[Thinking and practice of study on material basis of parched Chinese herbal medicines and their quality evaluation].

Though parched Chinese herbal medicines contain less effective or index components, their pharmacological actions do not reduce or even become improved to some extent. However, the current studies related to material basis could not explain the changes in property, flavour and efficacy of parched Chinese herbal medicines. Meanwhile, due to the lack of objective and specific evaluation indexes, the quality evaluation could not reflect features of parched Chinese herbal pieces. Therefore, how to break the bottleneck for the studies on parched Chinese herbal pieces, make further innovation and conduct in-depth studies on the material basis of parched Chinese herbal medicines are common problems that medical scholars are facing. According to the findings in the previous studies, the author proposed to explain the material basis of parched Chinese herbal medicines by studying Maillard reaction and establish specific quality evaluation indexes according to the features of parched Chinese herbal pieces, and conducted relevant studies.

[A study of the clinical features and the effect of therapy on acute respiratory distress syndrome patients as a result of severe triphosgene poisoning].

OBJECTIVE: To investigate the clinical features and treatment strategy for acute respiratory distress syndrome (ARDS) caused by phosgene. METHODS: Individualized therapy was carried out in 17 cases of severe phosgene poison patients. Blood routine, electrolytes, blood gas analysis, hepatic and renal function tests and cardiac enzymes were examined before and after treatment. RESULTS: Vital signs, fluid, electrolytes and acid-base disturbances were improved after treatment. As compared to that of pre-treatment period, white blood cells [WBC, ×10(9)/L: 12.18 ± 4.76 vs. 21.93 ± 6.21], neutrophil percentage (0.87 ± 0.05 vs. 0.92 ± 0.03), hemoglobin (Hb, g/L: 128.12 ± 25.65 vs. 173.71 ± 23.53), blood platelet count [PLT,×10(9)/L:165.12 ± 31.70 vs. 254.47 ± 70.80], alanine transaminase (ALT, U/L: 70.71 ± 46.70 vs. 212.71 ± 141.34), aspartate aminotransferase (AST, U/L: 52.47 ± 34.68 vs. 82.41 ± 34.60), blood urea nitrogen (BUN, mmol/L: 5.83 ± 4.09 vs. 7.89 ± 5.96), serum creatinine (SCr, µmol/L: 48.13 ± 14.97 vs. 67.25 ± 24.29), lactate dehydrogenase (LDH, U/L: 280.10 ± 81.77 vs. 586.35 ± 186.71), creatine kinase (CK, U/L: 199.12 ± 106.75 vs. 683.00 ± 323.21), MB isoenzyme of creatine kinase (CK-MB, U/L: 26.94 ± 9.13 vs. 45.59 ± 11.21), serum chlorine anion [Cl(-), mmol/L: 95.88 ± 6.06 vs. 102.29 ± 7.28], respiratory rate (RR, beats/min: 20.88 ± 4.30 vs. 30.06 ± 5.78), heart rate (HR, beats/min: 82.76 ± 17.16 vs. 113.35 ± 16.90), blood pH value (7.34 ± 0.44 vs. 7.39 ± 0.03) were all decreased (P < 0.05 or P < 0.01). Serum sodium ion [Na(+),mmol/L:140.61 ± 6.69 vs. 134.06 ± 4.80], arterial partial pressure of oxygen [PO(2), mm Hg, 1 mm Hg = 0.133 kPa: 84.41 ± 30.58 vs. 59.88 ± 15.19] and pulse oxygen saturation [SpO(2): 0.91 ± 0.08 vs. 0.78 ± 0.15] were increased (P < 0.05 or P < 0.01). Sixteen patients totally recovered, 1 patient died, and the cure rate was 94.12%. CONCLUSIONS: Respiratory system could be mainly injured as the result of exposure to phosgene and leading to ARDS. Early initial combination therapies with corticosteroids and respiratory support should be addressed.

[Effect of albumin and hemoglobin level on prognosis of patients with uncomplicated severe traumatic brain injury: a retrospective cohort study].

OBJECTIVE: To evaluate the best level of albumin and hemoglobin for the patients with uncomplicated severe traumatic brain injury (TBI). METHODS: A retrospective cohort study was conducted. One hundred and sixty-eight patients with uncomplicated severe TBI admitted to intensive care unit (ICU) of Anhui Provincial Hospital were enrolled. The relationship between albumin and hemoglobin level within 3 days after admission and prognosis was analyzed. Mean 3-day albumin level was obtained, and then the patients were divided into <25, 25-28, 29-31 and ≥32 g/L groups according to quartiles based on mean albumin, and also were divided into <90, 90-99, 100-109 and≥110 g/L groups according to the mean hemoglobin concentration. Multivariable log-binomial regression was used to model the association between mean albumin and hemoglobin concentration and prognosis. RESULTS: One hundred and nine patients were enrolled based on inclusion/exclusion criteria. Among them, 32 patients (29.4%) received a red blood cell (RBC) transfusion, and 24 patients (22.0%) were given albumin treatment. According to the average level of albumin, there were significant differences in mortality among <25, 25-28, 29-31 and ≥32 g/L groups [85.2%(23/27), 59.3%(16/27), 32.1%(9/28), 44.4%(12/27), respectively, P=0.001]. According to the hemoglobin level, there was no significant difference in mortality rate among <90, 90-99, 100-109 and ≥110 g/L groups[61.8%(34/55), 43.8%(7/16), 53.3%(8/15), 47.8%(11/23), respectively, P>0.05]. When using the albumin level, Glasgow coma score (GCS), age and time of onset for logistic analysis, albumin level and age had influence on the mortality of patients, and mortality rate was generally decreased with an increase in albumin. But when the levels of albumin was ≥32 g/L, the risk of death was higher than in the 29-31 g/L group[relative risk (RR) of albumin 29-31 g/L=0.070, 95% confidence interval (95%CI) 0.015-0.331, P=0.001; RR of albumin≥32 g/L=0.153, 95%CI 0.035-0.663, P=0.012; RR of age=0.691, 95%CI 0.526-0.907, P=0.008]. When the hemoglobin level, GCS, age and time of onset were used for logistic regression analysis, only GCS entered the regression model (RR=0.696,95%CI 0.550-0.880, P=0.002), illustrating that the hemoglobin level had no significant influence on mortality, and mortality rate declined with an increase in GCS. CONCLUSIONS: The most favorable level of albumin for uncomplicated severe traumatic brain injury is 29-31 g/L. There is no difference in mortality rate when hemoglobin >90 g/L.