Taking feasible precautions is an important step in effectively reducing medical disputes and improving medical quality. Guarding against medical disputes is a complex systematic project, which shares similarities with disease prevention. In view of the causes, evolution and various manifestations of medical disputes, it is imperative to take measures from the following three aspects and guard against them on three levels: ①taking first level(primary) precautions so as to boost overall development and tackle medical disputes at the source; ②taking second level(key) precautions so as to conduct timely imterventions and nip medical disputes in the bud; ③taking third level(emergency) precautions so as to dissolve prominent conflicts and prevent the worsening of medical disputes.

OBJECTIVETo investigate the chemical constituents of Hypericum petiolulatum.

METHODThe chemical constituents were isolated and purified by column chromatography on silica gel, macroporous adsorbent resin, Sephadex LH-20, and preparative HPLC. Structures of the compounds were identified by NMR and MS spectroscopic methods.

RESULTNine lignans were obtained and their structures were elucidated as (-)-(2R, 3R)-1-O-feruloyl-8,8'-bisdihydrosiringenin (1), (-) -secoisolariciresinol 4-O-beta-D-glucopyrano-side (2), isolariciresinol-beta-4'-O-beta-D-glucopyranoside (3), 5-methoxy-9beta-xylopyra-nosyl-(+) -isolariciresinol (4), (+) -lyoniresinol 2alpha-O-beta-D-xylopyranoside (5), 5-methoxy-9-beta-xylopyranosyl-(-) -isolariciresinol (6), isolariciresinol 6a-O-beta-D-gluco-side (7), (+)-lyoniresinol 3alpha-O-beta-D-xylopyranoside (8) and 7-methoxy-5-benzofuranpropanol 4'-O-beta-D-glucopyranoside (9).

CONCLUSIONCoupound 1 was new and compounds 2-9 were obtained from the genus Hypericum for the first time.

Drugs, Chinese Herbal ; chemistry ; Hypericum ; chemistry ; Lignans ; chemistry ; Magnetic Resonance Spectroscopy ; Mass Spectrometry

Objective To conduct an epidemiological investigation on a case of familial arsenic poisoning in Yunnan Province,to find arsenic poisoning source and create a archive of typical cases,in order to raise awareness of endemic arsenicosis and provide scientific materials for prevention and treatment of the disease.Methods In Xiaxiaoying Village of Yunnan Province,all members of a family with arsenic poisoning patients were investigated in 2013,their health examination and epidemiological survey of arsenic poisoning were carried out,and arsenic poisoning family profiles and personal files were established.Drinking water,hair and urine samples were collected for arsenic content determination,blood samples were collected for biochemical detection,excessively keratose skin was collected for pathological biopsy.Results A total of 33 family members were investigated.Among them 15 were exposed to arsenic and 18 were not exposed to arsenic.Fifteen people exposed to arsenic were found to be have skin lesions,and two eldest males died of skin cancer and cerebral hemorrhage in 1994 and 2009,respectively.The survey found out that 15 patients born in 1935-1983 had been drinking arsenic pesticides polluted well water for 5 to 16 years from 1973 to 1989.As of 2013,the arsenic exposure had been stopped for 24 years,the content of arsenic in the polluted wells was 0.624 mg/L,which was 62.4 times the recommended maximum limit (0.01 mg/L) of the World Health Organization.The median of hair and urinary arsenic in arsenic exposed population and non-arsenic exposed population was 4.2,3.7 mg/kg and 60.9,41.0 μg/L,respectively.There was no statistically significant difference in hair arsenic (Z =-1.905,P ＞ 0.05),but the difference of urinary arsenic was statistically significant (Z =-3.002,P ＜ 0.05).The median of aspartate aminotransferase (AST),gammaglutamyltransferase (γ-GT) and 24 hours urinary ereatinine (Cr) in arsenic exposed population and non-arsenic exposed population was 37.5,31.0 U/L,25.5,12.0 U/L,13 834.0,and 6 843.0 μmol/L,respectively.The differences between the two groups were statistically significant (Z =-2.776,-2.311,-2.502,P ＜ 0.05).Twelve cases of arsenic poisoned patients who were conducted health examination and epidemiological investigation showed typical triad of skin,among them 2 cases were moderate and 10 cases were severe.Pathological biopsy results showed 8 cases had basal cell carcinoma or squamous cell carcinoma.Conclusions Drinking arsenical pesticide contaminated water can induce chronic arsenic poisoning,even after the cessation of arsenic exposure.We should pay close attention to its long-term serious harmful effect.

OBJECTIVE: To establish the method for simultaneous determination of pim-O-glucosylcimifugin, liquiritin, 5-0-methylvisammioside and amonium glycyrrhizinate in Xinyi byan pills.METHODS: HPLC-switching wavelength method was used for content determination of 52 batches of Xinyi byan pills sample from enterprises A, B, C. The determination was performed on Kromasil C18 column with mobile phase consisted of acetonitrile-0. 1 ％ phosphoric acid at the flow rate of 1. 0 mL/min. The detection wavelengths were set at 220 nm (pim-O-glucosylcimifugin, liquiritin, 5-O-methylvisammioside) and 250 nm (amonium glycyrrhizinate). The column temperature was 30℃, and sample size was 10 μ L. RESULTS: The linear ranges of prim-O-glucosylcimifugin, liquiritin, 5-O-methylvisammioside and amonium glycyrrhizinate were 6. 138-122. 77 μg/mL (r=0. 999 9), 2. 502-50. 03 μg/mL (r=0. 999 9), 5. 988-119. 75 μg/mL (r=0. 999 9) and 12. 788-255. 76 μg/mL (r=0. 999 9), respectively. RSDs of precision, stability and reproducibility tests were all lower than 2. 0％ (n=6). The recovery rate were 100. 32％ (RSD=0. 58％, n=6), 100. 24％ (RSD=0. 56％, n=6), 101. 28％ (RSD=0. 91％, n=6) and 101. 48％ (RSD=0. 79％, n=6), respectively. Total contents of 4 components in enterprise A were generally higher than enterprises B, C, among which the difference of liquiritin was significant; the content of prim-O-glucosylcimifugin in enterprise B was higher than enterprises A, C, while the content of 5-O-methylvisammioside was lower than enterprises A, C. The content of liquiritin in enterprise B was outlier. CONCLUSIONS: This method is simple, reproducible and can provide reference for quality control of Xinyi biyan pills.

Objective: To study the association between eating at night and skipping breakfast with college students anxiety symptoms, and to provide reference basis for preventing and alleviating college students anxiety symptoms. Methods: A cross sectional survey was conducted among 9 960 freshman from three universities in Kunming and Dali, Yunnan Province. The dietary frequency questionnaire was used to evaluate the dietary behavior of college students. The Depression Anxiety Stress Scale-21 (DASS-21) was used to evaluate the anxiety symptoms of college students. The association of late night snack and breakfast skipping with the association of anxiety symptoms in college students used generalized linear model and Logistic regression model. Results: The proportion of college students who reported eating at night and breakfast skipping in the last month was 72.5%(7 217/9 960) and 61.6%(6 131/9 960) respectively. The detection rate of anxiety symptoms in college students was 28.9%(2 875/9 960). There was a statistical significance between eating at night with anxiety symptoms( OR =1.40-2.54), and breakfast skipping with anxiety symptoms( OR =1.23-1.60)( P <0.05). The interaction between eating late at night and breakfast skipping was positively correlated with college students anxiety symptoms (multiplicative interaction, β=0.06, 95%CI=0.02- 0.10 , P<0.01; additive interaction, OR=2.00, 95%CI=1.59-2.51, P <0.01). Conclusion The study suggests that the college students who eat at night and frequently skipped breakfast are more likely to have anxiety symptoms. It suggested to promote the formation of healthy eating habits of college students, so as to reduce the occurrence of anxiety sympotoms.

Objective:To investigate the effects of drinking water-borne arsenic exposure on mammary gland development of female mice in early life.Methods:Healthy and sexually mature C57BL/6J mice were paired according to the female to male ratio of 2∶1. After confirmation of pregnancy, female mice were randomly divided into control (drinking double distilled water), low- (0.5 mg/L) and high- (5.0 mg/L) dose arsenic exposure groups, 10 mice in each group. The exposure time of arsenic in drinking water ranged from day 0 of pregnancy to day 28 after birth. At the end of arsenic exposure, female offspring (10 mice in each group) were sacrificed and mammary glands were dissected for whole tissue staining to evaluate the development of mammary glands and quantitative analysis of mammary gland development indexes. The expression of proliferating cell associated antigen Ki67 was detected by immunohistochemistry.Results:There were no significant differences in body weight and organ coefficients of liver, kidney and mammary glands between female offspring in low- and high-dose arsenic exposure groups and control group ( F=1.018, 1.033, 1.764, 0.199, P > 0.05). Compared with control group, low- and high- dose arsenic exposure groups showed more terminal end buds (TEB) and ductal branches as well as stronger longitudinal growth ability in mammary gland morphological analysis. Quantitative analysis results showed that the numbers of TEB in the low- and high-dose arsenic exposure groups (11.83 ± 4.40, 11.00 ± 3.74) were significantly higher than that in the control group (4.00 ± 1.83, P < 0.05). The ductal lengths in the low- and high-dose arsenic exposure groups [(6.43 ± 1.08), (6.08 ± 1.74) mm] were also significantly longer than that in the control group [(3.71 ± 0.61) mm, P < 0.05]. The distance of leading edge of ducts to the midpoint of lymph nodes in the low- and high-dose arsenic exposure groups [(0.58 ± 1.12), (- 0.02 ± 1.57) mm] was significantly shorter than that in the control group [(- 2.67 ± 0.87) mm, P < 0.05]. The mean maximum area of TEB in the low-dose arsenic exposure group [(0.04 ± 0.01) mm 2] was significantly larger than that in the control group [(0.02 ± 0.01) mm 2, P < 0.05]. Immunohistochemistry staining indicated strong staining of Ki67 within TEB in the low- and high-dose arsenic exposure groups. Conclusion:Early life inorganic arsenic exposure promotes the development of TEB, ductal extension and cell proliferation within TEB in female mice, indicating that early life arsenic exposure alters mammary gland development.