Objective To isolate and identify the components from the stem barks of Morus yunnanensis.Methods The compounds were isolated and purified by silic gel column,Sephadex LH-20,and RP-18 chromatography.Their chemical structures were elucidated on the basis of physicochemical properties and spectral data.Results Eleven compounds were isolated and identified as:mulberroside C(1),oxyresveratrol(2),2',4',7-trihydroxy-(2S)-flavone(3),norartocarpetin(4),moracin P(5),betulinic acid(6),sitosteryl 3?-glucoside 6'-O-palmitate(7),lupeol(8),betulinic acid(9),?-daucosterol(10),and ?-sitosterol(11).Conclusion All the compounds are isolated from the plant for the first time,and compound 9 shows cytotoxic activities.

Objective To explore the risk factors of primary nephritic syndrome complicated with thrombosis in children. Methods Clinical data of 238 children with primary nephritic syndrome were retrospectively analyzed. The children were divided into thrombosis group and non-thrombosis group according to whether complicated with thromboembolism. Univariate and logistic regression analysis were performed.Results Among 238 children, there were 32 cases of primary nephritic syndrome complicated with thrombosis and the rate was 13.44%. Univariate analysis showed that infections, the use of diuretic, degree of edema, white blood cell count, IgG, C3, total protein, albumin, urea nitrogen, plasma ifbrinogen, D-dimer, antithrombinⅢ, and 24-hour proteinuria were signiifcantly different between two groups (allP< 0.05). Multivariate analysis showed that D-dimer and 24-hour proteinuria were the independent risk factors for children with primary nephrotic syndrome complicated with thrombosis.Conclusion The elvated level of D-dimer and 24-hour proteinuria were the risk factors of children with primary nephrotic syndrome complicated with thrombosis.

Allergy and Immunology ; trends ; China ; Pediatrics ; trends

Objective To evaluate the blood-saving efficacy of acute hypervolemic hemodilution (AHH)-hemostatics-intraoperative blood salvage (IOBS) in patients undergoing orthopedic surgery. Methods One hundred and twenty ASA Ⅰ or Ⅱ patients of both sexes, aged 18-64 yr, scheduled for elective orthopedic surgery under general anesthesia with an expected blood loss of 800 ml or more, were randomly divided into 4 groups ( n = 30 each) : AHH + IOBS + hemostatics group; IOBS + hemostatics group; AHH + IOBS group; AHH + bemostatics group. AHH was induced with 6% hydroxyethyl starch 130/0.4 15 ml/kg infused iv at a rate of 40 ml/min immediately after tracheal intubation until the time of immediately before skin incision, IOBS was performed immediately before skin incision. Intravenous hemocoagulase 2 kU and im hemocoagulase 1 kU were injected 10 min before skin incision. The total volume of fluid intake and output, HR, MAP and CVP were recorded during the operation. Vein blood samples were taken for determination of Hb, Hct, platelet counts (Plt), prothrombin time (PT), activated partial thromboplastin time (APTT), and fibrinogen concentration (Fib) .Results CVP was significantly lower in IOBS+ hemostatics group than in AHH + IOBS + hemestaties group ( P < 0.05), while no significant difference in CVP was found between AHH + IOBS and AHH + IOBS + hemostatics group and between AHH + hemostatics and AHH +IOBS + hemostaties group (P > 0.05). The volume of blood loss was significantly higher in AHH + IOBS group, and the allogenic blood transfusion volume was significantly higher, while the percentage of the patients without allogeneie blood transfusion and without FFP transfusion lower in AHH + hemostatics group than in AHH + IOBS + hemostatics group ( P < 0.05 or 0.01 ), but there were no significant differences in the above parameters between IOBS + hemostatics group and AHH + IOBS + hemostatics group ( P > 0.05). Hb, Hct, Plt and Fib were significantly higher in IOBS + hemostatics group than in AHH + IOBS + hemostafics group( P < 0.05), but there were no significant differences in the above parameters between AHH + IOBS and AHH +IOBS + hemostatics group and between AHH + hemostatics and AHH + IOBS + hemestatlcs group (P > 0.05 ). Conclusion The blood-saving efficacy of AHH-bemostatics-IOBS is good in patients undergoing orthopedic surgery and it is a safe technique.

Objective To observe recycle homorheology index of two autologous blood recover machines in orthopedic operation , including maximum deformation index (DImax) ,aggregation index(AImax) ,osmotic fragility ,hematocrit(Hct) ,hemoglobin(Hb) , blood electrolytes and pH value ,the changes of in vivo Hct ,Hb ,blood electrolyte and pH value after the autotransfusion to provide references for rational clinical use of cell salvage .Methods Seventy‐six patients were randomly divided into group A (CATS) and group B (Cell Saver) ,38 cases in each group .Autologous test of DImax ,AImax ,osmotic fragility ,Hct ,Hb ,blood electrolytes ,pH value and Hct ,Hb ,osmotic fragility ,pH value of patients before and after autotransfusion ,24 h after operation ,used to determine the in vivo salvaged were measured .Results DImax of group A were lower than that of group B with no difference(P<0 .05);AImax of both groups had no different(P>0 .05) ,but was lower than the reference value .RBC osmotic fragility curve shifted to the right in group A ,each index was significantly lower than its reference value(P<0 .05) .The in vivo Hct ,Hb ,K+ of group A were significantly higher than that of group B ,Na+ level of group A was lower than of group B ,each index had significantly difference with its reference value(P<0 .05) .pH value of both groups was slightly alkaline .The in vivo Hct ,Hb ,K+ ,Na+ level and pH value of both groups had no difference at the point of before and immediately after autotransfusion and 24 h postoperatively ,there were no statistically difference(P>0 .05) .The in vivo Hct of both groups after autotransfusion were significantly higher than before(P<0 .05) .Conclusion The hemorheology index and quality of salvaged blood acquired from these two cell salvage systems in orthopae‐dic operation have no obvious differences .The function of these two kinds of cell salvage systems is safer and reliable .

Objective To study the effects of tetrahydroxy stilbene glucoside(TSG)on H2O2‐induced apoptosis of human umbilical vein endothelial cells (HUVECs)and on the expressions of X‐linked inhibitor of apoptosis protein (XIAP)and p53.Methods HUVECs were cultured in vitro and divided into 6 groups:control group ,300 μmol/L H2O2 group ,1 μmol/L TSG+ 300 μmol/L H2O2 group ,10 μmol/L TSG+300 μmol/L H2O2 group ,100 μmol/L TSG+ 300 μmol/L H2O2 group ,30μmol/L Embelin+ 10 μmol/L TSG+ 300 μmol/L H2O2 group.The morphology of apoptotic cells was observed by Hoechst 33258 staining.The mRNA and protein expressions of XIAP ,p53 ,Caspase‐3 were detected by RT‐PCR and Western blotting , respectively.Results The number of apoptotic cells and the expression level of p53 were significantly increased while the ex‐pression level of XIAP was dramatically decreased in H2O2 group as compared with control group.The expression level of p53 and the number of apoptotic cells were down‐regulated while the expression level of XIAP was up‐regulated after treatment with 10 or 100 μmol/L TSG when compared with H2O2group.Moreover ,compared with those in 10 μmol/L TSGgroup ,the number of apoptotic cells and the expression of Caspase‐3 were significantly enhanced after pretreatment with 30 μmol/L Embelin for 6 h.Conclusion TSG can inhibit H2O2‐induced apoptosis of HUVECs by down‐regulating the expression level of p53 and up‐reg‐ulating the expression level of XIAP.

The incidence of acute kidney injury(AKI) in neonate is not low,it occurs in many cases such as ischemic-hypoxic injury,infection,administration of nephrotoxicity drugs and urinary tract obstruction,of which perinatal asphyxia ranked first in China.Due to the severe food security crisis,the occurrence of urinary tract obstruction is rising in recent years.The child health care should pay attention to prevent and screen this kind of disease for the high risk group.The diagnosis of AKI is difficult for newborn because serum creatinine and urine are hard to make a definite boundary.So study of early markers of AKI seems to be of great importance,of which neutrophil gelatinase associated lipocalin and cystatin C are research focuses,treatments should aim at solving primary disease such as ischemic,and so on.Renal replacement therapy is recommended when it comes to severe cases,but mortality still remains high,corresponding to severe primary disease and complications.

Objective To analyze the prevalent feature and variant tendency of Scrub Typhus in Guangdong Province from 2006 to 2012, and provide a basis of strategy and measure on prevention and protection of Scrub Typhus. Methods Clinical information of all individual cases was gained from China Information System for Disease Control and Prevention. Cochran-Armitage trend χ2 test was used to describe the variance of Scrub Typhus incidence and the clinical cases of 2013 were predicted by autoregressive integrated moving average (ARIMA) model, while descriptive epidemiological analysis was adopted to describe the endemic distribution, seasonal characteristics and population distribution of Scrub Typhus. Results A total of 8 163 Scrub typhus cases were reported in Guangdong Province from 2006 to 2012. Annual mean incidence of the disease was 1.15/100 000 with the incidence showing an upward tendency (χ2 = 3 191.976, P < 0.01). There were 14 dead clinical cases reported with a fatality rate to be 1.72‰(14/8 163). Totally 3 166 people were predicted to infect Scrub Typhus in 2013 by ARIMA model. The disease was prevalent from the end of May to early October and the peak time was in late August (Z = 2 303.71, P < 0.01). The top five cities developed Scrub Typhus were Zhaoqing, Guangzhou, Yunfu, Shaoguan and Qingyuan. Male-female ratio was 1.00 ∶ 1.08 in all reported cases in which 52.78%(4 309/8 163) of them aged from 40 to 65 years old and 59.30%(4 841/8 163) of them were farmers. Conclusions The incidence of Scrub Typhus is rising in Guangdong Province, with the prevalent peak in summer and autumn, and rural populations are at high risk. The most effective preventions are strengthening health education , enhancing individual protection and protecting key populations in special districts.

ObjectiveStudy the relationship among CaSR expression, tubulointerstitial damage,metabolic disturbance of calcium and phosphorus and microvascular density around the tubulointerstitium in children with steroid-resistant nephrotic syndrome.Methods36 cases of children with primary nephrotic syndrome were divided into hormone-sensitive group and steroid-resistant group.Semi-quantitative scores for tubulointerstitial pathological evaluation of the extent of damage, automatic biochemical analyzer for the determination of serum calcium (Ca), phosphorus (P) concentration of renal tubular epithelial CaSR expression and microvessel microvascular density around the tubulointerstitium were determined by immunohistochemical assay.ResultsMore severe the tubulointerstitial damage, lower level of serum Ca and higher level of serum P were observed [(2.26 ± 0.15) mmol/L]in children of the steroid-resistant group and the steroid-sensitive group [(1.90 + 0.12) mmol/L, P ＜ 0.05].CaSR expression (4.63 + 0.78) of renal tubular epithelial cells in the steroid- sensitive group was significantly lower than that in the steroid-resistant group (6.56 + 1.22, P ＜ 0.05), but microvascular density was significantly higher in the steroid- sensitive group(2.98 +0.35 vs 2.02 +0.24, P ＜0.05).When the tubulointerstitial damage was mild, CaSR expression (4.15 +0.58) in renal tubular epithelial cells in the steroid- sensitive group (4.26 ±0.61) was lower than the steroid-resistant group(3.12 ± 0.33; 3.01 ± 0.21), and microvascular density was higher,but the difference was not significant(P ＞0.05).In the moderate tubulointerstitial damage, CaSR expression in renal tubular epithelial cells in the steroid- sensitive group (5.35 ± 0.64) was significantly lower than the resistant group (7.37 +0.81, P ＜0.01), and microvascular density was significantly higher than the resistant group (2.81 ±0.16, 2.02 ±0.14, P ＜0.05).Compared by mild and moderate tubulointerstitial damage in children with the steroid-resistant, CaSR expression (11.46 ± 1.38) in children with severe tubulointerstitial damage was significantly increased, and microvascular density (1.15 ± 0.11) was significantly decreased (all P ＜ 0.01).ConclusionsCaSR expression was increased and microvascular density around the tubulointerstitium was decreased in children with steroid-resistant nephrotic syndrome.Dut to steroid resistance, the cytotoxic of steroid damaged the renal tubular epithelial cells, the metabolic disturbance of calcium and phosphorus and the damage of blood vessel endothelium finally resulted in severe tubulointerstitial damage.

We enrolled 60 patients with American Association of Anesthesiologists grade Ⅰ - Ⅱ undergoing unilateral total knee arthroplasty. All patients received combined epidural and spinal anesthesia,and a nerve stimulator was used to guide placement of a femoral nerve catheter. Patients were divided into three groups according to the catheter location on X-ray : psoas muscle group ( n = 18 ), iliacus muscle group (n = 19) and local group (n =23). Visual analog scale (VAS) pain scores were recorded at rest and with movement at 4, 24 and 48 h postoperatively and sensory blockade of the femoral, obturator and lateral femoral cutaneous nerves was recorded at 24 h.There were no significant differences in femoral nerve blockade among the three groups. Obturator nerve blockade was significantly better in the psoas muscle group than in the iliacus muscle and local groups, and was also better in the local group than in the iliacus muscle group. There was no significant difference in lateral femoral cutaneous nerve blockade between the psoas muscle and iliacus muscle groups, but there was better blockade in both these groups than in the local group. At 4 h postoperatively, VAS pain scores at rest were significantly lower in the psoas muscle group than in the iliacus muscle and local groups, but there were no significant differences in VAS pain scores with movement among the three groups. At 24 and 48 h postoperatively, VAS scores at rest and with movement were significantly lower in the psoas muscle group than in the iliacus muscle and local groups.