Four diterpenoid alkaloids were isolated from Aeonitum longtounens T. L. Ming grown in Lijiang of Yunnan Province, for the first time. They were identified as foresaconitine, chasmaconitine, delsoline and delcosine by Physical contants and spectral data.

Objective To explore the feasibility and operation technique of endoscopic thyroid surgery. Methods A retrospective analysis was made on the clinical data of 42 patients with various thyroid diseases who were treated by endoscopic thyroidectomy.Results 41 cases were successful,1 case was converted to open operation because of operative bleeding. One case had a small area of ecchymosis in the presternal skin postoperatively, and 1 with hoarseness that recovered 3d after operation.No case of parathyroid injury or subcutaneous emphysema.The anterior cervical drain was removed 24h after operation, and patients were discharged 5d after operation.Conclusions With adherence to the indications of endoscopic thyroidectomy and operating with fine technique , endoscopic thyroidectomy is safe for the treatment of patients with thyroid disease and has a more favorable cosmetic effect.

Objective To validate the technique and establish the reference jitter values in voluntarily activated extensor digitorum communis using a concentric needle electrode (CNE) in healthy Chinese adults.Methods From January to August 2013,forty-two Chinese subjects from healthy examination center of our hospital were prospectively studied,including 20 males and 22 females.Routine electromyogram was tested and jitter was recorded with CNE in all subjects.The jitter values of action potentials pairs of muscle fibers were expressed as the mean consecutive difference (MCD) after 20 analyzed potential pairs.Results The mean MCD of 42 subjects was (23.0 ± 3.1) μs ranging from 17 to 32 μs.The mean jitter value of all 840 potential pairs was (22.8 ± 7.5) μs ranging from 8 to 54 μs.Upper 95％ confidence limits for mean MCD and individual MCD were 29.2 μs and 37.8 μs,respectively.The mean value of MCD of 20 males and 22 females were (23.2 ± 2.8) μs and (22.8 ± 3.4) μs,respectively.There was no statistic difference between genders in MCD (t =0.44,P =0.66).There was no correlation between age and MCD (r =0.11,P =0.48).The mean value of mean interpotential interval was (802 ± 139) μs ranging from 541 to 1 160 μs.Conclusion The present study confirms the suitability of jitter analysis with CNE,which can serve as an objective and valuable method for testing the function of neuromuscular conjunctions.

BACKGROUND:Hypoxic death limits application of cells in transplantation and tissue regeneration.
OBJECTIVE:To investigate the protective effects of mangiferin on bone marrow-derived mesenchymal stem cells against hypoxia injury-induced apoptosis resulted from cobalt chloride.
METHODS:Rat bone marrow-derived mesenchymal stem cells were in vitro cultured and hypoxia cellmodel was established by cobalt chloride. Model cells were treated with mangiferin. Protective effects of mangiferin were detected using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide;cellapoptosis and mitochondrial membrane potential were detected using flow cytometry.
RESULTS AND CONCLUSION:Cobalt chloride significantly inhibited growth of bone marrow-derived mesenchymal stem cells in a dose-dependent manner. The apoptosis rate of cells was (42.49±3.96)%after treated with 200μmol/L cobalt chloride for 12 hours, (46.37±4.49)%after treated for 24 hours. With increasing concentration of mangiferin, apoptosis of bone marrow-derived mesenchymal stem cells in hypoxic model was gradual y reduced (P<0.01), indicating that mangiferin has a protective effect in a concentration-dependent manner on rat bone marrow-derived mesenchymal stem cells in hypoxic injury. Cobalt chloride can induce hypoxic model successful y in bone marrow-derived mesenchymal stem cells. There are some advantages of accurate dose control, no special equipment requirements, and easy operation. Mangiferin can effectively inhibit bone marrow-derived mesenchymal stem cells apoptosis under hypoxic injury.

ObjectiveTo define the high intraarterial signals on conventional MRI. Methods Review the conventional MRI data in all of the acute ischemic stroke patients in the First Affiliated Hospital,School of Medicine, Zhejiang University from January 2010 to December 2010. ResultsIn year 2010,according to the diagnostic criteria of China, there were 280 cases of acute cerebral infarction, all underwent conventional MRI. Twenty six patients (9. 29％ ) showed high intraarterial signals on conventional MRI.There were 14 cases with high signals in the anterior circulation, including 11 cases in the carotid artery, 2 cases in the anterior cerebral artery, and 1 case in the middle cerebral artery combined with the anterior cerebral artery. In the 11 patients with high signals in the carotid artery, MRA confirmed 14 internal carotid arteries stenosis, with 100％ specificity and 78.6％ sensitivity. There were 12 cases with high signals in the posterior circulation, including 5 cases in the vertebral artery, 3 cases in the basilar artery, and 4 cases in the basilar artery with vertebral artery. One patient did not undergo MRA. MRA confirmed 14 arteries with stenosis, with 100％ specificity and 78.5％ sensitivity. ConclusionsIntravascular high signals showed by conventional MR sequences have high clinical specificity, and its vascular lesions are consistent with the results of MRA.

Objective To summarize the experience in the perioperative nursing of one-stage bilateral total hip arthroplaaty (THA) for the systemic lupus erythematosus (SLE) patients with avascular necrosis of the femoral head (ANFH).Methods From June 1998 to April 2007,17 cases of patients who were diagnosed as SLE with bilateral ANFH were treated by one-stage bilateral THA.Perioperative nursing included psychological support,diet control,observation and nursing of various complications,correct functional exercise and health education.Harris score and SF-36 score were evaluated before and after operation.Results There were 2 cases with delayed incision healing,1 with early prosthesis dislocation,1 with thigh pain for 10 months and 1 with acute renal failure postoperatively,which were improved and recovered after proper treatments.Asymptomatic deep vein thrombosis (DVT) in low extremities were detected by color Doppler ultrasonography in 6 cases.There were no pulmonary embolism and no deep infection around prosthesis.There was no Addisonian crisis postoperatively.The pain was relieved and the motion of joint was improved during follow-up.There was no radiological evidence of implant loosening.The Harris hip score and SF-36 score greatly alleviated after operation.All patients were followed up and the mean follow-up time was 28 months.Conclusions One-stage bilateral THA has good results for the patients with SLE and AVNH.Strengthening of perioperative nursing contributed to improvement of success rate of surgery and reduction of complication.

Objective: To explore the mechanisms of emodin in protecting intestinal mucosal barrier in rat with severe acute pancreatitis (SAP). Methods: Sixty SD rats were randomly divided into three groups: sham-operation group, untreated group, and emodin group. SAP in rats of the untreated group and the emodin group was induced by retrograde pumping of 3.0% sodium cholate to the common bile duct. Specimens were obtained 24 hours after the severe acute pancreatitis was induced. Serum level of leptin, serum activity of amylase and plasma content of endotoxin were measured. Ileum mucosa from ileocecal junction was observed by light microscopy and electron microscopy to measure pathological and ultrastructural changes. Apoptosis of ileum mucosal cells was detected by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling method, and expression of Bax in ileum mucosal cells was measured by immunohistochemical method. Results: Compared with the sham-operation group, there was significant increase in the levels of leptin, endotoxin, the activity of amylase, apoptosis index and Bax expression in the untreated group (P<0.01). Compared with the untreated group, the level of endotoxin, apoptotic index and Bax expression level in the emodin group were significantly reduced (P<0.01) and the leptin level was increased (P<0.05). More severe pathological changes appeared in the untreated group than in the sham-operation group under the light and electron microscopes; meanwhile less severe damage was observed in the emodin group as compared with the untreated group. Conclusion: Emodin can inhibit the apoptosis of intestinal mucosa cells and up-regulate the serum leptin content to protect the intestina1 barrier function and prevent the translocation of bacteria and endotoxin.

Objective To explore the characteristics of auditory brainstem response(ABR) in children with otitis media with effusion(OME) before and after myringotomy with grommet insertion and the significance of ABR in diagnosing OME.Methods ABR were recorded in 50 cases(100 ears) before receiving myringotomy with grommet insertion for OME,30 cases(60 ears) underwent ABR monitoring after surgery again.For comparison,50 age-matched healthy children(100 ears) were also tested with ABR.Furthermore,30 cases were divided into two groups according to the viscidity of tympanic cavity secretion and the response threshold of wave Ⅴ were compared between the two groups.Results The response threshold of wave Ⅴand the peak latency of wave Ⅰwere normal in 13 percent of 50 cases(100 ears) before surgery.The rate of missed diagnosis was 13%.Among 50 cases,41% had normal response threshold for wave Ⅴ,52% had slight abnormal responses of thresholds of wave Ⅴ and 7% had medium response threshold of wave Ⅴ.The peak latency of wavs Ⅰwas normal in 19% OME children,but it prolonged in 72% OME children and absent in 9% OME children.The prolonged peak latencies(waves Ⅰ,Ⅲ andⅤ) and eleveted response thresholds of wave Ⅴ and shorted transmission time between waves(Ⅰ-Ⅲ andⅠ-Ⅴ) significant when compared to the control group.After surgery,the response thresholds of wave Ⅴand the peak latency of wave Ⅰwere normal in 46.7% children,the response threshold of wave Ⅴ were normal in 70.5% and slight abnormal in 29.5%.Occuring(elicit) rate of wave Ⅰwas 100% and peak latency of wave Ⅰwas normal in 50.2% chilren.The differrence of peak latencies(waves Ⅰ,Ⅲ andⅤ) and the response threshold of wave Ⅴ before surgery

Objective To reconstruct the perfusion parameters of murine hindlimbs peripheral tissue by using fluorescence reflectance imaging technique. Methods BALB/c mice were injected with intravenous bolus injection of indocyanine green (ICG) (10μg) into the tail vein. Time-series fluorescence intensity images were obtained for 200 s immediately after the injection. After the serial imaging, silhouette images of the mice were taken under white light to obtain the region of interest (ROI) of the murine hindlimbs. Bi-exponential model was applied to analyze the dynamic fluorescence parameters and the peripheral tissue perfusion parameter images were reconstructed. Results The fitted perfusion curves obtained from bi-exponential model were in good agreement with the measured ones. The parametric images which reflected the vascular sufficiency of murine hindlimbs were reconstructed. Conclusions A novel method for parametric images of murine hindlimbs peripheral tissue blood perfusion is proposed in this paper, which is noninvasive with higher resolution and little damage to biological tissues.

Objective To explore the relationship between inflammatory cytokine expression and outcome of acute stroke.Methods Eighty six acute stroke patients and 80 health people were recruited as the case and control group respectively.Peripheral blood CD3 +, CD4 +, CD8 +T cells were analyzed with flow cytometry;IL-10, IL-6, IFN-γin peripheral blood and cerebrospinal fluid ( CSF) were detected with enzyme linked immunosorbent assay ( ELISA); Outcome of acute stroke patients were evaluated with Na-tional Institutes of Health Stroke Scale(NIHSS)scoring in the 5th day.Results Contrast with the controls, the expression of CD3 +, CD4 +and CD8 +in case group were decresed( P <0.01), IFN-γexpression in peripheral blood of cases (within the 24th hour) were lower( P <0.01).IL-10 expression were higher( P=0.001).IL-10 was down-regulation of expression( P <0.01)at the 5th day compared with the 24th hours in peripheral blood, but up-regulation in CFS( P <0.01), and IFN-γwas down-regulation of expression ( P <0.01) at the 5th day.Conclusions IL-10 and IFN-γexpression changes lead to disorder of immune balance and are harmful for progressive acute stroke patients, Monitoring the change of IL-10,IL-6 and IFN-γare helpful for diagnosis and prognosis of acute stroke.