Nine compounds were isolated from the n-butanol fraction of 95% ethanol extract of the fruit of Alpinia oxyphylla Miq. with a combination of various chromatographic approaches, including MDS resin, silica gel, reverse phase C18 and preparative HPLC. On the basis of spectroscopic data analysis, they were elucidated as (1R, 4R, 10R)-1β, 4α-dihydroxy-11, 12, 13-trinor-5, 6-eudesmen-7-one (1), 1β, 4β-dihydroxy-11, 12, 13-trinor-8, 9-eudesmen-7-one (2), oxyphyllenone A (3), oxyphyllenone B (4), rhamnocitrin (5), staphylionoside D (6), benzyl-1-O-β-D-glucopyranoside (7), 2-O-β-D-glucopyranosyl-(1S)-phenylethylene glycol (8), and (S)-1-phenylethyl-β-D-glucopyranoside (9). Among them, compound 1 is a new sesquiterpene, named as oxyphyllenone C; compounds 8 and 9 are new natural products; compounds 2 and 6 were isolated from the genus Alpinia for the first time, and compound 7 was isolated from A. oxyphylla for the first time.

OBJECTIVE: To observe the release mode and the amount of retention in skin of podophyllotoxin liposomes in topical application. METHODS: Two kinds of podophyllotoxin liposome suspension (DPPC liposome and bean lecithin liposome) and podophyllotoxin tincture in same concentration were topically applied on the skin of porkets and the amounts of retention of drug in skin of different preparations were detected with confocal laser scanning microscope.RESULTS: The quantity of retention of podophyllotoxin DPPC liposome in epidermis and superficial layer of dermis was larger than those of other two preparations and the drug concentration in applying DPPC liposome kept higher for 48 hours.CONCLUSION:Podophyllotoxin liposome coated by DPPC is much more targetable to skin and is a fairly good topical preparation for applying on skin.

Objective To investigate the application of preoperative autologous blood donation (PABD) in selective operation.Methods Retrospective investigations and analysis were carried out in clinical datas of 1 026 patients of PABD in selective operation from January 2016 to may 2017,comparing with those who had not performed PABD in the same time.Results ①The surgeries of PABD were mainly neurosurgery,urology,orthopedics,gynecology and hepatobiliary surgery,respectively,which accounted for 5.97％,4.90％,3.78％,3.76％ and 3.55％ of the patients in the same period;②The rate of transfusion of allogeneic red blood cells of selective operation in PABD group of neurosurgery,urology,orthopedics,gynecology and hepatobiliary surgery were 5.66％,2.51％,4.89％,0 and 4.88％,respetively,while not performed PABD group were 25.46％,28.58％,24.77％,10.62％ and 17.54％,respetively;③The rate of transfusion of the group of hemoglobin (Hb)＜ 120 g/L is significantly higher than those Hb is (120-129.9) g/L,(130-139.9)g/L and ≥ 140 g/L(7.65％vs 2.44％,3.66％ and 2.70％,P＞0.05).Conclusion ①PABD is mainly carried out in neurosurgery,urology,orthopedics,gynecology and hepatobiliary surgery;②The group of Hb＜ 120 g/L has a high rate transfusion of allogeneic erythrocyte in selective operations;③Only the PABD is improved can patients make benefit from it.

Objective To investigate the effect of preoperative application of leuprolide acetate on hormone levels,menstrual and uterine fibroids recurrence in patients with laparoscopic myomectomy.Methods A total of 100 patients with hysteromyoma were randomly divided into experimental group (n=50) and control group (n=50).The control group was treated with laparoscopic myomectomy,while the experimental group was treated with leuprorelin acetate before laparoscopic myomectomy.The levels of serum hormones,menstruation,fibroid volume and recurrence rate of uterine fibroids were observed.Results In the experimental group,after use of leuprolide acetate,the luteinizing hormone,follicle stimulating hormone and serum estradiol were significantly lower than those before treatment,and menstrual blood volume,uterine volume,leiomyoma volume were significantly less than those before treatment (P<0.05).Compared with the control group,the amount of bleeding in operation and pelvic drainage were significantly lower,and ambulation time,hospitalization time were significantly shorter in experimental group (P<0.05).Conclusion Before the laparoscopic myomectomy,the clinical efficacy and safety of leuprolide acetate is great,which can reduce the serum hormone level,improve the volume of leiomyoma.

Objective To investigate the effect of preoperative application of leuprolide acetate on hormone levels,menstrual and uterine fibroids recurrence in patients with laparoscopic myomectomy.Methods A total of 100 patients with hysteromyoma were randomly divided into experimental group (n=50) and control group (n=50).The control group was treated with laparoscopic myomectomy,while the experimental group was treated with leuprorelin acetate before laparoscopic myomectomy.The levels of serum hormones,menstruation,fibroid volume and recurrence rate of uterine fibroids were observed.Results In the experimental group,after use of leuprolide acetate,the luteinizing hormone,follicle stimulating hormone and serum estradiol were significantly lower than those before treatment,and menstrual blood volume,uterine volume,leiomyoma volume were significantly less than those before treatment (P<0.05).Compared with the control group,the amount of bleeding in operation and pelvic drainage were significantly lower,and ambulation time,hospitalization time were significantly shorter in experimental group (P<0.05).Conclusion Before the laparoscopic myomectomy,the clinical efficacy and safety of leuprolide acetate is great,which can reduce the serum hormone level,improve the volume of leiomyoma.

Objective:To analyze the effect of traditional Chinese medicine fasting therapy on atherogenic index of plasma and metabolic indices in patients with metabolic syndrome.Methods:A case-control study was conducted on 90 patients with metabolic syndrome who were treated at Wenzhou Traditional Chinese Medicine Hospital between June 2021 and June 2023. The patients were divided into two groups with 45 patients in each group using a random number table method. The control group was given a normal diet, while the observation group underwent traditional Chinese medicine fasting therapy. Blood lipid indexes, atherogenic index of plasma, Homeostasis Model Assessment of Insulin Resistance index, anthropometric indices, and oxidative stress response were compared between the two groups.Results:After treatment, the levels of low-density lipoprotein cholesterol, total cholesterol, and triglyceride in the observation group were (2.11 ± 0.26) mmol/L, (4.31 ± 0.26) mmol/L, and (1.39 ± 0.26) mmol/L, respectively. They were significantly lower than those in the control group [(2.95 ± 0.34) mmol/L, (5.24 ± 0.33) mmol/L, (2.68 ± 0.41) mmol/L, t = 13.16, 14.85, 17.82, all P < 0.05]. After treatment, the level of high-density lipoprotein cholesterol was significantly higher in the observation group than in the control group [(1.18 ± 0.09) mmol/L vs. (1.03 ± 0.04) mmol/L, t = 10.21, P < 0.001]. After treatment, atherogenic index of plasma and Homeostasis Model Assessment of Insulin Resistance index in the observation group were (0.10 ± 0.04) and (5.12 ± 0.42), respectively in the observation group. They were significantly lower than those in the control group [(0.28 ± 0.10), (5.80 ± 0.67), t = 11.21, 5.76, both P < 0.001]. After treatment, waist circumference, hip circumference, and visceral adiposity index in the observation group were (91.05 ± 4.26) cm, (98.16 ± 5.06) cm, and (3.94 ± 0.52), respectively. They were significantly lower than those in the control group [(95.55 ± 9.87) cm, (102.64 ± 9.84) cm, (5.66 ± 1.04), t = 2.80, 2.71, 9.92, all P < 0.05). After treatment, the level of superoxide dismutase in the observation group was significantly higher than that in the control group [(101.52 ± 13.52) U/mL vs. (80.01 ± 6.82) U/mL, t = 9.52, P < 0.001]. After treatment, the level of malondialdehyde in the observation group was significantly lower than that in the control group [(4.41±0.35) nmol/L vs. (6.26 ± 0.61) nmol/L, t = 17.64, P < 0.001). Conclusion:Traditional Chinese medicine fasting therapy can effectively reduce the atherogenic index of plasma, blood lipid level, waist circumference, hip circumference, and visceral adiposity index in patients with metabolic syndrome. It also reduces oxidative stress reactions and is highly effective.

Objectives To provide genetic counseling and prenatal molecular diagnosis for two families with megalencephalic leukoencephalopathy with subcortical cysts (MLC).Methods Two MLC patients (probands 1 and 2) were admitted to the Department of Pediatrics of Peking University First Hospital in June 2011 and June 2009,respectively.Peripheral blood was collected and DNA sequencing was performed for genetic analysis for the two MLC patients and their parents.Amniotic fluid and villus of two fetuses (fetus 1 and 2) were collected at 21+4 and 12+3 weeks of gestational age from their mothers when they were pregnant again.The genomic DNA of the two fetuses was extracted and corresponding sites of MLC1 gene were sequenced.Haplotype analysis using a combination of 3 microsatellite markers (AR,DXS6807 and DXS6797) on chromosome X and sex determining region of Y chromosome was performed to detect maternal cell contamination.Verification of the prenatal molecular diagnosis and follow up study after birth were conducted for both fetuses.Results Macrocephaly,motor development delay and typical findings on brain MRI were identified in the two probands,and were clinically diagnosed with MLC.Compound heterozygous mutations were detected in proband 1 [c.353C＞T (p.T118M) and c.803C＞G (p.T268R)] and proband 2 [c.353C＞T (p.T118M) and c.836T＞C(p.L279P)],respectively.MLC was genetically diagnosed.Heterozygous variation in c.353[c.353C＞T (p.T118M)] and wild c.803C were identified in fetus 1,and both wild c.353C and c.836T were found in fetus 2.No maternal cell contamination was detected in both fetuses.Sequencing the corresponding sites after birth confirmed the prenatal diagnosis,and the head circumference and motor development were normal in fetus 1 at 5 months old.No macrocephaly was found and no DNA sequencing was done in fetus 2 at one month old.Conclusions Genetic counseling and prenatal molecular diagnosis for MLC families combined with clinical and genetic diagnosis are important in preventing MLC.Haplotype analysis with a combination of three microsatellite markers on chromosome X and sex determining region of Y chromosome is useful in detecting maternal cell contamination and avoiding its influence on prenatal diagnosis,and confirming the reliability of prenatal diagnosis.

The 17α-hydroxylase/17, 20-lyase deficiency (17-OHD) is a rare disease. The clinical characteristics and gene mutation of 2 late-diagnosed 17-OHD patients with testicular tumor admitted to our hospital from March 2018 to February 2019 were analyzed retrospectively. The two 17-OHD patients were female (46, XY). Laparoscopic abdominal exploration found undeveloped testicles in grey-yellow or grey-red in the groin and iliac fossa. The testicles were removed and showed malignancy in pathology study. Sequencing of the CYP17A1 gene identified c.1247G>A/c.1427T>C and c.985_987delTACinsAA/c.1306G>A complex heterozygous mutations. Taking together, the possibility of 17-OHD should be considered in patients with hypertension, hypokalemia, adrenal adenomatoid hyperplasia together with 46, XY gonadal dysplasia, so as to make early diagnosis and treatment, and avoid dysplastic testicular turning to malignancy.

Abstract The COVID-19 pandemic has posed a series of complex challenges. COVID-19 in children and adolescents is generally less severe than in adults and the elderly; however, some children and adolescents may experience severe complications and adverse health effects even after mild or asymptomatic COVID-19 infections. The article focuses on gathering the epidemic characteristics, health impact, risk factors, prevention and control measures, and vaccination status of children and adolescents with COVID-19 infection to provide recommendations for protecting children and adolescents in the post COVID-19 era.

Objective:To explore clinical evaluation and genetic analysis of patients with idiopathic hypogonadotropic hypogonadism (IHH).Methods:The clinical data and phenotypes of 22 patients with IHH diagnosed and treated in our department were reviewed and analyzed. Whole-exome sequencing(WES)and Sanger method were used for variant analysis and verification.Results:Among the 22 cases of IHH probands, 12 cases of Kalman syndrome (KS) and 10 cases of IHH (nIHH) with normal sense of smell. On physical examination, males showed short penis, small testicles, small or inconspicuous laryngeal knots, and a sharp voice. Mammary gland development, mammary gland dysplasia, primary amenorrhea, etc. in women. Sex hormone examination: Follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T), estradiol (E2) levels are reduced or at the lower limit of normal. There were nine missense variants of CHD7 gene in 8 patients. Based on the American College of Medical Genetics and Genomics guidelines, the c. 307T>A(p.Ser103Thr), c.3143G>A(p.Gly1048Glu), c.6956G>T(p.Arg2319Leu) and c. 3145A>T(p.Ser1049Cys) variants of CHD7 gene were predicted to be likely pathogenic (PS1+ PP1+ PM2, PM2+ PM6+ PP2+ PP3, PM2+ PM5+ PM6+ PP2+ PP3 and PM2+ PM6+ PP2+ PP3), the remaining 14 cases of IHH patients had negative genetic screening. Conclusion:CHD7 gene variants may be related to IHH disease.