OBJECTIVE:To study the chemical constituents of the flower of Zang Epipremnum aureum. METHODS:The con-stituents of ethyl acetate extract of the flower of E. aureum were separated and purified with varied chromatographic techniques, and the structures were identified based on spectral data and chemical properties. RESULTS:Ten compounds were isolated from eth-yl acetate extract of the flower of E. aureum,they were identified as rutamontine(1),edgeworoside C(2),edgeworin(3),tiliro-side (4),helichrysoside (5),kaempferol (6),2,4-dihydroxypheny-2-hydroxy-4-metho-xybenzyl-ketone (7),ethyl caffeate (8), phthalic acid bis-(2-ethyl-hexyl) ester (9) and noreugenin (10). CONCLUSIONS:Compound 7 is firstly isolated from natural source,compounds 5,8 and 9 is firstly isolated from the family Thymelaeaceae,compound 6 is firstly isolated from Edgeworthia and compound 2 and 10 are firstly isolated from the flowers of E. aureum. The study lays certain foundation for the quality evalua-tion of E. aureum.

Objective To discuss the clinical effect of artificial pneumothorax combined with intercostal nerve block in alleviating chest pain occurring during and after percutaneous microwave ablation (MWA) for subpleural lung malignancy.Methods A total of 30 patients with subpleural lung malignancy were randomly and equally divided into group A (n=10),group B (n=10) and group C (n=10).The patients in group A received both artificial pneumothorax and intercostal nerve block before MWA.The patients in group B only received artificial pneumothorax before MWA,and the patients in group C only received intercostal nerve block before MWA.The degree of pain was evaluated by visual analogue scale (VAS) score during MWA,immediately after MWA and at 6 h,12 h and 24 h after WMA.The side effects after MWA were recorded.Results During MWA,no statistically significant differences in VAS scores existed between each other among the three groups (P=0.885).The VAS scores determined at 6 h,12 h and 24 h after MWA in group C were significantly increased (P=0.014,P=0.006 and P=0.006 respectively).No patient in group A and group B developed symptoms of chest tightness after artificial pneumothorax was performed.After treatment,a small amount of asymptomatic residual pneumothorax was still observed in 6 patients of group A and group B,which disappeared spontaneously in about one week.Another patient still showed massive pneumothorax even after thoracic gas suction,and the patient recovered after thoracic closed drainage for three days.No other serious complications related to artificial pneumothorax occurred.Conclusion Artificial pneumothorax combined with intercostal nerve block can effectively relieve the chest pain occurring during and after MWA in patients with subpleural lung malignancy,and clinically this technique is quite safe.(J Intervent Radiol,2017,26:269-273)

Objective To investigate the mechanism of Smad ubiquitination-related factor 2 (Smurf2)neddylation. Methods The Smurf2 protein level was tested by overexpression of Nedd8,while the method of immunoprecipitation(IP) and Western blotting were used to analyz Smurf2-Nedd8 modification.The GST-pulldown experiment was conducted to prove protein interactions.The protein was obtained by grinding mouse tissue and Western blotting was used to test the protein expression level.Results Over expression of Nedd8 could lead to the down regulation of the Smurf2′s protein level.Smurf1 and Smurf2 could interact in the GST-pulldown experiment. Smurf1 could enhance Smurf2-Nedd8 modification.The Smurf2′s protein level was up-regulated in mouse tissue of Smurf1 C426A.Conclusion There is some relationship and also difference between Smurf1 and Smurf2.Smurf1 can enhance Smurf2-Nedd8 modification.

Objective: To summarize the short-term clinical experience of minimally invasive direct cardiac surgery (MIDCS) with right anterolateral thoracotomy incision by closed cardiopulmonary bypass. Methods: A total of 42 patients received MIDCS in our hospital from 2013-09 to 2015-05 were summarized. There were 18 male and 24 female patients including 16 with atrial septal defect (ASD) repair, 4 with ventricular septal defect (VSD) repair, 16 with mitral valve replacement (MVR), 1 with mitral valve plasty (MVP) and 5 with aortic valve replacement (AVR). Direct cardiac surgery was performed by cardiopulmonary bypass through femoral artery-vein and right jugular vein annulations. A right anterolateral thoracotomy incision (length 3-5 cm) was made to enter the chest and complete the operation. Results: All 42 patients received successful operation, no peri-operative or early post-operative death, no incision infection occurred. Cardiopulmonary bypass time was [98-142 (122.4 ± 23.7) min], aortic cross-clamp time [0-118 (48.3 ± 26.2) min]. Post-operative mechanical ventilation time was [8-76 (17.4±13.1) h], intensive care unit stay time [45-124, (54.6 ± 32.6) h], hospital stay time [6-12, (8.2 ± 1.3) d]. Incision length was [3-7, (4.8 ± 1.5) cm], the draining volume at the 1st post-operative day was (356.9 ± 283.8) ml and there were 27 (64.3%) patients without transfusion. Conclusion: The short-term outcomes for MIDCS were good, it with superior safety, broad application range with minimal invasion and less complication.

Serum tartrate-resistant acid phosphatase-5b (TRAP-5b) is a marker reflecting bone absorption. The results showed that serum TRAP-5b level was higher in postmenopausal than that in premenopausal normal women (P

AIM:To observe the effect of Wnt/β-catenin signaling pathway on diabetic ulcer.METHODS:Diabetic animal model was established in the female Wistar rats by intraperitoneal injection of low-dose streptozotocin fol-lowing high-fat diet feeding.A circular wound was made on the dorsum of the rats in both control group and diabetic group. The condition of wound healing was recorded and the structures of the wound tissues were observed by HE staining in the 2 groups at 3, 7 and 14 d after wounding.The expression ofβ-catenin, GSK-3βand Rspo-3 at mRNA and protein levels in the wound tissues was detected by RT-PCR and ELISA.RESULTS:In diabetic group, the wound healing rate was lower (P<0.05), and the inflammatory cells, fibroblast cells and new capillaries in the wound tissues were fewer than those in control group.The expression of β-catenin and Rspo-3 at mRNA and protein levels in the wound tissues in control group was significantly higher than those in diabetic group, and the expression of GSK-3βwas exactly the opposite (P<0.05). CONCLUSION:The down-regulation of Wnt/β-catenin probably resultes from the decreased level of Rspo-3, which may be one of the reasons for delaying the diabetic ulcer healing.

Objective To explore the clinical value of early diagnosis of atherosclerosis in patients with systemic lupus erythematosus (SLE) using vascular echo-tracking technique and to detect changes of elastieity of carotid artery quantitatively in SLE patients.Methods Fifry patients with SLE were divided into SLE1 group(duration≤1 year),and SLE2 group(duration>1 year)based on different course.An ultrasonic echo-tracking method was used to measure patients'pressure strain elastic modulus (Ep),the stiffness constant(β),arterial compliance(AC),augmentation index(AI),pulse wave velocity (PWVβ) and intimamedia thickness(IMT)of the common carotid arteries in 50 patients with SLE and in 25 healthy control subjects.Results Among carotid artery elasticity indicators of three groups,there was no significant difference in AI(P>0.05).Ep,β,PWVβ parameters of SLE1 group and SLE2 group were statistically higher than that of the control group[Ep of SLE1 group,SLE2 group,control group was (69±20),(103±40),(48±18)kPa respectively;β was 5.2±1.9,8.0±3.1,4.2±1.3 respectively;PWVβ was 5.2±0.7,6.3±1.1,4.5±0.7]respectively,but AC(AC of SLE1 group,SLE2 group,control group was(1.1±0.3),(0.8±0.3),(1.2±0.6)mm2/k respectively]lower than the controls(P<0.01).Ep,β,PWVβ in SLE2 group was significantly increased compared with SLE1 group,but AC was decreased (P<0.01).Conclusion The application of echo-tracking technology can be used to diagnose early atherosclerosis.Complications of cardiovascular disease in SLE have high clinical value.

Objective To evaluate the predictive value of brain natriuretic peptide (BNP) on mortality in elderly patient with severe sepsis or septic shock. Method Eighty-three elderly patients meeting with criteria of severe sepsis or septic shock by the American College of Chest Physicians and the Society of Critical Care Medicine (ACCP/SCCM) in 2001, admitted in Intensive Care Unit (ICU) of Zhejiang Hospital during May 2004 to June 2007, were enrolled, and patients with chronic renal failure were excluded. The patients were divided into survivor and non - survivor group according to whether they survived within 28 days staying in ICU, the difference of plasma BNP level,serum C-creative protein (CRP) concentration, APACHE II and SOFA scores on admission day and BNP level on the third day between the two groups were compared; thereafter, the relationship between muhiple variables including age, admission day, BNP, CRP, APACHE 11 and SOFA scores, the 3rd day BNP level and 28-day mortality were analyzed by Logistic regression, and meanwhile the independent predictors for ICU moaality among which were determined. Results BNP levels on both admission day and the 3rd day were significantly higher in nomurvivor group than those in survivor group[ ( 1056.38±676.34) pg/ml vs. (611.59±610.02) pg/ml,p =0.002 and (1448.48+891.11) pg/ml vs. (522.41±575.20) pg/ml, P<0.001, respectively]. By Logistic regression analysis, BNP level on the 3rd day and SOFA score on admission day were independent predictors of ICU mortality, The receiver operating characteristic (ROC) curves indicated that values of areas under the curve of the admission day and the 3rd day BNP levels for 28-days mortality were 0.735 (95% CI,0. 621～0. 848, P <0.001) andO.836 (95% CI, 0.746～0,926,P<0.001), respectively. Conclusions Plasma BNP inereaseds in majority of eldedy patients with severe sepsis or septic shock, which may serve as irdex for prognosis in elderly severe septic paients.

Objective To deplore the immunoregulatory function changes of mesenchymal stem cells(MSCs)from multiple myeloma(MM)patients and its effects on the pathogenesis of myeloma bone disease.Methods MSCs from MM patients and normal controls were isolated and the immunophenotype was detected.Real-time PCR was performed to detect the expressions of TGF-β1,TGF-β2,TGF-β3,IL-6,IL3,TNF-α,FasL and RANKL of MSCs.Transwell coculture systems were performed between MSCs and T cells.Lymphocyte proliferative assay was employed to detect the effect of MSCs on T cell proliferation.The effect of MSCs on T cell cycle and T cell activation markers CD25 and CD69 expression were analyzed by flow cytometry.Cleaved caspase 3 protein by western blot and hoechst 33258 staining were employed to detect the apotosis of T cells.Influence of T cells on the osteogenesis potential of MSCs were detected by Von kossa stain,real-time PCR and Western blot.Results MSCs from both MM patients and normal controls possessed similar morphology and immunophenotypes.MM derived MSCs exhibited increased expressions of TGF-β1,IL-6,IL-3,TNF-α and RANKL and decreased expression of TGF-β2,TGF-β3 and FasL.The inhibitory effect of MM derived MSCs on T cell proliferative ability was attenuated compared to control MSCs.MSCs from normal controls silence more T cells in Go/G1 phase than those from MM patients.The daupening effect of MM derived MSCs on activation-induced T apoptosis seemed to be enhanced.Expression of T cell activation markers were significantly inhibited by MSCs from normal controls.Both T cells cocultured with MM deprived MSCs and T cells directly from MM patients inhibited osteogenesis potential of MSCs from normal controls.Conclusion MSCs from MM patients showed impaired immunoregulatory capability on T cells.The activated T cells,in turn,inhibited the osteogenesis potential of MSCs.This may participate in the pathogenesis of myeloma bone disease.

Objective To analyze the reliability and reproducibility of three different classification systems of Tile,Young Burgess and AO in pelvic fracture.Methods One hundred cases of pelvic fractures conforming to the inclusion standard and with intact imaging data were selected and classified according to these 3 classification methods by the orthopedic surgeons.The retyping was performed at 8 weeks after disorganizing the order.Then reliability and reproducibility analysis was performed by using the Kappa values and typing consistency.Results The reliability Kappa values during the two periods before and after the Tile classification were 0.743 and 0.745 respectively,and the reproducibility Kappa value was 0.771;the reliability Kappa values during the two periods before and after the Young-Burgess classification were 0.587 and 0.590 respectively,and the reproducibility Kappa value was 0.691;the reliability of Kappa values during the two periods before and after the OA classification were 0.402 and 0.406 respectively,and the reproducibility Kappa value was 0.498.Conclusion the Tile classification has better reliability and reproducibility than the other two classifications in pelvic fracture,which is easy to master and apply.