Pharmacokinetic study on peoniflorin, astilbin, rosmarinic acid, isofraxidin and liquiritin in rat blood after oral administration of shaolin xiaoyin tablets / 中国中药杂志

To establish a method for the determination of astilbin, peoniflorin, rasmarinci acid, isofraxidin and liquiritin contained in Shaolin Xiaoyin tablets, in order to lay a foundation for designing late-stage dosage forms and clinical medication schemes. In this paper, efforts were made to establish a method for the determination of the blood concentration of the five components and study the in vivo pharmacokinetics in rats. The blood concentration was determined by HPLC. Phenomenex C18 column (4.6 mm x 250 mm, 5 microm) was adopted and eluted with methanol-acetonitrile-0.05% formic acid, the flow rate was 0.8 mL x min(-1), and the wavelength was 275 nm. The samples were processed by the solid phase extraction method. After oral administration of Shaoling Xiaoyin tablets, the rat bloods were collected at different time points to determine the blood concentrations. The experimental results showed that the baseline separation could be adopted for the five components, and astilbin, peoniflorin, rasmarinci acid, isofraxidin and liquiritin showed good linear relations within ranges of 2.48-248, 0.213 6-21.36, 0.531-53.1, 0.704-70.4, 0.253-25.3 mg x L(-1). All the five components could be absorbed in blood and excreted quickly. The method established in this paper is rapid and accurate, and could be used for in vivo analysis on preparations containing similar components. The main components in Shaoling Xiaoyin tablets could be absorbed and excreted quickly, and thus suitable to be made into sustained release tablets. Common preparations are required to be taken for 4-6 times a day.

Clinical analysis of 25 gastric cancer cases undergoing totally laparoscopic distal gastrectomy / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the feasibility and safety of totally laparoscopic distal gastrectomy.</p><p><b>METHODS</b>Clinical data of 25 patients with distal gastric cancer undergoing totally laparoscopic distal gastrectomy between December 2011 and January 2013 were analyzed retrospectively. Only laparoscopic linear stapler was used in intracorporeal delta-shaped or Roux-en-Y anastomosis for reconstruction.</p><p><b>RESULTS</b>No patient required conversion to laparoscopy-assisted or open surgery. The mean total operative time and anastomotic time were (256±23.6) min and (35.7±8.4) min respectively in patients with delta-shaped anastomosis, and (287±11.5) min and (46.4±12.1) min in those with Roux-en-Y anastomosis. The mean blood loss was(109.6±42.3) ml, and the mean number of stapler used was 5.6. The mean time to the first flatus was (2.8±1.2) d, and mean time liquid diet to resume was (3.5±0.9) d. Postoperative complication occurred in 3 patients(12.0%).</p><p><b>CONCLUSION</b>Totally laparoscopic distal gastrectomy with intracorporeal anastomosis using laparoscopic linear stapler is safe and feasible.</p>

Symptomatic hyponatremia and hyperglycemia complicating hysteroscopic resection of intrauterine adhesion: a case report / 中华医学杂志(英文版)

Hysteroscopic surgery is a minimally invasive procedure for the treatment of intrauterine pathologies. However, it can result in fatal complications. We herein report a case of symptomatic hyponatremia and hyperglycemia during hysteroscopic resection of severe intrauterine adhesion with 5% dextrose in water as the distension medium. Because of the difficulty of the incision, the infusion pressure was 100 to 150 mmHg, and surgery was continued for 70 minutes. A total of 19 L of 5% dextrose in water was used as an irrigating fluid. Large-scale absorption of irrigating fluid (3 L) induced dilutional hyponatremia (120 mmol/L) and hyperglycemia (30 mmol/L). Initial signs were abnormal flatulence and postoperative coma. Hypertonic saline, diuretics, insulin, and liquid restriction were the prevailing treatment strategies for hyponatremia and hyperglycemia. Ionized calcium and potassium levels decreased during treatment. We emphasize the importance of prevention, recognition, and a meticulous perioperative treatment standard. Surgical teams must be vigilant in fluid deficit monitoring and serum electrolyte analysis.

Comparative study of transvaginal ultrasonographic and diagnostic hysteroscopic findings in postmenopausal breast cancer patients treated with tamoxifen / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>There is an association between postmenopausal tamoxifen therapy and endometrial pathologies. We investigated the usefulness of diagnostic hysteroscopy and transvaginal ultrasonography (TVS) and estimated whether diagnostic hysteroscopy improves detection of endometrial pathologies in postmenopausal breast cancer patients on tamoxifen.</p><p><b>METHODS</b>Ninety-seven postmenopausal breast cancer patients who had been taking tamoxifen 20 mg/d for ≥ 6 months went through TVS, diagnostic hysteroscopy, and endometrial biopsy examinations. The presence of endometrial histopathologic features with abnormal TVS and diagnostic hysteroscopic findings were correlated.</p><p><b>RESULTS</b>No endometrial cancer was found in any of the 97 patients. Fifty-three patients (54.6%) developed endometrial polyps as diagnosed histopathologically. Fifty-nine patients (60.8%) tested positive in TVS exams, of whom 43 had polyps, four had hyperplasia, and 12 atrophy. Thirty-eight patients (39.2%) tested negative in TVS exams, of whom 10 had polyps, three hyperplasia, and 25 atrophy. TVS exams presented 63.6% specificity, 81.8% sensitivity, 72.9% positive-predictive value, and 73.7% negative-predictive value, whereas the corresponding values of diagnostic hysteroscopy were 100%, 98.1%, 100%, and 97.8% respectively. The correct ratio of hysteroscopy was significantly higher than that of TVS (P = 0.000).</p><p><b>CONCLUSIONS</b>In postmenopausal breast cancer patients treated with tamoxifen, TVS alone is not sufficient for the detection of endometrial pathologies. Additional use of diagnostic hysteroscopy considerably improves the detection of polyps, thus significantly reducing the rate of false-negative findings of endometrial pathologies.</p>

Combination of methotrexate injection through hysteroscopic tubal catheterization and mifepristone per os in the conservative treatment of tubal pregnancy / 中国医学科学院学报

<p><b>OBJECTIVE</b>To evaluate the value of the combination of methotrexate(MTX) injection through hysteroscopic tubal catheterization and mifepristone per os in the conservative treatment of tubal pregnancy.</p><p><b>METHODS</b>Forty patients who met the criteria of conservative treatment were enrolled in this study and received the combined therapy of MTX 50 mg/d injection through hysteroscopic tubal catheterization and oral mifepristone 100mg/d for 5 days.</p><p><b>RESULTS</b>Of these 40 patients, 38 (95.0%) were cured. The human chorionic gonadotropin decreased to normal level within 3-48 days. The masses disappeared within 16-65 days. The menstruation returned normal within 28-42 days. No obvious side effect was observed. Of 30 patients who underwent hydrotubation through hysteroscopy three months later, 12 patients were unobstructed, 2 patients were completely obstructed, and 16 patients were partially obstructed. Five patients had full-term deliveries up to this report.</p><p><b>CONCLUSION</b>The combination of MTX injection through hysteroscopic tubal catheterization and mifepristone per os is safe and effective for early tubal pregnancy.</p>