AIM To study the chemical constituents from the stems of Clausena lansium (Lour.) Skeels.METHODS The n-butanol fraction of Clausena lansium stems' 95％ ethanol extract and herb residue's 50％ ethanol extract were isolated and purified by silica,RP-MPLC and PHPLC column,then the structures of obtained compounds were identified by spectral data.RESULTS Eight compounds were isolated and identified as marmesinin (1),nodakenin (2),decuroside Ⅳ (3),3,4-dimethoxyphenyl-β-D-glucopyranoside (4),glucosyringic acid (5),2-(3-methoxy-4-hydroxyphenyl)-ethanol-1-O-β-D-glucopyranoside (6),4-hydroxy-2-methoxy-phenyl-β-D-glucopyranoside (7),4-hydroxy-2,6-dimethoxyphenyl-β-D-glucopyranoside (8).CONCLUSION Compounds 4-6 and 8 are isolated from genus Clausena for the first time.

OBJECTIVE:To observe the clinical efficacy and safety of Shenmai injection combined with Trimetazidinee tablet in the treatment of hypothyroid heart disease. METHODS:64 patients with hypothyroid heart disease were randomly divided into control group and observation group. Patients in 2 groups were conventional treatment. Based on the treatment,control group was treated with Trimetazidine tablets 20 mg,orally,3 times a day;based on the treatment in control group,observation group was ad-ditionally treated with Shenmai injection 40 ml by intravenous infusion,once a day. The treatment course was 2 months. The clinic data was observed,including clinical efficacy,and T3,T4,TSH,LVEF,LVEDD and LVESD before and after treatment,pericar-dial effusion depth and incidence of adverse reactions. RESULTS:The total effective rate in observation group was significantly higher than control group(P<0.05). After treatment,T3 and T4 in 2 groups were significantly higher than before,TSH and LVESD were significantly lower than before(P<0.05),however,the difference was not statistically significant between 2 groups (P>0.05);LVEF in 2 groups was significantly higher than before,observation group was higher than control group,LVEDD and pericardial effusion depth were significantly lower than before,observation group was lower than control group(P<0.05). There were no obrious adverse reactions during treatment. CONCLUSIONS:Based on the conventional treatment,Shenmai injection com-bined with trimetazidinee has better efficacy than only trimetazidinee in the treatment of hypothyroid heart disease,with similar safety.

Objective To investigate the changes of iron-related proteins in different sex mice before and after burns.Methods The burn model in mice were prepared with 90 ℃ vapor.Both liver and spleen iron contents were measured by colorimetric method.Hepatic hepcidin and Fpn1 mRNA content were determined with RT-PCR.The Fpn1 protein was determined with Western blot.Results After burns,the content of spleen iron was increased and the expression of hepatic hepcidin was decreased in male mice,and at the same time the Fpn1 of liver and spleen was reduced.The content of iron homeostasis abnormality in female mice was less serious.Conclusion The change of iron-related proteins after burns may be one cause of iron homeostasis abnormality.The differences of iron-related protein expression in different sex after burns suggest that estrogen has a potentially protective function.

Objective:To establish a DNA typing method for HLA-I antigens with medium resolution method by DNA chip technique.Methods:The chip was made with specific medium distinguish-typing probes designed according to gene frequency of HLA-I alleles from Northern Chinese. Unsymmetrical PCR was used to amplify HLA-I exon2,3,and then the PCR products labeled and hybridized with probes on the chip.Typing of HLA-I was certified by scanning the hybridizing signals of through a set of computer software.Results:HLA-I alleles were successfully typed in 30 clinical samples .This medium-distinguishing probes were able to discern 57 HLA-I alleles accurately.Conclusion:DNA typing of HLA-I by chip has been proven to be a high-resolution and high-specific method. It is able to check out the new alleles that can not be distinguished by other methods with the same resolution., and it is more intuitional and more suitable for clinical application .

Objective To test the hypothesis that perceived organizational support(POS) plays a moderate role in the process of personality' s effect on emotional exhaustion.Methods Using POS,Revised NEO Personality Inventory and Emotional Exhaustion Inventory,376 special combat soldiers were tested from the Chinese Armed Police Force.Then SPSS 16.0 was used to conduct descriptive analysis,correlational analysis and hierarchical regression analysis.Results The interaction of neuroticism and POS as well as the interaction of conscientiousness and POS were significant or marginally significant,respectively.POS significantly moderated the relationship between neuroticism and emotional exhaustion(β=-0.19,t=-2.82,P＜0.01)as well as the relationship between conscientiousness and emotional exhaustion(β=-0.12,t=-1.95,P=0.052).Conclusion Neuroticism and conscientiousness are more strongly related with emotional exhaustion among individuals with low POS than high POS.

Objective To investigate the value of Cytochrome P450 (CYP3A5) * 3 gene polymorphism in providing individualized administration for the use of tacrolimus (Tac) in renal transplantation recipients.Method Pyrophosphate sequencing method was used to determine the CYP3A5 * 3 genotype of renal transplant patients in the first day after surgery.Sixty recipients were divided into experiment group and control group.Both groups of patients were routinely given the initial dose of Tac-4.0 mg/day in the first day after surgery.The experiment group of patients were given different doses of Tac based on the different CYP3A5 * 3 genotypes at the third day after surgery [for AA:0.12 mg/(kg· day),and for GG:0.06 mg/(kg· day)],and the control group of patients were given different dosages of Tac according to drug concentration.Different parameters were compared between two groups of patients:percentage of patients reaching the target concentration (3-8 μg/L) at the fifth day after surgery,days required to reach the target concentration level,times needed to adjust the dosage of Tac within two weeks.Result The percentage of patients reaching the target concentration in experiment group and control group was 90％ and 46.67％,respectively (P＜ 0.05).Days required to reach the target concentration were (3.67 ± 1.32) and (7.57 ± 3.42) on average,respectively (P ＜ 0.05).Times of adjusting the Tac dose in experiment group was significantly less than those in the control group (P＜0.05).In the experiment group,the target concentration was obtained even without dosage adjustment (70％).Conclusion Individualized adjustment of Tac doses for patients according to recipients' different CYP3A5 * 3 genotypes is beneficial for reaching target concentration as soon as possible,which is superior to traditional dosage regimen.

Objective To evaluate of the clinical efficacy of two kinds of methods extracorporeal shock wave lithotripsy in treatment of ureteral calculi. Methods A retrospective analysis was conducted on the data of 108 patients with acute renal colic and ureteral stones (calculi diameter<2 cm) from March 2011 to April 2013. The patients were divided into two groups. 69 cases in A group underwent emergency positioning urography ureteral catheterization combined extracorporeal shock wave lithotripsy, 39 cases in B group underwent emergency extracorporeal shock wave lithotripsy. Results A group:lithotripsy was successful in 63 cases among 69 cases at the first time,the first success rate was 91.33% (63/69), the second success rate was 94.2%(65/69),2 cases of retrograde ureteroscopy failed, 2 cases of self-discharge after intubation stones, the recurrent renal colic rate was 14.3%(9/63),the use of analgesic drugs rate was 11.1%(7/63) . B group:the first success rate of stone clearance rate was 74.4%(25/39),the second success rate of stone clearance rate was 87.2%(34/39),5 cases underwent ureteroscopy lithotripsy, the renal colic recurrence rate was 20.5% (8/39), the use rate of analgesic drugs was 15.4% (6/39) . Conclusion Extracorporeal shock wave lithotripsy assisted by urography through retrograde ureteral catheterization has satisfying therapeutic effect in treatment of patients with ureteral calculi.

Objective To explore the value of serum microRNA-155-5p and -133a-3p (miR-155-5p and miR-133a-3p) expression for the diagnosis and prognosis evaluation of sepsis. Methods A prospective observational study was conducted. 105 sepsis patients admitted to emergency intensive care unit (EICU) of the First Affiliated Hospital of Zhengzhou University from January 2015 to January 2016 were enrolled. They were divided into three groups according to the severity: 35 patients with sepsis, 35 with severe sepsis, and 35 with septic shock. At the same time, 35 healthy persons were selected as the control group. According to the prognosis, the patients were divided into improved group (n = 70) and in-hospital death group (n = 35). The clinical data of all the subjects were collected. The mRNA expressions of miR-155-5p and miR-133a-3p were determined by reverse transcription-polymerase chain reaction (RT-PCR). The receiver-operating characteristic curve (ROC) was plotted to evaluate their clinical value for the diagnosis and prognosis of sepsis. The binary logistic regression was used to analyze the risk factors affecting the prognosis of sepsis patients. Results ① The mRNA expressions of serum miR-155-5p and miR-133a-3p were gradually increased with the aggravation of sepsis. The mRNA expression of miR-155-5p (2-ΔCt) in sepsis, severe sepsis, sepsis shock groups was 1.89±0.48, 2.21±0.41, 2.79±0.73 (F = 23.737, P = 0.000), and the mRNA expression of miR-133a-3p (2-ΔCt) was 1.38±0.31, 1.74±0.65, 2.08±0.47, respectively (F = 27.710, P = 0.000). It was shown by ROC curve analysis that the area under the ROC curve (AUC) of serum miR-155-5p and miR-133a-3p for the diagnosis of sepsis was 0.855 [95% confidence interval (95%CI) = 0.761-0.949] and 0.769 (95%CI = 0.666-0.872) respectively. The cut-off value of miR-155-5p for the diagnosis of sepsis was 1.64, the sensitivity was 85.3%, and specificity was 80.6%. While the cut-off value of miR-133a-3p was 0.82, the sensitivity and specificity were 97.9% and 54.8% respectively. ② Compared with improved group, the patients of in-hospital death group were more serious, and procalcitonin (PCT), C-reactive protein (CRP), D-dimer, lactic acid (Lac), sequential organ failure assessment (SOFA) score, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, and the mRNA expressions of miR-155-5p and miR-133a-3p were significantly increased (all P < 0.05). While there was no statistically significant difference in gender, age, white blood cells (WBC), serum creatinine (SCr) between the two groups (all P > 0.05). It was shown by binary logistic regression analysis that Lac [odds ratio (OR) = 0.514, 95%CI = 0.260-0.893, P = 0.024], sepsis severity (OR = 0.039, 95%CI = 0.023-2.955, P = 0.016), SOFA score (OR = 0.668, 95%CI = 0.474-0.825, P = 0.001), serum miR-155-5p expression (OR = 0.117, 95%CI = 0.020-0.530, P = 0.007) were the risk factors affecting the prognosis of patients with sepsis. Conclusions The expression of serum miR-155-5p and miR-133a-3p may be used as specific indicators for the diagnosis of sepsis. And the expression of miR-155-5p can be used as independent impact factor for the estimation of sepsis prognosis.

There are many progresses in the therapy of MM with ASCT. ASCT improves the ratio of CR,EFS and OS,compared with conventional chemotherapy.Myeloma patients with renal failure or old age also can be candidate for ASCT.Tandem autologous transplantation improves the ratio of CR. Its impact to long-term EFS and OS still need to be judged.To improve conditional project,to choose suitable time,and- toselect consolidation schedule can boost therapeutic effect.

Objective To explore the application of video laryngoscope in patients with pituitary adenoma during endotracheal intubation.Methods Fifty-one patients (19 males, 32 females, aged 18-71 years, ASA physical status I or II) scheduled for resection of pituitary adenoma under general anesthesia were enrolled.These patients were randomly divided into two groups: Macintosh laryngoscope Group (group M, n=25) and Video laryngoscope Group (group VL, n=26).When performing endotracheal intubation, Macintosh laryngoscope was used to expose the glottis in group M, and video laryngoscope was used in group VL.Head tilted backward angle, mouth opening, thyromental distance, neck circumference, mandibular ramus length, modified Mallampati classification and the difficulty classification of mask ventilation of the patients in two groups were recorded during peri-operation period.The Cormark-Lehane grade, needed pressing of the cricoids cartilage, the ratio of a second attempt during intubation and the intubation time consumed were recorded.Results Less patients in group VL needed cricoids cartilage press (7.7% vs 48.0%) during the intubation than that in group M (P<0.01).Compared with group M, the Cormack-Lehane grade was significantly lower (P<0.01) and the intubation time consumed was significantly shorter in group VL [(32.4±11.7)s vs (45.8±12.6)s] (P<0.01).Conclusion In patients with pituitary adenoma,video laryngoscope may improve the glottis exposure and the success rate of intubation, as well as shorten the intubation time.