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Objective:To explore the endoscopic features of early gastric cancer (EGC) related to non-curative endoscopic resection, and to construct an assessment model to quantify the risk of non-curative resection.Methods:From August 2006 to October 2019, 378 lesions that underwent endoscopic resection and were diagnosed pathological as EGC in the Department of Gastroenterology, Peking Union Medical College Hospital were included in this case-control study.Seventy-eight (20.6%) non-curative resection lesions were included in the observation group, and 234 lesions which selected from 300 lesions of curative resection were included in the control group according to the difference of operation year ±1 with the observation group, and the ratio of 1∶3 of the observation group to the control group. Univariate and multivariate logistic regression analysis were performed to explore the risk factors for non-curative resection. The independent risk factor with the minimum β coefficient was assigned 1 point, and the remaining factors were scored according to the ratio of their β coefficient to the minimum. A predictive model was established to analyze the 378 lesions.The non-curative resection rates of lesions of different scores were calculated. Results:Univariate analysis showed that the lesion diameter, the location, redness, ulcer or ulcer scar, fold interruption, fold entanglement, and invasion depth observed with endoscopic ultrasonography (EUS) were associated with non-curative resection of EGC lesions ( P<0.05), and contact or spontaneous bleeding may be associated with non-curative resection ( P=0.068). Multivariate logistic regression analysis showed that submucosal involvement (VS confined to the mucosa: β=0.901, P=0.011, OR=2.46, 95% CI: 1.23-4.92), lesion diameter of 3-<5 cm (VS <3 cm: β=0.723, P=0.038, OR=2.06, 95% CI: 1.04-4.09), lesion diameter of ≥5 cm (VS <3 cm: β=2.078, P=0.003, OR=7.99, 95% CI: 2.02-31.66), location in the upper 1/3 of the stomach (VS lower 1/3: β=1.540, P<0.001, OR=4.66, 95% CI: 2.30-9.45), and fold interruption ( β=2.287, P=0.008, OR=1.93, 95% CI: 0.95-3.93) were independent risk factors for non-curative resection of EGC lesions. The factor of lesion diameter of 3-<5 cm and submucosal involvement were assigned 1 point respectively, location in the upper 1/3 of the stomach was assigned 2 points, diameter of ≥5 cm and fold interruption were assigned 3 points respectively, and other factors were assigned 0 point. Then the analysis of 378 lesions showed that the probability of non-curative resection at ≥2 points was 41.9% (37/93), 4 times as much as that at 0 [11.5% (25/217)]. Conclusion:EGC lesions with diameter ≥3 cm, located in the upper 1/3 of the stomach, interrupted folds or submucosal involvement are highly related to non-curative resection. The predictive model based on these factors achieves satisfactory efficacy, but it still needs further validation in larger cohorts.
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OBJECTIVE:To study the purification technology of Sanhuang yishen formula. METHODS:Using retention rate and impurity rate of purified total polysaccharide,astragaloside and calycosin glucoside as index,the purification effects of water extraction and alcohol precipitation method (50%,60%,70% ethanol) and clarifying agent method (101 juice clarifying agent, ZTC natural clarifying agent,chitosan clarifying agent) were respectively detected to screen the purification method;orthogonal test was used to optimize the technology parameters(mass concentration of liquid,amount of clarifying agent and pH of liquid)by the optimized purification method,and the verification test was conducted. RESULTS:The purification was better when using chito-san as clarifying agent with comprehensive score of 98.62;the purified technology parameters were mass concentration of liquid 1 g/mL,1% chitosan solution amount of 2 mL/g,pH 5.1;the average value of retention rate and impurity rate of purified total poly-saccharide, astragaloside and calycosin glucoside in verification test were 79.56%(RSD=1.24%, n=3), 78.11%(RSD=0.97%,n=3),79.46%(RSD=1.03%,n=3)and 32.18%(RSD=1.16%,n=3),respectively. CONCLUSIONS:Using chito-san as clarifying agent shows good purification effect for Sanhuang yishen formula,which is simple. The optimized technology is stable and feasible.
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OBJECTIVE:To optimize the extraction technology of Compound qima capsules. METHODS:With the blood pres-sure lowering of rats as index,pharmacological efficacy test was used to screen the preparation technology(A was whole herb de-coction;B was Gastrodia elata fine powder mixed with other decocted medical materials). The extraction technology was opti-mized by single factor and orthogonal test using the contents of astragaloside and isoflavone grape glycosides and the quality of sol-id as indexes,with added water,decoction time,decoction times as factors;and the verification test was carried out. RESULTS:Pharmacological efficacy test showed that antihypertensive effect of sample by technology B was superior. The optimal extraction condition of other medical materials of technology B was as follows as 12-fold water per time,decocting for 1.5 h,for 3 times. In verification test,average extraction rates of astragaloside and isoflavone grape glycosides were 64.02% and 51.97%,and average value of the quality of solid was 5.69 g(RSD≤1.92%,n=3). CONCLUSIONS:The optimized extraction technology is stable and feasible.
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AIM: To establish the quality standards for Fukang Capsules(Cortex Phellodendri Chinensis,Cortex Ailanthi,Fructus Schisandrae Chinensis,etc.). METHODS: Cortex Ailanthi,Fructus Schisandrae,Poria were identified by TLC,and the content of berberine hydrochloride was determined by TLC-scanning. RESULTS: Cortex Ailanthi,Fructus Schisandrae,Poria could be identified by TLC.Berberine hydrochloride showed a good linear relationship at a range of 25.32 ng-354.48 ng,r=0.993 28.The average recovery was 100.3%,and RSD was 2.04%. CONCLUSION: The method is accurate and can be used for the quality control of Fukang Capsules.
