Four compounds were isolated from the ethanolic extract of the bark of Alseodaphnehainanensis Merr. , The structures were identified as: a neolignan eusiderin A [(7R, 8R)-3,4,5,3′-tetram-ethox-△8’，9’-8-o-4’，7-o-5’lignan]（I）two benzylisoquinoline alkaloids (6,7-dimethoxyisoquinolinyl)-(4′-methoxyphenyl) methanone(Ⅱ), and( 6, 7-methylenedioxyisoquinolinyl )-( 4′-methoxyphenyl ) methanone (Ⅲ), and 4-hydroxy-3-methoxy benzoic acid ( Ⅳ ) on the basis of HR-SIMS，1HNMR，13CNMRand 2D-NMR spectroscopic analysis. CompoundsⅠ～Ⅲ were obtained from the Alseodaphne genus forthe first time.

Objective To investigate the role of high-mobility group box-1 (HMGB1) in the pathogenesis and the treatment of rheumatoid arthritis (RA) and the pathogenesis of TWP in treatment of RA.Methods A rat model of collagen induced arthritis (CIA) was developed and CIA rats were divided into the model group, the TWP group, the MTX group and the combination treatment group. And the tissues and blood were drawn from the rats 4 weeks later. HMGB1 expression in synovium, joint and the sera were tested by immunohistochemical stain and ELISA. Results HMGB l expression of the model in the synovium, joint and serum [(23.8±2.2) ng/ml] were remarkably higher than the control [(7.4±1.6) ng/ml] (P＜0.01); HMGB1 expression of the treatment groups in synovium, joint and serum [ (13.3±3.1), (17.4±4.9), (11.7±1.5 ) ng/ml]is obviously lower than the model (P＜0.01), and were higher than that of the controls(P＜0.05). Conclusion HMGB1 participates in the hyperplasia of synovial membrane, cartilage and bone destruction of CIA. The molecular mechanism for the TWP and MTX in the trentment of synovitis and bone destruction of RA is correlated with the expression of HMGB1.

Mesenehymal stem cells(MSCs)have been successfully isolated from almost all tissues in Mammals,and their multi-lineage differentiation ability leads to the attractive application of MSCs in regenerative medicine.More understanding of the biological characteristics of MSCs,the interaction between MSCs and the local environment,the molecules regulating MSC homing and differentiation have been achieved,which will benefit the effective clinical trials using MSCs as repair cells and/or vehicles for exogenous genes.

Objective To observe the effect of osteopontin (OPN) and integrin αtvβ3 in collageninduced arthritis (CIA) and the possible mechanism of Tripterygium wilfordii polyglycoside (TWP) in the treatment of rheumatoid arthritis (RA). Methods CIA rats model were developed and were randomly divided into the experimental group and the TWP group.And tissue samples were obtained 4 weeks later.Then the expressions of OPN and integrin αvβ3 in the synovium,synovium fluid and serum of each group were determined by immunohistochemical stain and ELISA.Variance analysis was used for data analysis.Results The concentrations of OPN of the normal controls,experimental group and the TWP group in the serum were (5.7±2.9), (7.8±6.2), (5.0±1.9) ng/ml respectively and there were significant differences between these 3 groups (F=6.74,P=0.016).The concentration of OPN (measured by mean grey value) in the synovium and cartilage of the three groups were 229±15,81±15,93±13 and 211±17,91±19,100±15 and there were significant differences between the three groups (F=52.48,P＜0.01; F=18.98,P=0.01).The concentrations of protein αvβ3 (measured by mean grey value) in the synovium and cartilage were 235±16,91±16,131±14 and 198±10,99±15,113±14,respectively and there were significant differences between the three groups (F=23.03,P=0.002; F=12.04,P=0.008).The expressions of OPN and integrin αvβ3 in the synovium,synovium fluid and serum of the experimental group were markedly higher than that of the controls.The expressions of OPN and integrin αvβ3 in the synovium,synovium fluid and serum of the treatment group were obviously lower than the experimental group.Conclusion OPN and integrin αtvβ3 are involved in the hyperplasia of the synovium,cartilage and bone destruction in CIA rats.The underlying molecular mechanism that TWP is effective in treating synovitis and bone destruction of RA is possibly related to down-regulation of the expression of OPN protein and integrin αvβ3.

Objective To understand health literacy levels in elderly people aged 60 years and above in Hunan, and explore factors related to health literacy.Methods Hunan residents aged 60 years and above were randomly recruited by the multistage stratified cluster sampling method.A total of 611 elderly people from 13 counties of Hunan were included in the study, which was conducted through questionnaires.Results The median health literacy score for elderly people aged 60 years and above was 51.00 (4-90), and it was lower than that for people under 60 years old, which was 56.00.Single factor analysis found that education level, occupation, number of family members, and household income each had an influence on health literacy scores (H=59.526, 20.609, 17.214, and 50.749, respectively;P=0.000, 0.002, 0.001 and 0.000, respectively).The number of people with basic health literacy accounted for 10.6％ (65/611) of the total.Multiple logistic regression analysis found that chronic disease was a factor affecting basic health literacy.Compared with elderly people without chronic diseases, a higher percentage of people with basic health literacy was among elderly people with chronic diseases (OR =1.870, 95％ CI: 1.037-3.373).Conclusions The health literacy level is lower in elderly people aged 60 years and above than those under 60 years old in Hunan.Only 10.6％ (65/611) of them show basic health literacy.Education level, occupation, number of family members, and household income are the factors related to health literacy.Health education about healthy lifestyle and behavior as well as chronic disease prevention and control should be increased in order to improve the health literacy level in elderly people.

OBJECTIVE: To study the optimum supercritical- fluid extraction technique for Xiangjiang Granula essential oil. METHODS: The orthogonal test was adopted to optimize the extraction process using the content of Ligustilide and the yield rate of essential oil as indicators, and 95% ethanol as co- solvents. The content of Ligustilide was determined by HPLC, using Phenomenex Luna C18( 250nm? 4. 6nm, 5? m) as column and methanol- 0. 5% glacial acetic acid( 30∶ 70) as mobile phase, with the detection wavelength set at 280 nm. RESULTS: The optimal extraction conditions were: temperature at 50℃ , pressure at 45MPa, extraction time for 3h, and 95% ethanol as co- solvents. The Ligustilide had a good linearty relationship between 5. 1～ 25. 5? g? mL- 1( r=0. 999 8) . CONCLUSIONS: This technique is easy, convenient and workable, and can provide theoretical support for production.

Objective To determine the risk factors associated with surgical site infection in closed calcaneal fractures.Methods A retrospective analysis was made on the clinical data of 312 patients with closed calcaneal fracture who had been treated by open plate osteosynthesis at our trauma centre from January 2008 to November 2014.They were 182 males and 130 females,from 18 to 75 years of age (average,44.3 years).By Sanders classification,52 cases were type Ⅱ,146 type Ⅲ,and 114 type Ⅳ.The fractures were caused by fall from a height in 159 cases,traffic accident in 97 ones,and crushing in 56 ones.All the patients received open reduction and internal fixation via a typical L-shaped lateral incision.Gender,age,cause for injury,smoking history,diabetes,interval between injury and operation,operation time and bone grafting were analyzed as possible risk factors in the study.Multivariate logistic regression was conducted for significant risk factors derived from the univariate analysis.Results The patients were divided into an infection group (28 cases,9.0％) and a non-infection group (284 cases,91.0％).The univariate analysis showed that the rate of smoking was significantly higher,the operation time significantly longer,the interval between injury and operation significantly shorter in the infection group than in the non-infection group (P ＜ 0.05).However,the logistic regression analysis revealed that operation time was the only independent risk factor for surgical site infection (P =0.005,OR =43.870).Conclusion Since operation time may be an independent risk factor for surgical site infection in closed calcaneal fracture,it is important to speed up surgery as quick as possible in control of surgical site infection as long as the surgical quality is ensured.

ObjectiveTo study the regulatory effect of Tripterygium wilfprdii polyglycoside (TWP) on the expression of EGFR and ErbB-2 induced arthritis rats.The effect of TWP on arthritis was also explored.MethodsAfter the model of CIA rats were established,the expression of EGFR and ErbB-2 in the synovium and articular cartilage were tested by immunohistochemical stain and real time PCR.ANOVA was used for statistical analysis.ResultsThe protein and mRNA expression of EGFR and ErbB-2 in the synovium (EGFR 0.268±0.059,ErbB-2 0.25±0.04,EGFR mRNA:14.2±0.55,ErbB-2 mRNA 23.46±3.64) and articular cartilage (EGFR 0.193±0.018,ErbB-2 0.217±0.033,EGFR mRNA:4.16±0.50,ErbB-2 mRNA 9.23±0.66) of the model group were significantly higher than those of the control group(P＜0.01).After being treated with TWP and MTX,the protein and mRNA expression of the EGFR and ErbB-2 decreased markedly (P＜0.01).Conclusion EGFR and ErbB-2 may play an important role in the pathogenesis of arthritis development.The molecular mechanism that TWP can treat synovitis and bone destruction of RA is related to the inhibition of EGFR and ErbB-2.

Objective To investigate the treatment and prevention strategies of hematomas in operation area after anterior approach surgery for cervical spondylosis.Methods A retrospective review was conducted on 12 with hematoma compression in operation area out of 785 patients managed by anterior cervical surgery from January 2007 to July 2013,including 10 males and 2 females at age ranging from 40-71 years (mean 56.8 years).Surgery method was anterior cervical corpectomy and interbody fusion using titanium mesh cage plus plate and intraoperative blood loss was 300-1 200 ml.Primary clinical manifestations were neurological dysfunction in 5 patients,dyspnea in 6,and both neurological dysfunction and dyspnea in 1.There were 10 patients with the presence of symptoms at postoperative 0.5-22 hours,1 at postoperative 73 hours,and 1 at postoperative 74 hours.All the 12 patients underwent a second anterior cervical exploration.Results There were 5 patients with epidural hematoma,6 with subcutaneous hematoma,and 1 with both hematomas.After surgical interventions,the patients presented improvement in respiratory and neurological function,with inapparent respiratory abnormality and improved neurological function at discharge.One patient was died of cardiovascular-associated disease after being discharged from hospital.The left 11 patients were followed up for mean 19.8 months (range,6-43 months),with improved Japanese Orthopedic Association (JOA) score at final follow-up.Conclusions Hematoma took place frequently in the early period,especially within 24 hours in operation area after anterior approach to cervical disorders and close attention should be paid to respiratory and limb sensation and motion functions.Early detection and early surgical interventions are the key countermeasures to avoiding the severe results.

Objective To investigate the methods and effects of posterior fixation and fusion in treatment of complete thoracolumbar fracture and dislocation.Methods The study enrolled 8 cases of complete thoracolumbar fracture and dislocation treated by posterior fixation and fusion with pedicle screwrod system between January 2006 and December 2012.There were 7 males and 1 female,at mean age of 31.9 years (range,19-49 years).Mean time interval between injury and surgery was 8.1 days (range,4-12 days).Fracture-dislocation classification was AO type C,Denis three-column injury,and Meyerding grade V.According to American Spinal Injury Association (ASIA),there 5 cases at grades A,1 at grade B,1 at grade C 1 at grade E.Fracture-dislocation segments included T5-T6 in 1 case,T12-L1 in 3,L1-L2 in 2,L3-L4 in 1 and L4-L5 in 1.Results Mean duration of surgery was 220.6 minutes (range,135-335 minutes) and mean intraoperative blood loss was 1 150 ml (range,500-2 400 ml).Seven cases sustained dural laceration during the operation,which were sutured or covered with autologous fat grafts,but 3 of them were subjected to cerebrospinal fluid leakage and healed after conservative therapy.Anatomic reduction was achieved in 6 cases,partial reduction in 1 and non-reduction in 1.Mean Cobb angle improved from 29.3 ° (range,8 °-51 °) preoperatively to 1.9 ° (range,-5°-10 °) postoperatively.After a mean follow-up of 39.3 months (range,2-76 months),2 cases were recovered from preoperative ASIA grade A and B to C respectively and 6 cases (4 A,1 C,1 E) revealed no significant improvement.There was no implant loosening or breakage.One case was died of lung-related complications at postoperative 4 years.One case sustained lumbar deep infection at postoperative 3 weeks and managed by debridement,irrigation,drainage and implant retention.Conclusion Posterior fixation and fusion is the general treatment principle for complete thoracolumbar fracture and dislocation,but the degree of reduction depends on severity of the injured spinal cord.