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OBJECTIVE：To improve the quality standard of Compound child antifebrile suppository. METHODS ：Based on the previous quality standard ，TLC identification methods were established for artificial cow-bezoar and Baphicacanthis Cusiae Rhizoma et Radix. HPLC method was established for content determination of choleic acid （CA），hyodeoxycholic acid （HDCA） and paracetamol. RESULTS ：TLC chromatogram of artificial cow-bezoar and Baphicacanthis Cusiae Rhizoma et Radix all showed the same color spots in the same position as the corresponding substance control or reference medicinal material ，while the negative samples had no interference. HPLC was performed on Welch Xtimate C 18 column（CA，HDCA）or Agilent ZORBAX SB-C 18 column（paracetamol）with mobile phase consisted of acetonitrile-0.5％ formic acetic acid （by gradient elution ，CA and HDCA ）or methanol-water（20∶80，V/V，paracetamol）at the flow rate of 1.0 mL/min. ELSD was used with a nitrogen flow-rate of 2.0 L/min at a drift tube temperature of 105 ℃（CA，HDCA）. The detection wavelength was set at 244 nm（paracetamol）. The linear ranges of CA，HDCA，paracetamol were 0.150 0-4.500 0，0.212 5-6.375 0，0.081 9-1.638 5 μg（all r＞0.999 2）. RSDs of precision ， reproducibility and stability tests were all lower than 3％（n＝6 or n＝7）. The average recoveries were 100.35％，101.39％， 98.81％（all RSD ＜3％，n＝6）. CONCLUSIONS ：Based on previous quality standard of Compound child antifebrile suppository ， TLC method is used to identify artificial cow-bezoar and Baphicacanthis Cusiae Rhizoma et Radix ，and the contents of CA ，HDCA and paracetamol are determined by HPLC ，which can effectively improve the quality control standard of the preparation.
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Objective To explore the diagnosis and treatment of parvovirus B19 infection-associated anemia after pediatric liver transplantation (LT) .Methods The clinical data were retrospectively reviewed for 2 children with severe anemia caused by parvovirus B19 infection after LT .Case 1 was a 2-year-old girl with a weight of 10 .7 kg .Classical orthotopic LT was performed due to ornithine carbamoyltransferase deficiency . Hemoglobin level began to progressively decline since Day 2 post-transplantation .And case 2 was a 5-month-old girl with an age of 5 months and a weight of 7 .2 kg .She underwent classic orthotopic LT for biliary atresia and decompensated liver cirrhosis .Hemoglobin level progressively declined at nearly 2 months post-transplantation . Results In case 1 ,bone marrow aspiration was performed at Day 54 post-transplantation .There was pure red cell aplasia and the detection of microvirus B19 nucleic acid was positive .Intravenous immunoglobulin was prescribed at a dose of 2 .5 g/day for 10 days ,tacrolimus was switched to cyclosporine and hemoglobin level spiked from 62 to 105 g/L after one-month treatment .In case 2 ,hemoglobin decreased to 44 g/L at 2 .5 months post-transplantation and the result of polymerase chain reaction of parvovirus B 19 was 9 .7 × 107 copies/ml .Then intravenous immunoglobulin was dosed at 2 .5 g/day for 10 days and hemoglobin level rose to 122 g/L at 25 days after treatment . Hemoglobin level decreased to 63 g/L again at 4 .5 months post-transplantation .Anemia was corrected by intravenous immunoglobulin injection plus a temporary discontinuation of tacrolimus and a reduced dose of tacrolimus .Conclusions Infection of parvovirus B19 can cause pure red cell aplasia after LT in children . Early diagnosis with intravenous immunoglobulin and modification of immunosuppressive regimen can obtain excellent therapeutic efficacies .
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Objective To explore the experience of infantile liver transplantation ,reconstructing portal vein (PV) and avoid the higher incidence of portal vein low flow and complications .Methods The clinical data were reviewed for 152 infantile liver transplantations performed by a single surgery group .And 114 cases with PV risk factors underwent customized PV reconstructions .All of them were diagnosed as cholestatic liver diseases and 106 (93％ ) belonged to biliary atresia .Forty-two cases (36％ ) had 2 or more risk factors .Results Most cases (n= 106 ,93％ ) underwent living donor transplantations using lateral left graft while another 8 cases had deceased donor transplantations . Four types of PV reconstructions were adopted based upon individual conditions :left/right branch of PV trunk (n= 103) ,autogenous patch PV venoplastic reconstruction (n= 3) ,duct-to-duct of PV trunk (n= 5) and donor PV duct-to-recipient confluence of SMV/CV and SV (n= 3) .Graft size reduction was performed when GRWR > 4 .5％ (n= 16) .During a median follow-up period of 6 .5 (1 .5-13) months ,there were 3 LPVF (2 .6％ ) ,2PVS (1 .7％ ) and 1 PVT (0 .8％ ) .Three LPVF cases was corrected by PV stenting ,two cases of PVS were stable after anticoagulation therapy while one PVT case undergoing thromboectomy plus PV stenting resumed a normal PV flow .Conclusions PV reconstruction of high-risk infants require comprehensive risk evaluations ,precise surgical skills and customized strategies .For PV complications ,stenting is both safe and feasible .
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Objective Hepatic artery (HA) reconstruction is one challenging procedure in pediatric liver transplantation (PLT).Here we review the first 115 microsurgical reconstructions of HA in PLT performed by a single surgeon,aiming to demonstrate the learning curve and the problems encountered.Methods From July 2016 to January 2017,a series of 115 microsurgical reconstructions of HA in PLT for end-stage liver disease were finished by one single surgeon with 4-year liver surgery experience and 2-week microsurgical training.HA reconstruction was performed with an operating microscope (Carl-Zeiss S88).Reconstruction was completed with interrupted sutures with 8-0 or 9-0 Prolene using the double clip for fixation.The blood flow was examined by Doppler scan daily after PLTs in first week and then once in 2nd week and first month for patency.A total of 143 artery anastomoses were performed in 115 PLTs.The age ranged from 3 months to 9 years.Indications for PLT included biliary atresia (105/115),Alagille syndrome (5/115),PFIC (3/115),Caroli disease (1/115),methylmalonicacidemia (1/115) and glycogen storage disease (1/115).Most of the PLTs were living donor liver transplantation (107/115),along with OLT (5/115) and split LT (3/115).Results The diameter of the arteries was mostly less than 2 mm (98/115).Up to date,one HA thrombosis (HAT) occurred at D8 after LT and 4 cases suspected as temporal HA stenosis (HAS) around 2 weeks after LT,which manifested as low velocity (<20 cm/s) and resistance index (<0.50) by Doppler.The HAT case failed in emergent re-anastomosis,but had a spontaneous recanalization at 3 weeks and is now in good condition without biliary problem.All the HAS children recovered to normal flows at first month.All children with HA complications started warfarin upon detection,with a targeted INR between 1.5-2.0.There were 6 deaths in this series including 5 cases of infections and 1 case of graft failure.Learning curve suggested a two phases growth (first 44 cases practicing phase vs.next 71 cases mature phase),which can be attributed to experience accumulation in terms of precise of manipulation,choice of inflow arteries for better match and stronger pulsation,avoidance of length redundant,prevention of kink.All the HAT and HASs happened in practicing phase while outcomes were excellent in mature phase.Moreover,time for each anastomosis was significantly shortened in second phase from 45-70 min to 30-55 min.Conclusion Microsurgical technique is highly safe in pediatric HA reconstruction,especially for very tiny arteries.It is possible to achieve low risk of complications for a new surgeon with adequate experience in liver surgery and microsurgical training.However,more surveillance and timing anticoagulation therapy is required before the mature of microsurgical technique.
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It is important to establish a simple method of culture in vitro to obtain purity oligodendrocyte. This paper introduced the re-searches about co-culture in vitro with rat cortical gliocyte, proliferation and differentiation of oligodendrocyte progenitor, differentiation of oligodendrocyte and identification of cell surface antigens at different stages of development.
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OBJECTIVE:To establish a method to determinate the content of paeoniflorin in Bailing tablet,and to evaluate the uncertainty of results. METHODS:HPLC was performed on the column of Platisil C18 with mobile phase of water- acetonitrile(87:13,V/V) at a flow rate of 1 ml/min,the detection wavelength was 230 nm,the column temperature was 25 ℃ and the injection volume was 10 μl. Quantitative analysis was conducted for the processes and procedures and the uncertainty was evaluated. RESULTS:The linear range of paeoniflorin was 0.100 1-2.502 8 μg;RSDs of precision,stability and reproducibility tests were lower than 2.0%,recovery rate was 98.7%-100.9%(RSD=0.86%,n=6). Reference substance amount,elution produce and the accuracy of method had great effect on the uncertainty. CONCLUSIONS:The established method can be used for the content determination of paeoniflorin in Bailing tablet,and the uncertainty evaluation provides reliability for the method.
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Objective To find the best way to terminate early intrauterine pregnancy through comparative observation. Methods Through comparing the method of using disposable suction curettage tube to terminate early intrauterine pregnancy and medical abortion, and the method of induced abortion with traditional metal suction tube combined with local infiltration anesthesia, the complete abortion rate, intraoperative pain, blood loss and complications,etc were observed. Results Using disposable suction curettage tube to terminate early intrauterine pregnancy can result in no pain or less pain,with a bleeding time 1 to 6 days ,3.5 days on average ,both of which less than menstrual volume,with 100% complete abortion and no complications. Postoperative recovery time of period was 25 to 40 days,32.8 days on average. This method was better than medical abortion and induced abortion with local infiltration anesthesia. Conclusion Using disposable suction curettage tube to terminate early intrauterine pregnanncy did not need cervical dilation,and had advantage of light suction,less bleeding,no pain or less pain for pregnant women,no complications,rapid recovery,and was easy and safe to operate. It was the best way to terminate early intrauterine pregnancy.
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Objective To evaluate the hemodynamic changes and vascular complications after pediatric living donor liver transplantation (LDLT).Methods The hemodynamic changes of the portal vein,the hepatic artery and the left hepatic vein of the 34 cases were evaluated by color Doppler ultrasound during 2 months after LDLT.The vascular complications after LDLT were also evaluated.Results Of the 34 cases,vascular complications occurred in 5 cases.One day after LDLT,the max velocity of portal vein was (53.97 ± 21.44) cm/s,the peak systolic velocity of hepatic artery was (52.88 ± 17.87) cm/s,the resistance index was 0.73 ± 0.09,the max velocity of left hepatic vein was (40.53 ± 25.07) cm/s.The parameters of the hemodynamics had no significant difference between 1day and 1 week after LDLT (P＞0.05).The max velocity of portal vein was decreased after 2 weeks (P＜0.05).After 2 months,the max velocity of portal vein and the peak systolic velocity were decreased (P＜0.01 and P＜0.05) compared to 1 day.Vascular thrombosis was found in 5 recipients and all occurred in the first week after LDLT.Hepatic artery thrombosis (HAT) occurred in 3 (8.8 %) cases,portal vein thrombosis (PVT) in 2 (5.9 %).Among the 5 cases,3 were died.Conclusion The max velocity of portal vein and the peak systolic velocity of hepatic artery were decreased gradually after LDLT.The vascular complications occurred in the early stage and had a relatively high rate.Doppler examination should be performed once every day within 7 post-transplant days.
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Purpose:The value of color doppler ultrasonography( CDUS) in monitoring hemodynamic changes was investigated in patients with hyperdynamic circulatory state before and during 730 days after orthotopic liver transplantation.Materials and Methods:83 cases of orthotopic liver transplantation (OLT) were examined by CDUS to assess the hemodynamic changes of portal vein,hepatic artery,splenic artery and longitudinal diameter of the spleen ( LDS).Results:(1) Portal flow velocity ( PFV) was significantly lower in pre-OLT but higher than controls (P < 0.05 ) during 730 days after OLT.Resistance index of the hepatic artery ( HARI) in pre-OLT and within 7 days- after OLT was significantly higher (P<0.05).(2) Resistance index of splenic artery ( SARI) was also significantly higher in pre-OLT (P < 0.05 ).LDS was significantly higher after OLT than in both pre-OLT phase and controls(P<0.05).Conclusions: In early stage after OLT,HARI changed from high to low value and so did PFV,which kept the stability of hepatic blood flow.In late stage,high PFV and large spleen improved,but could not back to normal.
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OBJECTIVE:To prepare a compound resorcinol liniment(RSA)for treating acne METHODS:To prepare RSA and observe its stability RESULTS:The quality of RSA was stable in the term of validity and its clinical effect rate amounted to 97 3% CONCLUSION:RSA is easy to prepare,the therapeutic effect is satisfactory,and its stability is good
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Objective To compare the rutin contents in 7 kinds of commercial Fructus jujubae by HPLC method. Methods The analysis was carried on MN NUCLEODUR C18 column. The mobile phase consisted of acetonitrile-0.05 % H3PO4(15 ∶ 85), flow rate was 1.0 mL/min, determination wavelength was 257 nm and the column temperature was at 40 ℃ . Results The linear range was 0.050 5～ 0.404 4 ? g and r= 0.998 7.The recovery was 96.2 % and RSD 1.6 % (n=6). Conclusion This method can eliminate the interference of sugar ingredients efficiently and is with good repeatability. It is suggested that the plumper the fruits of jujubae, the higher the content of rutin.
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Objective To make a qualitative and a quantitative control on the Calculus Bovis in Houzao Niuhuang Powder.Methods Hyodeoxycholic acid and bilirubin in Calculus Bovis were separately identified by TLC,and the cholic acid content was determined by TLCS with the scan wavelength of ?s=380 nm,?R=650 nm.Results TLC can be used for the identification in-vitro cultured Calculus Bovis and artificial Calulus Bovis,the samples containing cultured Calulus Bovis showed the specific spots of bilirubin but no hyodeoxycholic acid spot while the samples containing artifical Calulus Bovis showed the hyodeoxycholic acid spot but no bilirubin spot.TLC-scanning can be used to measure the quantity of cholic acid,with the linear range being 0.2～1.8 ?g,average recovery rate of 99.5 %,and RSD being 3.3 %(n=6),and the results accorded with the criterion of the cultured Calculus Bovis in Chinese pharmacopoeia.Conclusion The methods can effectively control the quality of Calculus Bovis in Houzao Niuhuang Powder.