OBJECTIVETo isolate and elucidate the chemical constituents of the fruits of Acanthopanax sessiliflorus.

METHODIsolation and purification were carried out on the column chromatography of silica gel and Sephadex LH-20. Their structures were elucidated on basis of physicochemical properties and spectral data.

RESULTNine compounds were isolated and identified as oleanolic acid-3-O-6'-O-methyl-beta-D-glucuronopyranoside (1), 22-alpha-hydroxychiisanogenin (2), oleanolic acid-3-O-beta-D-glucuronopyranoside (3), oleanolic acid-3-O-beta-D-glucopyranoside (4), oleanolic acid (5), chiisanogenin (6), (-)-sesamin (7), daucosterol (8), beta-sitosterol (9).

CONCLUSIONCompound 1 is obtained from the genus Acanthopanax genus for the first time. Compounds 2-5 are isolated from this plant for the first time.

Eleutherococcus ; chemistry ; Fruit ; chemistry ; Organic Chemicals ; analysis ; isolation & purification

Objective: To isolate and identify the structures of triterpenoids from the extract of Acanthopanax sessiliflorus fruits. Methods:The chemical constituents were systematically isolated by column chromatography and liquid chromatography, and their struc-tures were determined by spectral data including 1 H-NMR, 13 C-NMR, HSQC and HMBC combined with ESI-MS. Results:Totally 8 trit-erpenoids compounds were isolated and identified from Acanthopanax sessiliflorus fruits, 22-α-hydroxychiisanogenin (1), chiisanogenin (2), 3-oxo-24-methylenecycloartan (3), mangiferonic acid (4), isomangiferolic acid (5), oleanolic acid (6), betulin (7) and betulin-ic acid (8). Conclusion:Compound 3, 4 and 5 are obtained from Acanthopanax genus for the first time.

Transient central nervous system symptoms and reversible white matter lesions have been rarely reported in X-linked Charcot-Marie-Tooth disease type 1.We reported two cases of X-linked CharcotMarie-Tooth disease type 1 associated with reversible white matter lesions.Patient 1 is a 15-year old boy who presented with paroxysmal speech disorders and limb weakness at the beginning of the illness.He still walked unsteadily after discharge.Patient 2 is a 13-year old girl with transient numbness and weakness in her left extremities and slurred speech.She completely recovered.Both of them presented pes cavus without obvious family history or personal history.Both of them showed primary symptom of central nervous system with MRI abnormal findings in corpus callosum and periventricular areas.The electrophysiological studies showed a mixed demyelinating and axonal sensorimotor neuropathy in patient 1 but no significant abnormalities in patient 2.The genetic analysis of both patients showed a pathogenic mutation in GJB1 gene.Clinicians should improve the recognition of X-linked Charcot-Marie-Tooth disease type 1.This type of disorders can behave as symptoms of nervous system firstly even if there is no other typical characteristics,such as peripheral nervous system involvement.

Objective:To evaluate the microstructural changes of brain parenchyma in patients with essential hypertension by diffuse kurtosis imaging (DKI) and enhanced T2 star weighted angiography (ESWAN).Methods:A prospective study was performed; 27 patients with essential hypertension, admitted to our hospital from April 2019 to September 2019, and 16 healthy subjects matched with gender, age and education level were enrolled in our study. According to the presence or absence of cerebral microbleeds (CMBs), patients with essential hypertension were divided into essential hypertension with CMBs group ( n=8) and essential hypertension without CMBs group ( n=19). MRI, DKI and ESWAN were performed on all subjects. The mean kurtosis (MK), mean diffusivity (MD) and fractional anisotropy (FA) of bilateral hippocampal gyrus, centrum semiovale, caudate head, posterior limb of internal capsule, thalamus, red nucleus, substantia nigra, pons, and cerebellum were measured. Results:As compared with the healthy subjects, the patients with essential hypertension had significantly lower MK values in the left semioval center, bilateral caudate head, left posterior limb of internal capsule, and bilateral thalamus, significantly higher MD value in the right thalamus, and statistically lower FA value in the left posterior limb of internal capsule ( P<0.05). The essential hypertension with CMBs group had significantly lower MK values in left hippocampus gyrus, left centrum semiovale, bilateral caudate head, left posterior limb of internal capsule, bilateral thalamus, and left substantia nigra, significantly higher MD value in right thalamus, and significantly lower FA value in left posterior limb of internal capsule as compared with essential hypertension without CMBs group and healthy control group ( P<0.05). Conclusion:In patients with essential hypertension, the brain microstructural changes are found in the hippocampus, centrum semiovale, caudate head, posterior limb of internal capsule, thalamus and substantia nigra; these changes are more obvious in essential hypertension patients with CMBs; DKI and ESWAN can effectively assess the early brain microstructure changes in patients with essential hypertension.

[Abstact] Objective To investigate the efficacy and safety of sunitinib as first line therapy in treating those patients with metastatic renal cell carcinoma ( mRCC ) .Methods A total of 66 patients , including 42 male and 24 female cases ,with metastatic renal cell carcinoma were enrolled from January 2009 to June 2014.The median age was 52 years (range 26-75 years).According to American Joint Committee On Cancer (AJCC) staging,there were 35 cases of T3 stage,31 cases of T4 stage.All patients had distant metastasis ,including single organ metastasis in 52 patients and multiple organ metastasis in 14 cases.Sixty-one patients received prior radical nephrectomy ,5 patients received biopsy .Sixty-two patients were diagnosed as renal clear cell carcinoma and 4 patients were diagnosed as renal papillary cell carcinoma .Sunitinib was administered in standard 4/2 regimens.Briefly, patient takes 50 mg once a day orally for 4 weeks.Then the sunitinib will be stopped for 2 weeks.Six weeks was defined as 1 cycle.It should be continued until disease progression or occurrence of intolerable adverse reactions .The efficacy of sunitinib should be evaluated within 2 cycles.Results The duration of following-up ranged from 5 to 66 months.The efficacy could be evaluated in 63 patients.Two patients ( 3.2%) achieved complete remission .Twelve patients ( 19.0%) achieved partial remission.Forty-five patients (71.4%) demonstrated stable disease and 4 patients (6.3%)
developed progressive disease .The disease control rate was 93.7%(59/63) and the objective response rate was 22.2%(14/63).2 (3.2%) patients died due to the progression of disease .The most commonⅠ-Ⅱadverse events included fatigue in 36 cases ( 57.1%) , thrombocytopenia in 36 cases ( 57.1%) , hand-foot syndrome in 32 cases (50.8%),hypertension in 27 cases (42.9%),neutropenia in 15 cases (23.8%), hypothyroidism in 12 cases (19.0%), diarrhea in 6 cases (9.5%) and alopecia in 4 cases (6.3%).Ⅲ-Ⅳ adverse events were hand-foot syndrome in 4 cases ( 6.3%) , hypertension in 2 cases ( 3.2%) , neutropenia in 5 cases (7.9%) and thrombocytopenia in 5 cases (7.9%).Most mild adverse reactions after symptomatic treatment could be alleviated ,did not affect the medication .When the adverse events returned to the Ⅰ-Ⅱdegree, the 37.5 mg sunitinib was resumed once daily by orally.NoⅢ-Ⅳadverse events were reported again.Conclusions Sunitinib was efficacious in the treatment of advanced renal cell carcinoma.Most mild adverse events were tolerable ,and severe adverse events need medical treatment .

The severe fever with thrombocytopenia syndrome virus (SFTSV),a new RNA virus,was discovered in recent years,which can lead to fever,thrombocytopenia and multiple organ dysfunction.Picks is the main media A case of a SFTSV-related encephalitis diagnosed by second-generation gene sequencing was reported here.The patient had fever,disturbance of consciousness,convulsions,with thrombocytopenia and enzymatic indicators increased significantly.After active anti-virus and supportive treatment,the prognosis was good.It is our aim to suggest that,in the epidemic season,when you meet thesimilar patients like this,you should consider the possibility of SFTSV-related encephalitis.Virus nucleic acid detection and second-generation gene sequencing technology are helpful for timely diagnosis and treatment and reducing mortality of the disease.

Objective:To explore the clinical value of introducing 68Ga PSMA PET / CT into the prostate cancer(PCa)screening clinic, and to analyze the incidence rate and biopsy of PCa in the screening clinic of our hospital. Methods:The data of the people who participated in PCa screening in the urology screening clinic of our hospital from March 2021 to November 2021 were retrospectively analyzed. Serum PSA was used as the screening index. The subjects with PSA≥4ng/ml were first examined by mpMRI to find suspicious nodules, and the positive ones were further examined by 68Ga-PSMA PET/CT to determine the lesions.The puncture target was outlined, and systematic+ targeted puncture was conducted under ultrasound guidance. The age, PSA distribution, puncture detection rate, Gleason score and clinical stage of patients with PCa were recorded. Results:A total of 1 079 subjects were included in the screening, with an average age of (63.9±9.9)(ranging 40-92) years old, and 249 patients (23.1%, 249/1 079) with PSA≥4ng/ml. Among them, 87 cases (87/249, 34.9%) received mpMRI, and 34 cases (34/249, 13.7%) had PI-RADS score ≥3 points. These 34 patients with suspected nodules on MRI were further scanned with 68Ga-PSMA PET/CT, and 11 cases (11/249, 4.4%) had abnormal uptake of PSMA nuclide. A total of 32 patients (12 patients with PSA abnormalities and 20 patients with positive imaging) finally received prostate biopsy, and 11 patients were diagnosed with PCa, with a positive detection rate of 34.4% (11/32), accounting for 1.0% (11/1 079) of the screening population. Among them, 20 patients with positive imaging (9 patients with only mpMRI positive and 11 patients with both mpMRI and 68Ga-PSMA PET/CT positive) underwent system + targeted fusion biopsy, and the positive rate was 45% (9/20). 12 patients (only PSA abnormal) underwent routine systematic puncture biopsy, and the positive detection rate was 16.7% (2/12). The difference between the two groups was statistically significant ( P<0.05). Among the patients with confirmed PCa, 27.3% (3/11) had Gleason score less than 7, and 72.7% (8/11) had Gleason score≥7. Localized PCa (≤T 2) accounted for 45.4% (5/11), local progression (T 3-T 4) accounted for 18.2% (2/11), and metastatic PCa suggested by 68Ga-PSMA PET/CT accounted for 36.4% (4/11), including 3 systemic multiple bone metastases and one bone metastasis with distant lymph node metastasis. Clinically significant PCa accounted for 90.9% (10/11) of the confirmed patients, and the proportion of high-risk patients in localized or locally advanced PCa was 71.4% (5/7). Conclusions:In PCa screening, if 68Ga-PSMA PET/CT is introduced on the basis of conventional mpMRI, the detection rate of clinically meaningful PCa can be improved. Combined with targeted puncture, tumor lesions can be found early and the screening efficiency of PCa can be improved. In this study, the detection rate of PCa in outpatient screening reached 1.0%. In confirmed cases, the proportion of high-risk patients and metastatic patients was higher.

OBJECTIVETo explore the value of color doppler ultrasound examination of thyroid in occupational health care of radiation-exposed physicians.

METHODSOne hundred and thirty-four radiation-exposed physicians (observation group) and sixty-eight non-radiation-exposed physicians (control group) received color doppler ultrasound examination of thyroid using ALOKA SSD-4000 color doppler ultrasonic diagnostic apparatus, and the results were compared between the two groups.

RESULTSThe anteroposterior diameters of the left lobe, right lobe, and isthmus of the thyroid in the observation group were significantly larger than those in the control group (P < 0.01). Compared with the control group, the observation group had significantly larger internal diameters and peak blood flow velocities during systole of the right superior thyroid artery (P < 0.05, P < 0.05). There were no significant differences in detection rates of thyroid nodules and lymph nodes between the observation group and the control group (18.7% vs 13.2%, P > 0.05; 6.7% vs 1.5%, P > 0.05). The radiation-exposed physicians were exposed to low-dose ionizing radiation with a dose between 0.14 and 1.67 mSv/a.

CONCLUSIONThe color doppler ultrasound examination of the thyroid can detect early changes in the thyroid of radiation-exposed physicians exposed to long-term and low-dose ionizing radiation.

Humans ; Lymph Nodes ; Occupational Exposure ; analysis ; Occupational Health ; Physicians ; Radiation Exposure ; analysis ; Radiation, Ionizing ; Thyroid Gland ; diagnostic imaging ; radiation effects ; Ultrasonography, Doppler, Color

Objective To explore the correlation between the changes of mitochondrial DNA (mtDNA) copy number of peripheral blood leukocytes and the degree of neurological impairment after traumatic brain injury (TBI).Methods A total of 40 Sprague Dawley rats were randomly divided into 4 groups:control group (n=10),mild TBI group (n=10),moderate TBI group (n=10) and severe TBI group (n=10).The cortical impact injury method to construct TBI rat model of different damage degree.The neurological score (mNSS,screen test,open field test) after TBI 24 h,48 h,72 h was performed and the orbital venous plexus blood genomic DNA was extracted.The real-time PCR method to measure the relative mitochondrial DNA copy number.After the experiment,the rats were euthanized,and the brain tissue was stained with hematoxylin-eosin staining(HE).Results There were significant differences in the HE staining findings of brain tissue pathology (P＜ 0.05).Each group of rats with brain injury after peripheral blood mtDNA copy number in 24 h (9.63±3.62,P＜0.05) and 48 h (9.80±3.58,P＜0.05) increased,began to decline at 72 h (4.97±2.68,P＜0.05).The rats mNSS scores were related with the mtDNA copy number after TBI 24 h (r=0.578,P＜0.05) and 48 h (r=0.559,P＜0.05),and not related to TBI 72 h (r=0.487,P＞0.05).The rats screen test scores were related with the mtDNA copy number after TBI 24 h (r=0.573,P＜0.05) and 48 h (r =0.501,P＜0.05),and not related to TBI 72 h (r=0.273,P＞0.05).The rats level scores of open field test were negatively correlated with the mtDNA copy number after TBI24 h (r=-0.662,P＜0.05) and 48 h (r=-0.507,P＜0.05),and not negatively correlated to TBI 72 h (r=-0.410,P＞0.05).The rats vertical scores of open field test were negatively correlated with the mtDNA copy number after TBI 24 h (r=-0.662,P＜0.05)and 48 h (r =-0.607,P＜ 0.05),and not negatively correlated to TBI 72 h (r =-0.141,P＞ 0.05).Conclusion TBI is related with the copy of early peripheral white blood cell number and mtDNA of rat nerve function damage,and mtDNA copy number of peripheral white blood cell may become a clinical evaluation of TBI neural function damage degree of a potential biomarker.