Delivery of Health Care ; Government ; Humans ; Pneumoconiosis ; Social Values

Objective To discuss MSCT assessment of pulmonary arterial hypertension (PAH) in patients with IPF before lung transplantation.Methods Between Sep.2002 and Aug.2010,lung transplantation (LTX) was performed on 96 patients with end-stage lung disease.Thirty patients with IPF were found to have PAH,as defined by mean pulmonary artery pressure (mPAP) ≥25 mm Hg by cardiac catheterization.Fifteen control patients (mPAP ＜25 mm Hg) were also identified.The diameter of the principal pulmonary artery (PPA) and ratio of main pulmonary artery to aortic diameter (rPA) were assessed by MSCT.Results MSCT-determined PPA and rPA were (34.4 ±4.4) mm and 1.03 ± 0.09 in patients with PAH,and (25.3 ± 3.3) mm (P＜0.01) and 0.77 ± 0.12(P＜0.01) in controls.In our group of patients,PPA (28.5 mm) had a sensitivity of 86.7％ and specificity of 80％ for predicting PAH,and rPA 0.935 had a sensitivity of 96.7％ and specificity of 93.3％ for predicting PAH.There was a correlation between the degree of PAH and PPA (r =861,P ＜0.01 ),and between the degree of PAH and rPA (r =0.887,P＜ 0.01 ) in patients with IPF associated with PAH.Conclusion MSCT is useful for the detection of IPF with PAH,and CT determined rPA has an excellent diagnostic value.

From the chloroform-soluble fraction of the ethanol extracts of the whole plant of Taxus chinensis var. mairei (Lemee et Levl), four compounds were isolated by using repeated column chromatography on silica gel and Sephadex LH-20. Based on spectroscopic data (UV, IR, ESI-MS, 1H NMR and 13C NMR), the compounds were identified as taxamairin K (1), 2α, 4α-dideacetoxy-7β-benzoyloxy-5β,20-epoxy-9α,10β,13α,15-tetrahydroxy-11(15→1)abeotaxa-11-ene (2), 7β-xylosyl-taxol (3), 10-deacetoxy-7-xylosyl-taxol (4). Among them, taxamairin K is a new compound.

Objective To investigate the chemical constituents in the barks of Populus davidiana. Methods The constituent was isolated by column chromatography and its structure was determined on the basis of chemical and spectral data. Results Compound Ⅰ was identified as (E)-5-hydroxy-2-[3, 4, 5,-trihydroxy-6-(hydroxymethyl)-tetrahydro-2H-pyran-2-yloxy] benzyl 3-(4-hydroxypenyl) acrylate. Conclusion Compound I is a new phenolic glycoside named as davidianoside.

Objective To intensively investigate the chemical constituents in the heartwood of Taxus yunnanensis Cheng et L.K.Fu.Methods The heartwood was extracted with ethanol,the ethanol extract was subjected to the extraction with methylene trichloride,which was submitted to chromatography on sili-ca gel and Sephadex LH-20 column to isolate some compounds.And their structures were elucidated on the basis of spectral analysis(UV,IR,ESI-MS,1H-NMR,13C-NMR).Results The compounds were identified as 2?,5?,7?,9?,10?,13?-hexaacetoxy-4(20),11-taxadiene(Ⅰ),taxusin(Ⅱ),taxa-4(20),11-diene-2?,5?,10?-triacetoxy-14?,2-methybutyrate(Ⅲ),10?-hydroxy-2?,5?,14?-triacetoxy-4(20),11-taxadiene(Ⅳ),1-dehydroxybaccatin Ⅳ(Ⅴ),baccatin Ⅳ(Ⅵ),baccatin Ⅵ(Ⅶ),7,9-deacetylbaccatin Ⅵ(Ⅷ),10-deacetyltaxuyannine(Ⅸ),1?-accetoxy-5-deacetyl-baccatin Ⅰ(Ⅹ),baccatin Ⅰ(Ⅺ),taxuchin A(Ⅹ Ⅱ),secoisolariciresinol(Ⅹ Ⅲ),?-conidendrin(Ⅹ Ⅳ),isotaxiresinol(Ⅹ Ⅴ),lariciresinol(Ⅹ Ⅵ),sequoitol(Ⅹ Ⅶ),?-sitosterol(Ⅹ Ⅷ).Among them compounds Ⅰ,Ⅴ,Ⅵ,Ⅺ,Ⅹ Ⅱ,Ⅹ Ⅵ were obtained from the heartwood of T.yunnanensis for the first time.Conclusion The chemical constituents in the heartwood differ from the other parts of T.yunnanensis,but there is little difference within the species of Taxus L.

Objective To investigate the chemical constituents in the barks of Populus davidiana. Methods The constituents were isolated by column chromatography and their structures were determined on the basis of chemical and spectral data. Results Sixteen compounds were isolated and twelve of them were identified as 3?-acetoxyurs-12-en-28-oicacid (Ⅰ), ?-sitosterol (Ⅱ), 4-methoxyphenol (Ⅲ), 3-methoxyphenol (Ⅳ), sakuranetin (Ⅴ), scopoletin (Ⅵ), 2R, 3R-dihydro-7-methoxy-kaempferol (Ⅶ), salicyloyltremuloidin (Ⅷ), tremuloidin (Ⅸ), ?-sitosterol-3-O-glucoside (Ⅹ), salireposide (Ⅺ), and sakuranin ( ⅩⅡ ). Conclusion Compounds Ⅰ, Ⅴ, Ⅵ, and ⅩⅡ are isolated from the plants of Populus L. for the first time.

Lung transplantation is an effective treatment for end-stage lung diseases in children, and the only treatment for children with no response to conservative treatment.However, merely a few transplantation centers at home and abroad can provide lung transplantation at present.The mortality of pediatric lung transplantation is high, and it is difficult for donor matching.Besides, it has many complications.In recent years, pediatric lung transplantation has made positive progress and technological breakthroughs in many aspects.In this article, research progress in pediatric lung transplantation at home and abroad was reviewed.

Pulmonary fibrosis , an important cause of pulmonary diseases , has no effective protective and therapeutic meas-ures.Recent studies showed high mobility group protein B 1 (HMGB1) has an important role in the development of pulmonary fibrosis and many HMGB1 antagonists can alleviate pulmonary fibrosis in animal models .This paper summarizes the structure , function, intra-cellular signal transduction of HMGB1, the expression change of HMGB1 in pulmonary fibrosis and HMGB1 targeted therapy in pulmo-nary fibrosis in order to provide an effective basis for clinical treatment of pulmonary fibrosis .

Objective To study the influence of preoperative splenectomy on liver transplantation for portal hypertension and the management of complications.Methods From January 2008 to January 2013,a total of 136 patients underwent liver transplantation for portal hypertension (PHT) in Hepatobiliary Surgery Center,Fuzhou General Hospital of PLA Nanjing Military Region.Pre-liver transplantation splenectomy was carried out in 19 patients.We randomly selected according to the operation time 50 cases of liver transplantation as the control group.The operation time,bleeding,blood transfusion,infection,the incidence of acute rejection,biliary complication rate,survival rate,postoperative platelet recovery and arteriovenous thrombosis were analyzed.Results The preoperative group has longer surgical time,intraoperative blood loss,blood transfusion volume increased obviously,infection rate increased significantly compared with the control group.The accumulate survival rate of preoperative splenectomy group was significantly lower than that of the control group.The platelet count of the preoperative splenectomy group was significantly higher than that of the control group.The platelet count of both groups experienced the process of first rise after falling.Although the platelet count of the preoperative splenectomy group was higher than that of the control group,but there was no statistically significant difference.Conclusions Liver transplantation in PHT patients with previous splenectomy may lead to some unfavorable consequences including increases of technical diffculty of surgery,operative duration,intraoperative bleeding,postoperative infection and other serious complications,and surgical mortality.Therefore,splenectomy should be performed cautiously for the patients who may receive liver transplantation in the future.

Objective To study the relationship between tacrolimus blood level/dose and the genotype of CYP3A5 at 6th month after lung transplantation.Method Forty-six cases of lung transplant recipients who received the surgery between January 1st,2011 and January 1st,2013 served as the research subjects,and the genotypes of these patients were measured.These patients were divided into 3 groups (CYP 3A5 * 1 * 1,CYP 3A5 * 1 * 3,CYP 3A5 * 3 * 3) according to their different genotypes.The dose of tacrolimus and daily intake were detected at 6th month after surgery in each group,then the level/dose of tacrolimus was calculated.Result In all 46 recipients,5 of them were CYP 3A5 * 1 * 1 homozygous genotype,20 CYP 3A5 * 1 * 3 heterozygous genotype and 21 CYP 3A5 * 3 * 3 homozygous genotype.Under the condition of holding tacrolimus blood level between therapeutic range,there was significant difference in the dose of tacrolimus between the CYP3A5 * 1/ * 1 and * 1/* 3 versus * 3/* 3 genotypes (P＜0.01),but there was no significant difference between CYP3A5 * 1/* 1 genotype and * 1/* 3 genotype.Conclusion Tacrolimus dosing in lung transplant patients is associated with CYP 3A5 gene polymorphisms.