Steroids from Uncaria rhynchophylla / 中国中药杂志

Thirteen steroids(1-13) were isolated from the non-alkaloid constituents of Uncaria rhynchophylla by column chromatography on silica gel, ODS, Sephadex LH-20, and preparative HPLC chromatography, and their structures were elucidated by analyses of the MS and NMR spectral data. All the compounds were isolated from the genus Uncaria for the first time, and 1 was a new compound. The ~1H-NMR and ~(13)C-NMR data of two compounds(12 and 13) in deuteron-chloroform were completely assigned. This study enriched the steroid constituents of U. rhynchophylla and provided scientific references for the elucidation of active constituents and further development and utilization of U. rhynchophylla.

Simultaneous combined surgery for hepatic and renal cystic echinococcosis: a study on 11 cases / 中华普通外科杂志

Objective:To investigate the feasibility, safety and efficacy of simultaneous combined surgery for hepatic and renal cystic echinococcosis (CE).Methods:Clinical data of consecutive 11 hepatic and renal CE patients undergoing surgical treatment at the First Affiliated Hospital of Xinjiang Medical University from Oct 2009 to Feb 2017 were analyzed retrospectively.Results:There were 8 males and 3 females, median age was 44 years (22-60 years). Main symptoms were abdominal and/or flank pain and fever; nine and 2 patients respectively had cysts in liver plus right kidney and left kidney; median volume of cyst load for each patient was 944.1 cm 3 (67.1-9 310.4 cm 3). All patients were treated simultaneously by combined surgery, including total and subtotal cystectomies, hepatic or renal resections as well as extra lesions resection. All surgeries went uneventfully, radical rate was 63.6% (7/11), There was no postoperative liver or kidney dysfunctions. Median operative time, bleeding and length of hospital stay were 2.5 h (1.4-4.5 h), 100 ml (50-200 ml) and 7 d (5-10 d) respectively. All were followed-up for median 42 mouths (34-123 mouths) and all doing well without disease recurrence. Conclusions:Simultaneous combined surgery for recurrent or primary hepatic and renal double organ CE patients could be a feasible and effective approach.

Hepatectomy for hepatic alveolar echinococcosis complicating cavernous transformation of the portal vein / 中华普通外科杂志

Objective:To investigate the safety and feasibility of hepatectomy in the treatment of hepatic alveolar echinococcosis with secondary cavernous transformation of the portal vein.Methods:The clinical data of 7 patients undergoing surgery at the First Affiliated Hospital of Xinjiang Medical University from Jan 2010 to Dec 2019 were retrospectively analyzed.Results:There were 1 case of cavernous type Ⅰ transformation of the portal vein and 6 cases of type Ⅱ. All patients underwent partial hepatectomy. The average operation time was (9.24±4.09) h. Two patients underwent resection of cavernous segment of portal vein and reconstruction by graft, Albendazole was taken orally for 2 years after discharge. Anticoagulants were taken orally in patients with artificial vascular reconstruction. No recurrence and vascular complications were found. Five patients underwent palliative resection without resection of the cavernous segment of the portal vein. During the follow-up, cavernous transformation of the portal vein progressed in 3 patients, 2 of them esophageal varices rupture and bleeding.Conclusion:Radical hepatectomy and revascularization are the first choice for the treatment of hepatic alveolar echinococcosis complicated with secondary cavernous transformation of portal vein the result was fair.

A case report of testicular borderline mucinous cystadenoma / 中华泌尿外科杂志

Testicular/paratesticular mucinous cystadenoma is a rare type of ovarian epithelial tumor. This paper reported a patient with enlarged left testicle , and CT showed a multifocal cystic mass in left testis. Radical left testis orchiectomy was performed, and the pathology showed testicular borderline mucinous cystadenoma. The patient was followed up for 3 years and no recurrence and metastasis was observed.

The comparative study of lingual mucosal graft combined with buccal mucosal graft and ADM urethroplasty for failed hypospadias repair / 中华泌尿外科杂志

Objective:To compare the outcomes of combined lingual mucosal graft with buccal mucosal graft urethroplasty and combined lingual mucosal graft with ADM (acellular dermal matrix) urethroplasty for the treatment of repair failed hypospadias.Methods:From February 2017 to February 2019, 26 patients with failed hypospadias repairs were treated with combined lingual mucosal graft with buccal mucosal graft urethroplasty (14 cases in Group A), and combined lingual mucosal graft with ADM urethroplasty (12 cases in Group B). The mean age of Group A was (29.5±1.2) years (range 18.0-41.0 years), and (26.5±0.8) years (range 20.0-38.0 years) in Group B. The previous operation times was mean (3.6±0.7)(range 2-5 times) and (4.6±0.8)(range 3-5 times) in Group A and Group B respectively. Operation method: All patients were nasally intubated, the remaining curvature was corrected, the fibrous tissue or scar was removed, and the defected urethra was measured. In Group A, the lingual mucosa was spread and fixed to the corpora cavernosa over the midline as the urethral plate, the buccal mucosa was covered the lingual mucosa as ventral urethra, both the mucosa lateral edges was sutured. In Group B, the lingual mucosa was harvested and fixed to the corpora cavernosa the same as in Group A, the ADM was made appropriate length and width, covered and sutured with the lingual mucosa. The lingual mucosa was harvested mean (5.0±0.2)cm(range 4-6cm)long, mean (1.2±0.2)cm (range 1.0-1.5cm)wide and mean (5.0±0.2)cm(range 5-6cm)long, mean (1.2±0.2)cm (range 1.0-1.5cm)wide in Group A and Group B respectively( P<0.05). In Group A, the buccal mucosa was harvested mean (4.1±0.2)cm(range 3.5-5.5cm)long, mean (1.2±0.2)cm wide. Criteria for successful repair of hypospadias were set as: ①The appearance of the penis is nearly normal; ②The penis curvature was corrected; ③Urethra orifice in normal position; ④Urine flow line is normal. The outcomes of the two groups were analyzed and compared, statistical analysis was done using SPSS 18.0 software. Results:The mean follow-up time was (16.3±1.6)(8-24) months. The age, number of preoperative surgeries, number of previous oral mucous membranes, and length of urethral defects were no statistically significant differences between the two groups in A and B( P>0.05). The length of oral mucosa was harvested during the operation between group A and Group B were statistically significant differences( P<0.05). The incidence of oral complications in group A and B: Oral pain 7/14, 1/12; The feeling of tension in mouth 8/14, 1/12; The numbness in the oral 8/14, 1/12, A and Group B were statistically significant differences( P<0.05). The incidence of urethral complications in group A and Group B: the urethra fistula 1/14, 4/12; the urethral stricture 2/14, 6/12, there were statistically significant differences between the two groups ( P<0.05). Penile curvature 2/14, 1/12, ( P>0.05). The success rate was 12/14 and 5/12 in Group A and B respectively, with statistical difference( P<0.05). Conclusions:Combined lingual mucosal graft with buccal mucosal graft urethroplasty could be a good choice for repeated failed hypospadias repairs. Combined lingual mucosal graft with ADM urethroplasty has many complications and less success, should be performed in caution.

Current progress on lesion classification of hepatic alveolar echinococcosis / 中华肝胆外科杂志

Human alveolar echinococcosis is a chronic infectious disease caused by Echinococcus multilocularis infection. It predominantly injuries the liver and grows like the malignant tumor. The therapeutic options and prognosis depend on types of human alveolar echinococcosis, clinical stages, biological activity, vascular invasion, pathological characteristics, and patient's immune status. However, despite of multiple classification methods, there are still lacking of comprehensive typing schemes. which leads to inappropriate diagnosis and therapy. This research systematically reviewed the recent studies on human alveolar echinococcosis at home and abroad and analyzed the classifications based on ultrasound, computer tomography, magnetic resonance imaging, positron emission computed tomography, serology and pathology, and some novel technologies and summarized the individual advantage and disadvantage for each classification Relationships and their advantages plus disadvantages have been assessed comprehensively. Meanwhile, the possible reference factors or theoretical basis for optimized future classification are proposed, in order to establish a unified classification system to provide guidance for clinical diagnosis and treatment.

Investigation and suggestions on cleaning and disinfection of digestive endoscopes of Yunnan Province in 2019 / 中华消化内镜杂志

In order to strengthen the management of disinfection quality of endoscopes, Quality Control Center of Digestive Endoscopy and Nosocomial Infection Control Center of Yunnan Province investigated the diagnosis, treatment, cleaning and disinfection conditions and disinfection quality of digestive endoscopes in some medical institutions of Yunnan Province by web questionnaire from April to May in 2019, and 277 valid questionnaires were finally obtained. SPSS 19.0 statistical software was used to analyze the influencing factors of cleaning and disinfection process and the infection control implementation of digestive endoscopes in 227 secondary and tertiary hospitals. The results showed that the number of decontamination people who had received systematic training in Yunnan Province was significantly lower than that in other areas of China. The hospital level, the number of decontamination personnel, and decontamination methods affected the implementation of cleaning and decontamination process and infection control, while the allocation of decontamination supplies had no effects. It is important to establish an effective mechanism for the normalized implementation of cleaning and disinfection of digestive endoscopes.

Therapeutic effect and mechanism of Shouhui Tongbian Capsules on slow transit constipation model mice / 中国中药杂志

Shouhui Tongbian Capsules was used to explore the therapeutic effect and potential mechanism on slow transit constipation model mice induced by loperamide hydrochloride. In the experiment, loperamide hydrochloride-induced ICR mice were used as the model of slow transit constipation. Fifty ICR mice were divided into the blank group, model group and high, medium and low dose groups of Shouhui Tongbian Capsules extract(100, 200 and 400 mg·kg~(-1)). The model group and the administration groups were then modeled using loperamide hydrochloride intragastrically to obtain slow transit constipation. After successful modeling, high, medium and low doses of drugs were given to each drug group by intragastric administration. After 14 days of administration, the first defecation time, 6 h defecation grain number, 6 h defecation wet weight and dry weight, black feces discharged within 6 h and the fecal water content were measured. Intestinal tissues were taken for c-Kit and SCF immunohistochemical sections to detect the expression of c-Kit and SCF in the blank group, model group and high, medium and low dose groups of the medicinal extract of Shouhui Tongbian Capsules. The tissue changes in the intestinal wall of mice were detected by HE staining. At the same time, partial intestinal tissues were taken to test the activity of ATP synthase and isocitrate dehydrogenase in intestinal tissues of mice. RESULTS:: showed that Shouhui Tongbian Capsules effectively improved the symptoms of slow transit constipation in ICR mice and promoted intestinal movement. Shouhui Tongbian Capsules obviously shortened the time of discharging black stool for the first time, improved the intestinal propulsion rate, increased the water content and amount of feces, and improved the constipation symptoms. Mechanism study revealed that Shouhui Tongbian Capsules increased ATP synthase activity and mitochondrial isocitrate dehydrogenase activity in intestinal tissue, and up-regulated c-Kit/SCF signaling pathway to promote interstitial Cajal cells proliferation, intestinal nerve transmission, intestinal motility and transport capacity.

Identification of intestine direct targets of Shouhui Tongbian Capsules using "target fishing" strategy / 中国中药杂志

"Target fishing" strategy was used to investigate the direct targets and mechanism of Shouhui Tongbian Capsules on relaxing bowel. Magnetic beads cross-linked with the chemical constituents from Shouhui Tongbian Capsules were prepared. The potential target proteins were captured from the total protein lysates of rat intestine using the beads. The captured proteins were further identified by LC-MS/MS, and the associated pathways were analyzed by Cytoscape. RESULTS:: showed that 138 potential target proteins were identified, which were involved in eight signaling pathways, including tricarboxylic acid cycle, pyrimidine metabolism, sulfur metabolism, fatty acid degradation, alanine/aspartate/glutamate metabolism, arginine/proline metabolism, valine/leucine/isoleucine degradation, and β-alanine metabolism. Taken together, Shouhui Tongbian Capsules may exert relaxing bowel effect by acting on multiple signaling pathways to promote intestinal gurgling, inhibit inflammation, as well as improve intestinal barrier function, intestinal water secretion, and intestinal flora.

Clinical efficacy of laparoscopic surgery for hepatic cystic echinococcosis: a meta-analysis / 中华肝胆外科杂志

Objective:To explore the curative effect of laparoscopic surgery for hepatic cysticercosis.Methods:Search the literature from February 2010 to February 2020 on literature platforms such as Wanfang Data, VIP, CNKI, Pubmed, ScienceDirect, Web of Science, etc. the key words were "肝囊型包虫病" , "细粒棘球蚴" , "手术" , "开腹手术" , "腹腔镜" , "微创手术" , " echinococcosis " , " liver or hepatic " , " laparoscopic or minimal invasive " . Data on intraoperative indicators (e.g., operation time, bleeding volume), postoperative complications, hospital stay, recurrence rate, etc. in the literature included in the study were extracted and meta-analyzed.Results:A total of 9 articles were included, including 2 prospective studies and 7 retrospective case-control studies. A total of 1031 patients were enrolled, including 272 in the laparoscopic group and 759 in the laparotomy group. The results of the meta-analysis showed that the total postoperative complication rate in the laparoscopic group was lower than that in the laparotomy group ( OR=1.64, 95% CI: 1.10-2.45, P<0.05). Incision-related complications in the laparoscopy group and laparotomy group the difference was statistically significant ( OR=2.81, 95% CI: 1.03-7.70, P<0.05), and the hospital stay in the laparoscopic group was shorter ( SMD=1.21, 95% CI: 0.47-1.96, P<0.05). There was no significant difference between the two groups in operation time, postoperative bile leakage, residual cavity infection and effusion, and postoperative recurrence rate ( P>0.05). Conclusions:Under the premise of strictly grasping the indication of laparoscopic surgery, the incidence of complications after laparoscopic surgery is low, the hospitalization time is short.

Synergistic Mechanism of Interferon alpha-1b, Interleukin-2 and Thalidomide for Immune Regulation in Patients with Acute Myeloid Leukemia / 中国实验血液学杂志

OBJECTIVE@#To explore the synergistic immunomodulatory mechanism of interferon alpha-1b, interleukin-2 and thalidomide (ITI) regimen on patients with acute myeloid leukemia (AML).@*METHODS@#Sixty eight untreated de novo or relapsed or refractory or maintenance therapy patients with AML admitted in the Affiliated Cancer Hospital of Zhengzhou University and the other 11 medical units from March 2016 to May 2019 were treated with ITI regimen. Peripheral blood specimen per patient was collected into EDTA-K3 anticoagulation vacuum tube before the administration of ITI and 3 months after the treatment; peripheral blood lymphocyte subsets and perforin and Granzyme B expression were analyzed by using flow cytometry; the levels of VEGF, IFN-γ, TNF-α and IL-6 in the plasma were detected by using a cytometric bead array. Thirty-five healthy subjects from the hospital physical examination centre were selected as normal controls.@*RESULTS@#The ratio of CD4@*CONCLUSION@#The ITI regimen can raise the ratio of CD4

Treatment of combined hepatic with cerebral alveolar echinococcosis in 11 cases / 中华肝胆外科杂志

Objective:To analyze the treatment and the impact of brain metastases on patients with hepatic alveolar hydatid disease.Methods:The data of 11 patients with hepatic alveolar hydatidosis with brain metastases treated at the First Affiliated Hospital of Xinjiang Medical University from January 2014 to December 2019 were retrospectively analyzed. There were 7 males and 4 females. The age range was 19~49 years, with an average of 34 years. Of 11 patients, 7 were treated with surgery combined with drugs and 4 with drugs only. Analyze the treatment and results of patients.Results:Of the 7 patients who were treated with surgery and drugs, 2 patients underwent hepatectomy. They were treated with regular postoperative oral medication and were well on follow-up. Three patients underwent only brain surgery. On follow-up from 1 to 3 years, one patient developed pneumonia with atelectasis, another patient developed ascites and jaundice with physical decline. The third patient was stable and had an independent life. Two patients underwent partial hepatectomy and hydatidectomy, with one patient requiring repeated hydatidectomies. On follow-up for one of these 2 patients for 5 years, the patient was home bound and could not take care of himself. The other patient was followed up for 3 years and was stable, alive and able of self-care. Four patients were treated with albendazole liposome, including one patient who developed ascites, a second one with weight loss, physical decline, limb edema and a third one with pleural effusion, pelvic effusion and pneumonia. These patients were still alive with improvement of symptoms on supportive treatment.Conclusion:The treatment of hepatic alveolar hydatidosis with brain metastases is still mainly surgery and anti-hydatid drugs. The prognosis of most patients was poor. The surgical principle is neurosurgery first, followed by surgery on liver, lung, spleen and other organs involved by hydatid disease.

Clinical observation of elemene injection in perioperative treatment of esophageal cancer / 国际肿瘤学杂志

Objective:To observe the clinical effect of elemene injection in the perioperative treatment of esophageal cancer.Methods:A total of 180 patients with esophageal cancer who underwent surgical treatment in the Affiliated Hospital of Hebei University from January 2017 to July 2018 were selected and divided into the experimental group ( n=90) and the control group ( n=90) according to the random sequence number generated by the computer. In the experimental group, the thoracic cavity was rinsed and the elemene was instilled and intravenously instilled. The control group was treated with normal saline. Safety indexes, short-term efficacy indexes, immune indexes, tumor marker levels and long-term benefit indexes were observed in the two groups. Results:The incidences of leukocytosis, thrombocytopenia, low hemoglobin, elevated creatinine, transaminase elevation, nausea and vomiting in the experimental group were 43.33% (39/90), 0 (0/90), 5.55% (5/90), 6.67% (6/90), 4.44% (4/90) and 0 (0/90), those in the control group were 53.33% (48/90), 1.11% (1/90), 2.22% (2/90), 4.44% (4/90), 7.78% (7/90) and 1.11% (1/90), and there were no significant differences between the two groups ( χ2=1.802, P=0.179; P=1.000; χ2=0.595, P=0.441; χ2=0.424, P=0.515; χ2=0.871, P=0.351; P=1.000). The postoperative extubation time in the experimental group was (173.36±41.09) h, the postoperative hospital stay was (14.82±4.35) d, the Karnofsky functional status (KPS) score was 81.43±3.89, and those in the control group was (175.76±40.46) h, (15.34±5.22) d and 80.49±2.67, respectively. The differences between the two groups were not statistically significant ( t=-0.395, P=0.695; t=-0.726, P=0.472; t=1.890, P=0.061). The total amount of drainage fluid in the experimental group was (665.39±201.31) ml, and the incidence of anastomotic fistula was 1.11% (1/90), which were significantly lower than those in the control group [(732.67±213.84) ml and 8.89% (8/90)], with statistically significant differences ( t=-2.173, P=0.032; χ2=4.211, P=0.040). Before treatment, there were no statistically significant differences in immune function between the two groups (all P>0.05). One week after surgery, there was no statistically significant difference in CD3 + between the two groups [(55.45±6.96)% vs. (53.71±6.54)%, t=1.728, P=0.087]; CD4 + , CD4 + /CD8 + and NK cells in the experimental group were higher than those in the control group, and the differences were statistically significant [(29.43±5.05)% vs. (25.92±8.06)%, t=3.501, P=0.001; 1.30±0.21 vs. 1.23±0.20, t=0.229, P=0.028; (254.20±15.21)/μl vs. (237.05±10.73)/μl, t=2.741, P=0.007]. The levels of tumor markers carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), hypoxia-inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF) in the experimental group were (1.37±0.18) ng/ml, (1.26±0.28) ng/ml, (0.89±0.17) ng/ml and (1.06±0.24) ng/ml, significantly lower than those in the control group [(2.86±0.42) ng/ml, (2.92±0.45) ng/ml, (2.38±1.55) ng/ml, (2.82±0.15) ng/ml], and the differences were statistically significant ( t=13.928, P=0.014; t=19.728, P=0.011; t=17.924, P=0.006; t=16.625, P=0.003). The 1-year recurrence rate was 2.22% (2/90) in the experimental group, and the half-year mortality rate was 1.11% (1/90) in the experimental group, and 5.56% (5/90) and 2.22% (2/90) in the control group, with no statistically significant differences ( χ2=0.595, P=0.441; χ2=0.000, P=1.000). Conclusion:Elemene tumor-free sequential treatment combined with postoperative intravenous drip has a positive effect on postoperative recovery of patients with esophageal cancer, which can prevent the occurrence of postoperative anastomotic fistula, improve patients′ immune function, reduce the levels of tumor markers, and it is safe and feasible.

Chronic lymphocytic leukemia complicated with multiple myeloma: report of one case and review of literature / 白血病·淋巴瘤

Objective:To investigate the clinical features, diagnosis, occurrence sequence and clonal origin of chronic lymphocytic leukemia complicated with multiple myeloma.Methods:The diagnosis and treatment of one patient with multiple myeloma and chronic lymphocytic leukemia who was admitted to the First Hospital of Jilin University in May 2018 was retrospectively analyzed, and the related literatures were reviewed.Results:This patient began with lumbosacral pain, and he was diagnosed as chronic lymphocytic leukemia complicated with multiple myeloma after bone marrow aspiration, flow cytometry, and blood and urine immunofixation electrophoresis. It is recommended that Rd (lenalidomide + dexamethasone) or MPV (melphalan + prednisone + bortezomib) regimen, but the patient did not receive chemotherapy and died of infectious diarrhea 1 month later.Conclusions:The occurrence of multiple myeloma and chronic lymphoblastic leukemia may originate from the same clone or different new clone. It is very rare that multiple myeloma and chronic lymphoblastic leukemia can co-occur. Therapeutic options tend to be more aggressive multiple myeloma-based regimen.

Chronic lymphocytic leukemia complicated with multiple myeloma: report of one case and review of literature / 白血病·淋巴瘤

Objective@#To investigate the clinical features, diagnosis, occurrence sequence and clonal origin of chronic lymphocytic leukemia complicated with multiple myeloma.@*Methods@#The diagnosis and treatment of one patient with multiple myeloma and chronic lymphocytic leukemia who was admitted to the First Hospital of Jilin University in May 2018 was retrospectively analyzed, and the related literatures were reviewed.@*Results@#This patient began with lumbosacral pain, and he was diagnosed as chronic lymphocytic leukemia complicated with multiple myeloma after bone marrow aspiration, flow cytometry, and blood and urine immunofixation electrophoresis. It is recommended that Rd (lenalidomide + dexamethasone) or MPV (melphalan + prednisone + bortezomib) regimen, but the patient did not receive chemotherapy and died of infectious diarrhea 1 month later.@*Conclusions@#The occurrence of multiple myeloma and chronic lymphoblastic leukemia may originate from the same clone or different new clone. It is very rare that multiple myeloma and chronic lymphoblastic leukemia can co-occur. Therapeutic options tend to be more aggressive multiple myeloma-based regimen.

Research progress on the regulation of phenolic compounds of traditional Chinese herbs on oral microbes / 华西口腔医学杂志

Phenolic compounds are widely found in natural Chinese medicinal plants and have excellent pharmacological properties, such as antioxidation and anti-inflammation. They are the main pharmacological components of many medicinal Chinese herbs. Oral microbiota, especially its composition and metabolism, is highly related to the balance of oral microecology and plays a key role in the occurrence and development of oral diseases. Recent studies have shown that phenolic compounds of traditional Chinese herbs can prevent and treat oral diseases, such as caries, periodontal disease, and oral mucosal infection, by regulating the composition, metabolites, and virulence of oral microorganisms. This review will summarize and discuss the regulation of phenolic compounds on oral microbes.

Clinical Efficacy of Modified Sanzi Yangqintang and Colon Hydrotherapy on Treatment of Non-alcoholic Fatty Liver Disease with Phlegm-dampness / 中国实验方剂学杂志

Objective::To explore the clinical efficacy of modified Sanzi Yangqintang combined with colon hydrotherapy in the treatment of non-alcoholic fatty liver disease (NAFLD) with phlegm-dampness. Method::Totally 100 patients with NAFLD were selected and randomly divided into treatment group (50 cases) and control group (50 cases). Both groups were orally given silybin and glycyrrhizic acid diamine capsules.The treatment group was also added with modified Sanzi Yangqintang and colon hydrotherapy.The treatment lasted for 7 days.The control group was also added with saline colon hydrotherapy.Main traditional Chinese medicine (TCM) syndrome scores and liver function indexes before and after treatment [alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamate transpeptidase (GGT)], blood lipid routine [cholesterol (TCH), triglyceride (TG)], inflammatory factors [interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α)], FibroScan measurement [liver stiffness measurement (LSM), controlled attenuation parameters (CAP)], uric acid and body weight changes were observed.Adverse reactions were observed, and the patient's medication safety was evaluated. Result::TCM syndrome score, liver enzyme index, blood lipid index, inflammatory factor index, FibroScan CAP, uric acid and body weight of the two groups were significantly reduced than those before treatment(P<0.05, P<0.01) .There was no significant difference in liver enzymes, TCH, IL-6 and LSM between treatment group and control group.And TCM syndrome scores, UA, TNF-α, FibroScan CAP decreased were significantly different from control group (P<0.05). Conclusion::Modified Sanzi Yangqintang combined with colon hydrotherapy can not only alleviate NAFLD with phlegm-dampness symptoms, but also significantly reduce triglyceride, tumor necrosis factor and FibroScan CAP and body mass, with certain clinical efficacy in a short term.

Enhanced recovery after surgery in the application of day surgery laparoscopic cholecystectomy / 中华普通外科杂志

Objective@#To investigate the feasibility and safety of the concept of enhanced recovery after surgery (ERAS) in the perioperative application of ambulatory laparoscopic cholecystectomy (ALC).@*Methods@#A retrospective analysis was made on 168 patients (ALC group) undergoing ALC in the daytime ward from Aug 2017 to Aug 2018 in our hospital vs conventional laparoscopic cholecystectomy CLC in the general ward in 165 patients (CLC group) . Clinical data, operation time, intraoperative blood loss, conversion to laparotomy, postoperative complication, readmission, pain score after 6h, patient satisfaction, first postoperative anal exhaust, average length of hospital stay, and hospitalization expenses were compared between the two groups.@*Results@#In the ALC group, the pain score, the first anal exhaust time, the average length of hospital stay, and the hospitalization cost were significantly lower than those in the CLC group. Compared with the CLC group, the satisfaction of patients in the ALC group was significantly improved. There was no significant difference in the incidence of postoperative complications (biliary leakage, postoperative bleeding, bile duct injury, infection of the incision) and readmission rate.@*Conclusion@#Use of enhanced recovery after surgery in laparoscopic cholecystectomy in day surgery is safe and feasible. It has many advantages such as reducing hospitalization costs and postoperative pain and accelerating postoperative recovery.

The prognostic significance of dynamic monitoring of minimal residual disease (MRD) status in patients with newly-diagnosed multiple myeloma / 中华血液学杂志

Objective@#To evaluate the prognostic value of kinetic changes in minimal residual disease (MRD) status, as well as its relationship with risk stratification, therapeutic response and treatment in patients with newly-diagnosed multiple myeloma (MM) .@*Methods@#A total of 135 patients with newly-diagnosed MM were screened, and 105 patients who achieved VGPR or more as the best responses were included into this study. The MRD status was determined by multiparameter flow cytometry (MFC) at multiple intervals after two cycles of treatment until clinical relapse, death, or last follow-up. The statistical methods included Kaplan-Meier analysis, Cox regression, etc.@*Results@#①In all 135 patients, 57.8% (78/135) patients achieved MRD negativity (MRD-) after treatment. In 105 patients who achieved VGPR and thus included in this study, the MRD- rate was 72.4% (76/105) , with a median interval of 3 months from starting treatment to achievement of MRD- status. ②The 2-year PFS rate of patients with MRD- status was significantly higher than that of MRD+ status (62.2% vs 41.3%, P=0.001) , while MRD persistence (MRD+) was an independent factor for poor prognosis (multivariate analysis for PFS: P=0.044, HR=3.039, 95%CI 1.029-8.974) . ③Loss of MRD- status (i.e., MRD reappearance) showed inferior outcomes compared with MRD sustained negative ones, the PFS was 18 months versus not reach (P<0.001) and the OS was not reach for both (P=0.002) . ④The 2-year PFS and OS rates of patients with duration of MRD-status≥12 months were significantly higher than those of the control group (PFS: 77.7% vs 36.7%, P<0.001; OS: 96.4% vs 57.9%, P<0.001 respectively) . Duration of MRD- status was associated with a marked reduction in risk of relapse or death (univariate analysis for PFS: P<0.001, HR=0.865, 95%CI 0.815-0.918; for OS: P=0.001, HR=0.850, 95%CI 0.741-0.915 respectively) . ⑤Moreover, even in patients carrying high-risk cytogenetic abnormalities (CA) or ineligible for ASCT, MRD negativity remained its prognostic value to predict PFS (high-risk CA medianPFS: not reach vs 19 months, P=0.006; ineligible for ASCT medianPFS: not reach vs 25 months, P=0.052 respectively) . ⑥Last, treatment with the bortezomib-based regimens contributed to prolonged MRD- duration (median MRD- duratio: 25 months vs 10 months, P=0.034) .@*Conclusion@#Our findings supported MRD+ status as an independent poor prognostic factor in MM patients, which implicated that duration of MRD- status also played a significant role in evaluation of prognosis, while loss of MRD-status might serve as an early biomarker for relapse. Therefore, monitoring of MRD kinetics might more precisely predict prognosis, as well as guide treatment decision, especially for when to start retreatment in relapsed patients.

Enhanced recovery after surgery in the application of day surgery laparoscopic cholecystectomy / 中华普通外科杂志

Objective To investigate the feasibility and safety of the concept of enhanced recovery after surgery (ERAS) in the perioperative application of ambulatory laparoscopic cholecystectomy (ALC).Methods A retrospective analysis was made on 168 patients (ALC group) undergoing ALC in the daytime ward from Aug 2017 to Aug 2018 in our hospital vs conventional laparoscopic cholecystectomy CLC in the general ward in 165 patients (CLC group).Clinical data,operation time,intraoperative blood loss,conversion to laparotomy,postoperative complication,readmission,pain score after 6h,patient satisfaction,first postoperative anal exhaust,average length of hospital stay,and hospitalization expenses were compared between the two groups.Results In the ALC group,the pain score,the first anal exhaust time,the average length of hospital stay,and the hospitalization cost were significandy lower than those in the CLC group.Compared with the CLC group,the satisfaction of patients in the ALC group was significantly improved.There was no significant difference in the incidence of postoperative complications (biliary leakage,postoperative bleeding,bile duct injury,infection of the incision) and readmission rate.Conclusion Use of enhanced recovery after surgery in laparoscopic cholecystectomy in day surgery is safe and feasible.It has many advantages such as reducing hospitalization costs and postoperative pain and accelerating postoperative recovery.