Object To study the chemical constituents of Hypericum sampsonii Hance from Yunnan Province Methods Cytotoxicity screening of extracts from wild and cultivated H sampsonii was carried out by L 1210 cell and KB cell Chemical constituents for wild H sampsonii were isolated by column chromatography The chemical structures were identified by physical and chemical properties and spectral data analysis Results Six compounds have been isolated and established as 1 benzoyl 3 (3 methyl 2 butenyl) 6, 6, 13, 13 tetramethyl 11 geranyl 5 lxatetracycol[7 3 1 0 3, 7 0 4, 11 ] tridecane 2, 12 dione (sampsonione A, Ⅰ); 1 benzoyl 5 (1 hydroxy isopropyl) 6, 6, 13, 13 tetramethyl 11 geranyl tetracycol [7 3 1 1 0 3, 7 ] tetradecane 2, 12, 14 trione (sampsonione F, Ⅱ); 3 (1 hydroxy 5 methyl 4 hexenyl) 6, 10 di (3 methyl 2 butyryl) 8 benzoyl 9, 9 dimethyl 4 oxatricycol [6 3 1 0 1, 5 ] 5 dodecene 7, 12 dione (sampsonione K, Ⅲ); 1,2 dihydro 3, 6, 8 trihydroxy 1, 1 bis (3 methyl but 2 enyl) xanthen 2, 9 dione (patulone, Ⅳ); 1, 7 dihydroxy 4 methoxy xanthone (Ⅴ) and 1, 3, 6, 7 tetrahydroxy 8 (3 methyl but 2 enyl) xanthone (Ⅵ) Conclusion Compounds Ⅳ-Ⅵ are first obtained from H sampsonii In addition, the fractions of chloroform extracting and ethyl acetate extracting possess anticancer activities by cytotoxicity tests

Objective To evaluate methods of OP mesh spreading in preperitoneal tension-free repair of inguinal hernia via open anterior approach.Methods The clinical data of 1 528 cases underwent preperitoneal tension-free repair of inguinal hernia via open anterior approach from March 2012 to April 2015 was analyzed retrospectively.The methods of mesh crimp spreading, pectineal ligament suture fixation, pubic tubercle suture fixation and auxiliary support were used.Results The mesh crimp spreading method was used in 1 021 cases, pectineal ligament suture fixation method was used in 64 cases, pubic tubercle suture fixation method was used in 48 cases, auxiliary support method was used in 395 cases.Meshes were all well spreaded.Conclusions The four methods of mesh spreading are effective, simple, convenient and easy to use in preperitoneal tension-free repair of inguinal hernia via open anterior approach.

Objective To study the serum levels of melatonin,tumor necrosis factor alpha (TNF-α) and interferon gamma (IFN-γ) in multiple sclerosis (MS) patients and the correlation with disability.Methods Forty patients with multiple sclerosis were collected as MS group and 30 healthy participants were collected as control group.Serum levels of melatonin and cytokines,including IFN-γ and TNF-,were detected in all participants by the enzyme-linked immunosorbent assay (ELISA) method;disability status of patients with MS was evaluated by EDSS scale.The relevant analysis between serum melatonin,TNF-α,IFN-γ levels and EDSS score in patients with MS was conducted.Results The concentration of serum melatonin in MS group was significantly lower than control group (P＜0.01).TNF-α levels were higher than control group (P＜0.05) and the difference was statistically significant between MS patients and control group.Among MS group and control group,no significant correlation with the serum levels of IFN-γ was seen.The serum melatonin level was inversely correlated with EDSS score in MS patients (r =-0.76,P＜0.01),and positively correlated with TNF-α (r =0.83,P＜0.01) and as compared to IFN-γ,no significant correlation was found (r =0.17,P＞0.05).Conclusion The decrease of melatonin and increase of TNF-α can be a factor in the inflammatory reaction in patients with MS,and is closely related with dysfunction occurring in multiple sclerosis.Serum melatonin and TNF-α can be used as laboratory indicators to monitor clinical curative effect and evaluate prognosis of MS.

Objective To explore the major differences of the provider profiles in terms of structural characteristics, hospital facilities and workflow of traumatic brain injury ( TBI) centers between China and European Union and compare the efficacy. Methods The questionnaires were designed focusing on the provider profiling, and 45 Chinese centers and 71 European centers were recruited into Collaborative European NeuroTrauma Effectiveness Research in TBI ( CENTER-TBI) program. The structural characteristics, hospital facilities and work flow of the two groups were compared. Results The proportion of helicopter platform facilities[31％ (14/45)] : 80％ (57/71)]in China group was lower than that in European Union group (P <0. 01), while the proportion of neurological ICU facilities [98％ (44/45) : 57％ (40/71)] in China group was higher than that in European Union group (P <0. 01). China group has higher ratios in all-day trauma operation room [96％(43/45):75％(53/71)], open ICU [27％(12/45):4％(3/71)], transitional beds[93％(42/45):71％(50/71)] than those in European Union group (P<0.01). European Union group had higher ratios in implementing brain parenchymal intracranial pressure monitoring [31％ (21/67) :7％ (344)] and adopting 20 mmHg as the threshold of intracranial hypertension [86％(57/66):64％(29/45)](P<0.01). The China group adopted more basic life support and followed the US TBI guidelines for clinical management. Conclusions Significant differences are disclosed upon TBI centers between China and EU, mainly demonstrated in neurological ICU facilities, all-day trauma operation room, brain parenchymal intracranial pressure monitoring, and the threshold of intracranial hypertension management. These differences provide a working analysis basis for further comparative studies in the field of TBI and for determining the best clinical practice.

Objective To compare the repair effects of different eyelid defect repair methods af-ter eyelid tumor resection.Methods The clinical data of 90 patients with eyelid malignancies were retrospectively analyzed.All patients underwent eyelid tumor resection and eyelid defect was repaired after surgery.According to the repair method,they were divided into observation group(n=34)and traditional group(n=56).The observation group was repaired using allogeneic scleral transplanta-tion,while the traditional group was repaired using autologous lip mucosa and adjacent skin flap transfer.The repair effects,eyelid morphology,and cosmetic effects before and after repair were com-pared between the two groups.The occurrence of complications was compared between the two groups at one month after surgery.Results After repair,the total effective rate of the observation group was 94.12％,which was higher than 73.21％of the traditional group,and the difference was statistically significant(P＜0.05).After repair,the difference in eyelid fissure height and length of the two groups was lower than before surgery,and the observation group was lower than the traditional group(P＜0.05).After repair,the cosmetic effect score of the observation group was(1.65±0.27),which was higher than(1.36±0.20)of the traditional group,and the difference was statistically sig-nificant(P＜0.05).After repair,the total complication rate of the observation group was 11.76％,which was lower than 30.36％of the traditional group,and the difference was statistically significant(P＜0.05).Conclusion The clinical effect of allogeneic scleral transplantation in repairing eyelid defects is better,which can effectively improve eyelid morphology and cosmetic effects,and reduce the incidence of complications.

Objective To compare the repair effects of different eyelid defect repair methods af-ter eyelid tumor resection.Methods The clinical data of 90 patients with eyelid malignancies were retrospectively analyzed.All patients underwent eyelid tumor resection and eyelid defect was repaired after surgery.According to the repair method,they were divided into observation group(n=34)and traditional group(n=56).The observation group was repaired using allogeneic scleral transplanta-tion,while the traditional group was repaired using autologous lip mucosa and adjacent skin flap transfer.The repair effects,eyelid morphology,and cosmetic effects before and after repair were com-pared between the two groups.The occurrence of complications was compared between the two groups at one month after surgery.Results After repair,the total effective rate of the observation group was 94.12％,which was higher than 73.21％of the traditional group,and the difference was statistically significant(P＜0.05).After repair,the difference in eyelid fissure height and length of the two groups was lower than before surgery,and the observation group was lower than the traditional group(P＜0.05).After repair,the cosmetic effect score of the observation group was(1.65±0.27),which was higher than(1.36±0.20)of the traditional group,and the difference was statistically sig-nificant(P＜0.05).After repair,the total complication rate of the observation group was 11.76％,which was lower than 30.36％of the traditional group,and the difference was statistically significant(P＜0.05).Conclusion The clinical effect of allogeneic scleral transplantation in repairing eyelid defects is better,which can effectively improve eyelid morphology and cosmetic effects,and reduce the incidence of complications.

Objective To evaluate the value of quantitative analysis of dynamic contrast-enhanced MRI (DCE-MRI) and diffusion weighted imaging (DWI) for differentiating malignant from benign orbital lymphoproliferative disorder(OLPD). Methods Forty-three patients with OLPDs(20 patients with benign OLPDs and 23 patients with orbital lymphoma) confirmed by histopathology or clinical follow-up were enrolled in this retrospective study.Quantitative parameters of DCE-MRI including volume transfer constant (Ktrans), flux rate constant (Kep), and extravascular extracellular volume fraction (Ve) and mean apparent diffusion coefficient(ADC)values were obtained. χ2test and t test were used to compare the differences of qualitative and quantitative parameters between two groups. Receiver operating characteristic (ROC) curve analyses were used to evaluate the diagnostic ability of each parameter and its combination. Results Malignant group showed significantly lower mean ADC values and higher Kepvalues than benign group [ADC:(0.674±0.126)×10-3mm2/s vs(1.030±0.304)×10-3mm2/s,P<0.001;Kep:(1.299±0.566)/min vs(0.787± 0.311)/min, P= 0.001], while no significant differences was found on Ktrans(P= 0.637) and Ve(P= 0.023). ROC analyses results indicated that,a sensitivity of 95.7%,specificity of 80.0% and area under curve(AUC) of 0.896 could be obtained,when using ADC=0.809×10-3mm2/s as the cut-off value.Setting the Kepvalue of 0.863/min as the cut-off value, a sensitivity of 91.3%, specificity of 75.0% and AUC of 0.848 could be obtained. When combination of mean ADC and Kepwas used, optimal diagnostic performance could be obtained (AUC, 0.926;sensitivity, 91.3%;specificity, 90.0%). Conclusion Mean ADC values and Kepare significant variables in predicting malignant OLPDs. Combination of DWI and DCE-MRI can further improve the diagnostic capability in differentiating malignant from benign OLPDs.

Objective To evaluate midterm outcomes of thoracic endovascular aortic repair (TEVAR) with in situ fenestration (ISF) to revascularize the aortic arch vessels.Methods From Feb 2012 to Dec 2014,10 patients underwent TEVAR with aortic arch vessels revascularized via ISF.There were 6 patients of thoracic aortic aneurysms (TAA) and 4 of type B aortic dissection (TBAD).Patients were followed for all-cause mortality,endoleak of post-TEVAR,integrity and patency of aortic endograft and branch vessels.Results Totally 11 branch vessels [10 left subclavian arteries (LSA),1 left common carotid artery (LCA)] via ISF were revascularized in 10 patients.Patients were followed-up for 24-55 mouths,mean of 42.80 months.1 TAA patient died in 2 years post-TEVAR unrelated to the operation.All fenestrations remained patent,and there were no endoleaks and no occlusion,compression,or fracture of stents.There were no postoperative strokes and left upper limbs ischemia.1 patient had distal aortic endograft pseudoaneurysms formation in 2 years post-TEVAR and underwent reTEVAR treatment.Conclusion Aortic arch vessels revascularization via ISF in TEVAR is safe and feasible.Midterm outcomes is satisfactory.

Objective To evaluate the outcome of the endovascular aortic repair (EVAR) of abdominal aortic aneurysms (AAA) with diabetes mellitus (DM) and analyze the factors that influence its mid-long-term curative effect.Methods From Jan 2004 to Jun 2014,follow-up data of 103 AAA patients with DM treated with EVAR was analyzed retrospectively.Results Effective follow-up visits were conducted on 88 patients (85.43％).The patients were tracked for an median of 3.59 years,with the longest follow-up 10.32 years.25 deaths occurred and the all-cause mortality rate was 24.3％.6 cases had intervention-related complications (5.8％),including endoleaks,thrombosis,embolism,infection,false aneurysms.2 secondary interventions were conducted on 2 patients.The five-year cumulative survival rate was 70％ and the ten-year cumulative survival rate was 61％.Conclusion EVAR is safe for AAA patients with DM.

Object:To investigate the impact of carbon nanoparticle tracing on the number of lymph nodes harvested in obese patients during radical gastrectomy for gastric cancer.Methods:Clinical data of 127 patients undergoing D 2 radical gastrectomy in the Affiliated Tumor Hospital of Zhengzhou University from Jan 2015 to Dec 2019 were retrospectively analyzed. According to whether the patients were injected with carbon nano particles during operation, they were divided into two groups: 64 patients without carbon nano particles during operation served as control group; 63 patients with carbon nano particles were included into experimental group. Results:The operation time of the control group was (160±31) min and that of the experimental group was (168±28) min ( t=-1.521, P=0.445). Intraoperative blood lose in the control group was (234±82) ml and that in the experimental group was (238±84) ml ( t=-0.295, P=0.846). The number of lymph nodes harvested in the first station, in the second station, the number of total lymph nodes and the number of lymph nodes with diameter <5 mm in the control group were less than those in the experimental group(10.4±3.8 vs. 24.5±10.6, t=-10.054),(6.6±2.8 vs. 16.8±7.3, t=-10.381),(17.1±6.4 vs. 41.2±17.6, t=-10.293),(3.9±2.5 vs. 21.2±9.1, t=-14.662) (all P<0.05), while the number of positive lymph nodes was not statistically different between the two groups all (5.9±6.2 vs. 4.2±3.4, t=-1.963, P>0.05). Black staining of lymph nodes in nano carbon group: 1 542 black stained lymph nodes were detected in the experimental group, the black staining rate of lymph nodes was 59.44% (1 542/2 594). Conclusion:Intraoperative application of carbon nanoparticles can significantly increase the number of harvested lymph nodes in obese (BMI≥25 kg/m 2) gastric cancer patients after radical resection.