Object To isolate and identify the chemical constituents of Saussurea japonica (Thunb.) DC. and to obtain some rules of chemical shift effects on hydroxylation and O-glycosylation. Methods The constituents were isolated by silica gel column chromatography and HPLC (RP-18), and their structures were elucidated through spectroscopic analysis (NMR and FABMS). The rules were obtained by comparison with those of known analogous lignans. Results Three lignan glycosides were isolated and identifiedcas (+)-1-hydroxypinoresinol-4″-?-D-glucopyranoside (Ⅵ), (+)-lariciresinol-4-?-D-glucopyranoside (Ⅷ), and (+)-1-lariciresinol-4′-?-D-glucopyranoside (Ⅸ), as well as the rules for effects of the hydroxy group at C-1 (upshift about ??-4.2) and O-glucosylation (downshift about ??+3.0) on 13CNMR chemical shifts of (+)-pinoresinol and (+)-lariciresinol. Conclusion All these compounds were obtained from the plants of Saussurea DC. for the first time and the rules should be as some important evidences to assign the position of hydroxylation and glycosylation.

rate being 86. 0% cured rate being 60. 0%, remarked-ly higher .than that of the western medication group.100 cases of such patients were randomly divided into 2 groups, each 50 cases. The treating group was treated with spleen-strengthening and damp-removing recipes and medicaments. The cllinical effective

Objective To explore the changes of plasma catecholamines(CA)[including epinephrine(E) and norepinephrine(NE)] and atrial natriuretic peptide(ANP) in children with varying degrees of left ventricular ejection function(LVEF) in chronic heart failure(CHF),and establish natriuretic hormone factors as one of the diagnostic criteria of CHF.Methods Thirty-five patients with CHF and 35 children in good health were enrolled,and the concentration of plasma NE,E,ANP and the LVEF were determined.Results 1.The levels of plasma NE,E and ANP in 35 patients with CHF before treatment were significantly higher than those in control group(Pa

Objective To review the diagnosis and treatment of adrenal myelolipoma(ML).Methods The medical records of 21 patients with adrenal myelolipoma were reviewed.All patients were examined by B-ultrasound,CT and endocrine tests while some were also examined by MRI and 131I-MIBG.Results All patients had undergone resection of adrenal ML.The mean diameter of tumors was 6.7 cm(4.5 cm～12 cm).Pathological examination of all tumors confirmed the diagnosis of adrenal ML.No recurrence was recorded during the follow-up period(1～15years).Conclusion Adrenal ML is a kind of rare,benign tumor and is often incidentally discovered.Its prognosis is generally good.

Common Bile Duct ; surgery ; Gallstones ; surgery ; Humans ; Laparoscopy ; methods ; trends

BACKGROUND: Cryotherapy of acute soft tissue injury has been widely used in clinical practice.OBJECTIVE: To observe the histological changes and treatment effect of different cryotherapies on the rats' acute damage of soft tissue. METHODS: Neonatal Wistar rats were randomized to normal, model, intermittent cryotherapy and continuous cryotherapy groups. Models of acute damage of soft tissue were established in model, intermittent cryotherapy and continuous cryotherapy groups. In intermittent cryotherapy group, the injury was treated by intermittent cryotherapy with ice bag at 4 °C; in the continuous cryotherapy group, the injury was treated by continuous cryotherapy with ice bag at 4 °C; the model group was not treated. Histological changes were observed at 48 hours. Injury degree was evaluated using injury symptom index.RESULTS AND CONCLUSION: Compared with model group, the scores of injury symptom index and histology were lower, interleukin-1β expression was reduced, and transforming growth factor-β1 (TGF-β1) expression was increased in intermittent cryotherapy and continuous cryotherapy groups (P < 0.05). Compared with intermittent cryotherapy group, the scores of injury symptom index and histology were reduced (P < 0.05), interleukin-1β expression was reduced (P < 0.05), and TGF-β1 expression was increased in continuous cryotherapy group (P < 0.05). Results demonstrated that cryotherapy can cure the acute damage of soft tissue by reducing interleukin-1β expression and raising TGF-β1 expression. Continuous cryotherapy is superior over intermittent cryotherapy.

Emergency departments of hospitals are exposed to risks of patient complaints and disputes, and the emergency department of a stomatology hospital is no exception. Medical disputes at the emergency department of Peking University Stomatology Hospital, as registered at the department of medical affairs of the hospital in the past ten years, are analyzed with statistical processing. The results are used in studying characteristics of medical disputes frequently found in stomatology emergency cases, for references and recommendations on prevention and avoidance of such disputes in future.

Objective To discuss the opportunity of hemilateral craniotomy in treatment of a large area combined middle cerebral artery (MCA) infarction.Methods Thirty-two patients with a large area combined MCA infarction were performed by hemilateral craniotomy.Initial clinical presentation was evaluated by the Glasgow coma scale(GCS).All survivors were assessed three months after surgical decompression according to Barthel index(BI).The effects of pre-hemia decompressive surgery(before any signs of cerebral hernia,based on clinical status and CT or DWI findings)versus post-hernia surgery (after signs of hernia) on mortality,functional outcome.Results In 18 patients with pre-hernia decompressive surgery,3 patients (16.7%)were dead and average BI was (66.94±7.75)scores.The mortality was 57.1%(8/14)and average BI was (38.43±9.82)scores of post-hernia surgery with 3 cases severe aphasia.Conclusion Hemilateral craniotamy is performed before occurrence of cerebral hernia may decrease the mortality and improve outcome in these patients.

Objective To determine the occurrence and baseline predictive factors of early neurological deterioration ( END) among mild ischemic stroke patients.Methods Mild ischemic stroke patients admitted in the hospital were prospectively enrolled.Univariate and multivariate Logistic recession analyses were used to analyze the demographic data, risk factors of ischemic stroke, clinical, brain imaging and laboratory data.Risk factors of END were identified.Results From June 2012 to August 2013, a total of 319 patients with mild ischemic stroke were enrolled, 45 patients (14.1%) of them experienced END.Univariate analysis showed that baseline NIHSS ( U=3522.000,P=0.000), baseline systolic blood pressure (t=2.871,P=0.004), proportion of symptomatic large artery severe stenosis or occlusion (χ2 =52.564,P=0.000) and proportion of large artery atherosclerosis among TOAST subtypes (χ2 =47.287,P=0.000) in END group were significantly higher than those in non-END group. Multivariate logistic regression analysis showed that baseline systolic blood pressure>142 mmHg (1 mmHg=0.133 kPa) (OR=3.954, 95%CI:1.693-9.236, P=0.001), symptomatic large artery severe stenosis or occlusion (OR=3.170, 95%CI:1.170-8.583, P=0.023) and baseline NIHSS (OR=2.038, 95%CI:1.359-3.057, P=0.001) were associated with END.Conclusions About 14.1% of the mild ischemic stroke patients can occur END.Baseline systolic blood pressure>142 mmHg, symptomatic large artery severe stenosis or occlusion and higher baseline NIHSS were the independent risk factors of END.

Objective To summarize the experiences got from perioperative management for intravital liver transplantation. Methods Of 30 cases of intravital liver transplantation, executed from June 2006 to December 2007 in the General Hospital of PLA, the data of perioperative management were retrospectively analyzed. Among the recipients, 26 received right hepatic lobe including middle hepatic vein (MHV), 2 received right hepatic lobe without MHV, 1 received complementary liver transplantation with MHV in left half liver, and the remained one received right hepatic lobe plus left external lobe including MHV. The primary diseases in the recipients included serious chronic hepatitis (8 cases), primary hepatocarcinoma (9 cases), fulminant hepatic failure (5 cases), final-stage cirrhosis (5 cases), and one each of liver purpura, liver angiosarcoma and Kinnier-Wilson syndrome. On Child-Pugh status, 5 cases in grade A, 9 in grade B and 16 in grade C. The score on the model for end-stage of liver disease (MEHD) was 27.7 (6.8-45.6). The total and right half liver volumes of donors were evaluated by conventional 3-D CT, and well-provided preoperative evaluation was done to both donors and recipients. Results For donors the average length of stay was 11 days (9-15) and average blood loss was 341 ml (160-1200ml), only one donor suffered from intra-operative blood loss of 1200 ml and then received 600 ml of concentrated erythrocytes. No severe complications were found in donors, and all of them recovered finally. The complications occurred in 5 recipients (16.7%), including bile leakage (2 cases), pulmonary infection (2 cases) and one case of diffusive Aspergillus infection. The survival rate of recipients was 90% (27/30), 2 recipients died from severe pulmonary infection and 1 from diffusive Aspergillus infection. Conclusion Sufficient pre-operative assessment for both donors and recipients and exquisite technology are the keys for a successful liver transplantation, and well-provided perioperative managements are also requirements.