AIM　To study the chemical components of the root of Clematis chinensis. METHODS Various chromatographic techniques were used to separate and purify the components. Their structures were determined on the basis of spectral and chemical evidence. RESULTS　Two compounds were isolated and elucidated as: clemaphenol A (I) and dihydro-4-hydroxy-5-hyroxymethyl-2(3H)-furanone (II). CONCLUSION Compound I and II are new compounds.

The root of Caragana sinica (Buc' hoz)Rehd' is a Chinese folk medicine which is said to be useful for thetreatment of asthenia syndrome,vascular hypertension, leukorrhagia, arthrodynia, and as antiinflammatory agent. In the course of our search for inhibitors of protein kinase C from Chinese herbs,chemical constituentsof the root of C. sinica was examined. Frorn ethanol extract of this crude drug,five isof1avones were isolatedand identified as flemichapparnin B, formononetin, pseudobaptigenin, 5-hydroxy-7, 4'-dimethoxy isoflavone,and 5-hydroxy-7-methoxy-3', 4' -methylenedioxy isoflavone.

Objective To observe the effect of early non-invasive positive pressure ventilation(NIPPV)on the treatment of serious hypoxemia induced by acute left heart failure. Methods Forty patients with acute left heart failure( Grade Ⅳ heart function)were randomly divided into two groups. Patients in both groups accepted supportive treatment included cardiotonics, diuretics, vasodilators, in additional to these high concentrations of oxygen were given in conventional group, and non-invasive positive pressure ventilation were given in NIPPV group by biphasic positive airway pressure(BiPAP). Systolic blood pressure, heart rate, respiratory rate, blood-gas analysis( pH, PaO2, PaCO2, SaO2 )and clinical signs were observed at 2 hours after treatments. Results Compared to control,RR( [ 19.55 ± 1.88] vs [21.85 ±3.51 ] ) BPM] ,HR ( [96.40 ±2.80] vs[ 103.20 ±6.78 ] BPM), SBP ( [ 116.30 ± 8.95 ] mm Hg vs [ 122.50 ± 6.13 ] mm Hg), pH (7.404 ± 0.027 vs 7.358 ±0.05) ,SaO2 ( [93.57 ± 1.18]% vs [91.97 ± 1.85]% ) ,PaO2 ( [75.58 ±4.61 ]mm Hg vs [68.38 ±7.95]mm Hg), PaCO2 ( [ 38.69 ± 3.06 ] mm Hg vs [ 43.61 ± 2.65 ] mmHg) were significantly different in NIPPV group( t = 2.582,4.146,2.558,3.534,3.256,3.505,5.428, Ps ＜ 0.05 ). We found no significant differences in the comparisons before treatments. Hypoxia improved in NIPPV group,and the total effective rate was 95% in NIPPV group and 70% in control group,which showed significant difference( x2 =4.329 ,P ＜0.05 ) Conclusion BiPAP non-invasive positive pressure ventilation combined with routine treatment in treating heart failure, could promptly correct hypoxia, improve heart function and shortening disease course.

Objective To investigate the value of narrow band imaging (NBI) and lugol chromo-endoscopy (LCE) in the diagnosis of advanced esophageal carcinoma.Methods The clinical data of 162 patients with advanced esophageal carcinoma who received NBI and LCE at the Cancer Hospital of Peking University from November 2010 to May 2012 were retrospectively analyzed.Esophageal mucosa was first examined using white light imaging (WLI),and then followed by NBI and LCE,and the lengths of the lesions were recorded.Biopsy histology was obtained in all abnormal mucosa which were detected by NBI or LCE.Difference in the length of lesions detected by the NBI/LCE and WLI was calculated.Surgical approach and method of anastomosis were recorded for patients who received surgical treatment,and the final treatment method was recorded for patients who did not receive surgical treatment.Difference in the treatment methods was compared before and after endoscopy.Results The length of the lesions detected by the 3 methods was identical in 121 patients,different in 41 patients.The difference ranged between 1 and 3 cm was observed in 22 patients,＞3 cm and ≤5 cm in 8 patients,＞5 cm and ≤10 cm in 7 patients,＞ 10 cm in 4 patients.Of the patients in the above mentioned 4 categories,there were 1,2,2,4 patients in each category received neo-adjuvant therapy,and the rest patients received operation.Superficial cancer contiguous to the primary lesion was found in 41 patients,including squamous cell carcinoma in 31 patients,carcinoma-in-situ in 3 patients and severe dysplasia in 7 patients.Of the 153 patients who received surgery,the surgical plan for 12 patients was modified.Intrathoracic anastomosis was changed to cervical anastomosis in 2 patients,anastomosis under the aortic arch was changed to anastomosis above the aortic arch in 3 patients,trans-abdominal operation was changed to thoraco-abdominal operation in 7 patients.Conclusions The combination of NBI and LCE is more accurate to evaluate the extent of lesions of advanced esophageal carcinoma,and is useful to decide the treatment protocol.Pathological examination of the adjacent abnormal mucosa should be carried out for patients whose lesion length was inconsistent under different observation methods.

To investigate whether a series of water-soluble cross-linked chitosan derivates synthesized in the guide of imprinting technology could be used as a uranium chelating agent to protect cells exposed to depleted uranium (DU), the imprinted chitosan derivates with high UO2(2+) chelating ability were screened, and cell model of human renal proximal tubule epithelium cells (HK-2) exposed to DU (500 micromol.L-1) was built, chitosan derivates (400 mg.L-1 ) was added to test group and diethylenetriaminepentaacetic acid (DTPA, 50 mg.L-1) was added to positive control group. The results showed that three Cu2+ imprinted chitosan derivates had higher uranium chelating ability (>49 microg.mg-1) than chitosan and non-imprinted chitosan derivates. Compared to the cells exposed to DU only, survival of cells in group added chitosan derivates rose up significantly (increased from 57.3% to 88.7%, and DTPA to 72.6%), and DU intracellular accumulation decreased, membrane damage and DNA damage also eased. Among the imprinted chitosan derivates, Cu2+ imprinted penta dialdehyde cross-linked carboxymethyl chitosan (Cu-P-CMC) was the best, and better than DTPA. From ultrastructure observation, the DU precipitates of test group added Cu-P-CMC were most grouped in a big hairy clusters in a string together outside cells. It is possible that the DU-chitosan derivates precipitates are too big to enter into cells, and from this way, the DU uptake by cells decreased so as to detoxication.

ObjectiveTo study the effect of a fast-track surgery (FTS) program on the clinical outcomes in cirrhotic patients with portal hypertension.Methods42 cirrhotic patients with portal hypertension were randomly allocated into the FTS group (n=21) and the conventional therapy control group (n=21).The postoperative time to first defecation,hospital stay,hospitalization cost,and postoperative complications were compared between the two groups.ResultsCompared with the control group,the postoperative time to first defecation was significantly shorter in the FTS group (P=0.0287).Furthermore,the postoperative hospital stay was significantly shorter in the FTS group than the control group (P=0.002).Additionally,hospitalization cost was significantly lower in the FTS group than the control group (P＜0.001).The postoperative complication was also significantly different between the two groups (7.15 ％ vs 21.5 ％,P=0.001).ConclusionA FTS program contributed to better postoperative rehabilitation in cirrhotic patients with portal hypertension.

Objective To investigate the clinical efficacy of covered self-expanding metal stent in the treatment of malignant esophageal stricture.Methods The clinical data of 512 patients accepted stent were retrospectively analyzed,which included patients' profiles,relief of dysphagia,incidence of complications and survival period.The data were analyzed by t test.Results A total of 596 stents were placed in 512 patients.There was significant difference in mean dysphagia score between before and after stent placement (grade 3.4±0.6 vs grade 1.1±0.8,t=54.09,P＜0.01).After the placement,the overall incidence of complications was 14.5％ (74/512),of which there were 21 cases of severe retrosternal pain (4.1％),16 cases of bleeding (3.1 ％),29 cases of stent displacement (5.7％),six cases of food impaction (1.2％),two cases of fistula without completely blocked (0.4％).The survival period of 238 patients with complete follow-up ranged from 30 to 1445 days,the mean time was 218.9 days.Conclusion Endoscopic covered self-expanding metal stent placement may effectively relieve dysphagia symptoms in patients with malignant esophageal stricture.

Objective To explore the expression and its significance of growth-associated protein(GAP-43 ) and brain-derived neurotrophic factor (BDNK) receptor TrkB gene in rat hippocampus after epilepsy induced by pilocarpine (PILO). Methods In situ hybrid histochemical method was used to observe the changes of the expression of GAP-43 and TrkB mRNA in hippocampus after status epilepticus( SE) induced by PIOL. Results At 3 - 6h following the onset of status epilepticus(SE), TrkB mRNA expression was dramatically high than control groups in the dentate gyrus granule cell and CA3,CA1 pyramidal cell layers(P

Objective To explore the relationship between Wuyishan cliff tea and esophageal cancer,and make integrated measures to prevent and control esophageal cancer.Methods A case-control study was conducted with a ratio of 1 to 1 and a health survey was conducted on objects which included 92 cases with histologically confirmed diagnoses of squamous-cell carcinoma of the esophagus and 92 controls matched by age,sex and resident.The analysis method of conditional logistic regression was used to analyze the influence of cliff tea on the development of esophageal cancer. Results The frequency of cliff tea drinking was 73.91% in cases with esophageal cancer compared with 84.78% in controls. As compared with subjects without tea drinking,subjects with cliff tea drinking significantly decreased the risk for developing esophageal cancer (P<0.05),and its OR were 0.60.The risk of esophageal cancer significantly reduced with increasing frequency of cliff tea drinking per week. Furthermore, we also found that the risk of esophageal cancer significantly reduced with the duration of cliff tea drinking and the early of beginning to drink cliff tea.Conclusion Wuyishan cliff tea drinking may protect against the risk of esophageal cancer.

Objective To investigate the possible mechanism for the different CPI susceptibili-ties. Methods Using a conditioned place preference (CPP) model, rats were selected into high and low preference groups. Using in situ hybridization, we examined the mRNA expression of 5-hydroxytryptamine transporter (5-HTT) and 5 -hydroxytryptamine 1 A receptor (5-HT1 AR) in 3 cruci-al regions in addiction, namely the ventral tegmental area (VTA) , the nucleus accumbens (NAc) ,and the medial prefrontal cortex (mPFC) , during the dependence and withdrawal. Results During dependence state, the expression of 5-HTT mRNA in each of the regions in the high preference group was significantly lower than that of the low preference group, while higher expression of 5-HT1AR mRNA in each of the regions in the high preference group than that of the low preference group was found (P<0.05). During withdrawal state, the expression of 5-HTT mRNA in each of the regions in high preference group was significantly higher than that of the low preference group, while lower expres-sion of 5-HTIAR mRNA in each of the regions in the high preference group than that of the low prefe-rence group was found (P<0.05). Conclusion 5-HTT and 5-HT1 AR may play a role in diffe-rences in susceptibility to morphine.