Establishment of specific chromatogram，chemical pattern recognition analysis and identification with different origins and counterfeit products of Uncariae Ramulus Cum Uncis / 中国药房

OBJECTIVE To establish the ultra-high liquid chromatography （UPLC） characteristic spectrum of Uncariae Ramulus Cum Uncis from different producing areas， to conduct chemical pattern recognition analysis， and to identify the medicinal materials of their different origins and counterfeit products. METHODS UPLC method was adopted to establish the characteristic spectra of 43 batches of Uncariae Ramulus Cum Uncis from different origins； cluster analysis combined with principal component analysis were used to analyze their quality； Uncariae Ramulus Cum Uncis from different origins and counterfeit products were identified. RESULTS UPLC specific spectrum of Uncariae Ramulus Cum Uncis was established， and 13 common peaks were calibrated； peak 2 was identified as catechin， peak 3 as chlorogenic acid， peak 4 as cryptochlorogenic acid， peak 7 as isochlorogenic acid B， peak 8 as isodehydroguotenine， peak 9 as isooguotenine， peak 10 as dehydroguotenine， peak 11 as isochlorogenic acid C， peak 12 as goutenine， and peak 13 as camptothecin. Through cluster analysis， the medicinal materials of 43 batches of Uncariae Ramulus Cum Uncis could be divided into 5 categories according to their different origins. Further principal component analysis revealed that the principal component comprehensive scores of Uncariae Ramulus Cum Uncis produced in Jiangxi and Hunan were relatively high， ranging from 0.264 to 2.904. The specific chromatogram could effectively distinguish among the different origins and their counterfeit products of Uncariae Ramulus Cum Uncis. CONCLUSIONS The established UPLC specific chromatogram can be used for quality control of Uncariae Ramulus Cum Uncis， and the study found that the quality of Uncariae Ramulus Cum Uncis from Jiangxi and Hunan provinces is relatively good.

Identification and clinical significance of corynebacterium from abscess in granulomatous mastitis / 中华内分泌外科杂志

Objective:To make the early clinical antibiotic regimen by finding out the infection of corynebacterium in the pus of patients with granulomatous mastitis in the early stage.Methods:A total of 42 patients who were diagnosed and treated in the Breast Center of Guangdong Maternal and Child Health Hospital from Jun. 2016 to Mar. 2017 with complete follow-up data were retrospectively analyzed. PCR method was used to detect corynebacterium in the patients’ pus. Patients in the positive group were treated with antibiotics alone, antibiotics + hormones and hormones alone, while patients in the negative group were treated with antibiotics + hormones and hormones alone. The postoperative recurrence rate and cure rate of different groups of patients were observed.Results:The antibiotic regimen for granulomatous mastitis in patients with corynebacterium infection included a combination of short-acting levofloxacin and azithromycin and long-acting anti-mycobacterium drugs. Among the 42 patients in the subgroup, 21 patients were confirmed positive for corynebacterium by PCR detection of pus, and the postoperative recurrence rate was 23.5%. There was a statistically significant difference between the antibiotic group, the antibiotic + hormone group and the hormone group in treatment of granulomatous mastitis infected with corynebacterium ( χ2=5.494, P=0.036) . PCR detection shouwed corynebacterium negative in 21 cases, and postoperative recurrence rate of 16.7%. No statistically significant difference in efficacy was found between antibiotic + hormone group and hormone only group for GM patients without bacterial infection ( χ2=1.129, P=0.719) . Conclusion:Early detection of corynebacterium infection in GM patients is significant for clinical guidance of the application of lipophilic antibiotics.

Hemostasis with balloon urinary catheter after vacuum-assisted breast biopsy / 中华内分泌外科杂志

Objective To evaluate the hemostasis effect of balloon urinary catheter after vacuum-assisted breast biopsy (VABB).Methods From May.2016 to May.2017,270 patients undergoing VABB were randomized into study group (135 cases) and control group (135cases).Patients in the study group received VABB postoperative indwelling catheter balloon hemostasis,while patients in the control group received VABB postoperative conventional thoracic pressure bandage to stop bleeding.Postoperative bleeding and hematoma were recorded and compared between the two groups.Results The rates of postoperative bleeding and hematoma in the study group were significantly lower than that in the control group (6.7％ vs 16.3％,P＜0.05;8.9％ vs 24.4％,P＜0.05).Among patients with lesions ≤ 1.5 cm,the rates of postoperative bleeding and hematoma were 1.6％ and 4.7％ in the study group,and 6.5％ and 8.1％ in the control group.There was no significant difference between the two group (P＞0.05).Among patients with lesions ＞1.5 cm,the rates of postoperative bleeding and hematoma in the study group were significantly lower than those in the control group (11.3％ vs 24.7％,P＜0.05;12.7％ vs 32.9％,P＜0.05).Conclusion Hemostasis with balloon urinary catheter is a safe and effective method for postoperative bleeding and hematoma control after VABB.

Accuracy of preoperative 11G vacuum-assisted core needle biopsy in determining histological type and molecular subtype in breast cancer / 国际外科学杂志

Objective To assess the accuracy of histological type and molecular subtype observed in preoperative 11-gauge vacuum-assisted core needle biopsy(VACNB) specimens in breast cancer.Methods Patients diagnosed by preoperative 1 l-gauge VACNB and received subsequent open excisional biopsy (OEB) from Mar 1 st 2014 to Mar 31 st 2015 were included.Kappa testing was used to test the concordance rate of histological type,estrogen receptor(ER),progesterone receptor(PR),human epidermal growth factor 2(Her-2),Ki-67 and molecular subgroups between VACNB and paired OEB specimens.ER,PgR,Her-2,and Ki-67 were determined by immunohistochemistry (IHC).Patients with Her-2 IHC (+ +) were further examined by FISH.Molecular subtypes were classified as follows:LuminalA,LuminalB,Triple Negative,and Her-2 positive.Results There were 36 patients analyzed(32 of them had invasive breast cancer).Between VACNB and paired OEB specimens,concordance rate of histological type,ER,PR,Her-2,Ki-67 and molecular group were 94.4％ (κ =0.934),96.9％ (κ =0.904),87.5％ (κ =0.710),100％ (κ =1.000),84.4％ (κ =0.570),78.1％ (κ =0.621).No significant difference was detected in the expression of ER,PR and Ki-67 between VACNB and OEB specimens according to paired t-test results.Concordance rate of each molecular subtype between VACNB and OEB specimens were 100％ for Her-2 positive subtype,94.1％ for LuminalB subtype,50％ for LuminalA,and 33.3％ for TNBC.When the threshold for ER/PR positivity was upgraded from ≥1％ to ≥10％ and Ki-67 cutoff value to≥20％,the concordance rate for ER,PR,Ki-67 and molecular subtype reached to 100％,93.8％,87.5％,81.3％.Conclusions 11 G vacuum-assisted core needle biopsy was accurate in determining histological type and molecular subtype in breast cancer.

Comparative study of mammogram and magnetic resonance imaging on diagnosis of breast ductal carcinoma in situ with or without microinvasion / 中华普通外科杂志

Objective To compare the sensitivity and diagnostic features of mammogram (MG) and magnetic resonance imaging (MRI) on diagnosis of breast ductal carcinoma in situ (DCIS) with or without microinvasion (DCIS-MI).Methods From Jan 2012 to Nov 2013,results of MG and MRI from 72 cases of DCIS or DCIS-MI were retrospectively analyzed.Results The sensitivity of MG was 52.8％ (38/72).The sensitivity of MRI was 87.5％ (63/72),among those 76.2％ (48/63)lesions presented as non-mass-like enhancement.Sensitivity of MRI was significantly higher in DCIS-MI than DCIS (84.6％ vs 100％,P =0.027).Logistic regression analysis showed calcifications was an independent factor influencing the sensitivity of MG (OR =23.785,P ＜ 0.001).Conclusions The sensitivity of MRI is higher than MG for the diagnosis of DCIS and DCIS-MI.