Objective To study the chemical constituents from EtOAc extracts of Paeonia lactiflora. Methods Compounds were isolated by various chromatographic techniques and structures were elucidated on the basis of spectral analysis. Results Seventeen compounds were obtained and their structures were identified as l,2,6-benzenetriol-l-O-α-D-glucoside (1), paeoniflorin (2), 4-methylpaeoniflorin (3), albiflorin (4), paeonidanin (5), benzoylpaeoniflorin (6), 4-methylbenzoylpaeoniflorin (7), benzoylalbiflorin (8), paeonidanin A (9), galloylalbiflorin (10), debenzoylalbiflorin (11), 4',5-dihydroxyflavanone-7-O-β-D-glucoside (12), 5,7-dihydroxy flavanone-4'-O-β-D-glucoside (13), (+)-catechin (14), gallic acid (15), vanillic acid (16), and 1,2,3-benzenetriol (17). Conclusion Compound 1 is a new compound named paeoniphenoside. Compounds 12 and 13 are firstly obtained from genus Paeonia L., and compounds S and 9 are isolated from P. lactiflora for the first time.

Objective To discuss efficacy of movement combined with calcium vitamin D in preventing osteoporosis in early postmenopausal women .Methods There were 100 cases ,which were divided into treatment group(50 cases) and control group(50 cases) ,to detect x-ray bone density and three kinds of absorptiometry bone markers as a baseline .The treatment group were given calcium carbonate ,vitamin D3 tablets ,continuous 3 ,6 ,12 ,18 months after the detection of bone mineral density and bone markers a-gain ,observe the change of various index .Results Early menopause women are very high in bone metabolic conversion rate .Com-bined therapy with calcium carbonate and vitamin D ,could significantly affect the level of the three types of bone markers ,there were negative phase ,and the changes in bone turnover markers were preference to BMD Treatment group three kinds of bone mark-ers had changed within three months ,fell by 25% ,12% and 10% respectively .Vitamin D and calcium carbonate effects on bone markers in monitoring ,and so ,three kinds of bone markers with different characteristics .Type Ⅰ collage carboxy-terminal peptide (β-CTX) in the early days could be a significant reduction in 3 months ,6 months after basic hadn′t changed much ;Type Ⅰ procol-lagen amino-terminal peptide (P1NP) and N-terminal osteocalcin (N-MID) reaction time was longer ,the heavy absorption resist-ance was remarkable changes after 6 months ,1 years maintained at a certain level ,and the change of bone mineral density(BMD) at least need more than 12 months .Conclusion Exercise and calcium carbonate and vitamin D supplement ,which could effectively re-duce the bone absorption and improve vitamin D levels ,prevent bone loose women in early menopause has great significance

Objective　To investigate the change of epithelium growth factor(EGF), tumor necrosis factor (TNF), superoxide dismutese(SOD) and hemorrheology (HL) in patients with diabetic retinopathy.Methods　EGF、TNF、SOD levels and HL changes have been measured in 30 NIDDM patients with retinopathy (DR group), 29 NIDDM patients without retinopathy (NDR group), and 29 patients with senile cataract and without diabetes as control (C group). Results　The mean levels of EGF、TNF and blood viscosity were significantly higher in both DR and NDR group than those in C group; the mean levels of SOD was significantly lower in both DR and NDR group than that in C group. The EGF、TNF and blood viscosity was significantly higher in proliferative type DR than in background DR; The SOD was significantly lower in proliferative type DR than in background DR.Conclusion　The development of diabetic retinopathy is related to the increase of EGF、TNF、blood viscosity and decrease of serum SOD.

Objective To investigate the effect of second generation antipsychotics (SGAs) on adiponectin (APN) and metabolic indicators and to explore the role of APN in the antipsychotic-induced weight gain (AIWG). Methods A total of 86 drug na?ve first episode schizophrenia patients and 88 sex-and age-matched healthy controls were collected. All patients received a single SGAs treatment for 8 weeks. In patient group, the level of weight, body mass index (BMI), waist-to-hip ratio (WHR), fasting plasma glucose (FPG), triglyceride (TG), total cholesterol (TC), APN and fasting insulin (FINS) were measured before and after 8-week treatment. While as the control group was only measured once after enroll?ment. Results The serum APN [(9.32 ± 0.76) μg/mL vs. (10.9 ± 0.66) μg/mL] was lower and FINS was higher [(20.27 ± 15.02)μIU/mL vs. (12.68±11.70)μIU/mL] in drug na?ve patients compared with healthy controls (P<0.05). After 8-weekSGAs treatment, patients showed significant increases in weight [(59.01 ± 10.56) kg vs. (63.80 ± 9.78) kg], BMI [(21.74 ± 3.57) kg/m2 vs.(23.49±3.44) kg/m2], WHR [(0.88±0.07) vs. (0.92±0.05)], TG [(0.94±0.92) mmol/L vs. (1.63±1.08) mmol/L] and FINS [(12.68 ± 11.70)μIU/mL vs. (20.27 ± 15.02)μIU/mL], and significant decreases in APN [(9.32 ± 0.76)μg/mL vs. (8.03±0.68)μg/mL] and FPG [(5.04±1.01) mmol/L vs. (4.46±0.57) mmol/L] (all P<0.05). In male patients, baseline APN levels were positively correlated with AIWG (r=0.548,P=0.005). Conclusion The serum APN levels in drug na?ve first episode schizophrenic patients are significantly lower than normal and are further decreased after SGAs treatment. Base?line APN may predict the AIWG in male patients.

Objective To explore the effect of the proximal femoral nail antirotation(PFNa) for the treatment of femoral intertrochanteric fracture.Methods 272 consecutive patients with femoral intertrochanteric fracture were treated with PFNa.Results The mean operative time was 55min(range 35 ～95)min.The mean blood loss was 85ml (range:20 ～200)ml.The mean follow-up was 15.6months( range:6 ～36)monthsand achieved bone healing with an average time of 14.5weeks.According to the Harris criterion for evaluation.Conclusion PFNa was more comfortable for human's biomechanism and more favorable for the healing of the fracture as well as the recovery of the hip function.It had the advantage of simple manipulation,fewer trauma,strong fixation,anti-rotation,less osclerotin.PFNa was an ideal treatment for intertrochanteric fracture,specially the unstable intertrochanteric fracture and senile osteoporosis.

Objective To investigate the risk factors related to failure of proximal femoral nail anti-rotation(PFNA)internal fixation for intertrochanteric fracture of femur.Methods A retrospective research was done on 249 cases with intertrochanteric fracture of femur after PFNA internal fixation.The failure ratios related to sex,fat,fracture pattern,osteoporosis,replace condition in operation and tip-apex distance(TAD)were calculated.And the risk factors related to failure of PFNA were statistically analysed.Results Two hundred and forty-three cases were followed up ranged from 10 months to 3 years after operation.Plain AP and lateral radiographs were obtained at each follow-up patient,13 of 243 cases resulted in failing by PFNA internal fixation.The failure ratios in PFNA internal fixation with fat,unstable fracture,TAD≥25 mm and bad replace condition in operation were 8.5％(12/141),7.8％(12/153),18.5 ％(5/27)and 26.1％(6/23),respectively,which were higher than those in PFNA internal fixation with nonobese,stable fracture,TAD ＜ 25 mm and good replace condition in operation[1.0％(1/102),1.1％(1/90),3.7％(8/216)and 3.2％(7/220),respectively](P＜0.05 or ＜0.01).Conclusions Fat,unstable fracture,TAD≥25 mm and bad replace condition in operation are the relatively independent risk factors related to failure of PFNA internal fixation for intertrochanteric fracture of femur.Furthermore,it will prevent and reduce the ratio of complications to avoid these risk factors when PFNA internal fixation is selected for treatment intertrochanteric fracture of femur.

OBJECTIVEThe objective of this study is to investigate the association between laryngeal carcinoma and laryngopharyngeal reflux.

METHODSThis was a case-control study with 31 laryngeal cancer patients who had undergone 24-hour ambulatory double pH monitoring and 76 in the control group which were divided into negative group (36 patients) and positive group (40 patients) by the score of RSI (reflux symptom index) and RFI (reflux findings index) scale. The results of reflux and parameters of 24-hour ambulatory double pH monitoring among the three groups were statistically analysed.

RESULTSThe smoking rate of 80.6% (25/31) in laryngeal carcinoma group was significantly higher than that of (36.1%, P < 0.0167) in the negative group while it did not vary in laryngeal carcinoma group and the positive group (65.0%, P > 0.0167). The drinking rate of 71.0% (22/31) in laryngeal carcinoma group was higher than that of (36.1%, P < 0.0167) in the negative group whereas there was no significant difference between laryngeal carcinoma group and positive group (50.0%, P > 0.0167). The positive rate of laryngopharyngeal reflux in laryngeal carcinoma group, the positive group, the negative group were 74.2% (23/31), 16.7% (6/36) and 52.5% (21/40) respectively, which was significantly different (P < 0.05). The positive rate of gastroesophageal reflux in the three groups above were 71.0% (22/31), 52.8% (19/36) and 75.0% (30/40), which had no significant difference (P > 0.05). The positive rate of laryngopharyngeal reflux differed in laryngeal carcinoma group and the negative group (P < 0.0167) while did not differ in laryngeal carcinoma group and the positive group (P > 0.0167). In the results of 24-hour ambulatory double pH monitoring, there was significant difference in the total and upright reflux number, the total reflux time, the percent times for the pH falling below 4, total reflux number which lasted more than 5 minutes and DeMeester Scores.

CONCLUSIONSThe positive rate of laryngopharyngeal reflux in laryngeal carcinoma group was very high while the drinking and smoking rate were also high. Therefore whether the laryngopharyngeal reflux is a risk factor of the laryngeal carcinoma, it needs further research.

Adult ; Aged ; Case-Control Studies ; Esophageal pH Monitoring ; Female ; Humans ; Laryngeal Neoplasms ; complications ; epidemiology ; Laryngopharyngeal Reflux ; complications ; epidemiology ; Male ; Middle Aged ; Risk Factors

Objective To retrospectively study the incidence and risk factors of thyroid disease induced by peginterferon plus ribavirin (Peg IFN/RBV) antiviral treatment in patients with chronic hepatitis C (CHC).Methods From January 2012 to December 2014,a total of 362 CHC patients were treated with Peg IFN/RBV antiviral therapy at Wuxi Fifth People's Hospital,among whom 315 patients were included in this study.Thyroid function,autoantibodies and thyroid ultrasound were measured at baseline,weeks 12,24 and 48.Comparisons between groups were performed using chi-square test for qualitative data and the unpaired t test for continuous variables.Results After treatment,thyroid dysfunction developed in 12.1％ of patients.Positive anti-thyroid peroxidase and anti-thyrobolulin antibodies were detected in 21％ of patients.The thyroid ultrasound changes developed in 14.9％ of the patients,among whom normal thyroid function and thyroid autoantibodies negative were detected in 8.7 ％ of patients.The titer of thyroid autoantibodies increased steadily from baseline to the end of treatment.Logistic regression analysis showed that positive thyroid autoantibody (OR =5.423,95％ CI:3.441 8.716),sustained virological response (OR=7.201,95％CI:6.231-10.206),female(OR=1.22,95％ CI:0.951-2.212) were the risk factors of thyroid dysfunction.Conclusions Peg IFN/RBV antiviral treatment increases the incidence of thyroid disease in CHC patients.Positive thyroid autoantibody,sustained virological response and the female gender are the risk factors of thyroid dysfunction.

Objective:To explore the therapeutic effect of multi-mode sequential combination of artificial liver in the treatment of hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF).Methods:The clinical data of HBV-ACLF patients treated with artificial liver in Wuxi Fifth People′s Hospital from January 2018 to June 2021 were retrospectively analyzed. Eighty-six patients were divided into artificial liver multi-mode sequential combination therapy group (sequential combination group) and conventional treatment group. The cytokine level changes and model for end-stage liver disease (MELD) score were analyzed at 14 days of disease duration. The survival outcome and complications of artificial liver were analyzed after 30 days of follow-up. Two independent samples t test and chi-square test were used for statistical analysis. Cox regression analysis was used to analyze the risk factors of death, and Kaplan-Meier method was used to analyze the survival rate of patients. Results:A total of 86 patients were enrolled, including 48 patients in sequential combination group with the average number of artificial liver of 4.68 times/person, and 38 patients in conventional treatment group with the average number of artificial liver of 3.17 times/person. At 14 days of disease duration, interleukin (IL)-6, IL-8, interferon γ-inducible protein (IP)-10 level and MELD score in sequential combination group decreased significantly than those in the conventional treatment group ( t=3.80, 3.62, 4.95 and 1.11, respectively, all P<0.050). After 30 days of follow-up, 63 patients survived and 23 patients died. Cox regression analysis showed that baseline international normalized ratio (hazard ratio ( HR)=0.558, 95% confidence interval ( CI) 0.193 to 0.856, P=0.027), baseline antithrombin Ⅲ activity ( HR=0.876, 95% CI 0.824 to 0.932, P<0.001), artificial liver mode ( HR=0.819, 95% CI 0.236 to 0.992, P=0.005), spontaneous peritonitis ( HR=0.170, 95% CI 0.045 to 0.647, P=0.009) and hepatic encephalopathy ( HR=0.004, 95% CI 0.001 to 0.030, P<0.001) were independent influencing factors for 30-day survival outcome. The cumulative survival rate of sequential combination group was higher than that of conventional treatment group, and the difference was statistically significant ( χ2=5.45, P=0.020). There were no significant differences in the proportions of bleeding, deep vein thrombosis, heart rate and blood pressure instability between the two groups ( χ2=0.63, 1.20 and 0.54, respectively, all P>0.050). The platelet decline of patients in sequential combination group was slighter than that in conventional treatment group, and the difference was statistically significant ( t=-4.17, P=0.002). Conclusions:Multi-mode sequential combination therapy of artificial liver could eliminate cytokines and reduce MELD score more effectively in patients with HBV-ACLF, and prolong the survival time of patients and have little effect on platelet count.

ObjectiveTo evaluate the effectiveness and safety of neck seven-line method combined with periauricular acupuncture as salvage treatment for sudden hearing loss in non-acute stage. MethodsSixty-six patients with non-acute stage of sudden hearing loss with a disease duration of 15-90 days were randomly divided into 33 cases each in treatment group and control group. The treatment group was given neck seven-line method combined with acupuncture at periauricular points； the control group used sham acupuncture and sham electroacupuncture at the same points. Both groups were treated 3 times a week for 6 weeks. The pure tone average hearing threshold of impaired frequencies were examined before treatment， after treatment finish and at follow-up （week 10）， and the difference between pure tone average hearing threshold of impaired frequencies before and after treatment was calculated； calculate the proportion of patients with ≥10 dB improvement in pure tone average hearing threshold of impaired frequency after treatment and at follow-up； compare the patients' Tinnitus Evaluation Scale （TEQ） scores， Chinese Medicine Quality of Life Assessment Scale （CQ-11D） health utility values and the difference between before and after treatment， and record the occurrence of adverse events. ResultsThe pure tone average of impaired frequency in the treatment group were （50.57±18.07） dB and （47.70±17.42） dB at post-treatment and follow-up respectively， and （54.38±21.77） dB and （53.36±20.99） dB in the control group at post-treatment and follow-up. Compared with the pre-treatment period， the pure tone average hearing threshold of impaired frequency in the two groups significantly decreased （P＜0.05） at post-treatment and follow-up. The difference of pure tone average hearing threshold of impaired frequency in the treatment group after treatment and at the follow-up visit compared to that before treatment was lower than those in the control group （P＜0.05）. After treatment， 13 patients （39.39%） in the treatment group and 10 patients （30.30%） in the control group showed improvement of ≥10 dB in pure tone average hearing threshold of impaired frequency； at the follow-up visit， 18 patients （54.55%） in the treatment group and 10 patients （30.30%） in the control group showed improvement of ≥10 dB in the pure tone average hearing threshold of impaired frequency， and there was no statistical significance for comparison between groups at the time of post-treatment and follow-up （P＞0.05）. The TEQ score of the treatment group significantly lower than that before treatment （P＜0.05）； the TEQ score of the treatment group and the difference between before and after treatment significantly lower than that of the control group （P＜0.05）. The difference in CQ-11D health utility values and the difference between before and after treatment were not statistically significant between the two groups （P＞0.05）. Eight cases of acupuncture-related adverse events occurred among 66 patients， including subcutaneous haematomas after needling， severe pain during needling and needle fainting， which disappeared after symptomatic treatment and did not affect the following treatment. ConclusionNeck seven-line method combined with periauricular acupuncture could be used as salvage treatment for sudden hearing loss in non-acute stage to improve the pure tone average hearing threshold of impaired frequency， alleviate tinnitus， with safety.