AIM:To study the chemical constituents of the roots of Astragalus hoantchy Franch.. METHOD:Isolation and elucidation of the chemical constituents,were conducted by chromatography and spectral evidences. RESULTS and CONCLUSION:Six steroids and four anthraquinones were isolated from the roots of A. hoantchy. Their structures were identified to be stigmastane-3,6-dione (1),5α,8α-epidioxy- (22E,24R)-ergosta-6,22-dien-3β-ol (2),stigmastane-3β,6α-diol (3),daucosterol (4),β-sitosterol (5),stigmasterol (6),chrysophanol (7),emodin (8),physion (9) and aloe-emodin (10) on the basis of spectral data and physical constants. Among them,compounds 1,2,3,7,8,9,10 were isolated from the genus Astragalus for the first time.

Background Trachoma is a serious blinding eye disease.At present,the incidence rate of trachoma in China has been greatly reduced with the unremitting efforts of World Health Orgnization (WHO) and Chinese government.However,in some economically underdeveloped areas,there is still active trachoma.Ohjective This study aimed to survey the prevalence of children's active trachoma in rural area of Naxi district and Jiangyang district of Luzhou city and assess the prevention and treatment outcome of trachoma during 10 years.Methods A cross-sectional study was performed in Naxi district and Jiangyang district of Luzhou city,the economic underdeveloping and water-starved regions in the year 2000.The active trachoma was screened in 214 school-age children with the male 113 and female 101 based on simplified trachoma grading system and trachoma rapid assessment survey standards and requirements of WHO.The symptoms of active trachoma were divided into trachomatous follicular (TF),trachomatous inflammation intense (TI),trachomatous scarring (TS),trachoma trichiasis (TT) and corneal opacities (CO).The epidemiological survey was re-assessed in 100 school-age children (with the male 58 and female 42) in these regions in the year 2013 to evaluate the prevalence change of children active trachoma during 10 years.Results In the year 2000,214 children were screened in 4 villages of Naxi district and Jiangyang district,and the prevalence rate of TF was 49.07％ (105/214) in the year 2000.The prevalence rate of TF was 49.05％ (52/106) in the Naxi district and 49.07％ (53/108) in the Jiangyang district,showing no significant difference between them (x2 =0.01,P =0.99).In the 100 school-age children who received survey in Naxi district and Jiangyang district in the year 2013,no TF,TF,TI,TS,TT and CO was found,showing no active trachoma.Conclusions The active trachoma has been controlled in rural areas of Luzhou city following the prevention and treatment of trachoma and the improvement of economic status in past decade.

Objective: To investigate the clinical efficacies of fire acupuncture in treat various types of acne. Methods: An open test was designed. One thousand and eighty-six patients who visited for clinical service were collected as a sample. Results: The cure and marked effective rate was 78.5% for lung heat type, 80.8% for heat toxin type, 77.4% for disharmony of the Thoroughfare and Conception Vessels type and 80.1% for blood stasis and phlegm accumulation type. Statistical analysis showed no significant differences in therapeutic effect between different types (P>0.05). Conclusion: Fire acupuncture has an exact therapeutic effect on various types of acne without toxic side effects.

[ ABSTRACT] AIM:To investigate the effect of hydrogen sulfide ( H2 S) on airway inflammation induced by ozone (O3) exposure and its mechanisms.METHODS:C57BL/6 mice (n=32) were randomly divided into control group, O3 group, NaHS+O3 group and NaHS group.The mice in O3 group and O3 +NaHS group were exposed to 2.14 mg/m3 O3 for 3 h on days 1, 3 and 5, while the mice in control group and NaHS group were exposed to filtered air .NaHS (14μmol/kg) was administered intraperitoneally to the mice in NaHS group and O 3 +NaHS group 30 min before each exposure .After the last exposure for 24 h, the airway responsiveness was determined , and bronchoalveolar lavage fluid ( BALF) was collected for counting inflammatory cells and measuring total protein concentration .The lung tissues were collected for observing the morphological changes with HE staining .The levels of interleukin-6 ( IL-6 ) , interleukin-8 ( IL-8 ) , malondialdehyde ( MDA) and NF-κB p65 protein in the lungs were determined .RESULTS: Compared with control group , the airway re-sponsiveness, inflammatory cells, protein concentration, inflammation score, levels of IL-6, IL-8, MDA and NF-κB p65 in O3 group increased significantly , but these in NaHS+O3 group decreased compared with O 3 group.CONCLUSION: The present findings suggest that H 2 S attenuates O3 induced airway inflammation by inhibiting NF-κB expression and preventing lipid peroxidation .

Important/potential value of macrolides has been proved in the management of chronic respiratory diseases by increasing basic and clinical trials.Through three face-to-face discussions,10 experts examined important data and drafted this consensus related to macrolides:(1) mechanism of nonantiinfective effects;(2) clinical use in chronic respiratory diseases;(3) cautions of long-term use.The mechanism out of non-antiinfective effects includes anti-inflammatory effect,modifying airway secretion,immune-regulation related to antibacterial effect,corticoid saving effect and anti-viral effect.The efficacy of long-term use of low-dose macrolides is definitely confirmed in diffuse panbronchiolitis,chronic rhinosinusitis.It is considerably used in bronchiectasia,cystic fibrosis,severe asthma and chronic obstructive pulmonary disease.Further studies should be conducted in cryptogenic organizing pneumonia and respiratory viral infection.It should be paid attention to its possible adverse effects (including drug interactions,cardiac toxicity,ototoxicity and disturbance of intestinal flora) and drug resistance in long-term use.A Chinese consensus for non-antiinfective effects and clinical use of macrolides is developed for the first time,which aims to expand their rational use and the further research.

The construction of featured specialties is the current development strategy of community health service institutions to improve the service scope and to meet the health needs of residents. The rehabilitation medicine has undergone 12 years of development and become a relatively mature featured specialty in Fenglin Community Health Service Center. Based on the Fenglin′s experience, this article discusses the development status and restriction bottlenecks of general practice, and the development status and trend of rehabilitation medicine in the community; and also explores the integrated development model of community-featured specialty with general practice.

OBJECTIVE To investigate the effect of sustained-release glucocorticoid stent on nasal mucosal eosinophil(Eos)%and nasal microbiota in patients undergoing eosinophilic chronic sinusitis with nasal polyps(ECRSwNP)surgery.METHODS A total of 104 patients with ECRSwNP admitted to Qianjiang Central Hospital from August 2020 to August 2022 were selected.The patients were randomly divided into an observation group and a control group,with 52 patients in each group.During nasal endoscopic surgery,slow-release glucocorticoid stents were implanted or not.The hospital stay,nasal ventilation recovery time,and total effective rate of treatment were compared between the two groups.The nasal mucosal Eos%and nasal microbiota were compared between the two groups before and one month after surgery.The Lund-Kennedy score of nasal endoscopy,SNOT-22 outcome tests,and visual analogue scale(VAS)scores were compared between the two groups before and three months after surgery.The intervention rate and frontal sinus patency rate at 3 months after surgery in two groups.RESULTS The hospitalization time and nasal ventilation recovery time of the observation group were significantly lower than those of the control group(P<0.05).The total effective rate of the observation group treatment was 92.31%(48/52),which was significantly higher than that of the control group 76.92%(40/52)(P<0.05).After surgery,the Eos%of the nasal mucosa in both groups significantly decreased compared to before surgery(P<0.05),and the observation group was lower than the control group(P<0.05).There was no statistically significant difference in Shannon index and Chaol index between the two groups before surgery(P>0.05);The Shannon index in the control group decreased significantly after surgery(P<0.05),while the Chaol index increased significantly after surgery(P<0.05);There was no significant difference in postoperative Shannon index and Chaol index between the observation group and preoperative group(P>0.05).After surgery,the Lund-Kennedy score,SNOT-22 score,and VAS score in both groups were significantly lower than before(P<0.05),and the observation group was lower than the control group(P<0.05).The intervention rate of the observation group was significantly lower than that of the control group(P<0.05),and the frontal sinus patency rate was significantly higher than that of the control group(P<0.05).CONCLUSION The sustained-release glucocorticoid stent is beneficial for the epithelialization of the surgical cavity in ECRSwNP patients,reducing mucosal Eos%,improving clinical symptoms,ensuring smooth frontal sinus drainage,reducing postoperative intervention rates,and having no significant impact on nasal microbiota.

Objective To explore the influence of dexmedetomidine combined with sufentanil on postoperative analgesia effect and immune function for patients undergoing lower limb fracture surgery. Methods One hundred cases patients of lower limb fracture undergoing open reduction and internal fixation of elective surgery in our hospital from January 2016 to November 2016 were selected ( ASAⅠ-Ⅱgrade, male 51 cases and female 49 cases, 30-65 years old, 50-75 kg). All cases were randomly divided into sufentanil group (Group S) and dexmedetomidine combined with sufentanil group (Group DS) according to the random number table, who used patient-controlled intravenous analgesia (PCIA). The PCIA drug formulations of two groups were as followings: sufentanil group (Group S) used 3 μg/h sufentanil+ondansetron 16 mg, dissolved in 0.9%sodium chloride injection 100 ml;dexmedetomidine combined with sufentanil group (Group DS) used dexmedetomidine 0.1μg/(kg · h)+sufentanil 2μg/h+ondansetron 16 mg, dissolved in 0.9%sodium chloride injection 100 ml;background infusion rate was 2 ml/h, and loading dose was 2 ml. Dose for patient-controlled analgesia (PCA) was 0.5 ml, and locking time was 15 min. The changes of pain, MAP, HR , sedation scores were recorded at 4 h (T1), 8 h (T2), 24 h (T3) and 48 h (T4) after operation; nausea and vomiting, hypotension, bradycardia, respiratory depression and other adverse reactions were aslo recorded at the same time. At 10 min before induction of anesthesia (T0) and T1-T4 after operation, the CD3+, CD4+, CD8+and NK cell activity of peripheral blood T lymphocyte subsets were determined using flow cytometry, and CD4 +/CD8 + ratio was calculated. Results The levels of MAP and HR in DS group at each time point after operation were lower than those in group S (P<0.05), the level of visual analogue score (VAS) in DS group at different time points were significantly lower than those of s group: (1.8 ± 0.3) scores vs. (2.5 ± 0.5) scores, (1.1 ± 0.5) scores vs. (1.9 ± 0.3) scores, (1.0 ± 0.5) scores vs. (1.8 ± 0.5) scores, (0.8 ± 0.3) scores vs. (1.5 ± 0.6) scores (P < 0.05), Ramsay Sedation score was significantly higher than that of s group: (3.5 ± 0.3) scores vs. (2.4 ± 0.6) scores, (3.3 ± 0.5) scores vs. (2.5 ± 0.3) scores, (3.5 ± 0.6) scores vs. (2.3 ± 0.5) scores, (3.2 ± 0.4) scores vs. (2.2 ± 0.5)scores (P<0.05);nausea and vomiting occurred in two patients after the operation of group DS , which was significantly lower than that of S group (P<0.05);compared with those at T0, CD3+, CD4+, CD4+/CD8+and NK cells in the two groups of patients decreased significantly at the time of T1-T4 (P<0.05);The levels of CD3+, CD4+, CD4+/CD8+and NK cells were significantly higher in group DS at T1- T4 than those in group S(P < 0.05). Conclusions Dexmedetomidine combined with sufentanil for analgesia in patients with lower limb fracture surgery has better effect. It decreases the incidence of nausea and vomiting, and improves the cellular immune function of patients.

ObjectiveTo investigate the features of patients with recurrence of hypertriglyceridemic acute pancreatitis (HTG-AP) and the influence of metabolic syndrome (MetS) on recurrence through a retrospective analysis. MethodsA retrospective analysis was performed for 132 patients with recurrent HTG-AP who were admitted to The Affiliated Hospital of Southwest Medical University from June 2013 to December(recurrence group), and 132 patients with non-recurrent HTG-AP who were treated during the same period of time were enrolled as control group. Related data were collected, including basic information (age, sex, diabetes, hypertension, and body mass index), clinical data (etiology, routine blood test results, and biochemical results), and complications ［systemic inflammatory response syndrome (SIRS), acute peripancreatic fluid collection (APFC), acute necrosis collection (ANC), acute respiratory distress syndrome (ARDS), acute renal failure (ARF), multiple organ dysfunction syndrome (MODS), and ICU admission rate］. The t-test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups; the chi-square test or the Fisher’s exact test was used for comparison of categorical data between groups. A logistic regression analysis was used for comparison of related variables, and the receiver operating characteristic (ROC) curve was used to validate the diagnostic value of variables. ResultsCompared with the control group, the recurrence group had a significantly higher proportion of patients with MetS, obesity, a high-density lipoprotein cholesterol (HDL-C) level of ＜1 mmol/L, or ANC and significantly higher levels of blood glucose and C-reactive protein (CRP) and white blood cell count (WBC) (χ2=9.138, χ2=6.823, χ2=13.251, χ2=9587, Z=-2.255, Z=-2.202, Z=-4.674, all P＜0.05). The 132 patients in the recurrence group were divided into MetS group with 92 patients and non-MetS group with 40 patients, and compared with the non-MetS group, the MetS group had significantly higher WBC and blood glucose and a significantly higher proportion of patients with SIRS, APFC, ANC, or progression to moderate-to-severe AP (MSAP) (t=2.434, t=4.881, χ2=4.513, χ2=7.936, χ2=7.031, χ2=7.150, all P＜0.05). MetS (odds ratio ［OR］=2.007, 95% confidence interval ［CI］: 1.152-3.497, P＜0.05), ANC (OR=2.270, 95%CI: 1.185-4.347, P＜0.05), and WBC (OR=1.135, 95%CI: 1.059-1.217, P＜0.05) were independent risk factors for recurrence in HTG-AP patients. The combination of MetS, ANC, and WBC had a relatively high value in predicting the recurrence of HTG-AP, with an area under the ROC curve of 0.692. In the recurrence group, the levels of triglyceride, blood glucose, and CRP and the proportion of patients with smoking, HDL-C ＜1 mmol/L, or obesity in 125 patients (7 patients were excluded due to incomplete case data) at the time of recurrence were significantly lower than those in 132 patients at initial admission (Z=-3.270,Z=-3.546,Z=-4.382,χ2=0547,χ2=8.259,χ2=5.143, all P＜0.05), with further reductions in the proportion of patients with MSAP, APFC, or ANC (χ2=4.086,χ2=11.930,χ2=4.967,all P＜005). ConclusionMetS aggravates disease severity in patients with recurrent HTG-AP and is an important factor for recurrence. Smoking cessation, weight loss, and oral lipid-lowering drugs can reduce disease severity at the time of readmission.

ObjectiveTo investigate the influence of portal vein thrombosis (PVT) on the short-term prognosis of patients with liver cirrhosis and the risk factors for the prognosis of patients with liver cirrhosis. MethodsA retrospective analysis was performed for the clinical data of the patients with liver cirrhosis who were hospitalized in our hospital from September 2018 to March 2020, among whom 58 patients with PVT were enrolled as PVT group and 116 patients without PVT were enrolled as non-PVT group, and 44 patients were selected from each group based on propensity score matching (PSM) at a ratio of 1∶1 to balance the covariates between groups. The t-test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups. The Kaplan-Meier method and the log-rank method were used to analyze survival status and bleeding before and after PSM, and the Cox risk model was used to analyze the risk factors for the prognosis of patients with liver cirrhosis. ResultsBefore PSM, the non-PVT group had a significantly higher overall survival rate than the PVT group (P=0.008), while after PSM, there was no significant difference in overall survival rate between the two groups (P=0.076). Before PSM, the non-PVT group had significantly lower incidence rates of upper gastrointestinal bleeding or rebleeding than the PVT group before and after PSM (P＜0.001), and the results after PSM were consistent with those before PSM (P=0.028). The multivariate analysis of the prognosis of the patients with liver cirrhosis before PSM showed that PVT (hazard ratio ［HR］=2.944, 95% confidence interval ［CI］: 1.364-6.441, P=0.007) and Model for End-Stage Liver Disease (MELD) score ≥15 (HR=3.531, 95% CI: 1.630-7.650, P=0.001) were risk factors for short-term death of the patients with liver cirrhosis, and the multivariate analysis after PSM showed that MELD score ≥15 (HR=3.312, 95% CI: 1.049-10457, P=0.041) was a risk factor for short-term death of the patients with liver cirrhosis. ConclusionLiver cirrhosis with PVT increases the risk of upper gastrointestinal bleeding or rebleeding, but it is not an independent risk factor for short-term death in patients with liver cirrhosis. MELD score ≥15 is an independent risk factor for short-term death in patients with liver cirrhosis.