ObjectiveTo study the ent-kaurane diterpenoids from Rabdosia rubescens.MethodsThe compounds were isolated by chromatographies and their structures were identified by spectral analyses.ResultsFour compounds were isolated,and they were identified as bisrubescensin E (1),2α,3α,24-trihydroxyurs-12-en-28-oic acid (2),2α,3α,24-trihydroxyurs-12,20-(30)-dien-28-oic acid (3),and 6,7-dihydroxycoumarin (4).ConclusionCompound 1 is a new asymmetric ent-kauranoid dimer.Compound 2 is isolated from the plant for the first time.Compounds 3 and 4 are isolated from the plants ofRabdosia (B1.) Hassk for the first time.

Objective To assess the efficacy of interventional bronchoscopic techniques used to treat stenosis of bronchial anastomosis after lung transplantation.Methods A retrospective study of 24 cases who underwent lung transplantation from September 2003 to August 2005 in our Unit was done. All recipients were subjected to surveillance bronchoscopy with biopsy at predetermined intervals and when clinically indicated. Endobronchial electrocauterization with microwave therapy apparatus and endobronchial electrocoagulation with high-frequency electrotome were performed for the management of bronchial stenosis or granuloma formation.Results There were 2 of 24 recipients (2/24,8.3 %) with stenosis of bronchial anastomosis. Airway stenosis appeared in 3 of 28 anastomoses (3/28,10.7 %): 2 on the left and 1 on the right. These patients with airway stenosis responded to interventional bronchoscopy,and their respiratory function was improved significantly.Conclusions Despite the improvements in surgical technique and immunosuppression strategies,a small number of patients still had airway complications after lung transplantation. Interventional bronchoscopic techniques,i.e. endobronchial electrocauterization with microwave therapy apparatus and endobronchial electrocoagulation with high-frequency electrotome will be effective in the treatment of airway complications after lung transplantation and with good response in respiratory function.

Viral myocarditis (VMC) is a clinical frequent cardiovascular disease with extremely high mortality and disability rate ,which seriously impairs the health of children and young adults ,and its pathogenesis has not been fully elucidated .It is generally believed that VMC pathogenesis is mainly related to direct damage on myocardial cells ,immune damage ,cell apoptosis and cytokines .The present article made a summary about the research progress of its pathogenesis .

Objective To compare early enteral with parenteral nutrional support in patients after hepatectomy. Methods In this study, 59 patients were randomized into 2 groups to respectively receive enteral or parenteral nutritional support beginning the first day post-op for a week. The general nutrition condition, liver function, gut function, dosage of albumin, mortality, complication rate and expense were recorded. Results Patients were given same quantity of heat and nitrogen. At the end of the study, serum albumin, body weight and upper arm circumference had not reached the preoperative level in patients receiving enteral mutrition while all except for serum prealbumin had not reached the level in parenterally nutritional patients. Furthermore, the time of gut begins functional (29?12) h in enterally nutritional patients was shorter than in parenterally nutritional patients (38?14) h. Enteral nutrition was more economic than parenteral nutrition (P

ObjectiveTo study the water/fat ratio of patients with pancreatic ductal adenocarcinoma (PDAC) and mass-forming focal chronic pancreatitis (MFP),and to provided guide for the clinicians.MethodsThirteen patients with PDAC,8 patients with MFP and 20 healthy volunteers were scanned by GE 3.0T MR IDEAL sequence.The signal strength of outcome images was measured; the water/fat ratio analysis was performed.Two kinds of formula were applied,the first was WF1 =SW/SF,the second was WF2 =( SIP + SOP) / ( SIP - SOP).SW was the signal strength of water,SF was the signal strength of fat,and SIP was the signal strength of in-phase,while SOP was the signal strength of opposite phase.ResultsBy using the WF1 formula,the water/fat ratio of normal pancreas,PDAC,MFP was 7.97 ±0.95,9.94 ±1.19,5.08 ±0.49,respectively.By using the WF2 formula,the water/fat ratio of normal pancreas,PDAC,MFP was 11.51 ± 1.62,13.87 ±1.84,5.73 ±0.65,respectively.The difference among the three groups was statistically significant (P ＜ 0.05 ) under the same formula.The value of WF2 was higher than that of WF1,the difference in PDAC groups was also statistically significant ( P ＜0.05 ).ConclusionsThe water/fat ratio of pancreas among PDAC,MFP and normal pancreas is different.PDAC has the highest water/fat ratio,followed by the normal pancreas; MFP has the lowest ratio.

ObjectiveTo explore the methods and effectiveness of interventional revascularization of complex arteriosclerosis obliterans (ASO)of lower extremity arteries according to their imaging characteristics.Methods Seventy-eight patients with lower extremity ASO complex lesions classified as TASC Ⅱ C/D ( n =68 ) and TASC Ⅱ B ( n =10) underwent antigrade or combined antigrade-retrograde subintimal angioplasty.Their clinical situations were Fontaine stage Ⅲ/Ⅳ or severe stage Ⅱ.All the long occlusion,flush occlusion,multiple occlusion,popliteal artery occlusion,below knee artery occlusion and aortoiliac artery occlusion were identified as complex lesion imaging features and as the indication of interventional treatment if only there were visible outflow vessels and suitable puncture site.Statistical analysis was used to compare ankle-brachial index (ABI) pretreatment and post-treatment by t test.Results Successful revascularization was achieved in 73 patients technically.No obvious complications occurred.Ischemia symptoms improved quickly after accomplishment of recanalization.Average ABI increased from 0.45 ±0.07 to 0.76 ±0.11 after the treatment(t =- 19.78,P ＜0.01 ).Symptoms in 5 patients who failed to get arterial recanalization were stable.Follow up of 6 to 12 months in 47 patients showed stable improvement in 22 of them.Conclusion It is more practical to choose and expand application of interventional treatment for complex ASO according to imaging characteristics of lesions than according to TASC classification.

ObjectiveTo investigate the treatment effects of comprehensive nursing intervention on patients with chronic obstructive pulmonary disease(COPD) treated by non-invasive mechanical ventilation with BiPAP mode.Methods96 patients with diagnosed COPD and using non-invasive mechanical ven- tilation with BiPAP mode were randomly divided into the control group(46 cases) which was treated with routine measures and the comprehensive nursing intervention group (50 cases) which adopted comprehen- sive nursing intervention according to experimental design. The frightening degree, incidence rate of com- plications and clinical treatment effect by ventilator were compared between the two groups.ResultsPa- tients compliance with treatment and clinical treatment effect by ventilator in the comprehensive nursing in- tervention group was better than that of the control group. The frightening degree and incidence rate ofcomplications were lower than those of the control group (P < 0.01 ).ConclusionsComprehensive nurs-ing intervention with non-invasive mechanical ventilation with BiPAP mode can improve the treatmentcompliance of COPD patients,reduce complications followed by non-invasive mechanical ventilation andreach the prospective treatment effect.

Objective To investigate the value of percutaneous transsplenic varices embolization (PTSVE) for treatment of upper gastrointestinal bleeding. Methods Twenty cases with liver cirrhosis and portal hypertension suffered upper gastrointestinal bleeding. PTSVE was administered to them with hardener and coils. Among them, 8 cases had massive hepatocellular carcinoma (HCC) in right lobe; 10 cases with hepatocellular carcinoma had portal vein tumor thrombus and occlusion; the other two cases with liver cirrhosis had portal vein thrombosis. All of these cases were not suitable for percutaneous transhepatic varices embolization (PTHVE) . PTSVE was performed under the guidance of fluoroscopy. Results Technical success was achieved in 18 patients. A total of 35 gastric coronary veins were embolized. In all these cases, upper gastrointestinal bleeding stopped after PTSVE. There was no recurrence within 1 month follow-up. No serious complication occurred. Conclusion PTSVE is a safe and efficient alternative treatment for upper gastrointestinal bleeding, especially for cases with portal vein occlusion or with massive HCC in right lobe of liver.

Objective To investigate the diagnostic value of DSA for micro hepatocelluar carcinoma(MHCC)in patients with hepatic cirrhosis. Methods Three hundred and fourty cases of hepatic cirrhosis who were going to receive bone marrow stem cells transplantation via hepatic artery underwent hepatic arterial DSA. No definite evidence of hepatoma had been found during the former CT scan and ultrasound test in these patients. Multi-angle projection DSA was performed to display the characteristics of MHCC and super-selective TACE treatment was given in cases of the diagnosed MHCC. Results MHCC were found by DSA in 20 cases who were all of post-hepatitis B cirrhosis and with single-lesion of sized 0.4 - 1.0 cm. DSA showed the characteristics of nodular stains in early or middle arterial phase in angiography. 18 lesions were in the right lobe and 2 in the left lobe. AFP were negative in 16 cases and positive in 4 cases. Super-selective segmental TACE were performed with micro catheter system for the treatment. Conclusions DSA is more sensitive to detect MHCC in the patients with hepatic cirrhosis, comparing with regular contrasted CT scan or ultrasound.

Objective To evaluate interventional techniques for the treatment of visceral aneurysms. Methods A total of 11 aneurysms were found in 9 patients with visceral aneurysms who received interventional treatment. Of the 9 patients, single aneurysm at both superior mesenteric artery (SMA) and right colonic artery was seen in one, 2 aneurysms at same splenic artery in one, one aneurysm at splenic artery in 5, aneurysm at right gastric artery in one and pseudoaneurysm at hepatic artery in one. In 9 patients the transcatheter endovascular coil embolization was successfully carried out for 10 aneurysms, including splenic (n = 7), right colonic artery (n = 1), right gastric artery (n = 1) and hepatic pseudoaneurysm (n = 1). One stent-graft was used for the SMA aneurysm. Results Technical success was achieved in all cases without any serious complications. Conclusion Interventional embolization with coils can successfully occlude most visceral aneurysms, while stent-graft should be used when the aneurysm is difficult to be occluded with coil.