Objective To compare the effectiveness and safety of ultra-early (< 24 h)and delayed (≥ 24 h ) endovascular embolization of ruptured intracranial aneurysms with systematic review. Methods PubMed,Embase,the Cochrane Library,VIP,Wanfang Data,and China National Knowledge Internet (CNKI)were retrieved according to inclusion,exclusion criteria and retrieval strategies,and the clinical literature of ultra-early and delayed endovascular embolization for the treatment of ruptured intracranial aneurysms were obtained. The Review Manager 5. 3 software was used to conduct Meta-analysis for good prognosis rate,postoperative mortality,and postoperative rebleeding rate. Results A total of 10 articles were included,9 of them were retrospective control studies and 1 was prospective control study. A total of 2 021 patients were enrolled,including 970 patients treated with ultra-early treatment;1 051 patients treated with delayed treatment. There was significant difference in the good prognosis rate (OR,2. 67,95% CI 2. 07 -3. 44,P < 0. 01)and the postoperative rebleeding rate (OR,0. 23,95% CI 0. 11 -0. 47)between the ultra - early embolization group and the delayed embolization group (all P < 0. 01). There were no significant difference in the mortality between the two groups (OR,0. 76,95% CI 0. 51 -1. 13,P = 0. 17). The subgroup analysis showed that there were significant differences in the good prognosis rate in the ultra-early group compared with the early group (< 3 d,OR,1. 98,95% CI 1. 33 -2. 95)and the middle and late group (≥3 d,OR,4. 66,95% CI 2. 21 -9. 81,all P < 0. 01). Conclusion Compared with the delayed group, ultra-early embolization of ruptured intracranial aneurysms may improve the good prognosis rate,reduce the rebleeding rate,and not increase the mortality after procedure at the same time. However,more high quality and large sample randomized controlled trials are needed to confirm them.

Taking application of some isolation and purification technologies, such as solvent extraction, preliminary solvent isolation, column chromatographies over silica gel and Sephadex LH-20 gel and preparative HPLC, 10 compounds were obtained from Gynura nepalensis cultivated in the suburban area of Beijing. Their structures were identified by spectroscopic methods and comparison with literature as (3R) -3-hydroxy-β-ionone (1), (3S,5R, 6S, 7E) -5, 6-epoxy-3-hydroxy-7-megastigmen-9-one (2), (+) -boscialin (3), 3, 6-trans-3-hydroxy-α-ionone (4), 3, 6-cis-3-hydroxy-α-ionone (5), 3, 4-cis-3, 4-dihydroxy-β-ionone (6), ethyl caffeate (7), loliolide (8), 1H-indole-3-carbaldehyde (9), and 3-(hydroxyacetyl)indole (10), respectively. All compounds were isolated from the title plant for the first time, and with compounds 1, 2, 4-7, 9 and 10 being isolated from Gynura species for the first time. Structurally, the above compounds 1-6 belong to C13 nor-sesquiterpenoids, sharing the same carbon skeleton of megastigmane. According to this study, they are one of major kinds of chemical constituents of Gynura nepalensis and have important reference value for the investigation on phytotaxonomy of this species.
Asteraceae ; chemistry ; Caffeic Acids ; chemistry ; Cyclohexanones ; Drugs, Chinese Herbal ; chemistry ; Glucosides ; Indoles ; chemistry ; Mass Spectrometry ; Molecular Structure ; Norisoprenoids ; chemistry

Objective To analyze the results of the Objective Structured Clinical Examination(OSCE) of medical interns in Department of Gynecology and Obstetrics,and to assess the role of OSCE in clinical teaching and practice. MethodsAtolal of 104 medical interns of five-year education program in 2002 and seven-year education program in 2003 in School of Medicine had taken part in OSCE of gynecology and obstetrics.The OSCE consisted of six stations: gynecologic examination,obstetric examination,oral test,interrogation of standardized-patients(SP),drawing partogram,and non-stress test(NST) explanation.After gathering the data of each station,the software of SPSS 11.0 was used to make statistical analysis. Results The median scores were as follows: 92.0 for gynecologic examination,91.0 for obstetric examination,83.5 for oral test,80.0 for interrogation of SP,80.0 for drawing partogram,and 70.0 for NST explanation.There was no significant impact of familiarity to OSCE on the results of the test.The results showed that medical interns did good job in basic performance,but lack of clinical practice skills in some complicated practice of gynecology and obstetrics.Conclusion The grading system and stations setup of OSCE in Department of Gynecology and Obstetrics in Shanghai Sixth People's Hospital show objectivity and equity.The OSCE can be widely applied in the after-department examination and even graduation examination.

Objective To observe the sub-chronic effects of low doses of arsenic poisoning in rabbits exposed to different periods on some of the serum enzymes and biochemical indicators, and to provide the basis for screening of meaningful hematologic indicators for early diagnosis of arsenic poisoning. Methods Twelve adult rabbits,weighing 2.0 - 3.5 kg, were randomly divided into four groups, 3 in each group, and they were fed with drinking water containing sodium arsenite 0(control),0.01,0.05,0.25 mg/L, respectively. Serum alanine aminotransferase (ALT), aspartate amino transferase (AST), alkaline phosphatase (ALP), γ-glutamyl transacylase (y-GT), total protein(TP), albumin(ALB), globulin(GLP), and ALB/GLP of rabbit were measured by SYSMEX-180 automated biochemistry analyzer after 8 weeks and 12 weeks exposure. Results The results showed that ALT in 0.05 mg/Lgroup of 12 week[(60.00 ± 4.14)U/L]increased significantly compared with the control[(41.50 ± 2.12)U/L, P ＜0.05];AST in 0.25 mg/L group of 8 week and 12 week[(46.50 ± 3.21 ), (52.33 ± 3.81 )U/L]increased significantly compared with the control[(21.33 ± 3.53), (29.50 ± 3.23 )U/L, all P ＜ 0.05];ALP in 0.05 mg/L and 0.25 mg/L group of 12 week [(78.68 ± 4.85 ), ( 103.00 ± 7.83 ) U / L]increased significantly compared with the control [(45.50 ± 5.50)U/L, all P ＜ 0.05];γ-GT in 0.05 mg/L group of 12 week[(19.33 ± 7.50)U/L]increased significantly compared with the contro1[(8.50 ± 3.53)U/L, P＜ 0.05]. TP, ALB, GLP, ALB/GLP of different groups of 8 week and 12 week were not significantly different statistically(F= 0.77,0.02,0.16,3.14 and 0.51,0.29,0.41,0.52, all P ＞ 0.05). Conclusions Zero point zero five mg/L and higher doses of sub-chronic arsenic exposure has some major damage to the liver. Compared with other serum enzymes and the biochemical indexes, serum AST is a early sensitive indicator of liver injury of the arsenic poisoning.

Abstract: Objective　To investigate a poisoning incident caused by eating eight treasure congee, and establish liquid chromatography (LC)-mass spectrometry (MS)/MS screening method of 28 alkaloids to provide references for disposal of similar poisoning incidents. Methods　LC-MS/MS was used for screening 28 alkaloids in the urine, eight treasure congee and food raw material, and the detected alkaloids were quantified. Samples were extracted with 0.4% formic acid aqueous solution and separated by a Acquity UPLC BEH C18 column (1.7 μm, 100 × 2.1 mm). Acetonitrile-0.2% formic acid aqueous solution was used as the mobile phase and gradient elution was adopted. The ionization mode was electrospray positive ionization mode, and the detection method was multi-reaction monitoring (MRM). Analytes were quantified with the external standard method. Results　In the concentration range of 0-100 ng/mL, the linear correlation coefficient r were greater than 0.999 for 28 alkaloids. The recovery of 28 alkaloids in urine sample ranged from 63.0% to 105.0%, and the relative standard deviations (RSDs) were between 5.8% and 8.6%. The recovery of 28 alkaloids in eight treasure congee sample ranged from 72.0% to 109.0%, and the RSDs were between 6.3% and 9.7%. The recovery of 28 alkaloids in semen sesami nigrum sample ranged from 60.0% to 95.0%, and the RSDs were between 4.8% and 8.2%. Hyoscyamine (2 380.0 ng/mL), scopliamine (3.6 ng/mL) and rac-anisodamine (4.7 ng/mL) were detected in the patient's urine. Hyoscyamine (63.3 μg/g), scopliamine (5.7 μg/g) and rac-anisodamine (2.1 μg/g) were detected in eight treasure congee. Hyoscyamine (901.0 μg/g), scopliamine (80.0 μg/g) and rac-anisodamine (30.1 μg/g) were detected in the seed of Datura stramonium L. The ratio of scopliamine and hyoscyamine in the seed of D. stramonium was 1∶11, which complies with the characteristics of D. stramonium L. In urine sample, the proportion of scopliamine and rac-anisodamine was 0.15% and 0.20%, and hyoscyamine accounted for 99.65%. Conclusion　Seed morphology, the content range and proportion of three alkaloids are all in accord with the characteristics of D. stramonium. Combined with the clinical symptoms of atropine poisoning, it can be deduced that this incident is a family food poisoning caused by accidental consumption of seed of D. stramonium L. The method can provide technical support for the clinical diagnosis and treatment of alkaloid poisoning patients, and also provide a basis for emergency detection and disposal of alkaloid poisoning events.

Objective To study the effect of sub-chronic exposure to dehamethrin(DM) on the behavior of mice in learning and memory.Methods 60 Female SPF Kunming mice were randomly divided into 4 groups and given DM by gavaging for 60 days.Morris water maze (MWM) was used to evaluate spatial memory in mice.Results After exposure to DM,the escape latency of the solvent control group and the treatment groups were (12.20±6.5)s,(14.99±5.4) s,(15.64±8.3)s,(22.71±6.2)s on the fifth day.The escape latency of the high-dose group was higher than those of the low-dose group (P=0.0041) and the solvent control group (P=0.019) in the navigation test.The number of crossing position of the platform in the high-dose group ((2.93± 1.53)times) and the middle-dose group ((3.40± 1.12) times) were lower than that in the solvent control group ((5.87 ± 1.55) times) and the low-dose group ((4.90± 1.41)times)(P＜0.05).Conclusion Sub-chronic exposure to DM can damage the spatial learning and memory of mice.

A systematic review was undertaken, including studies that evaluated the incidence of the blood system adverse events of Tripterygium wilfordii (TWP). Medline, Embase and the Cochrane library were searched for relevant studies, including RCT, cohort studies and case series, of patients treated with TWP published in English and Chinese from inception up until May 25th, 2013 with the keywords including "Tripterygium wilfordii", "toxicity", "reproductive", "side effect", "adverse", "safety" and "tolerability". Relevant information was extracted and the incidence of the blood system adverse events was pooled with MetaAnalyst software. Besides, subgroup and sensitivity analyses were performed based on age, mode of medicine, observation time and disease system. According to inclusion and exclusion criteria, a total of 49 articles were included in the meta-analysis, they were split into 54 researches incorporated in the analysis. There is a large degree of heterogeneity among the studies, so data was analyzed using random-effects model and the summary estimates of incidence of the blood system adverse events was 6.1%. The weighted combined incidence of three major blood system adverse events were white-blood cells decreasing 5.6% (95% CI, 4.3% - 7.3%), hemoglobin decreasing 1.7% (95% CI, 0.5% - 5.0%) and platelet decreasing 1.8% (95% CI, 1.0% - 3.1%), respectively . Sensitivity analyses based on 45 studies with high quality showed the combined value was close to the summary estimate of total 54 studies. The current evidence indicates that the incidence of the blood system adverse events induced by TWP was high; attentions should be paid on to the prevention and treatment of the blood system adverse events.
Blood Cells ; drug effects ; Hemoglobins ; analysis ; Humans ; Tripterygium ; adverse effects

Objective To investigate the distribution of water-borne fluoride and the current situation of endemic fluorosis in Yan'an city in 2006, and to evaluate the effect of water defluoridation project by improving driking water quality. Method In 2006 in Yan'an city, 5 samples from water source were collected in each selected village that was chosen according to 5 directions of East, West, South, North, and Central. Meanwhile, 1 sample from water source, 1 sample from water processing factory and 2 tap water samples were collected from each water defluoridation project. Water fluoride was determined by spectrophotometric method, teeth and skeletal fluorosis examination were performed by Dean method and "national criteria of endemic skeletal fluorosis diagnosis of China" in children aged 8-12 year and adults, respectively if water fluoride level > 1.00 mg/L Results Of 726 water samples from 293 villages tested, samples from 25 villages had higher fluoride( > 1.00 mg/L), and these villages covered a population of 11 610 people and most of these people were in Wuqi and Yanchuan counties. Water fluoride ranged from 0.10 mg/L to 3.50 mg/L, with median being 0.59 mg/L. Of 100 water samples from 25 water defluoridation projects, only 1 sample exceeded the national criteria in Yanchuan, and Wuqi counties, respectively,with fluoride level being 1.85 mg/L and 1.60 mg/L, respectively, and population exposed was 3083 and 708, respectively, with water fluoride ranged 0.30 - 2.00 mg/L In the examination of 1281 children aged 8 - 12, we detected 238 cases of dental fluorosis, and the detection rate reached 18.58%; 13 900 adults were checked, and 375 cases were confirmed of skeletal fluorosis, a detection rate reached 2.70%. Conclusions Yan'an has a wide range of water with high fluoride and severe fluorosis people. The water defluoridation projects need to be further improved. The task of prevention of endemic fluorosis is still arduous, and we should speed up the implementation of comprehensive water defluoridation measures.

Objective To improve the diagnosis level of solitary bone plasmacytoma (SBP) through analysing the clinical characteristics and therapy of this disease. Methods The clinical data of 18 cases were retrospectively analysis since 1999 in five hospitals, the clinical characteristics and therapeutic effect was summarized. Results The average age of 18 cases is 54.2 year (35-78), male were 1.6 times than female. 8 of 10 patients survived for 1-10 year after chemoradiotherapy, 2 of them progressed to multiple myeloma (MM)and died. 5 of 8 patients survived after only chemotherapy or radiotherapy. There were 11 cases of all patients in continue complete remission (CCS), the average CCS time was 47.3 months. Conclusion SBP is a type low-grade malignant tumor. Chemotherapy and radiotherapy is the main therapy. The patients can gain satisfactory prognosis with chemoradiotherapy, part of them can progress to MM.

OBJECTIVETo determine the threshold of millimeter wave irradiation for fetal injury in mice and the mechanism of decrease of learning and memory function in their offsprings and to verify whether the millimeter wave has the non-thermal effect.

METHODSPregnant mice were irradiated by millimeter wave with frequencies of 37.4, 42.2, 53.0 and 60.0 GHz at power densities of 1, 3, 5, 8 mW/cm(2) for two hours daily from the 6th to 15th day of their gestation. Learning and memory functions of their offsprings were tested by a Y-type electric maze. c-Fos protein expression level in hippocampus of their offsprings was determined with immunohistochemistry 0, 30, 60, 90 and 120 minutes after the offsprings were trained respectively.

RESULTSThe minimal power density of millimeter wave for the decrease in learning and memory function and decrease of c-Fos protein expression level in hippocampus of their offsprings caused by 37.4, 42.2 GHz and 53.0, 60.0 GHz was 5 and 3 mW/cm(2). Severity of injury for learning and memory in offsprings caused by irradiation increased with the power density of millimeter wave. The millimeter wave did not cause increase of the body temperature of the pregnant mice.

CONCLUSIONThe threshold of millimeter wave with 37.4, 42.2 GHz, and 53.0, 60.0 GHz causing fetal injury in mice is 5 and 3 mW/cm(2) respectively. The decrease in learning and memory functions in offspring mice is related with decrease of c-Fos protein expression level in hippocampus. Millimeter wave has the non-thermal effects.

Animals ; Dose-Response Relationship, Radiation ; Female ; Hippocampus ; metabolism ; radiation effects ; Immunohistochemistry ; Learning ; radiation effects ; Memory ; radiation effects ; Mice ; Mice, Inbred BALB C ; Microwaves ; adverse effects ; Pregnancy ; Prenatal Exposure Delayed Effects ; Proto-Oncogene Proteins c-fos ; biosynthesis