This study was aimed to extract and separate fibrauretine from Chinese herbal medicine Fibraurea recisa Pierre. and to prepare tetrahydropulmatine with fibrauretine. Extraction method of fibrauretine were optimized by the L9(34) orthogonal arrays as experimental designs. Then, elution chromatography method was studied with the macroporous adsorption resin chromatography technology. At last, tetrahydropulmatine was prepared by the reaction of sodium borohydride hydrogenating fibrauretine. The results showed that the content and yield of obtained fibrauretine were 36.40% and 3.17%, respectively. The reflux exacted methods of fibrauretine were with 10 times amount (v/w) of 50%ethanol solution for 2 hours and 3 times. Then, HPD-300 macroporous resin was used to absorb fibrauretine, and purify water. The 20% and 60% ethanol solution was used for elution. The content and yield of obtained fibrauretine were 65.47% and 82.44%, respectively. And the content and yield of obtained tetrahydropulmatine were 98.31% and 72.04%, respectively. It was concluded that the method can obtain fibrauretine with relative high content and yield. Using this material can obtain tetrahydrofibrauretine with relative high content and yield.

Objective To analyze the causes,neuroimaging and clinical manifestations of isolated unilateral pontine infarction and to discuss its relationship to progressive motor deficit(PMD).Methods All 58 patients with isolated acute unilateral pontine infarction confirmed by magnetic resonance imaging (MRI) were recruited in this study for retrospective review.Thirty-one patients of them had brain and neck multi-slice spiral CT angiography(CTA) within 1 week after admission.PMD severity was accessed using the dynamic National Institutes of Health Stroke Scale (NIHSS) within 5 days after onset.All 58 patients were divided into two groups:patients with PMD (23 cases) in group 1 and patients without PMD (35 cases) in group 2.Two groups were compared for the risk factors,initial NIHSS scores,modified Rankin Scale (mRS) scores at 1 month after onset,clinical manifestations,infarction distribution,size and morphology of infarctions and basilar artery lesions.Results The major cause was pathologic changes in basilar artery branch in both groups(6/12 in group 1 and 10/19 in group 2).The proportion of patients with infarction extending to the pontine surface in group 1 was higher than that in group 2 (21/23,91.3％ vs 20/35,57.1％,x2 =7.817,P =0.005).Initial NIHSS score in group 1 was higher than that in group 2(6.7 ±2.9 vs 4.5 ± 2.4,t =3.121,P =0.003).mRS score at 1 month after onset in group 1 was higher than that in group 2(2.2 ± 1.1 vs 1.5 ± 0.8,t =2.909,P =0.004).The Logistic regression analysis showed that isolated unilateral pontine infarction extending to the pontine surface was positively related to PMD (odds ratio 9.670,95％ confidence interval 1.171-79.856,P =0.035).Conclusions Progressive isolated unilateral pontine infarction is mostly caused by pathologic changes in basilar artery branch.Patients with PMD have a more severe initial clinical manifest and they have a worse short-term prognosis than patients without PMD.Isolated unilateral pontine infarction extending to the pontine surface may be a risk predictor in stroke evolution.

To investigate the CT findings of thoracic sarcoidosis and improve the understanding and diagnostic level of the disease. Retrospective analysis of the pathology or clinical treatment were observed in 20 patients with thoracic sarcoidosis accorded with the diagnostic standard of CT performance. There were 15 cases confirmed by pathology and 5 cases verified after clinical treatment. There were hilar or mediastinal lymph nodes in 90% cas-es, pulmonary mainly nodules in 60% case, pulmonary fibrosis in 20% cases, bronchovascular bundle thickening in 15%cases, pleural effusion in 10% cases, interlobular septal thickening in 15% cases, ground-glass opacity in 10% cases and pulmonary consolidation in 5% cases. CT findings of thoracic sarcoidosis may help improve the rate of its diagnosis.

Aim To investigate the effect and mecha-nism of quercetin combined with cisplatin on prolifera-tion and apoptosis of human osteosarcoma cell line MG-63 . Methods MG-63 cells were treated with quercetin alone or combined with cisplatin. Cellular morphologic changes were observed under inverted phase contrast microscope. The effects of proliferation inhibition were assayed by CCK-8 method. The combination effect was judged through Chou-Talaly analysis. The apoptosis ra-tios of cells were analyzed by flow cytometry. The gene expression of Bcl-2 and caspase-3 was detected by RT-PCR assay. The protein expression of Bcl-2 and caspase-3 was measured by Western blot assay. Re-sults Quercetin alone or combined with cisplatin could inhibit the proliferation, but induce the apoptosis of MG-63 cells. Combination of quercetin and cisplatin revealed a synergistic effect on cell proliferation and apoptosis as it reduced the expression of Bcl-2 but en-hanced that of caspase-3 at both gene and protein lev-els. Conclusion Synergistic effect of quercetin com-bined with cisplatin on cell proliferation and apoptosis of MG-63 cells is possibly due to reduction of Bcl-2 and enhancement of caspase-3 expression.

Objective To investigate the optimal display orientation of rotator cuff space(RI)structures on magnetic resonance(MR)scanning and arthrography.Methods A total of 80 patients who underwent MR scanning and arthrography in our hospital from January 2021 to March 2023 were selected and all of them were confirmed to have normal RI by shoulder arthroscopy.The RI and the superior glenohumeral ligament(SGHL),the long head of biceps tendon(LHBT),and the coracohumeral ligament(CHL)in the transverse axial,oblique sagittal,and oblique coronal positions were counted in the transverse axial,oblique sagittal,and oblique coronal positions on MR scanning and arthrography.Results The display rate of RI structure by oblique sagittal scan was 17.50%higher than that by horizontal scan,0.00%and oblique coronal scan,5.00%(4/80)(χ2 = 18.739,P<0.001).The display of SGHL,LHBT and CHL in RI by MR Oblique sagittal scan was better than that in transverse axis and oblique coronal scan(χ2 = 26.036,P<0.001).MR oblique sagittal arthrography showed a higher rate of RI structures 57.50%than transverse axial 5.00%and oblique coronal 17.50%(χ2 = 61.534,P<0.001);MR oblique sagittal arthrography showed better display of SGHL,LHBT,and CHL structures in RI than transverse axial and oblique coronal(χ2 = 64.569,P<0.001);MR oblique sagittal arthrography had a significantly higher rate of complete visualization of RI structures in 57.50%than MR oblique sagittal plain scanning in 17.50%(χ2 = 27.307,P<0.05).Conclusion Oblique sagittal position is the optimal display orientation for MR scanning and arthrography to show RI structures.

Objective:To analyze the efficacy and safety of dual antiplatelet therapy guided by thromboelastography (TEG).Methods:One hundred and nine patients with ischemic cerebrovascular diseases, admitted to and accepted dual antiplatelet therapy in our hospital from August 2020 to April 2021, were enrolled in this study. TEG test was completed 3-5 d after treatment, and clopidogrel gene test was completed during hospitalization. According to the results of adenosine diphosphate (ADP) inhibition rate in TEG, they were divided into high-efficiency group, moderate efficiency group and low efficiency group. No medication change was recommended for patients in the high-efficiency group, but medication changes were recommended for patients in the moderate efficiency group and low efficiency group; differences of National Institutes of Health Stroke Scale (NIHSS) scores, efficacies and safety were recorded in these 3 groups after drug adjustment.Results:The proportion of patients with coronary heart disease in moderate efficiency group was statistically higher than that in high-efficiency group and low efficiency group ( P<0.05). Six patients in the high-efficiency group switched to use aspirin and cilostazol; 28 in the moderate efficiency group and 14 patients in the low efficiency group were disinclined to change their medications and continued to use aspirin+clopidogrel. In patients from the high-efficiency group, the overall incidence of new stroke and in-stent restenosis in patients without changing medications (1/39) was lower than that in patients with changing medications (1/6); in patients from the moderate efficiency group, that in patients without changing medications (6/28) was higher than that in patients with changing medications (1/9); in patients from the low efficiency group, that in patients without changing medications (3/14) was higher than that in patients with changing medications (0/13). In patients with slow metabolism from high-efficiency group, the overall incidence of new stroke and in-stent restenosis in patients without changing medications (2/3) was higher than that in patients with changing medications (1/2). Conclusions:Dual antiplatelet therapy guided by TEG can reduce clinical adverse events without increasing the risk of bleeding. For patients with ADP inhibition rate>70% and clopidogrel genotype (slow metabolism), clopidogrel replacement can further improve efficacy.