AIM To study the chemical constituents from Sonchus oleraceus L..METHODS The 50％ ethanol fraction of 70％ ethanol extract from S.oleraceus was isolated and purfieid by macroporous resin,Sephadex LH-20,ODS and RP-HPLC column,then the structures of obtained compounds were identified by physiochemical properties and spectral data.RESULTS Eleven compounds were isolated and identified as isololiolide (1),bluemenol A (2),5-methoxyisolariciresinol (3),lyoniresinol (4),syringaresinol mono-β-D-glucoside (5),robinin (6),loliolide (7),dehydrovomifoliol (8),5-(1 '-hydroxyethyl)-methyl nicotinate (9),2-methoxy-1,4-benzenediol (10),4-methoxyphenol (11).CONCLUSION Compounds 1-9 are isolated from genus Sonchus for the first time.

Objective:To observe the correlation of platelet activation and the inflammatory factors in patients with coronary heart disease (CHD).Methods:A total of 150 patients with CHD were divided into three groups according to the guideline of ACC/AHA:Stable angina pectoris (SAP) group (n=47,aspirin 100 mg/d); Unstable angina pectoris(UAP) group (n=50,aspirin 100 mg/d+Dalteparin 5000 U Q12 h); Acute myocardial infarction (AMI) group (n=53,aspirin 100 mg/d+Dalteparin 5000 U Q12 h+Plavix 75 mg/d).53 healthy adults served as the Control group.The fast blood sugar,lipid,platelet count,platelet aggregation of plasma,fibrinogen,high sensitivity C reactive protein (hs-CRP) of plasma,and 11-dehydro thromboxane B_2 (11-DH-TXB_2) of urine were detected upon patients' admission.Results:The level of plasma hs-CRP in groups of SAP,UAP and AMI(4.25±2.95 mg/l,7.61±6.11 mg/l,15.46±8.22 mg/l)were significantly higher than that in Control group(2.07±1.28 mg/l,P<0.05).The max rate of platelet aggregation induced by ADP in groups of UAP and AMI were significantly higher than that in Control and SAP groups(74.35±8.91%,73.88±8.35% vs.66.22±7.51%,68.67±6.87%,P<0.05).There were significant differences in the max rate of platelet aggregation induced by arachidonic acid (AA) and 11-DH-TXB_2 of urine in different groups (P<0.05).The level of plasma hs-CRP in all patients with CHD were significantly positively correlated with the max rate of platelet aggregation induced by ADP (r=0.473,P=0.000),AA(r=0.434,P=0.000) and 11-DH-TXB_2 of urine (r=0.554,P=0.000).Conclusion:There were significant relationship between the levels of plasma hs-CRP,11-DH-TXB_2 and the max rate of platelet aggregation,which indicating inflammation might induce platelet aggregation in CHD patients.

Objective To evaluate the clinical effect and complications of total hip replacement (THR) in novel femoral neck fracture,old femoral neck fracture, aseptic necrosis of femoral head and coxa degenerative osteoarthropathy. To provide instructions to surgical indications and treatment effects analysis.Methods One hundrde and four patients were divided into 4 groups by disease type: novel femoral neck fracture group (n = 32 ), old femoral neck fracture group (n = 22) ,aseptic necrosis of femoral head group (n =34) and coxa degenerative osteoarthropathy group (n = 16). These patients were followed-up for 12 - 144 months after THR, their Harris standard score and complications data, before and after operation, were analyzed retrospectively. Results After operation, the Harris standard scores were 92. 6 ± 5.8,90. 1 ± 5. 2,86. 3 ± 4. 6,81.9 ±4. 1 in novel femoral neck fracture,old femoral neck fracture,aseptic necrosis of femoral head and coxa degenerative osteoarthropathy groups respectively, which were significantly higher than the scores before operation (25.6±1.8,36.7±2.6,52.9±4.3,42. 1 ±3.8,Ps ＜0.05). Conclusion THR has good effects in the four types of diseases. Short length of stay and high healing rate are marked characteristics of THR. More attention shoud be paid to the complications of THR.

Objective To analyze the correlative factors of hypopituitarism in patients with intracranial non-sellar tumors.Methods Eighty-three patients with intracranial non-sellar tumors,admitted to our hospital from May 2014 to April 2015,were included in our study;their clinical data were retrospectively analyzed.The status of pituitary function was assessed according to the level of preoperative serum hormone.Univariate and multivariate Logistic regression analyses were employed to analyze the correlations of preoperative hypopituitarism with age,gender,hypertension,epilepsy history,course of disease,mass effect of tumor,tumor location,intracranial pressure (ICP),and composition of cerebrospinal fluid.Results Before surgery,30 showed hypopituitarism,accounting for 36.14％:23 had deficiency in one pituitary axe and 7 had multi-axial deficiency.Univariate analysis showed that high ICP (ICP＞200 mmH2O),acute or sub-acute course (≤ 3 months) and presence of mass effect by non-sellar brain tumor were the risk factors of hypopituitarism (P＜0.05).Multivariate Logistic regression analysis revealed that intracranial mass effect in patients with non-sellar brain tumor was an independent risk factor (OR=3.197,95％CI=1.085-9.423,P=0.035).Conclusion Hypopituitarism has high morbidity in patients with non-sellar brain tumor;intracranial mass effect is an independent risk factor for hypopituitarism.

Objective:To explore the safety and clinical value of ultrasound-guided percutaneous core needle biopsy in the diagnosis of cardiac intermural tumors and pericardial tumors.Methods:Seven patients who underwent ultrasound-guided percutaneous cardiac tumors needle biopsy in Fujian Provincial Hospital from January 2012 to December 2019 were selected for this study. The locations and sizes of the lesions were recorded preoperatively by echocardiography and the operation time was recorded by conventional ultrasonography. The postoperative complications was followed up, and the satisfaction of pathological materials was used as the evaluation standard to comprehensively analyze the safety and clinical application value of ultrasound-guided percutaneous biopsy in the diagnosis of cardiac tumors.Results:Ultrasound-guided percutaneous biopsy was performed successfully in all the 7 cases, 3 of them were intermural tumors and 4 of them were pericardial tumors. Except for 2 patients with diffuse pericardial space, the maximum diameter of the remaining 5 patients was (58.6±23.5)mm. Six cases were punctured from the apex of the heart, and 1 case from the left parasternal through third intercostal space toward the bottom of the heart as the needle pathway. The satisfaction of pathological material was 100%, and the time of procedure was (15.1±3.3)min. There were no postoperative complications such as bleeding, infection or arrhythmia.Conclusions:Ultrasound-guided percutaneous transthoracic needle biopsy is safe and feasible, which provides a simple and easy method for the biopsy of cardiac intramural tumors and pericardial tumors.

Objective:To compare the setup errors in the supraclavicular regions of two different postures (arms placed on each side of the body, namely the body side group; arms crossed and elbows placed above forehead, namely the uplifted group) using the chest and abdomen flat frame fixation device in lung and esophageal cancer.Methods:Clinical data of patients with stage Ⅰ to Ⅳ lung or esophageal cancer who received three-dimensional radiotherapy with chest and abdomen flat frame fixation device in our institution from November 2020 to April 2021 were retrospectively analyzed. The setup errors of two postures were compared.Results:A total of 56 patients were included, including 31 patients (55%) in the body side group and 25 patients (45%) in the uplifted group. A total of 424 CBCTs were performed in the whole group. The overall setup errors in the X, Y and Z directions were similar in both groups ( P>0.05). The setup errors of sternoclavicular joint in the X and RZ directions in the body side group were significantly smaller than those in the uplifted group [(0.163±0.120) cm vs. (0.209 ±0.152) cm, P=0.033; 0.715°±0.628° vs. 0.910°±0.753°, P=0.011]. The setup errors of acromioclavicular joint in the Y, Z and RZ directions in the body side group were significantly smaller than those in the uplifted group [(0.233±0.135) cm vs. (0.284±0.193) cm, P=0.033; (0.202±0.140) cm vs. (0.252±0.173) cm, P=0.005; 0.671°±0.639° vs. 0.885°±0.822°, P=0.023]. The margins of target volume for setup errors were smaller in the X (0.45 cm vs. 0.54 cm) and Y (0.54 cm vs. 0.65 cm) directions of the sternoclavicular joint, as well as in the Y (0.59 cm vs. 0.78 cm) and Z directions (0.53 cm vs. 0.72 cm) of the acromioclavicular joint in the body side group. Conclusions:For lung and esophageal cancer patients requiring supraclavicular irradiation, the body side group yields smaller setup errors and corresponding margins of target volume than the uplifted group. In clinical practice, it is necessary to take comprehensive consideration of the accuracy of radiotherapy and additional radiation of the limbs to select appropriate posture.

The teaching of orthognathic surgery is difficult because it is complex and emphasizes the combination of theory and practice. The traditional teaching method focuses on theoretical teaching, but due to the limitation of conditions, it is difficult for students to master the operation. In this paper, we apply the digital three-dimensional surgical simulation system combined with 3D printing in specialist training of orthognathic surgery. Digital software and 3D printing are applied in the theoretical teaching, surgical operation, summary and reflection to combine practical teaching with theoretical teaching, so as to stimulate the subjective initiative of the students. The results showed that the teaching evaluation of the experimental group [(3.89±0.84) points] was better than that of the control group [(2.91±1.21) points]. The application of digital three-dimensional surgical simulation system combined with 3D printing has achieved satisfactory results.

AIM: To compare and observe the accuracy of five intraocular lens(IOL)power calculation formulas in patients with cataracts who have previously undergone corneal refractive surgery.METHODS: Prospective case series study. A total of 23 cataract patients(34 eyes)with a history of myopic corneal refractive surgery at Jinan Mingshui Eye Hospital from September 2021 to March 2023 were collected, including 1 eye treated with photorefractive keratectomy(PRK)and 22 patients(33 eyes)treated with laser-assisted in situ keratomileusis(LASIK). Preoperative ocular biometry was performed using the IOL Master 700, while corneal true net refractive power(TNP)was measured via Pentacam analyzer. Anterior segment optical coherence tomography(OCT)was used to assesse net corneal power(NCP), posterior corneal refractive power, and central corneal thickness(CCT). The Shammas, Haigis-L, Potvin-Hill Pentacam, OCT, and Barrett True K formulas were utilized for IOL power calculations, with the optimal power selected accordingly. At 1 mo postoperatively, actual refractive outcomes were determined through subjective refraction, based on objective optometry results. The refractive prediction error(RPE)and refractive absolute error(RAE)of each formula were calculated and compared, and the percentage of eyes with RAE ≤0.5 D and ≤1.0 D was counted.RESULTS: No significant statistical difference was found in the RPE of the five formulas when compared to zero(all P>0.05), nor were there significant differences in RPE and RAE among the formulas(F=0.554, P=0.696; H=4.402, P=0.354). The RAE was within ≤0.5 D for 26 eyes(76%)using the Potvin-Hill Pentacam formula and for 24 eyes(71%)using the Barrett True K formula, with both formulas achieving an RAE within ≤1.0D in 33 eyes(97%).CONCLUSIONS: The Barrett True K and Potvin-Hill Pentacam formulas demonstrated high predictive accuracy for IOL power calculations in post-corneal refractive surgery cataract patients. Given the variability in corneal refractive power among these patients, further research on IOL power calculation is warranted. Clinically, it is advisable to consider a range of formulas for optimal outcomes.

Objective To investigate the current status of off-label drug use(OLDU)management in tertiary hospitals of Guizhou province and to provide baseline evidence for developing a unified administration regulation for OLDU in Guizhou province.Methods In line with the relevant policies and regulations,a questionnaire including basic information about the person filling out the form,basic information about the hospitals,and information about OLDU was developed.The questionnaire was sent to 84 tertiary hospitals in Guizhou province through the Wenjuanxing.Results A total of 84 questionnaires were distributed and recovered,with a response rate of 100.00%.Of the 84 hospitals,77 had OLDU,of which 68(88.31%)had established a management system for OLDU.Among the 77 hospitals with OLDU,65(84.42%),42(54.55%),58(75.32%),36(46.75%),15(19.48%),and 21(27.27%)hospitals respectively,required approval from the Committee on Drug Administration and Pharmacotherapy before OLDU,restricted the qualifications of doctors prescribing OLDU,required informed consent from patients or their families before OLDU,recorded the matters and reasons in the medical records of patients treated with OLDU,followed up patients in their files and evaluated the reasonableness of the OLDU,and carried out special reviews for OLDU.Only 30(38.96%)hospitals have set up a catalogue of OLDUs,and 58(75.32%)hospitals have urgent needs to set up a unified provincial catalogue of OLDUs.Conclusion The pharmacy administration level of OLDU in tertiary hospitals of Guizhou province is relatively low,so there is an urgent need to establish a unified OLDU management system and medication catalog.

Objective: To investigate the anti-tumor effect of CTL cells on colon cancer xenograft in nude mice after knocking out the immune check point CTLA-4 by CRISPR/Cas9 technology. Methods: A specific small guide RNA (sgRNA) for CTLA-4 was designed to construct sgRNA/Cas9 plasmid, which was then transfected into CTL using a lentiviral vector to obtain CTL cells with CTLA-4 deletion (CTLA-4 KO CTL). The transfection efficiency of the plasmid and the deletion efficiency of CTLA-4 were verified. BALB/c nude mice were randomly divided into two groups to prophylactically inoculate CTLA-4 KO CTL (experimental group) or CTL (control group); 3 days later, the animals of two groups were inoculated with colon cancer cell line LS174-T to observe the tumor formation rate and tumor formation time. After constructing colon cancer xenograft model in nude mice, the animals were randomly divided into two groups, respectively treated with CTLA-4 KO CTL (experimental group) and CTL (control group) cells to observe the tumor growth volume and survival time of mice. The serum levels of TNF-α and IFN-γ in nude mice were detected. Results: sgRNAwas designed and CRSIPR/Cas9 system with lentivirus as vector was successfully constructed. CTL cells were transfected with the established CRSIPR/ Cas9 system, and the highest transfection efficiency was up to (28.80±0.62)%. After transfection, the deletion efficiency of CTLA-4 was detected by Flow cytometry. The CTLA-4 expression of CTLA-4 KO CTL group was significantly lower than that of CTL group [(0.91±0.25)% vs (42.70±2.72)%, P<0.05]. In prophylactic assay, the formation rate of colon cancer xenografts in the experimental group was significantly lower than that in the control group(33.33%vs100%,P<0.05). In treatment assay, the tumor volume in the experimental group was significantly inhibited compared with the control group ([503±23.9] vs [911.2±51.4] mm3, P<0.05), and the survivaltimeoftheexperimentalgroupwassignificantlyprolonged (mediansurvivaltime:78dvs42d,P<0.05); Moreover, the secretion levels of serumTNF-α([268.93±17.04]pg/mlvs[148.26±20.07]pg/ml,P<0.05) and IFN-γ(315.38±18.67 pg/ml vs 202.92±29.32 pg/ml, P<0.05) in the experimental group were significantly higher than those in the control group. Conclusions: The lentiviral vector CRSIPR/Cas9 system is an effective gene editing method; its successful deletion of CTLA-4 in CTL cells can significantly inhibit the tumor formation rate of colon cancer xenografts in nude mice and enhance the anti-tumor effect of CTLon colon cancer xenografts.