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.

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 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.

Allergy and Immunology ; trends ; China ; Pediatrics ; trends

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 research Henoch-Schonlein purpura purpura (HSP) and renal pathology in children.Methods 31 hospitalized HSP children that with normal urine routine and accepted renal biopsy in our hospital.Results There were different levels of kidney pathological damage in this group of 31 cases,the results of light microscope were from grade Ⅱ to grade Ⅵ The proportion was grade Ⅱ(35.48％,11 of 31),grade Ⅲ (54.83％,17 of 31),and grade Ⅳ,Ⅴ and Ⅵ (each 1 case of 31,3.23％ ).lmmunofluorescence pathology results were showed as following:merely IgA depositional (48.38％,15 of 31 ),IgA + IgG depositional ( 19.36％,6 of 31 ),IgA + IgM depositional ( 19.36％,6of 31 ),IgA + igG + IgM depositional ( 12.90％,4 of 31 ).Microalbuminuria had been founded in 14 cases,and the microalbuminuria level of 10 cases were higher than normal value( 10 of 14,71.43％ ).Conclusions HSP children had renal pathologic dysfunction,even the urine routine were normal,and the detection of urine microalbumin was a significant marker in the early stage.

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.

ObjectiveTo explore the changes and significances of cardiac troponin Ⅰ (cTnⅠ),myoglobin (Mb) and creatine kinase MB (CK-MB) in old patients with acute myocardial infarction(AMI).MethodThe levels of cTnⅠ, Mb and CK-MB in 89 cases with AMI patients (AMI group) and 100 healthy controls (control group) were detected and compared. ResultsThe levels of cTnⅠ, Mb and CK-MB in AMI group were ( 8.15 + 3.26) μ g/L, (478.45 ± 96.87 ) μ g/L and ( 128.17 ± 53.26 ) U/L, while were (0.03 ±0.02) μ g/L, (21.61 + 9.38 ) μ g/L and (9.53 ± 2.94) U/L in control group, the levels of cTnⅠ, Mb and CK-MB in AMI group were significantly higher than those in control group(P ＜ 0.05 ). The sensitivity rate of cTnⅠ,Mb and CK-MB for detecting AMI was 95.5％ (85/89), 97.8％ (87/89) and 87.6％ (78/89), and the specificity rate was 98.0％(98/100), 82.0％(82/100) and 94.0％(94/100). ConclusionThe levels of cTnⅠ, Mb and CK-MB are significantly increased in AMI patients, which cTnⅠ for detecting AMI has high sensitivity and specificity.

Objective To observe the clinical effect of artificial ventilation combined continuous positive airway pressure(CPAP) with removal of tracheobronchial foreign bodies for children and to explore the possibility and security of the method. Methods 60 children with tracheobronchial foreign body, underwent total intravenous anesthesia ,were randomly divided into A group and B group. Each group had 30 cases. A group was given artificial ventilation with CPAP. The bronchofibroscope was connected to anesthesia machine with side hole after induction for 3 minutes,and high fresh gas flow(10 ～ 15L/min) was given to maintain continuous positive airway pressure. B group were given high frequency jet ventilation(HFJV) ,60 ～ 100 bpm. The mask ventilation was given in stand of bronchofibroscope when SpO2 ＜ 90% and until SpO2 improved. MAP, HR, ECG, SpO2, PaO2, PaCO2 were monitored and recorded at time points: T0 (entered operation room), T1 (beginning of bronchofibroscopy), T2 (5 min after bronchofibroscopy), T3 (10 min after bronchofibroscopy), T4 (end of operation). The side effects, the rate of fail to bronchofibroscopy and the rate of intubations after operation in two groups were observed and recorded. Results The HR of post-anesthesia in two groups significantly decreased than those at T0 (P ＜ 0.01), but no difference showed in HR between two groups(P ＞ 0.05). SpO2 and PaO2 of post-anesthesia in two groups significantly increased than those at T0 (P ＜0. 01) ,PaO2 at T1 ,T2 ,T3 in A group were significantly higher than those in B group(P ＜0.05). PaCO2 gradually increased after bronchofibroscopy in two groups ,and the values in A group was significantly lower than in B group(P ＜0.05 or 0. 01). There were no significant differences in the rates of fail to bronchofibroscopy and of intubations after operation between two groups, but the total number of B group was higher. Conclusion Artificial ventilation with CPAP for children with removal of tracheobronchial foreign bodies was safe and practical, and has a better controllability, a minor effect to respiratory function, deserve popularizing.