Evaluation and treatment strategy of limb length discrepancy after total hip arthroplasty / 中华外科杂志

Limb length discrepancy(LLD) is a common complication after total hip arthroplasty (THA). Good positioning of the prosthesis and suitable soft tissue tension are essential to ensure hip joint stability. Patients will be more satisfied if almost the same length of both lower extremities is achieved. Preoperative comprehensive evaluation of patients is helpful to prevent the occurrence of LLD after surgery. Therefore, the pelvic spine conditions, as well as type and cause of LLD should be analyzed in detail before surgery. During operation, limb length should be adjusted by touching the position of patella, Kirschner's wires positioning and referring to the relationship between the center of femoral head and the tip of greater trochanter. After surgery, it is necessary to clearly distinguish true LLD from functional LLD, and make a reasonable therapeutic plan according to patient's symptoms and the range of differences in limb length. This article reviews the latest literatures based on clinical practice experience and summarizes the research status of LLD after THA, which helps joint surgeons to have an in-depth understanding of this postoperative complication.

FMO3-TMAO axis modulates the clinical outcome in chronic heart-failure patients with reduced ejection fraction: evidence from an Asian population / 医学前沿

The association among plasma trimethylamine-N-oxide (TMAO), FMO3 polymorphisms, and chronic heart failure (CHF) remains to be elucidated. TMAO is a microbiota-dependent metabolite from dietary choline and carnitine. A prospective study was performed including 955 consecutively diagnosed CHF patients with reduced ejection fraction, with the longest follow-up of 7 years. The concentrations of plasma TMAO and its precursors, namely, choline and carnitine, were determined by liquid chromatography-mass spectrometry, and the FMO3 E158K polymorphisms (rs2266782) were genotyped. The top tertile of plasma TMAO was associated with a significant increment in hazard ratio (HR) for the composite outcome of cardiovascular death or heart transplantation (HR = 1.47, 95% CI = 1.13-1.91, P = 0.004) compared with the lowest tertile. After adjustments of the potential confounders, higher TMAO could still be used to predict the risk of the primary endpoint (adjusted HR = 1.33, 95% CI = 1.01-1.74, P = 0.039). This result was also obtained after further adjustment for carnitine (adjusted HR = 1.33, 95% CI = 1.01-1.74, P = 0.039). The FMO3 rs2266782 polymorphism was associated with the plasma TMAO concentrations in our cohort, and lower TMAO levels were found in the AA-genotype. Thus, higher plasma TMAO levels indicated increased risk of the composite outcome of cardiovascular death or heart transplantation independent of potential confounders, and the FMO3 AA-genotype in rs2266782 was related to lower plasma TMAO levels.

Two-stage repair of composite soft tissue defect of dorsal wrist: Free flap transfer followed by transplantation of allogeneic tendon / 中华显微外科杂志

Objective:To explore the clinical effect of a two-staged repair and reconstruction of composite soft tissue defect of dorsal wrist with transfer of free flap (in stage-one) repair and followed by transplantation of allogeneic tendon (in stage-two) reconstruction.Methods:From December 2018 to January 2021, 6 cases with dorsal wrist composite tissue injury and extensor tendon defect were treated in the Department of Hand and Microsurgery of the Fourth People's Hospital of Guiyang City. Four cases were treated with free anterolateral thigh flap (ALTF) combined with allogeneic tendon in the first stage to reconstruct finger dorsiflexion function, and 2 cases were treated with free ilioinguinal flap combined with allogeneic tendon in the second stage to reconstruct finger dorsiflexion function. The age of the patients ranged from 22 to 62 years old. The areas of defect were 5.0 cm×12.0 cm-8.0 cm×20.0 cm. Two cases had 2 extensor tendons defect, 1 had 3 extensor tendons defect, 2 had 4 extensor tendons defect, and 1 had 5 extensor tendons defect. The length of extensor tendon defects was 7.0-22.0 cm. In 5 cases, the wounds were covered by VSD for 5 to 7 days after complete emergenly debridement. Then, after the wounds had been cleared and clean, the wounds of 3 cases were covered with free ALTF, 2 with free ilioinguinal flap, and 1 with free ALTF after skin graft scar resection. At 3-4 months later, the extension function of digit was reconstructed with the transplantation of allogeneic tendons. Postoperative appearance of the flaps and functions of digits were observed at the outpatient clinics during the follow-up.Results:The postoperative follow-up lasted for 10 to 26 (15 in average) months. All 6 flaps surrived completely, and 1 case was further treated with flap thinning at 4 months after the second surgery. During the follow-up, all flaps healed well and were good in appearance and texture. Meanwhile, the donor areas were all healed well with no dysfunction nor sensory disorder. All the transplanted tendons were in good glide without adhesion. The active motion of metacarpophalangeal joints ranged from (10±10) ° to (80±10) °. According to the Evaluation Trial Standards of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association, at the final follow-up, 4 cases were excellent and 2 cases were good.Conclusion:It is safe and effective that using the two-staged procedure in repair of composite tissue defect of dorsal wrist with stage-one ALTF or ilioinguinal flap transfer combined with stage-two reconstruction with transplantation of allogeneic tendon. It can minimize the adhesion after tendon transplantation and donor site damage

Effects of different habitat processing methods on the quality of Cyperus rotundus / 中国药房

OBJECTIVE To investigate the eff ects of different habitat processing methods on the quality of Cyperus rotundus ， such as sun-drying after steaming ，sun-drying after boiling and direct sun-drying ，and to investigate the optimal habitat processing method of C. rotundus from the perspective of chemical component. METHODS The fingerprint of C. rotundus was established by high performance liquid chromatography （HPLC）combined with the Similarity Evaluation System for Chromatographic Fingerprint of TCM （2012 edition）. The similarity evaluation was conducted to determine the common peak. Cluster analysis （CA）combined with principal component analysis （PCA）and partial least squares-discriminant analysis （PLS-DA）was used to differentiate and compare C. rotundus treated by different habitat processing methods. And the contents of cyperrenone ，α-cyperone，luteolin and ferulic acid in C. rotundus were determined by HPLC. RESULTS There were 22 common peaks in the HPLC fingerprints of C. rotundus reated by different habitat processing methods ；their similarities were higher than 0.9；common peak 16 and common peak 20 were cyperrenone and α-cyperone. CA results showed that C. rotundus boiled for 4，8 and 12 min were clustered into one category，the rest of the samples clustered into one category. PCA results showed that comprehensive score of C. rotundus steamed for 10 and 15 min and boiled for 2 min were the highest. The steaming treatment had small effect on comprehensive score of samples，while the boiling treatment had a great effect on the quality of the samples ；the overall score of samples decreased sharply after boiling for 2 min. Results of PLS-DA showed that variable importance projection （VIP）of peak 20（α-cyperone），peak 16 （cyperrenone），peak 22，peak 17 and peak 22 in HPLC fingerprints were all higher than 1. The results of content determination showed that there was significant difference in the contents of α-cyperone，cyperrenone and luteolin in samples treated by different habitat processing methods.With the increase of steaming and boiling time ，the contents of α-cyperone，cyperrenone and luteolin showed a significant downward trend ，and boiling had a great impact on them. CONCLUSIONS Too long boiling treatment greatly；2019 destroys the chemical composition of C. rotundus ， andsteaming for 10，15 min or boiling for 2 min is the optimal processing method.

"Massive hemoptysis" and shock after fever and cough / 中国当代儿科杂志

A boy, aged 11 years, was admitted due to intermittent fever for 15 days, cough for 10 days, and "hemoptysis" for 7 days. The boy had fever and cough with left neck pain 15 days ago, and antibiotic treatment was effective. During the course of disease, the boy developed massive "hemoptysis" which caused shock. Fiberoptic bronchoscopy revealed a left pyriform sinus fistula with continuous bleeding. In combination with neck and vascular imaging examination results, the boy was diagnosed with internal jugular vein injury and thrombosis due to congenital pyriform sinus fistula infection and neck abscess. The boy was improved after treatment with temperature-controlled radiofrequency ablation for the closure of pyriform sinus fistula, and no recurrence was observed during the follow-up for one year and six months. No reports of massive hemorrhage and shock due to pyriform sinus fistula infection were found in the searched literature, and this article summarizes the clinical features, diagnosis, and treatment of this boy, so as to provide a reference for the early diagnosis of such disease and the prevention and treatment of its complications.

Systematic evaluation and sequential Meta-analysis of modified Xuefu Zhuyu Decoction combined with Western medicine in treatment of leiomyoma / 中国中药杂志

CNKI, PubMed and other databases were retrieved to extract eligible randomized controlled trial(RCT) about modified Xuefu Zhuyu Decoction(MXZD) combined with Western medicine(trial group) versus Western medicine alone(control group) in the treatment of leiomyoma. Therefore, a total of 25 RCTs were included, involving 2 328 patients. Bias risk evaluation tool in Cochrane Handbook 5.1.0 was used for evaluating the quality of these RCTs. Meta-analysis was performed for the reported indicators, including total efficiency, serum hormone level [progesterone(P), luteinizing hormone(LH), estradiol(E_2), follicle stimulating hormone(FSH)], uterine size, fibroids size and adverse reactions by using Stata 14.0 software. Meta-analysis showed that the total efficiency(RR=1.21,95%CI[1.17,1.25],P<0.05) of trial group was better than that of control group. Serum hormone level(WMD_P=-3.86,95%CI[-4.31,-3.41],P<0.05; WMD_(LH)=-3.64,95%CI[-4.47,-2.82],P<0.05; WMD_(E_2)=-39.99,95%CI[-53.45,-26.52],P<0.05; WMD_(FSH)=-3.79,95%CI[-4.86,-2.72],P<0.05), uterine size(WMD=-50.02,95%CI[-55.98,-44.06],P<0.05), fibroids size(WMD=-15.79,95%CI[-18.11,-13.46],P<0.05) and adverse reactions(RR=0.65,95%CI[0.48,0.88],P<0.05) of trial group were all lower than those of control group, with statistical significances. Trial sequential analysis(TSA) was performed by using TSA 0.9 software, and showed a reliable therapeutic effect of the experimental group. In short, our study indicated that modified Xuefu Zhuyu Decoction combined with Western medicine had a better therapeutic effect on leiomyoma than Western medicine alone, but more high-quality studies are needed to verify this conclusion in the future.

Association of Overlapped and Un-overlapped Comorbidities with COVID-19 Severity and Treatment Outcomes: A Retrospective Cohort Study from Nine Provinces in China / 生物医学与环境科学（英文）

Objective@#Several COVID-19 patients have overlapping comorbidities. The independent role of each component contributing to the risk of COVID-19 is unknown, and how some non-cardiometabolic comorbidities affect the risk of COVID-19 remains unclear.@*Methods@#A retrospective follow-up design was adopted. A total of 1,160 laboratory-confirmed patients were enrolled from nine provinces in China. Data on comorbidities were obtained from the patients' medical records. Multivariable logistic regression models were used to estimate the odds ratio ( @*Results@#Overall, 158 (13.6%) patients were diagnosed with severe illness and 32 (2.7%) had unfavorable outcomes. Hypertension (2.87, 1.30-6.32), type 2 diabetes (T2DM) (3.57, 2.32-5.49), cardiovascular disease (CVD) (3.78, 1.81-7.89), fatty liver disease (7.53, 1.96-28.96), hyperlipidemia (2.15, 1.26-3.67), other lung diseases (6.00, 3.01-11.96), and electrolyte imbalance (10.40, 3.00-26.10) were independently linked to increased odds of being severely ill. T2DM (6.07, 2.89-12.75), CVD (8.47, 6.03-11.89), and electrolyte imbalance (19.44, 11.47-32.96) were also strong predictors of unfavorable outcomes. Women with comorbidities were more likely to have severe disease on admission (5.46, 3.25-9.19), while men with comorbidities were more likely to have unfavorable treatment outcomes (6.58, 1.46-29.64) within two weeks.@*Conclusion@#Besides hypertension, diabetes, and CVD, fatty liver disease, hyperlipidemia, other lung diseases, and electrolyte imbalance were independent risk factors for COVID-19 severity and poor treatment outcome. Women with comorbidities were more likely to have severe disease, while men with comorbidities were more likely to have unfavorable treatment outcomes.

HPLC Fingerprints of Different Polarity Fractions of Achyranthes bidentata of Different Specifications / 中国药学杂志

OBJECTIVE: To study and compare the HPLC fingerprints of different polar parts of Achyranthes bidentata of different specifications, investigate their internal quality differences, and provide reference for the standard improvement and clinical use of the medicinal material. METHODS: The Achyranthes bidentata samples were refluxed with 75% ethanol, the extract was dissolved with 40 mL water and then,extracted in turn with petroleum ether, chloroform, ethyl acetate and n-butanol, each extracted phase and aqueous phase were obtained and concentrated. The HPLC fingerprint of each part was collected. The data was analyzed by similarity and comprehensive clustering. Meanwhile, the fingerprints of different parts were compared and analyzed. RESULTS: Eleven common peaks were determined in the HPLC fingerprints of petroleum ether fraction and chloroform extract fraction, 10,19,and 8 common peaks were determined in the HPLC fingerprints of ethyl acetate fraction, n-butyl alcohol fraction,and water extract respectively. The similarity of the fingerprints of chloroform parts was quite low.The similarity of the fingerprints of other parts was higher,all above 0.9. The difference in the fingerprints of petroleum ether parts was mainly reflected in the peak height. The chemical compositions and peak heights of ethyl acetate, chloroform and water extracts were different. Comprehensive cluster analysis could distinguish different specifications of Achyranthes bidentata. CONCLUSION: The internal qualities of different specifications of Achyranthes bidentata are different. HPLC fingerprint established in this experiment can comprehensively reflect the chemical components distribution of Achyranthes bidentata of different specifications. It provides reference for the whole quality evaluation of different specifications of Achyranthes bidentata.

Uncertainty analysis for detecting methyl mercury in fish tissue with liquid chromatography-atomic fluorescence spectrometry / 中国医学装备

Objective: To establish a method of liquid chromatography-atomic fluorescence spectrometry (LC-AFS), and carry out uncertainty analysis of detecting methyl mercury in fish tissue. Methods: LC-AFS method was adopted to determine the content of methyl mercury in fish tissue. And the theory of assessment and expression about uncertainty measurement based on JJF1059.1-2012 of State Administration for Market Regulation was applied to analyze the source of factors that affect its uncertainty. Through evaluated various factors of uncertainty and calculated and combined uncertainty to obtain the extended uncertainty of measurement results. Results: The content of methyl mercury in fish tissue by using LC-AFS wasω=(817.94±105.02)μg/kg (k=2, confidence level was 95%). Conclusion: The measurement uncertainty assessment can be used in the uncertainty analysis that LC-AFS measure content of methyl mercury in fish tissue. Therefore, the results are more reliable.

Study on longitudinal integration of medical service resources considering patients' preference in tiered medical care system / 中国卫生政策研究

The hierarchical diagnosis and treatment system is an important measure for rational allocation of medical resources, promotion of equalization of basic medical services, improving the patients' disorderly medical treatment and guiding patients' hospital choice behavior. This paper defines the utility function of rational medical treatment of patients affected by multiple factors such as the personal disposable income,the age,the severity of the self-induced illness and the decision-makers' education level, and considered the outpatient price, service capacity and other factors of medical institutions. The present study constructed the incomplete information dynamic game model based on fictitious play method. It provided the quantitative analysis of the statistical data of Qinhuangdao and obtained the patients distribution in medical institution. The rationality of the model was verified by comparing the simulation with actual data,and showed the choice is more reasonable between the primary health care and general hospital. Therefore,the emphasis of optimizing the medical service resources in hierarchical diagnosis and treatment system is to establish the treatment system of integrated medical service for patients'on-demand and on-demand medi-cal services. At the same,various incentives should be used to enhance patients'enthusiasm for primary health care.

Evolutionary game of resources integration on secondary hospital and tertiary hospital in tiered medical care system / 中国卫生政策研究

The paper analyzed the decision-making process of the doctor's treatment and patient's decision-making. Then established the evolutionary game model of patient's and the secondary-tertiary hospital doctor's strate-gy. The Matlab simulation software were used to analyze the influencing factors of patient-doctor strategy-making sys-tem. We proposed the advice reducing critical patient's utility loss diagnosed in secondary hospital,improving medi-cal experience of common patient in secondary hospital,strengthening disease prevention of critical patient,and pro-moting labor division and cooperation between secondary and tertiary hospital to make result develop towards reduction the disorderly,chaotic and dislocated medical need and an integrated secondary and tertiary system.

Design and practice of network migration and reconstruction for one hospital with two addresses / 医疗卫生装备

Object To migrate and reconstruct the hospital network to solve its problems in obsolete equipment, network architecture, software configuration and etc.Methods A network migration and reconstruction scheme was proposed based on the physical environment of one hospital with two addresses as well as some network technologies such as open shortest path first (OSPF) protocol, port trunking and stacking.Results The network migration and reconstruction were implemented as desired, and the core switching network was upgraded to ten gigabit Ethernet.Conclusion The hospital network is optimizedin architecture, software configuration, reliability and performances, and lays a foundation for hospital informatization.

Microsurgical treatment to open degloving injuries in plantar soft tissue / 中华显微外科杂志

Objective To explore the emergency strategy of microsurgical replantation to open degloving injuries in plantar soft tissue.Methods From July,2013 to July,2017,5 patients with plantar degloving injury were treated by micro-replantation,3 of which were injuried by traffic accident and 2 caused by crashed injury.After early debridement,4 cases received anastomosis of blood vessels,and 1 treated with Venous Autograft to get recovery of blood circulation.The avulsion flaps were sutured without tension.Results Four flaps survived after plantar replantation,and 1 developed a partial necrosis and secondery repaird with skin graft.The plantar repair made sensory function preserved in the maximum extent.All patients were followed-up for 0.5-2.0 years.The appearance,elasticity and feel of flaps was good.Conclusion Complete debridement,early recovery of blood supply and maximum preservation of plantar tissue function should be the key to successful replantation of open plantar degloving injuries.

Concerns relating the surgical management of severe acute pancreatitis / 中华消化外科杂志

Nowadays,some new characteristics emerge in the modem management of severe acute pancreatitis (SAP),such as minimally invasive,staging,multidisciplinary,specialized and diversified.There is a prevalent insufficiency in the surgical management of SAP due to various reasons.A precise grasp of timing,indication and manner in the surgical management of SAP is of great importance to further improve the curative rate.Surgical intervention of SAP is performed in a staged step-up framework,which should not only be indicated by infectious complications in the late-phase of SAP,but also by a failure of nonsurgical therapy and a progression to abdominal compartment syndrome and/or multiple organ failure (MOF) in the earlyphase of SAP.In a staged step-up framework,imaging-guided percutaneous catheter drainage could be established relatively early,MOF and heterogeneous collection are independent risk factors of the necessity of surgical debridement,and the merits of open debridement should not be under-estimated.A sameadmission cholecystectomy could be arranged for patients with gallstone SAP,and laparoscopic cholecystectomy serves as the initial choice.In the context of minimal-invasiveness and diversification,the surgeons should endeavor to establish their predominant role in the multidisciplinary team,preventing from insufficient surgical intervention in the management of SAP.

Concerns relating the surgical management of severe acute pancreatitis / 中华消化外科杂志

Nowadays,some new characteristics emerge in the modem management of severe acute pancreatitis (SAP),such as minimally invasive,staging,multidisciplinary,specialized and diversified.There is a prevalent insufficiency in the surgical management of SAP due to various reasons.A precise grasp of timing,indication and manner in the surgical management of SAP is of great importance to further improve the curative rate.Surgical intervention of SAP is performed in a staged step-up framework,which should not only be indicated by infectious complications in the late-phase of SAP,but also by a failure of nonsurgical therapy and a progression to abdominal compartment syndrome and/or multiple organ failure (MOF) in the earlyphase of SAP.In a staged step-up framework,imaging-guided percutaneous catheter drainage could be established relatively early,MOF and heterogeneous collection are independent risk factors of the necessity of surgical debridement,and the merits of open debridement should not be under-estimated.A sameadmission cholecystectomy could be arranged for patients with gallstone SAP,and laparoscopic cholecystectomy serves as the initial choice.In the context of minimal-invasiveness and diversification,the surgeons should endeavor to establish their predominant role in the multidisciplinary team,preventing from insufficient surgical intervention in the management of SAP.

The clinical practice and related reflections of staged step-up approach in the treatment of patients with severe acute pancreatitis / 中华外科杂志

Both new insights in the pathophysiology of severe acute pancreatitis (SAP) and upspringing related evidence-based supports prompt the staged step-up approach, which stress emphasis on minimal invasiveness and damage control, to be accepted and advocated by the majority of guidelines. For documented or suspected patients with infected pancreatic necrosis, an imaging-guided percutaneous catheter drainage or an endoscopic transluminal drainage should be initially performed followed by, if necessary, a minimal access retroperitoneal necrosectomy, or a video-assisted retroperitoneal debridement, or an endoscopic transluminal necrosectomy, or an even an open access necrosectomy. The outstanding performance of staged step-up approach in patients with SAP has been justified from both a clinical and a health economic point of view, meanwhile, there are some issues remained to be further elucidated and optimized.

Cognitive status and influencing factors for hand hygiene among health care workers in a general hospital / 中国感染控制杂志

Objective To investigate cognitive status and influencing factors for hand hygiene(HH)among health care workers(HCWs),and provide basis for scientific management of HH.Methods In April 2013,HCWs in a general hospital were selected by randomly sampling method,questionnaires were used to survey the implementation of HH in recent one month and HCWs’cognition on knowledge about HH.Results A total of 750 HCWs were in-vestigated,652 available questionnaires were collected.The frequency of hand washing and hand disinfection per day among most HCWs were 10 - 19 times,accounting for 46.62% and 47.85% respectively;30.52% of HCWs washed their hands for ≥30 seconds each time,60.58% of HCWs dried hands with paper towel after washing hands,57.21 % of HCWs abided by six-step hand washing method.The overall correct rate of cognition on ten op-portunities that requiring HH in clinical practice was 68.68%.The main factors influencing the implementation of HH were as follows:skin irritation of hand sanitizer and hand disinfectant subjectively considered by HCWs (63.34%),inadequate hand washing facilities(41 .10%);high cost of hand sanitizer ,hand disinfectant,and dry paper towel (38.96%),et al.Conclusion In addition to intensifying education on HH,installing rational HH facili-ties and improving HH standard are key points in strengthening HH in general hospital.

"Re-evaluation upon suspected event" is an approach for post-marketing clinical study: lessons from adverse drug events related to Bupleuri Radix preparations / 中国中药杂志

We revisited the "Xiao Chaihu Decoction event (XCHDE)" occurred in late 1980s in Japan and the Bupleuri Radix related adverse drug reaction (ADR) reports in China After careful review, comparison, analysis and evaluation, we think the interstitial pneumonitis, drug induced Liver injury (DILI) and other severe adverse drug envents (ADEs) including death happened in Japan is probably results from multiple factors, including combinatory use of XCHDE with interferon, Kampo usage under modern medicine theory guidance, and use of XCHD on the basis of disease diagnosis instead of traditional Chinese syndrome complex differentiation. There are less ADE case reports related to XCHD preparation in China compared to Japan, mostly manifest with hypersensitivity responses of skin and perfuse perspiration. The symptoms of Radix Bupleuri injection related ADEs mainly manifest hypersensitivity-like response, 2 cases of intravenous infusion instead of intramuscular injection developed hypokalemia and renal failure. One case died from severe hypersensitivity shock. In Chinese literatures, there is no report of the interstitial pneumonitis and DILI associated with XCHDG in Japan. So far, there is no voluntary monitoring data and large sample clinical research data available. The author elaborated the classification of "reevaluation" and clarified "re-evaluation upon events" included the reaction to the suspected safety and efficacy events. Based on the current status of the clinical research on the Radix Bupleuri preparations, the author points out that post-marketing "re-evaluation upon suspected event" is not only a necessity of continuous evaluation of the safety, efficacy of drugs, it is also a necessity for providing objective clinical research data to share with the international and domestic drug administrations in the risk-benefit evaluation. It is also the unavoidable pathway to culture and push the excellent species and famous brands of TCM to the international market, in that it enhances the pharmaceutical manufactures the ability to control enterprise risk and eliminate the negative impact on traditional Chinese medicine. With the widely used and ADR report concentrated Radix Bupleuri injection as an example, the author provide a new approach to post-marketing clinical research.

Surgical treatment of chronic pancreatitis and choice of procedure / 中华胰腺病杂志

Objective To analyze the results of surgical treatment on chronic pancreatitis(CP),and investigate how to choose the appropriate surgical procedure.Methods The clinical data of 54 patients with chronic pancreatitis who underwent surgery at the First Affiliated Hospital of Harbin Medical University from January 2007 to December 2011 were retrospectively analyzed.Results All the 54 patients underwent surgery,including 8 decompression and drainage procedure (Partington procedure) ; 13 resections (7 cases of pancreaticoduodenectomy,1 case of distal pancreatectomy,4 cases of distal pancreatectomy combined with splenectomy and 1 case of pancreaticoduodenectomy combined with distal pancreatectomy,respectively); 12hybrids (7 cases of Beger procedure and 5 cases of Frey procedure,respectively) and 21 other procedures (15 cases of pancreatic pseudocyst jejunostomy,4 cases of exploratory laparotomy combined with pancreatic tissue biopsy,2 cases of gastrojejunostomy combined with choledochojejunostomy,respectively).There were 4 cases of post-operative pathologic evidence of cancer.Twelve patients had postoperative complications and were cured with non-operative management.Forty-four patients (81.5％) were followed for 2 to 67 months,36 out of 42(85.7％) patients who suffered from abdominal pain had a persistent remission,there were one case of new on-set diabetes and no steatorrhea was reported.Conclusions For CP patients with surgical indications,the choice of procedure should be individualized for the purpose of preserving the endocrine and exocrine functions of pancreas,and taking effectiveness as well as safety into consideration.

Post-marketing clinical study of traditional Chinese medicine--lessons learned from comprehensive evaluation of Fufang Zaoren capsule / 中国中药杂志

By comprehensive review and analysis of post-marketing clinical research on the efficacy and safety,we concluded that Fufang Zaoren capsule has certain therapeutic effects for insomnia, although current clinical research design needs improving. The post-marketing clinical studies also showed that it causes several adverse reactions at the recommended doses, such as chills, fever, dizziness, nausea, shortness of breath, chest tightness and palpitations, whereas high doses of Fufang Zaoren capsule can cause delayed extrapyramidal symptoms. Health Canada government website also prompted the L-tetrahydropalmatine in Fufang Zaoren capsule caused liver damage in pregnant women. The authors summarized the risk points, factors and risk control in the clinical use of Fufang Zaoren capsule and also present their perspective on the research status, existing problems and corresponding countermeasures in the post-marketing clinical re-evaluation of traditional Chinese medicine.