This study was to investigate the chemical constituents from pseudobulbs of Pleione yunnanensis, one of the source of traditional Chinese medicine "Shancigu". The chemical constituents were isolated by various chromatography methods, including silica gel, ODS, Sephadex LH-20, and semi-preparative HPLC. Fourteen compounds were isolated and identified from the EtOAc fraction of 90% ethanol extract, including five dihydrophenanthrenes, four bibenzyls, two triterpenoids, and three phenylacrylic acids. Their structures were identified on the basis of the spectral data as 4, 7-dihydroxy-2-methoxy-9,10-dihydrophenanthrene (1), 4, 7-dihydroxy-1-(p-hydroxybenzyl)-2-methoxy-9,10-dihydrophenanthrene (2), (2,3-trans)-2-(4-hydroxy-3-methoxyphenyl) -3-hydroxymethyl-10-methoxy-2,3,4,5-tetrahydro-phenanthro[2,1-b]furan-7-ol (3), pleionesin B (4), blestriarene A (5), batatasin III (6), 3, 3'-dihydroxy-2-(p-hydroxybenzyl) -5-methoxybibenzyl (7), 3', 5-dihydroxy-2-(p-hydroxybenzyl) -3-methoxybibenzyl (8), 3,3'-dihydroxy-2,6-bis(4-hydroxybenzyl) -5-methoxybibenzyl (9), triphyllol (10), pholidotin (11), (E) -p-hydroxycinnamic acid (12), (E)-ferulic acid (13), and (E)-ferulic acid hexacosyl ester (14). Compounds 5,10-14 were separated from this plant for the first time.
Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Molecular Structure ; Orchidaceae ; chemistry ; Spectrometry, Mass, Electrospray Ionization

Objective To investigate the application value of perioperative enhanced recovery after surgery (ERAS) combined with laparoscopic common bile duct exploration (LCBDE) in the treatment of choledocholithiasis.Methods The clinical data of 84 patients with choledocholithiasis who were admitted to the Yijishan Hospital from January 2011 to December 2013 were prospectively analyzed.A single-blind,randomized,controlled study was performed in the 75 patients who were allocated into the control group and the enhanced recovery after surgery group (ERAS group) based on a random number table.All the patients underwent LCBDE,the patients in the control group received conventional perioperative management and the patients in the ERAS group received perioperative management according to enhanced recovery rehabilitation program.All the patients were followed up by outpatient interview till postoperative month 6.The clinical features,liver function and residual stones in the patients were observed.The operation time,postoperative complications,postoperative intestinal function recovery,duration of hospital stay and hospital expenses in the two groups were compared.Measurement data with normal distribution were presented as x ± s.Comparison between groups were evaluated with an independant sample t test.Count data were analyzed using the chi-square test.Results All the 75 eligible patients undergoing successful operation were randomly divided into the control group (35 patients) and the ERAS group (40 patients).The operation time and volume of intraoperative blood loss in the control group and the ERAS group were (185 ±46)minutes and (124 ±28)mL,(178 ±37) minutes and (114 ±32)mL,respectively,with no significant difference (t =0.729,1.431,P ＞ 0.05).There were 12,14 and 10 patients in the control group and 5,6 and 4 patients in the ERAS group with postoperative incision pain,vomit and infection,showing a significant difference (x2=5.054,5.966,4.241,P ＜ 0.05).The level of white blood cell,alanine aminotrausferase and direct bilirubin in the control group and in the ERAS group were (11.4 ± 3.5) × 109/L,(128 ± 33)U/L,(38 ±14) μmol/L and (10.6 ± 3.0) × 109/L,(135 ± 35) U/L,(44 ± 16) μmol/L at postoperative day 1,compared with (7.8 ±2.9) × 109/L,(48 ± 14) U/L,(21 ± 8) μmol/L and (6.9 ±2.1) × 109/L,(43 ± 13) U/L,(20 ±7) μmol/L in the 2 groups at postoperative day 4,respectively,showing no significant difference between the 2 groups (t =1.018,-0.872,-1.767,1.553,1.836,1.044,P ＞ 0.05).The postoperative first flatus day,time of food intake,time of postoperative infusion and duration of hospital stay were (42 ± 13)hour,(45 ±14) hours,(6.8 ±2.3)days and (11.3 ±4.5)days in the control group,and (35± 11)hours,(19 ±7)hours,(4.2 ± 1.8) days and (9.6 ± 2.4) days in the ERAS group,with a significant difference between the 2 groups (t =2.741,10.524,5.485,2.077,P ＜ 0.05).The total hospital expenses was (18 729 ± 3 127) yuan in the control group,which was significantly greater than (16 981 ±2 756) yuan in the ERAS group (t =2.574,P ＜ 0.05).The liver function of all the patients was recovered at the postoperative month 1.Four patients with residual stones in the 2 groups were detected by T-tube cholangiography,and were cured by removal of gallstones by choledochoscopy.There were no complications of the abdominal pain,jaundice and fever in all the patients till the end of follow-up.Conclusion ERAS combined with LCBDE for the treatment of choledocholithiasis is safe and feasible,with the advantages of low morbidity,quick recovery,short duration of hospital stay and less hospital expenses.

Ten glucosyloxybenzyl 2-isobutylmalates and one benzyl alcohol glycoside were isolated from the dry tuber of Pleione bulbocodioides, which is a specie of Orchidaceae family and its dry tuber is one of the main sources of traditional Chinese medicine "shanci-gu", by a combination of various column chromatographic methods, including ODS, macroporous adsorbent resin, Sepheadex LH-20, and preparative HPLC. Their structures were identified on the basis of chemical evidences and spectroscopic analysis asloroglossin (1), grammatophylloside A (2), cronupapine (3), (-)-(2R, 3S)-1-(4-β-D-glucopyranosyloxybenzyl)-4-methyl-2-isobutyltartrate (4), vandateroside II (5), grammatophylloside B (6), bis [4-(β-D-glucopyranosyloxy) -benzyl] (S) -2-isopropylmalate (7), gymnoside I (8), militarine (9), dactylorhin A (10), gastrodin (11). Compounds 1-7 were isolated from this genus for the firt time.
Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Glucosides ; chemistry ; isolation & purification ; Malates ; chemistry ; isolation & purification ; Molecular Structure ; Orchidaceae ; chemistry ; Spectrometry, Mass, Electrospray Ionization

Objective To compare the operative results of removing large olfactory groove meningiomas(diameter≥3 cm)using either a unilat?eral or bilateral subfrontal approach ,and to determine whether there is an advantage in the unilateral approach. Methods Sixty?nine cases of large olfactory groove meningioma,treated in our department,by either a unilateral or bilateral subfrontal approach microsurgery were retrospec?tively reviewed. Removal grading,post?operative complications,and other clinical indices were evaluated. Results Total resection(Simpson Ⅰ or Ⅱ)was achieved in all the cases. There were lesser complications with use of the unilateral subfrontal approach. Conclusion Patients with ol?factory groove meningioma have a good prognosis when a unilateral subfrontal approach is used for surgery.

Fourteen compoumds were isolated from the ethyl acetate portion of the 95% ethanolic extract of Pleione bulbocodioides by a combination of various chromatographic techniques including silica gel, ODS, macroporous adsorbent resin, Sephadex LH-20, and preparative HPLC, of which ten compoumds were phenanthrenes and dihydrophenanthrenes, two compoumds were bibenzyls, one was lignan and a sterol. Their structures were identified on the basis of spectroscopic data as monbarbatain A(1), 2, 7, 2'-trihy-droxy-4, 4', 7'-trimethoxy-1, 1'- biphenanthrene(2), blestriarene A(3), pleionesin B(4), shanciol H(5), 17-hydroxy-7'-(4'-hy-droxy-3 '-methoxyphenyl)- 4-methoxy-9, 10, 7', 8'-tetrahydrophenanthro[2, 3-b]furan-8'-yl methyl acetate(6), 1-p-hydroxybenzyl-4-methoxy phenanthrene-2, 7-diol(7), 1-p-hydroxybenzyl-4-met-hoxy-9, 10-dihydrophenanthrene-2, 7-diol(8), hircinol(9), coelonin( 10), gigantol(11), batatasin 11 (12), syringaresinol(13) and ergosta4, 6, 8 ( 14) , 22-tetraen-3-one (14). Compounds 1-3, 9, 13 and 14 were isolated from this genus for the first time.
Drugs, Chinese Herbal ; chemistry ; Orchidaceae ; chemistry ; Organic Chemicals ; analysis

BACKGROUND: Fibrin glue has been demonstrated to function as a kind of biomaterial with high quality. It has been used in nerve tissue engineering and proved to be a kind of scaffold for some cells.OBJECTIVE: To explore the biocompatibility of fibrin glue and olfactory ensheathing cells (OECs).DESIGN, TIME AND SETTING: An in vitro control trial based on cytology was performed at the Institute of Neurobiology,Nantong University from August 2007 to February 2008.MATERIALS: Fibrin glue was made of fibrin and catalyst, and OECs derived from rats' olfactory bulb were normally primary-cultured.METHODS: OECs were divided into control (OECs clone spheres were cultured alone) and in fibrin glue (OECs clone spheres were cultured and combined with fibrin glue) groups. After 1 week of culture, the proliferation of OECs were observed by convert microscope and detected by S-100 immunofluorescence histochemical staining.MAIN OUTCOME M EASURES: OECs morphology, cell count, the area of the cell bodies and the perimeter of the cell were determined.RESULTS: OECs could survive, migrate in fibrin glue, and float in the fibrin glue in the lower layer. After 7 days of incubation, cell body exhibited fusiform or triangle, predominantly bipolar or bipolar. The number of the S-100 positive cells was more, and cell bodies were larger in fibrin glue group than control group (P < 0.05). However, there was no obvious difference between two groups in cell perimeter (P > 0.05).CONCLUSION: Fibrin glue has good biocompatibility with OECs, and OECs can survive and migrate in fibrin glue.

OBJECTIVETo investigate the density and distribution of nerve endings and neuropeptide Y (NPY) in lumbar facet joints of patients with low back pain.

METHODSFifteen patients without low back pain were selected as control group (group A). Facet joint samples in group A were obtained during the operation or lumbar spinal canal tumor they suffered from. Those patients with low back pain were divided into three groups according to their different origins of pain, such as not from facet joint (group B, 15 patients) ,from facet joint only (group C, 20 patients), or from facet joint partially (group D, 20 patients). Different origins were determined by VAS after facet joint block. The density and distribution of nerve ending and neuropeptide in the capsular tissues were analyzed by a modified gold chloride staining and immunochemistry respectively.

RESULTSCompared with the ones in group A and B, the fact joints in group C and D were more inclined to be degenerated and got more nerve endings. NPY was expressed mainly in the facet joint of patients with low back pain in group C and D. In addition, there was a significant relationship between the distribution of nerve endings and NPY expression,while none of them were related with MRI Fujiwara grade of facet joint.

CONCLUSIONThese results suggest that the number of mechanoreceptors, neural sprouting and secreted peptides in the facet joint capsules vary with the change of mechanical or nociceptive stimulation, which may promote the development of low back pain in return.

Adult ; Aged ; Case-Control Studies ; Chronic Pain ; etiology ; metabolism ; pathology ; Female ; Humans ; Low Back Pain ; etiology ; metabolism ; pathology ; Male ; Mechanoreceptors ; physiology ; Middle Aged ; Nerve Endings ; pathology ; Neuropeptide Y ; analysis

OBJECTIVETo study the clinical efficacy of Chinese herbal retention enema combined with intrauterine douching for patients with endometritis diagnosed by hysteroscopy. They failed in in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI)-embryo transfer (ET) treatment.

METHODS131 patients received hysteroscopy after they failed in routine IVF/ICSI-ET treatment. Of them, 66 patients diagnosed as endometritis were enrolled as the test group and 65 patients without endometritis were enrolled as the control group. Chinese herbal retention enema combined with intrauterine douching was performed on patients in the test group before the next IVF/ICSI, while direct IVF/ICSI was performed on those in the control group. The embryo implantation rate and the clinical pregnancy rate were compared between the two groups.

RESULTSThe clinical pregnancy rate and the embryo implantation rate were 48.5% and 24.2% respectively, while they were 29.2% and 14.9% respectively in the control group, showing significant difference (P < 0.05).

CONCLUSIONChinese herbal retention enema combined with intrauterine douching could improve the embryo implantation rate and the clinical pregnancy in patients with endometritis.

Adult ; Drugs, Chinese Herbal ; administration & dosage ; therapeutic use ; Embryo Transfer ; Endometritis ; therapy ; Enema ; methods ; Female ; Fertilization in Vitro ; Humans ; Hysteroscopy ; methods ; Pregnancy ; Pregnancy Rate ; Sperm Injections, Intracytoplasmic ; Therapeutic Irrigation ; methods ; Treatment Failure

Objective To evaluate the feasibility and clinical outcomes of second sacral alar-iliac (S2AI) technique utilized in patients with tuberculosis of Lumbosacral spine.Methods 24 cases (15 male,9 female,aged 36-73 years old,average 47.1 years) of tuberculosis of Lumbosacral spine were collected for surgery using spinal and pelvic fixation system (S2AI or IS) between January 2014 and May 2016.Lumbosacral pain and restricted movement were noticed in all cases,of which 9 cases with radiating pain of lower limb and 7 cases with intermittent claudication,2 cases with saddle anesthesia.Formal anti-tuberculosis medicine treatment was given for at least 2-3 weeks before operation.All patients with lumbosacropelvic fixation were compared by recording with ESR/CRP,preoperatively,postoperatively and the last following-up.The clinical effect oswestry disability index (ODI) score,visual analogue scale (VAS),ambulatory status,SF-36 scale and related complications of 2 groups were also compared.Results The average follow-up period was average 23.4 months in the two groups.The results show that operative time,blood loss,drainage time,hospitalization days and fusion time were not statistically significant;the recording of ESR,CRP,ODI,VAS scores and ambulatory status scores between S2AI and IS groups showed no significantly different,preoperatively,postoperatively and the last following-up.Comparisons within each group were improved at postoperatively and the last following-up related to preoperatively;The difference of the SF-36 scales in each group was statistically significant between preoperatively and the last following-up;There was no statistically difference in recurrence,sinus,pseudarthrosis between two groups,but The S2AI technique was associated with lower rates of symptomatic screw prominence compared to the IS technique.Conclusion Application of S2AI screw technique in the treatment of lumbosacral tuberculosis can achieve solid fixation and satisfactory clinical effect,and reduce the complications of traditional IS screws,which is an alternative method of posterior structure reconstruction of lumbosacral tuberculosis.

Objective To investigate the clinical and pathological characteristics of atypical polypoid adenomyoma (APA) for improvement of the diagnosis, different diagnosis and treatment of the disease. Methods The clinical data, pathological characteristics, and the follow-up information were retrospectively analyzed in 27 cases of APA admitted in Peking Univeristy People′s Hospital from 2007 to 2016. Results The median age was 42.6 years old (range 25-60 years old). Fifteen patients were nullipara, 2 patients were postmenopausal. The most common presenting symptom was abnormal uterine bleeding (81%,22/27). Leisions were obtained by using hysteroscopy in 23 cases, hysterectomy 3 cases and dilatation and curettage 1 case. Fertility preserving treatments were performed in 10 patients who had strong desire for fertility, among which 1 case progressed into endometrial carcinoma. Among 15 patients underwent hysterectomy and (or) bilateral salpingo-oophorectomy, 9 cases of them had endometrial atypical hyperplasia. Endometrial carcinoma along with APA were found in three patients, 2 cases of them underwent hysterectomy and bilateral salpingo-oophorectomy and pelvic lymphadenectomy, the other one received medication for fertility preservation. Follow up information were available in 24 cases(89%,24/27)with a median follow up of 46 months (range 4-108 months), 1 case recurred and 1 case progressed into endometrial carcinoma. One case died of other malignancy, while the other patients were alive. Conclusions APA is a rare uterine neoplasm mixed with epithelial and mesenchymal component. It occurs mostly in childbearing-age women and its diagnosis is dependent on pathology. Although it′s clinical course is benign, there is risk of co-existance of endometrial carcinoma and endometrial atypical hyperplasia. For those who has desire of fertility, the treatment strategy is completely removed the lesion and closely followed up. For those who do not desire to preserve fertility, hysterectomy may be an option.