Objective To study the chemical constituents from the roots of Gypsophila pacifica. Methods The chemical constituents were isolated by various column chromatographic methods and their structures were identified by spectral data together with physicochemical analysis. Results Five compounds were isolated and identified as 3-O-β-D-galactopyranosyl-(1→2)-[β-D-xylopyranosyl-(1→3)]-β-D-glucuronopyranosyl gypsogenin 28-O-β-D-xylopyranosyl-(1→4)-α-L-rhamnopyranosyl-(1→2)-β-D-fucopyranoside (1), 3-O-β-D-galactopyranosyl-(1→2)-[β-D-xylopyranosyl-(1→3)]-β-D-glucuronopyranosyl quillaic acid 28-O-β-D-xylopyranosyl-(1→4)-α-L-rhamnopyranosyl-(1→2)-β-D-fucopyranoside (2), 3-O-β-D-galactopyranosyl-( 1→ 2 )-[β-D-xylopyranosyl-( 1→ 3 ) ]-β- D-glucuronopyranosyl gypsogenin 28-O-β-D-glucopyranosyl-( 1→ 3 )-[β-D-xylopyranosyl-( 1→4 ) ]-α-L-rhamnop yranosyl-( 1 → 2 )-β-D-fucopyranoside (3),3-O-β-D-galactopyranosyl-(1→2)-[β-D-xylopyranosyl-(1→3)]-β-D-glucuronopyranosyl quillaic acid 28-O-β-D-glucopyranosyl-( 1→ 3 )-[β-D-xylopyranosyl-( 1→4 ) ]-α-L-rhamnopyranosyl-( 1→2 )-β-D-fucopyranoside ( 4), 3-O-β-D-galactopyranosyl-(1→2)-[β-D-xylopyranosyl-(1→3)]-β-D-glucuronopyranosyl quillaic acid 28-O-α-L-arabinopyranosyl-(1→4)-α-L-arabinopyranosyl-(1→3)-β-D-xylopyranosyl-(1→4)-α-L-rhamnopyranosyl-(1→2)-β-D-fucopyranoside (5). Conclusion The five compounds are isolated from this plant for the first time.

[Objective]To study the surgical treatment of thoracolumbar fractures in multiple injured patients.[Method]Data from 12 consecutive patients with thoracolumbar fractures and multiple trauma were reviewed retrospectively.Three patients with thoracolumber fractures were complicated by pelvic(acetabular) fracture,11 by lower extremity fracture and 6 by upper extremity fracture.All the patients were treated operatively.The spinal injury and pelvic fractures were first treated.The operation time,bleeding volume as well as Frankle score were recorded.[Result]The average operation time was(202?52)min and the blood loss was(500?325)ml per patient,and the average operation time was 59 min and blood loss was 146 ml for an injury.The average Frankle score increased from 2.8 preoperatirely to 3.5 at 3 months after operation.Bone reunion or fusion was achieved in 8 patients at a one-year follow-up.[Conclusion]Damage control orthopedics should be emphasized for severe polytrama.The operation timing and techniques depend on the characteristics of fractures and the general conditions of the patients.Minimally invasive technique is useful in reducing the operation time and injury reaction,promoting early mobilization and lessening complications.

Objective To investigate the correlation between cerebral microbleed (CMB) and hemorrhage transformation (HT) after urokinase intra-arterial thrombolysis in patients with acute ischemic stroke.Methods The patients with acute cerebral infarction treated with intra-arterial urokinase were enrolled.They were divided into either an HT group or a non-HT goup according to whether they had HT or not.Conventional MRI sequences,susceptibility-weighted imaging (SWI),and CT scan were performed before procedure.CT or MRI was reexamined within 48 hours after procedure.The patients' demographic data,vascular risk factors,and the SWI sequences showed the numbers of CMB were documented in detail and they were compared and analyzed.Results A total of 62 patients were included,22 in HT group and 40 in non-HT group.Univariate analysis showed that the proportions of hypertension (81.8％ vs.57.5％ ; x2 =3.125,P =0.048),diabetes (63.6％ vs.40.0％ ; x2 =4.019,P =0.042),smoking (72.7％ vs.37.5％ ; x2 =4.971,P =0.030),and presence of CMB (x2 =5.297,P =0.018) of patients in the HT group were significantly higher than those in the non-HT group.Multivariate logistic regression analysis showed that hypertension (odds ratio [OR]1.51,95％ confidence interval [CI]1.102-2.954; P =0.028),diabetes (OR 1.48,95％ CI 1.09-2.825; P =0.039),and CMB (OR 1.867,95％ CI 1.103-3.158; P =0.020) were the independent risk factors for HT after urokinase intra-arterial thrombolysis in patients with acute ischemic stroke.Conclusions CMB was one of the independent risk factors for occurring HT after urokinase intra-arterial thrombolysis in patients with acute ischemic stroke.

Herba Epimedii (named Yinyanghuo in Chinese) of the family Berberidaceae is one of the most famous traditional Chinese medicines (TCMs) recorded in the pharmacopoeia of the People's Republic of China.Total flavonoids of Epimedium (TFE) are considered to be its active components.TFE content was measured by ultraviolet method and its representative constituents,icariin and epimedin C,were determined by high performance liquid chromatography.The test results from 36 samples of 4 species showed that the contents differed significantly in different species.The average data of the summation (icariin and epimedin C) content were 20.83,7.61,14.43,23.29 mg/g in Epimedium pubescens Maxim.,E.koreanum Nakai.,E.brevicornum Maxim.,E.sagittatum (Sieb.Et Zucc.) Maxim.,respectively.Both E.sagittatum and E.pubescens performed better than the other two batches.E.sagittatum hardly has any circulation in Chinese herbal medicine market.The results showed that E.pubescens,which had much more amounts of icariin,epimedin C and TFE than those of other species,has a better quality and may be considered as potential anti-osteoporosis drug.

Objective To study DSA characteristics of traumatic renal hemorrhage and to discuss the methods for treatment of this disease.Methods Superselective renal arterial angiography was carried in 14 patients with traumatic renal hematuria from 2001~2007.11 cases were iatrogenic renal damage and 3 cases were renal trauma.6 of them were under unstable hemodynamic conditions.Results The bleeding was found in 7 cases,located at the interlobar artery,the branch of segmental artery of the kidney,and the proximal end of arcuate artery.They presented as renal arterial-pelvic fistula(4 cases),arterial venous fistula(1 case) and renal arterial-pelvic fistula with AV fistula(2 cases),2 of them accompanied with pseudoaneurysm.The characteristics on DSA were radiopaque contrast medium overflow rapidly and abundantly,and the lesions were far from peripheral area of kidney,in the other 7 patients,the bleeing arteriae were located at the distal end of arcuate artery and the smaller branches of interlobular artery.The radiopaque material remained in parenchyma of kidney until parenchymal phase.There were no obvious artery-vein fistula or renal arterial-pelvic fistula in all cases.Conclusion DSA examination is very helpful in diagnosis and treatment of traumatic renal hemorrhage.

Objective To evaluate the preventive effect of auricular therapy in schizophrenia pa-tients with constipation. Methods 200 psychotic inpatients with anti-psychotic medication were random-ly divided into the intervention group and the control group with 100 cases in each group. The intervention group received conventional therapy combined with auricular therapy while the control group adopted only conventional therapy. The incidence of constipation was observed in the two groups. Results The rate of constipation was 11.34% and 36.73% in the intervention group and the control group, respectively. Auricu-lar therapy showed various effect in constipation caused by different drugs, especially for constipation caused by clozapine, chlorpromazine and pentiapine. Conclusions Auricular therapy showed good effect in preventing constipation induced by antipsychotic drags with less pain and adverse effect, easy and safe to operate, besides, it can improve the medication compliance of patients and promote their rehabilitation.

OBJECTIVETo study on the chemical constituents of effective part of Semen Ziziphi Spinosae.

METHODThe sample was extracted with methanol and purified by macroporous resin. The structures were identified by high performance liquid chromatography/electrospray ionization with multi-stage tandem mass spectrometry.

RESULTThirteen compounds were identified from the effective part of Semen Ziziphi Spinosae.

CONCLUSIONThe method is simple and rapid for the identification of the flavonoids and triterpenoid saponins from Semen Ziziphi Spinosae.

Chromatography, High Pressure Liquid ; methods ; Drugs, Chinese Herbal ; chemistry ; Flavonoids ; chemistry ; Saponins ; chemistry ; Semen ; chemistry ; Spectrometry, Mass, Electrospray Ionization ; methods

Objective:To explore whether the phospholipidoproteinaceous material deposit within the alveoli by a high-ifeld 3T MRI has signal characters and its application for diagnosing pulmonary alveolar proteinosis.Methods:A total of 11 patients with pulmonary alveolar proteinosis previously diagnosed by ifberoptic bronchoscope lung biopsy underwent 64-slice helical CT scans and 3T MRI scans, and the CT scans and the MRI scans were compared.
Results:hTe phospholipidoproteinaceous material deposit within the alveoli presented longer or equal T1 relaxation time and longer T2 relaxation time, without characters of fatty or deposits of protein-like substance signals and enhancement. The distribution, form, number and size of the lesions at T2WI were almost the same as those at CT, the lesions were irregular in morphology, and there was a clear boundary between the lesions and the adjacent normal lung tissues. Dynamic contrast-enhanced MRI showed thickened pulmonary arteriolae and venulae in the lesions with more obviously thickened pulmonary venulae, which were in conformity with the pulmonary artery and venule enhancement. CT scan in 1 out of the 11 cases showed lesions in both lungs mainly consisted of stripe-shaped and reticular structures, and no obvious sign of pulmonary alveolar proteinosis residue was found. MRI scan detected alveolar proteinosis that failed to be shown by CT scan.
Conclusion:3T MRI T2WI can easily detect the lesions of long T2 signals formed by the lipoproteinaceous material deposit within the alveoli. In the lesions, geographic appearance was presented, and the crazy paving pattern was dimly visualized. MRI can relfect the morphological characters of PAP like CT and it is slightly better compared with CT in such aspects as evaluating the theraputic effect of lung lavage. As supplement to CT, high-field 3T MRI can serve as an important examination for lung diseases.

OBJECTIVE: To evaluate the diagnostic value and limits of transbronchial lung biopsy (TBLB) in pulmonary alveolar proteinosis (PAP). METHODS: The complete hospital data from Second Xiangya Hospital, Central South University, between June, 2006 and December, 2012, were analyzed retrospectively in 25 patients with PAP (who were diagnosed pathologically by TBLB or not by TBLB) and in 4 patients with other disease (who were misdiagnosed by TBLB). RESULTS: Among the 25 patients with PAP, 14 patients were confirmed by TBLB in the fi rst time [TBLB positive rate in the first time was 56% (14/25)]; 6 patients who were misdiagnosed by TBLB in the fi rst time were confirmed by TBLB in the second time [the positive rate in the second time was 24% (6/25)]. Th e total positive rate was 80% (20/25). Th e total negative rate was 20% (5/25). Five patients with PAP, who showed negative results in TBLB analysis, were confirmed by the typical CT as well as the whole lung lavage. In addition, 4 patients with other diseases were misdiagnosed as PAP by TBLB. CONCLUSION TBLB is a very good diagnosis method. But the negative results in the first time cannot exclude PAP. TBLB should be repeated if conditions allow. If clinical manifestation and CT results are typical, it can be used for diagnosis of PAP combined with the positive results from bronchoalveolar lavage fluid check. However, for non-typical cases, it needs TBLB pathological diagnosis.
Biopsy ; Diagnostic Errors ; Humans ; Lung ; pathology ; Pulmonary Alveolar Proteinosis ; diagnosis ; pathology ; Retrospective Studies

OBJECTIVE: To explore CT findings and pathologic basis of crazy paving pattern caused by pulmonary alveolar proteinosis. METHODS: Twenty-four patients who were diagnosed pathologically as pulmonary alveolar proteinosis by transbronchial lung biopsy and bronchoalveolar lavage fluid from June 2006 to May 2012 were included in this retrospective study. All patients underwent a 64-slice CT of the lungs. RESULTS: CT findings: crazy paving pattern was observed on CT imaging of all 24 patients. In 23 patients, crazy paving pattern displayed strip-shaped opacities with smooth edges, and there was a clear boundary between the pathological and normal lung tissues. The reticular opacities were connected with peripheral blood vessels and the branches were formed, and their diameters decreased slightly. Microscopically, hemangiectasis were seen in 17 patients. CONCLUSION Crazy paving pattern caused by pulmonary alveolar proteinosis displayed clear edges, and smooth reticular opacities, most of which were due to hemangiectasis of interlobular, interacinar and interalveolar septa. These findings of CT are helpful for the specific diagnosis of pulmonary alveolar proteinosis.
Biopsy ; Humans ; Lung ; pathology ; Pulmonary Alveolar Proteinosis ; pathology ; Retrospective Studies ; Tomography, X-Ray Computed