), distant metastasis-free survival (DMFS), and locoregional relapse-free survival (LRFS). Patients with PLN metastasis had a worse prognosis than N3 disease. Five independent prognostic factors were included in the nomogram, which showed a C-index of 0.743. The calibration curves for probability of 3- and 5-year OS indicated satisfactory agreement between nomogram-based prediction and actual observation. All results were confirmed in the validation cohort. @*Conclusion@#NPC patient with PLN metastasis had poorer survival outcome (OS, PFS, DMFS, and LRFS) than N3 disease. We developed a nomogram to provide individual prediction of OS for patients with PLN metastasis.
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BACKGROUND@#Human infections with zoonotic coronaviruses (CoVs), including severe acute respiratory syndrome (SARS)-CoV and Middle East respiratory syndrome (MERS)-CoV, have raised great public health concern globally. Here, we report a novel bat-origin CoV causing severe and fatal pneumonia in humans.@*METHODS@#We collected clinical data and bronchoalveolar lavage (BAL) specimens from five patients with severe pneumonia from Wuhan Jinyintan Hospital, Hubei province, China. Nucleic acids of the BAL were extracted and subjected to next-generation sequencing. Virus isolation was carried out, and maximum-likelihood phylogenetic trees were constructed.@*RESULTS@#Five patients hospitalized from December 18 to December 29, 2019 presented with fever, cough, and dyspnea accompanied by complications of acute respiratory distress syndrome. Chest radiography revealed diffuse opacities and consolidation. One of these patients died. Sequence results revealed the presence of a previously unknown β-CoV strain in all five patients, with 99.8% to 99.9% nucleotide identities among the isolates. These isolates showed 79.0% nucleotide identity with the sequence of SARS-CoV (GenBank NC_004718) and 51.8% identity with the sequence of MERS-CoV (GenBank NC_019843). The virus is phylogenetically closest to a bat SARS-like CoV (SL-ZC45, GenBank MG772933) with 87.6% to 87.7% nucleotide identity, but is in a separate clade. Moreover, these viruses have a single intact open reading frame gene 8, as a further indicator of bat-origin CoVs. However, the amino acid sequence of the tentative receptor-binding domain resembles that of SARS-CoV, indicating that these viruses might use the same receptor.@*CONCLUSION@#A novel bat-borne CoV was identified that is associated with severe and fatal respiratory disease in humans.
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Adult , Aged , Female , Humans , Male , Middle Aged , Betacoronavirus , Genetics , Coronavirus Infections , Diagnostic Imaging , Therapeutics , Virology , Pandemics , Pneumonia, Viral , Diagnostic Imaging , Therapeutics , Virology , Tomography, X-Ray , Treatment OutcomeABSTRACT
Background: Human infections with zoonotic coronaviruses (CoVs), including severe acute respiratory syndrome (SARS)-CoV and Middle East respiratory syndrome (MERS)-CoV, have raised great public health concern globally. Here, we report a novel bat-origin CoV causing severe and fatal pneumonia in humans. Methods: We collected clinical data and bronchoalveolar lavage (BAL) specimens from five patients with severe pneumonia from Jin Yin-tan Hospital, Wuhan, Hubei province, China. Nucleic acids of the BAL were extracted and subjected to next-generation sequencing. Virus isolation was carried out, and maximum-likelihood phylogenetic trees were constructed. Results: Five patients hospitalized from December 18 to December 29, 2019 presented with fever, cough, and dyspnea accompanied by complications of acute respiratory distress syndrome. Chest radiography revealed diffuse opacities and consolidation. One of these patients died. Sequence results revealed the presence of a previously unknown β-CoV strain in all five patients, with 99.8–99.9% nucleotide identities among the isolates. These isolates showed 79.0% nucleotide identity with the sequence of SARS-CoV (GenBank NC_004718) and 51.8% identity with the sequence of MERS-CoV (GenBank NC_019843). The virus is phylogenetically closest to a bat SARS-like CoV (SL-ZC45, GenBank MG772933) with 87.6–87.7% nucleotide identity, but is in a separate clade. Moreover, these viruses have a single intact open reading frame gene 8, as a further indicator of bat-origin CoVs. However, the amino acid sequence of the tentative receptor-binding domain resembles that of SARS-CoV, indicating that these viruses might use the same receptor. Conclusion: A novel bat-borne CoV was identified that is associated with severe and fatal respiratory disease in humans.
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Realgar is a mineral traditional medicine with definite efficacy. The function of realgar is detoxicating, insecticiding, eliminating dampness and phlegm, etc. It is widely applied in clinical practice by compatibility medicines. However, the safety and scientificalness of clinical application are questioned because of the toxic effect caused by arsenic compounds. At present, there are still many problems in the research of realgar, which are mainly manifested in three areas: the expression of main components and effective substances are inconsistent; the anti-tumor mechanism is difficult to explain at the molecular level; the mechanism of compatibility is not clear. As a result, realgar and realgar-containing Chinese patent medicines are frequently prohibited from entering the international market, and the reputation of traditional Chinese medicine is also damaged. This paper would analyze the research status of realgar at home and abroad as well as its problems from its main components, effective substances, anti-tumor mechanism and compatibility mechanism. In view of these difficulties, quantum chemical calculation method is proposed to solve them, so as to make up for the shortcomings and limitations of experimental technology and experimental conditions, reduce the cost of realgar research and improve research efficiency. Moreover, it provides inspiration for research of other mineral medicine.
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Arsenicals , Pharmacology , Medicine, Chinese Traditional , Minerals , Sulfides , PharmacologyABSTRACT
Objective: To investigate the antidiarrheal effect and the gastrointestinal motility of two kinds of Limonitum with different mineral genesis, so as to select the optimal mineral genesis, and provide a theoretical basis for clinical use. Method: The selected research samples were leaching type and sedimentary type Limonitum with different mineral genesis, including powder, water decoction and dregs. In the experiment, castor oil (0.2 mL/10 g) was used to induce diarrhea, loperamide (4 mg·kg-1) was used for positive control, and then the antidiarrheal activity and the gastrointestinal motility were observed. Result: In the castor oil-induced diarrhea experiment, the diarrhea index of the water decoction (2.5,5,10 g·kg-1) and the dregs (2.5 g·kg-1) of leaching type Limonitum significantly reduced (P-1) of leaching type limonitum and the dregs (2.5,5,10 g·kg-1) of the leaching type Limonitum were significant different at the first defecation (P-1) and the water decoction (2.5 g·kg-1) of leaching type Limonitum, and the total feces weight of the mice were significantly decreased (P-1), the dregs (2.5,5,10 g·kg-1) of the sedimentary, the powder (2.5,5 g·kg-1), the water decoction (2.5,5,10 g·kg-1) and the dregs (10 g·kg-1) of leaching type Limonitum were significantly lower than those of the model group on the intestinal motility, with charcoal as a marker (P-1) of leaching type Limonitum was significantly higher than that of the model group on the content of small intestine contents (P-1) of sedimentary type limonitum, and the water decoction (2.5,5 g·kg-1) of leaching type Limonitum were significantly lower than those of the model group on gastric residual rate (P-1), the dregs (5 g·kg-1) of sedimentary type Limonitum were significantly reduced on the water content of large intestine compared with the model group (P-1 of Limonitum can inhibit the contraction of isolated ileum induced by acetylcholine in rabbits except 0.003 3 g·mL-1 water decoction of leaching type. Conclusion: Mineral medicine Limonitum has a certain therapeutic effect in castor oil-induced diarrhea. Leaching type limonitum has the best antidiarrheal effect.
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Objective: Ammonium alum is a common counterfeit of Alumen,and the processed product of ammonium alum is a common counterfeits of calcined Alumen. This paper aims to establish a method for identifying Alumen,calcined Alumen,ammonium alum and their processed products. Method: The samples were analyzed by scanning electron microscope (SEM) and X ray diffraction (XRD) in this paper. Result: Ammonium alum and Alumen showed obvious changes in morphology after processing. Both Alumen and ammonium alum showed obvious differences in morphology at×250 and×1 000 times microscope. Alumen presented irregular fragments,clear edge corners,smooth surface,scattered irregular small particles,occasional holes and longitudinal edges. Ammonium alum presented irregular clumps,blunt edges,not obvious edges and corners,uneven surface,scattered smaller and round-like particles. The difference in morphology was not obvious at×250 times microscope between Alumen and ammonium alum processed products. While at×1 000 times,the surface of calcined Alumen was uneven with coarse particles; the surface of counterfeit calcined Alumen was flat,and the coarse particle characteristics were not obvious. XRD can be used to rapidly and accurately identify the primary phase of Alumen,calcined Alumen,ammonium alum and ammonium alum processed products:KAl(SO4)2·12H2O,NH4Al(SO4)2·12H2O,KAl(SO4)2,and NH4Al(SO4)2 respectively, with 2θ angle characteristic value of 23,12,22 and 5 respectively for XRD peak. Conclusion: SEM and XRD techniques can be used for the identification of Alumen,calcined Alumen,ammonium alum and their counterfeit products.
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Objective: To provide the new quality control means for Alumen by investigating the elemental differences between calcined Alumen and its counterfeit processed products of ammonium alum, and establishing their characteristic chromatogram. Method: The contents of 22 inorganic elements both in calcined Alumen and processed products of ammonium alum were determined by means of inductively coupled plasma (ICP)-optical emission spectrometer-mass spectrometry (ICP-OES/ICP-MS),SPSS 16.0 was used for cluster analysis (CA) while SIMCA-P 13.0 with t-test and Rank-Sum test was used to identify the differential inorganic elements. In addition, the characteristic spectrum of the inorganic elements for calcined Alumen and counterfeit calcined alumen were established. Result: Calcined Alumen had highest contents of K and Al while counterfeit calcined Alumen has highest contents of Al and Fe;Cr,Sr,and Mn contents in calcined Alumen were relatively higher,while Mn,Ti,and Ga contents in processed products of ammonium alum were relatively higher. The content of K in calcined Alumen was about 205 times of that of counterfeit products. On the contrary,the average contents of Fe,Ti,Mn and Ga in counterfeit products of ammonium alum were much higher than those in calcined Alumen,33,46,38, 27 times, respectively. A total of 18 samples were clustered into two categories in CA:calcined Alumen and processed products of ammonium alum. 18 inorganic elements showed significant difference in contents(PConclusion: This method can be used for quality control of calcined Alumen.
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Objective: To study the accumulation of mercury in liver, kidney and brain of rats and its toxicity on liver and kidney after 4 weeks of administration of different doses of Zhuhong ointment, in order to provide data reference for the safe clinical use of Zhuhong ointment. Method: Forty-four Sprague-Dawley (SD) rats were randomly divided into 4 groups:control group, normal-dose group (1.875 mg·kg-1), medium-dose group (37.5 mg·kg-1), and high-dose group (75 mg·kg-1). After transdermal administration for consecutive 4 weeks, the mercury content in the urine, blood, liver, kidney and brain of the rats was measured. In addition, serum alanine aminotransferase (ALT), serum aspartate aminotransferase (AST), serum urea nitrogen (BUN), and serum creatinine (SCr), urine β2-miSCroglobulin (β2-BMG) and urine N-acetyl-beta-D glucosidase (NAG) contents were measured, and pathological morphology changes of liver and kidney were observed. Result:Compared with the control group, the levels of blood mercury and urine mercury in Zhuhong ointment groups showed significant increases after administration for 4 weeks(PPPPPPConclusion:Zhuhong ointment is not toxic at the normal dose, but long-term use can lead to the accumulation of mercury in liver, kidney and bra, which causes liver and kidney toxicity. This study did not find a more sensitive indicator of liver and kidney toxicity than liver and kidney pathology. However, because the rising levels of urinary mercury and blood mercury may predict toxicity, the relationship between mercury exposure and toxicity could be further studied. This study provides a reference for the rational use and toxicity monitoring of Zhuhong ointment.
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OBJECTIVE: To summarize the experience of diagnosis and treatment of autoimmune pancreatitis(AIP)and to investigate the value of surgery in the management of AIP.METHODS: The clinical data of 17 patients with AIP who were admitted to Fujian Medical University Union Hospital between January 2013 and June 2017 were analyzed retrospectively. Observed indexes included clinical manifestations,blood test results,imaging findings,diagnosis and treatment and follow-up status. RESULTS:(1)Clinical manifestations:of the 17 patients,7 demonstrated obstructive jaundice,8 had upper abdominal pain,1 had recurrent diarrhea and 1 was found a pancreatic tumor by health checkup. Extrapancreatic organ involvement was detected in 11 of the 17 patients.(2)Blood test results:13 patients underwent serum IgG4 detection and increased expression of IgG4 was found in 13 patients.Increased expression of serum CA199 was detected in 4 patients. Elevated level of serum amylase was found in 3 patients.(3)Imaging findings:all the 17 patients underwent enhanced computed tomography(CT)scan of pancreas.Diffused enlargement of pancreas was observed in 12 patients and localized pancreatic enlargement was observed in 5 patients.(4)Diagnosis and treatment:All of the 17 patients were diagnosed as type 1 AIP. Three of the 17 patients underwent operation due to suspicion of pancreatic cancer and were diagnosed as AIP based on postoperative pathological examinations, including 2 pancreaticoduodenctomy and 1 distal pancreatectomy with splenectomy.Fourteen patients received initial steroid treatment. After steroid treatment,11 patients achieved remission, 1 underwent distal pancreatectomy with splenectomy due to continuous elevation of serum CA199,1 underwent pancreaticoduodenctomy because of a continuous enlarged pancreatic pseudocyst in the head of pancreas with obstructive jaundice,and 1 underwent cystjejunostomy due to a pancreatic pseudocyst in the body of pancreas with abdominal pain.(5)Follow-up status:All of the 17 patients were followed up for an average time of 29 months(range,12-66 months). Three patients who initially underwent pancreatectomy achieved remission after operation and no recurrence was observed. Of the 14 patients who received initial steroid treatment,11 got remission and the other three patients received maintenance steroid treatment for 3 months after operation and no recurrence was observed. CONCLUSION: The diagnosis of AIP should be based on the clinical manifestations,blood test results,imaging findings and pathological examinations. Steroid is the most critical therapy for AIP,but surgery is still important for the management of AIP,especially for localized AIP which is difficultly distinguished from pancreatic cancer and AIP with pancreatic pseudocyst which is refractory to steroid treatment.
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OBJECTIVE: To evaluate the clinical significance of laparoscopic extraperitoneal para-aortic lmphadenectomy(PAL)in high para-aortic lymphadenectomy.METHODS: A non-randomized controlled method was used to analyze the clinical data of laparoscopic extraperitoneal PAL in 35 patients(extraperitoneal group)and laparoscopic transabdominal PAL in 40 patients(transabdominal group)in the Gynecological Department of the First Affiliated Hospital of Xiamen University from March 2018 to April 2019.RESULTS: All the 35 cases of laparoscopic extraperitoneal PAL reached the level of renal vein.Endometrial cancer accounted for the largest proportion,with an average age of 47.57 years and an average body mass index of 23.77.The average operation time was 109 minutes in the first 6 cases and 74.73 minutes in the other 29 cases.The amount of hemorrhage was 15.19 mL,and the average number of para-aortic lymph nodes(PALN)resected was 17.87.There were 5 cases of positive PALN metastasis,and the average gastrointestinal recovery time was13.43 hours.The average postoperative pelvic drainage was 76.57 hours and the average postoperative hospital stay was8.24 days.Intraoperative and postoperative complications included 1 case of inferior vena cava rupture,1 case of chyle leakage,and 1 case of vulvar edema.None of the 40 cases of laparoscopic transabdominal PAL reached the level of renal vein,and endometrial cancer accounted for the largest proportion,with the average age of 46.78 years and the average body mass index of 24.03.The average operation time was 90.55 min;the average intraoperative blood loss was 67.40 mL The average number of para-aortic lymph nodes was 3.30.There was one case of PALN metastasis.The average gastrointestinal recovery time was 22.35 hours,and the average postoperative pelvic drainage time was 75.75 hours.The average length of hospital stay was 8.90 days.There were 2 cases of rupture of the inferior mesenteric artery,3 cases of chyle leakage,and 2 cases of vulvar edema.The number of PALN resection,intraoperative blood loss,and operation time in the extraperitoneal group were not related to the body mass index,but the number of PALN in obese patients in the laparoscopic transabdominal group was significantly reduced,the operation time was longer,the intraoperative blood loss was more,and postoperative gastrointestinal recovery time is longer(P<0.05).CONCLUSION: Laparoscopic extraperitoneal PAL can solve the problems of laparoscopic transabdominal PAL lymph node resection,which is difficult to reach the level of renal vein,intraoperative intestinal tube interference,and the number of lymph nodes resected.It is especially suitable for obese patients.Laparoscopic extra-peritoneal high-grade PAL is safe,feasible,and recommended.