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ObjectiveTo establish the quality standard of Liangditang benchmark samples. MethodUltra performance liquid chromatography-quadrupole time-of-flight mass spectrometry （UPLC-QTOF-MS） was used to qualitatively analyze the chemical composition of Liangditang on the basis of molecular and fragment ion peak information with cracking law. The mobile phase was methanol （A）-0.05% phosphate aqueous solution （B） for gradient elution （0-10 min， 5%-23.5%A； 10-20 min， 23.5%A； 20-58 min， 23.5%-63%A； 58-60 min， 63%-90%A）， the flow rate was 0.8 mL·min-1， and the detection wavelength was 254 nm. Electrospray ionization was employed under positive ion mode， the detection range was m/z 100-1 700. Key quality attributes and sources were determined by comparing with single medicine and reference substances. Through mass transfer analysis of multiple batches from decoction pieces to benchmark samples， high performance liquid chromatography （HPLC） for determining the contents of index components and HPLC detection of characteristic maps were established. Through the determination of 15 batches of benchmark samples， the content range of the index components and the common peaks of the characteristic map were determined. Thin layer chromatography （TLC） was applied to the identification of 5 medicines in the formula. Moisture and dry extract yield of the benchmark samples were determined by drying method. ResultA total of 27 compounds were inferred from the benchmark samples of Liangditang， among which 9 compounds were confirmed by comparison with the control， including catalpol， harpagide， gallic acid， albiflorin， paeoniflorin， verbascoside， angoroside C， cinnamic acid and harpagoside. A method for determining the characteristic maps of the benchmark samples were established and 13 peaks were assigned， and the characteristic peaks were mainly derived from wine-processed products of Rehmanniae Radix， Scrophulariae Radix and wine-processed products of Paeoniae Radix Alba. The similarity between the characteristic map of 15 batches of benchmark samples and the control characteristic map was >0.9. Methods for the determination of paeoniflorin， harpagoside， L-hydroxyproline and glycine were established， and the contents of these four components in 15 batches of benchmark samples were within ±30% of the corresponding mean value， and the transfer rate of decoction pieces to the benchmark samples was stable and controllable. TLC was established to identify 5 prescription drugs （except Ejiao） with two kinds of test solutions， and the results showed that the method had good specificity. The average dry extract yield was 48.06%， and the average moisture was 5.58%， which were within the range of ±10% and ±30% of their mean values， respectively. ConclusionThe quality standard of Liangditang benchmark samples was as follows：the similarity between the benchmark samples and the control characteristic map is >0.9， the contents of paeoniflorin， harpagoside， L-hydroxyproline and glycine are 217-403， 24-46， 634-1 178， 1 253-2 328 mg per dose， the dry extract yield is 43.0%-53.0%， the moisture is 4.0%-7.0%， under the set detection conditions， the benchmark samples have corresponding characteristic spots by comparing with the control herbs of 5 medicines. This quality standard is stable and reliable， which fills the gap in the quality control of Liangditang， and can provide a reference for the establishment of the quality standard of Liangditang granules.
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Objective:To explore the clinicopathological factors that influence the prognosis and pathological complete response (PCR) of young breast cancer patients after neoadjuvant chemotherapy.Methods:From January 2007 to December 2017, 87 cases of female breast cancer patients aged ≤40 who received neoadjuvant chemotherapy and were admitted to the breast surgery department of Qingdao 8th people′s hospital were analyzed retrospectively.According to the pathological results, , the patients were divided into three groups: 30 in the PCR group and 57 in the non PCR group. To compare the correlation between the composition of PCR, recurrence/metastasis and death and clinicopathological characteristics, and to analyze the relationship between PCR and disease-free survival(DFS) and overall survival(OS).Results:After neoadjuvant chemotherapy, 30 of the 87 patients reached to PCR (34.5%). The proportion of PCR after neoadjuvant chemotherapy in young breast cancer is related to estrogen receptor (ER), progesterone receptor (PR), preoperative lymph node status, Ki67 level and molecular typing( χ 2 values were 3.592, 4.614, 8.373, 4.251 and 14.569, respectively, P values were 0.047, 0.032, 0.039, 0.039 and 0.006, respectively; the proportion of recurrence and metastasis patients with Er, PR and human epidermal growth factor receptor 2 2, HER-2, tumor size and lymph node status were correlated (χ 2 values were 8.778, 6.243, 9.413, 14.910, 23.074, P values were 0.003, 0.013, 0.009, 0.002, < 0.001, respectively); the proportion of dead patients was correlated with Er, PR, HER-2, grade, tumor size and lymph node status (χ 2 values were 6.686, 4.340, 11.874, 15.707, 12.428, 26.564, respectively, P values were 0.010, 0.037, 0.003, < 0.001, 0.006, < 0.001). Er, PR, HER-2, tumor size, preoperative lymph node status and molecular typing were correlated with DFS ( HR(95% CI) was 0.53 (0.31-0.93), 2.12 (1.21-3.64), 0.46 (0.27-0.77), 1.91 (1.40-2.62), 2.22 (1.55-3.20), 1.21 (0.95-1.55), all P< 0.05), while er, PR, HER-2, classification, tumor size and preoperative lymph node status were closely correlated with OS ( HR(95% CI was 0.47 (0.23-0.98), 2.14 (1.03-4.44), 0.37 (0.19-0.76), 2.90 (1.45-5.79), 1.86 (1.24-2.79) and 2.22 (1.39-3.56), respectively (all P < 0.05)). Among the 33 patients with recurrence and metastasis, 5 (16.7%)patients had PCR, while the remaining 28 (49.1%)patients had not reached PCR, accounting for 49.1% (28/57) of all the non PCR patients. The difference between the two groups was statistically significant ( P = 0.019). Among the 21 patients who died, there were 2 patients with PCR, accounting for 6.7% (2/30) of all the patients with PCR; the remaining 19 patients did not reach PCR, accounting for 33.3% (19/57) of all the patients without PCR. The difference between the two groups was statistically significant( P= 0.026). Conclusion:The proportion of PCR, DFS and OS in young breast cancer patients after neoadjuvant chemotherapy were affected by many clinicopathological factors.
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OBJECTIVE： To study the mechanism of Cistanche deserticola in the treatment of osteoporosis by network pharmacology. METHODS： The active components of C. deserticola were retrieved and obtained by TCM system platform （TCMSP）. Reverse molecular docking server DRAR-CPI and related databases GeneCards and OMIM were used to screen the target of C. deserticola active ingredients in the treatment of osteoporosis. The “component-target”network of C. deserticola was constructed by Cytoscape software， and the interaction between targets was plotted by String database and Cytoscape software. The combination activity of target and active ingredient was evaluated via molecular docking with Systems Dock WebSite server. GO classification and enrichment analysis and KEGG pathway enrichment analysis were conducted for target genes using DAVID database. RESULTS： Totally 13 active ingredients were screened out from C. deserticola， such as verbascoside， leonurine， geniposidic acid. There were 43 active ingredient-treated potential targets， such as RUNX2， VEGF， IL-6， BGP， TNF. Multiple signaling pathways were involved in target action， such as WNT （Wingless/Integrated）， VEGF， TNF. CONCLUSIONS： This study preliminarily explores and validates the main targets and pathways of C. deserticola in the treatment of osteoporosis， which lay the foundation for further study of its mechanism.
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BACKGROUND: In the treatment of osteoporotic vertebral compression fractures with percutaneous vertebroplasty, the efficacy and safety of bone cement injection by unipedicular and bipedicular approaches are still controversial. Some studies suggest that bone cement injection via unipedicular approach can shorten operation time and reduce postoperative complications, while the other studies suggest that bone cement injection via bipedicular approach can make bone cement distribute more evenly in the vertebral body and relieve pain better. OBJECTIVE: To systematically assess the efficacy and safety of percutaneous vertebroplasty via unipedicular versus bipedicular approach in the treatment of osteoporotic vertebral compression fractures. METHODS: Randomized controlled trials about unipedicular versus bipedicular percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fracture published before September 18 t h, 2018 were retrieved in the PubMed, Cochrane library, Embase, CNKI, VIP, WanFang data and CBM. Two researchers independently screened all the literatures, carried out data extraction and used improved Jadad to evaluate the methodological quality of the included studies. Meta-analysis using Revam 5.3 was conducted. Egger's test was utilized to evaluate the publication bias. RESULTS AND CONCLUSION: Totally 14 randomized controlled trials including 900 cases were eventually included, 452 cases in unipedicular approach group and 448 cases in bipedicular approach group. The Meta-analysis results showed that compared with the bipedicular approach, the unipedicular approach required shorter operation time [weighted mean difference (WMD) =-16.59, 95％ confidence interval (CI) (-19.25, -13.94), P < 0.001], smaller amount of bone cement injected [WMD=-1.27, 95％ CI (-1.64, -0.89), P < 0.001], and had lower incidence of cement leakage [relative risk=0.70, 95％ CI (0.53, 0.92), P =0.01]. There were no significant differences in short-and long-term Visual Analogue Scale scores, short-and long-term Oswestry Disability Index scores, and the postoperative incidence of adjacent vertebral fractures between the two groups (P> 0.05). Overall, bone cement injection both via bipedicular and unipedicular approaches can lead to a significant improvement in pain relief and living quality of osteoporotic vertebral compression fracture patients, but bone cement injection via unipedicular approach can shorten operation time, reduce cement volume and lower the incidence of cement leakage compared with the bipedicular approach.
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With the increasing demand for health care, the consumption and cost of drugs have increased dramatically. Pharmacoeconomics is a new interdisciplinary subject in recent years. It mainly focuses on the cost and benefit of drug treatment. In this paper, the authors analyze the drug cost management based on an antimicrobial treatment case. The results show that by using cost-effectiveness method, we could reduce the cost of drugs in the course of treatment, the proportion of antimicrobial drugs are also reduced accordingly. By using the concept of pharmacoeconomics, in order to standardize the process of diagnosis and treatment, and to increase the economic performance of the drug delivery plan