This study was aimed to extract and separate fibrauretine from Chinese herbal medicine Fibraurea recisa Pierre. and to prepare tetrahydropulmatine with fibrauretine. Extraction method of fibrauretine were optimized by the L9(34) orthogonal arrays as experimental designs. Then, elution chromatography method was studied with the macroporous adsorption resin chromatography technology. At last, tetrahydropulmatine was prepared by the reaction of sodium borohydride hydrogenating fibrauretine. The results showed that the content and yield of obtained fibrauretine were 36.40% and 3.17%, respectively. The reflux exacted methods of fibrauretine were with 10 times amount (v/w) of 50%ethanol solution for 2 hours and 3 times. Then, HPD-300 macroporous resin was used to absorb fibrauretine, and purify water. The 20% and 60% ethanol solution was used for elution. The content and yield of obtained fibrauretine were 65.47% and 82.44%, respectively. And the content and yield of obtained tetrahydropulmatine were 98.31% and 72.04%, respectively. It was concluded that the method can obtain fibrauretine with relative high content and yield. Using this material can obtain tetrahydrofibrauretine with relative high content and yield.

ObjectiveTo evaluate the value of early secretory antigenic target 6 (ESAT-6) in monocytes of cerebrospinal fluid (CSF) in the early diagnosis and judgment of the tuberculous meningitis (TBM). MethodsForty cases with TBM (TBM group) and 40 patients with other meningitis patients (control group,9 cases with purulent meningitis,24 cases with viral meningitis,3 cases with cryptococcal meningitis,3 cases with cerebral cysticercosis, 1 case with neurosyphyilis) were involved in this study.Conventional examination of CSF was inspected after admission, and the ESAT-6 in monocytes of CSF was detected by immunocytochemical stain. ResultsThe positive rate of ESAT-6 was 24％ in TBM group and 0 in control group (P ＜ 0.01 ). In ROC curve, if the rate of ESAT-6 ≥8.5％ judged as positive, and ＜ 8.5％ judged as negative, 35 patients of TBM group and 4 patients of control group were ESAT-6 positive. The sensitivity of the ESAT-6 in the diagnosis of TBM was 87.5％, and the specificity of TBM was 90.0％. Thirty patients in TBM group were not given anti-tuberculosis drug treatment, and the positive rate of ESAT-6 was 93.3％ (28/30) before treatment, and was 46.7％ (14/30) after treatment of 2 weeks (P =0.000).ConclusionsESAT-6 in monocytes of CSF detected by immunocytochemical stain has higher sensitivity and specificity in the diagnosis of TBM in early stage. Observing the positive rate of ESAT-6 dynamicly has practical value in judgment the severity of TBM.

Objective To investigate the mechanism of neural protection of mouse nerve growth factor combined with sub-hypothermia in the treatment of patients with severe traumatic brain injury. Methods 90 cases of severe traumatic brain injury were randomly divided into study group and control group with 45 cases of each group, the control group were given routine treatment; the study group were given on the basis of routine treatment of mouse nerve growth factor combined with sub-hypothermia treatment, with 2 weeks treatment, the clinical indicators and corresponding nerve injury, inflammation, oxidative stress indexes, clinical effect and complications were compared after 2 weeks treatment. Results Compared with before treatment or control group, scores of Glasgow coma scale (GCS) and Glasgow outcome scale (GOS) and montreal cognitive assessment (MoCA) in study group after the treatment increased, National Institute of Health stroke scale (NIHSS) score decreased(P<0.05), neuronspecific enolase (NSE), myelin basic protein (MBP) and S100 beta levels decreased(P<0.05), the serum tumor necrosis factor-α (TNF-α),interleukin-6 (IL-6), IL-10 levels decreased (P<0.05), the malondialdehyde (MDA) decreased, the glutathione peroxidase (GPx) and oxidation resistance (AOA) levels increased (P<0.05). The control group efficiency was 73.33%, the study group efficiency was 91.11%, there was significant difference (P<0.05). All patients were followed up, no case off, there was no significant difference in adverse drug reaction rate between two groups. Conclusion Mouse nerve growth factor and sub-hypothermia has the significant neural protection for patients with severe traumatic brain injury, and its mechanism may be related to reduce nerve injury indicators and improve inflammatory factor and oxidative stress response.

0.05).Conclusion:Helicid had no effects on the early development of central nervous system in rat offspring.

Objective:To establish a quality standard for vinegar frankincense in Liuwei Jingkang capsules. Methods: TLC was used for the identification of vinegar frankincense. HPLC was used for the content determination of acetyl-11-keto-β-boswellic acid (AKBA), which was the main active component in vinegar frankincense. A SHIMADZU Shim-pack VP-ODS(250 mm × 4. 6 mm,5μm) column was used. The mobile phase consisted of acetonitrile and water containing 0. 01 mol·L-1 hydrochloric acid (78 ∶22) at a flow rate of 1. 5 ml·min-1 . The column temperature was 30℃. The detection wavelength was 252 nm, and the injection volume was 10 μl. Results:The TLC method could identify the characteristic fluorescence of vinegar frankincense was without interference from the blank. There was a good linear relationship of AKBA within the concentration range of 0. 036 5-0. 730 8 mg·ml-1(r=0. 999 7). The average recovery was 98. 24% (RSD=0. 83%, n=9). Conclusion:The established method is accurate, highly sensitive and well re-producible, which can be used for the quality control of Liuwei Jingkang capsules.

0.05).Conclusion The administration of helicid to pregnant rats did not affect the early development of nervous system, neurobehavioral function and brain histology of offspring.

Objective To summarize our experience of laparoscopic surgery for complex choledochal cysts (type Ⅳ-A). Methods The clinical data of 65 children of choledochal cyst undergoing laparoscopic choledochal cyst resection were retrospectively reviewed from 2002 to 2009 in our institute.Among those type Ⅳ-A cyst was found in 16 patients. Hepaticojejunostomy was performed using a Roux-en-Y jejunal loop after extrahepatic cyst excision and ductoplasty. Results Laparoscopic procedures were successfully performed in 16 patients with type Ⅳ-A cysts. The stenotic segment was splited or excised and a wide hepaticojejunostomy was completed at the porta hepatis in 8 patients with a stricture extending to the level of common hepatic duct. The constrictive confluence of the bilateral hepatic duct was incised and the bi-ductal cystojejunostomy was achieved at the bifurcation in 4 cases. A septum was found at the orifice of right hepatic duct and was excised through the hilar stoma in 2 cases. A downstream stricture of the left hepatic duct was incised from the hilum to the dilated segment along the lateral wall in 2 patients, so that a long intrahepatic cystojejunostomy was completed in an oblique course. Postoperative complications developed in 2 cases including temporary bile leakage in one case and anastomotic stricture in another. The intrahepatic cysts were remarkably reduced in size during the follow-up. Conclusions With the magnified laparoscopic view, the radical resection of extrahepatic cyst and correction of the intrahepatic bile ductal stenosis can be easily performed. Laparoscopic hepaticojejunostomy and/or intrahepatic cystojejunostomy is effective and safe for children with type Ⅳ-A choledochal cysts.

Objective To investigate the value of cardiac troponin Ⅰ (cTn Ⅰ) in diagnosis of multi-trauma patients combined with myocardiac contusion.Methods A retrospective review was made on 98 cases of multi-trauma patients combined with blunt chest trauma.The groups were identified according to whether the patients were associated with myocardiac contusion or not,including myocardiac contusion group (n =48) and non-myocardiac contusion group (n =50).The detection and diagnosis of myocardiac contusion in the use of different cut-off points of cTn Ⅰ and creatine kinase MB isoenzyme/creatine kinase (CKMB/CK) or their combination were compared between groups.Results cTn Ⅰ ≥0.60 ng/ml had a specificity of 90.0％,a sensitivity of 64.6％ and a Youden index of 0.54 in diagnosis of myocardiac contusion,indicating a best diagnostic accuracy as a single parameter.As compared with the single use of cTn Ⅰ ≥ 0.60 ng/ml or CKMB/CK ≥ 6％ in diagnosis of myocardiac contusion,the combined use of two parameters presented a significantly higher diagnostic sensitivity (85.4％ vs 64.6％ ; 85.4％ vs 27.1％ respectively,both P ＜ 0.05),but no markedly lower specificity (84.0％ vs 90.0％ ; 84.0％ vs 88.0％ respectively,both P ＞0.05).cTn Ⅰ level was positively correlated with ISS score of the multi-trauma patients combined with myocardiac contusion (r =0.534,P ＜ 0.01).Mortality rate in patients with severely increased cTn Ⅰ was much higher than that in patients with mild-moderately increased cTn Ⅰ (P ＜ 0.01).Conclusions cTn Ⅰ ≥0.60 ng/ml presents a high sensitivity and preferable specificity for diagnosis of multiple trauma patients combined with myocardiac contusion.It can be served as a biomarker for diagnosis of MC and its combination with CKMB/CK≥6％ improves the diagnostic sensitivity.cTn Ⅰ can be used as an assessment indicator for the early risk stratification and outcome in multi-trauma patients combined with myocardiac contusion.

Objective To observe the apeptosis in liver injury following limbs ischemia-reperfusion(IR) in rats and the protective effects of taurine.Methods The model of limbs ischemia-reperfusion injury was established.30 Wistar rats were randomized into 3 groups: control group,IR group and tanrine + reperfusion group (TR group) (n = 10 for each group).The levels of malondialdehyde (MDA) and xanthineoxidas (XOD), calcium and myeloper-oxidase (MPO) in the liver tissue were measured.DNA fragmentation was observed and analyzed by agarose gel e-lectrophoresis.Apoptosis was detected by TUNEL methods.The morphologic changes were observed with HE stai-ning.Results Compared with control group,the values of MDA, XOD, MPO, calcium in liver tissue were increased significantly in IR group (P<0.01), but the values of those in TR group were lower than in IR group (P<0.01).The percentage of apeptosis cell was higher in IR group than in control group(P<0.01).Compared with IR group, the percentage of apoptosis cell was lower in TR group (P<0.01).IR group presented DNA ladder pattern, while TR group showed no specific DNA ladder pattern in agarose gel electrophoresis.Conclusion Apoptosis participates in the liver injury after limb ischemia-reperfusion.Taurine can mitigate the liver injury and apoptosis after limb is-chemia-reperfusion injury in rats.

Objective To investigate the clinical and molecular pathological features of limb-girdle muscular dystrophy 2A (LGMD2A) of Chinese patients. Methods Thirty cases of LGMD with excluding LGMD2B were included in this study. The muscle specimens were performed by a standard series methods of histochemistry, enzymohistochemistry, immunohistochemistry and Western blot. The clinical and molecular pathological features of LGMD2A were retrospective analyzed. Results Five cases with no or only trace expression of calpain-3 protein were diagnosed as calpainopathy (LGMD2A) by Western blot analysis. The age of onset of these 5 patients ranged from 10 to 45 years and the duration of the disease were about 2-10 years. Proximal muscles weakness and atrophy of lower limbs were predominantly involved. In all patients,symptoms progressed slowly. The ambulation could be retained for many years but running and jumping were impaired early. The serum creatine kinase level was elevated moderately to markedly. Electromyography showed myopathic patterns in all cases. Two siblings had similar symptoms indicating autosomai recessive inherited pattern. Pathologically, there was marked variation in fibre size and most small fibres were round. Some necrotic and regenerating fibers were seen. Fibres with centrally placed nuclei can be found frequently. No infiltrations of inflammatory cells were seen. Lobulated fibers were observed in 2 patients by NADH-TR stain. The expression of dystrophin, caveolin-3, α-, β-, γ- and δ-sarcoglycan protein were normally staining of 5 LGMD2A patients' specimens by immunohistochemistry. Two patients had reduced staining of dysferlin by immunohistochemistry study. Conclusions Clinical and pathological characteristics of our 5 LGMD2A patients are consistent with typical muscular dystrophy features reported in other countries. Identification of calpian-3 deletion by Western blot is essential for the diagnosis of calpainopathy.