Six new oleanane-type saponins, arilloside A-F (Ⅰ～Ⅵ), along with a known saponin, polygalasaponin ⅩⅩⅩⅤ(Ⅶ), were isolated from the root of Polygala arillata Buch.-Ham.. The structures of these new compounds were elucidated as 3-O-β-D-glucopyranosyl presenegenin 28-O-β-D-xylopyranosyl (1→4)-α-L-rhamnopyranosyl (1→2)-(3, 4-di-O-acetyl)-β-D-fucopyranoside(Ⅰ); 3-O-β-D-glucopyranosyl presenegenin 28-O-β-D-xylopyranosyl (1→3)-β-D-xylopyranosyl (1→4)-α-L-rhamnopyranosyl (1→2)-β-D-fucopyranoside(Ⅱ); 3-O-β-D-glucopyranosyl presenegenin 28-O-β-D-xylopyranosyl (1→3)-β-D-xylopyranosyl (1→4)-α-L-rhamnopyranosyl (1→2)-(3,4-di-O-acetyl)-β-D-fucopyranoside(Ⅲ); 3-O-β-D-glucopyranosyl presenegenin 28-O-β-D-xylopyranosyl (1→3)-[β-D-galactopyranosyl (1→4)]-β-D-β-D-xylopyranosyl (1→4)-α-L-rhamnopyranosyl (1→2)-β-D-fucopyranoside(Ⅳ); 3-O-β-D-glucopyranosyl presenegenin 28-O-β-D-xylopyranosyl (1→3)-[β-D-galactopyranosyl (1→4)]-β-D-xylopyranosyl (1→4)-α-L-rhamnopyranosyl (1→2)-(3-O-acetyl)-β-D-fucopyranoside(Ⅴ) and 3-O-β-D-glucopyranosyl presenegenin 28-O-β-D-xylopyranosyl (1→3)-[β-D-galactopyranosyl (1→4)]-β-D-xylopyranosyl (1→4)-α-L-rhamnopyranosyl (1→2)-(3,4-di-O-acetyl)-β-D-fucopyranoside(Ⅵ) on the basis of spectroscopic and chemical methods.

Objective To study the feature of bone metabolism in different phase of elder type 2 diabetic nephropathy (DN) patients.Methods One hundred and fifty elder type 2 DN patients (non-microalbuminuria group,microalbuminuria group,clinic proteinuria group,DN renal inadequacy group and DN uremia group,each group was 30 cases),60 elder non-DN patients in chronic renal failure (CRF) (non-DN renal inadequacy group and non-DN uremia group,each group was 30 cases) ,and 30 elder healthy people (control group) were selected to observe the changes of osteocalcin (OT),β -crosslaps,parathyroid hormone ( iPTH),alkaline phosphatase (AKP),serum calcium (Ca),serum phosphorus (P) and Ca × P.Results In non-microalbuminuria group,microalbuminuria group and clinic proteinuria group,OT and β -crosslaps levels were lower than those in control group,and the lowest in microalbuminunia group (P＜0.01).In DN renal inadequacy group and DN uremia group,OT and β -crosslaps levels were higher than those in control group(P＜0.01).In the phase of CRF,OT,β -crosslaps and iPTH had no statistic difference between DN patients and non-DN patients,but had linear correlation.Serum P level was higher in DN renal inadequacy group and DN uremia group than that in control group(P＜0.01).Either DN or non-DN,serum P had more influence to Ca × P than serum Ca.Conclusions In the different phase of elder type 2 DNpatients,the effect of bone metabolism is different because of the different injury of renal function.Bone metabolism in the different phase has respective feature and mechanism,with low turnover in the first and high turnover in the end.

Objective To investigate the MRI features of malignant mesothelioma(MM).Methods MRI data of 18 cases of MM confirmed by pathology were analyzed retrospectively.1 5 cases were malignant pleural mesothelioma,and 3 cases malignant peritone-um mesothelioma.MRI scans were performed in all cases,including MRI plain scan,MRI enhancement and diffusion weighted ima-ging(DWI).We evaluated the location,shape,size,signal,enhancement mode,dispersion characteristics,invasions of surrounding tissues and concomitant changes of MM.Results Among the 15 cases of malignant pleural mesothelioma,14 cases were diffuse type, 1 case was localized type,and 3 cases of malignant peritoneum mesothelioma were all diffuse types.10 of 14 diffuse malignant pleural mesothelioma had a thickening pleural of more than 3 cm,the average thickness was (5.3±3.8)cm,in which soft tissue mass was showed in 6 cases.2 of 3 diffuse malignant peritoneum mesotheliom had a thickening peritoneal of more than 3 cm with soft tissue mass.On T1 WI images,slightly low signal were showed in 7 cases,and equal signal in 1 1 cases.On T2 fat suppression sequence,low signal were showed in 4 cases,slightly high signal in 10 cases and high signal in 4 cases.On DWI,18 cases of MM lesions all showed high signal.On enhanced scan,continuous enhancement were showed in 1 8 cases of MM and the enhancement was the most obvious at 180 s.8 cases with lymph node enlargement (8/18).The diseased lateral thoracic profile was significantly narrowed in 11 cases with malignant pleural mesothelioma,of which 7 cases with chest wall invasion.Conclusion The MRI features of MM have certain char-acteristics,and MRI examination will help to make accurate diagnosis before treatment.

Objective To explore the utility of Kinect motion sensing technology in the rehabilitation of shoulder joint dysfunction caused by surgical neck fracture of the humerus.Methods Fifty-one patients with shoulder joint dysfunction caused by surgical neck fracture of the humerus were randomly divided into a Kinect group (26 cases) and a control group (25 cases).Both groups were given routine joint mobilization and rehabilitation training,while the Kinect group additionally spent time on a computer with Kinect software in activities such as picking peaches,playing golf,climbing ladders,throwing balls and with a game called open sesame.Before and after 4 weeks of treatment,both groups were assessed for pain,ability in the activities of daily living (ADL),and range of motion (ROM) of the shoulder joint using the Constant-Murley shoulder functional rating score scale (CMS) and a muscle test scale.Results After the treatment,significant improvement in all of the measurements was observed in the Kinect group,and in all except the average ROM in the control group.The average pain,ADL,ROM and muscular strength of the Kinect group were then all significantly better compared to the control group.After the treatment,the average total CMS score of the Kinect group was also significantly better.Among all the patients in the Kinect group,88.46％ had good or excellent treatment effect.Conclusion Kinect-based motion sensing technology can significantly improve rehabilitation outcomes for such patients.

Objective To explore the function of the regional medical image network consultation system in propelling the quality control of regional medical image.Methods Based on the regional medical image network con-sultation system,the unified standard of quality control was implemented to reach the integrated management of the imaging quality control in region.The imaging specialists checked the quality of image and report in real time.In addi-tion,the specialists and inspectors monthly examined the quality of image and report.Subsequently,the unqualified causes were analyzed and the improvement measures were used.Finally,the quality of image and report were continu-ously improved.Results After the homogeneity management was applied for one year,the rates of remaking photos and returning the report were significantly decreased from 10% to 2%,and 12% to 4% respectively.Additionally,the rates of good image and report were significantly increased from 83% to 98%,and 89% to 100% respectively.The objective of good rate ≥90% was excellently achieved.Conclusion Based on the regional medical image network consultation system,the management in quality control of the networking hospitals has been uniform,and the technique of examination and the report format have been consistent.The standardability and accuracy of image examination have been realized.

Objective To study the short-term clinical efficacy and its possible mechanism of refractory hypertension(RH) treated by continuous veno-venous hemofiltration (CVVH) in maintenance hemodialysis (MHD) patients. Methods Thirty-four MHD patients with RH treated with CVVH enrolled in the treatment group,all these patients were treatment of 2 -3 times,each time 8 - 10 hours. Thirty MHD patients with wellcontroled blood pressure were recruited as control. Changes of blood pressure, dry weight, plasma levels of parathyroid hormone (PTH), renin ( RA), angiotensin Ⅰ , Ⅱ ( AT Ⅰ , AT Ⅱ ), aldosterone ( Ald ) were observed before and after hemodialysis. Results In the treatment group,compared with pre-treatment, the blood pressure decreased significantly with an effective rate of 64.7% and efficient rate of 100. 0%. Before treatment, plasma RA was ([1.10 ±0.25] μg/(L · h)and [0:78 ±0.26] μg/(L · h),AT Ⅰ was [0.89 ±0.21] μg/L and [ 0. 52 ± 0. 14 ] μg/L, AT Ⅱ was [ 177.68 ± 89.46 ] ng/L and [ 89. 25 ± 12. 84 ] ng/L, Ald was [72. 06 ± 11.47 ]ng/L and [ 48.92 ± 8. 65 ] ng/L, PTH was [ 306. 81 ± 69. 37 ] ng/L and [ 248.76 ± 134. 62 ] ng/L in the treatment and control group respectively. All the measurements in the treatment group were significantly higher than those in the control group (P ＜ 0. 05 ). In the treatment group, compared to pre-treatment, plasma RA significantly decreased ( [ 1.10 ± 0. 25 ]μg/ ( L · h) vs [ 0. 76 ± 0. 17 ] μg/( L · h ), as well as AT Ⅰ ( [ 0. 89 ±0.21]μg/L vs [0.50 ±0.12] μg/L),ATⅡ([177.68±89.46]ng/L vs [ 87.13±14.22] ng/L),Ald ([72.06±11.47]ng/Lvs [ 46. 01± 9. 86 ] ng/L ) and PTH ( [ 306. 81 ±69.37]ng/L vs [ 186.53 ±32.93 ] ng/L) ( P ＜ 0. 05 ). However, there was no significant changes in the above mentioned measurements between before and after hemodialysis in the control group (P ＞ 0. 05). Conclusion CVVH may be an effective methods in the treatment of MHD patients with RH, and its antihypertensive mechanisms may be that CVVH can effectively remove the excess water in the body, and reduce plasma RA, AT Ⅰ , AT Ⅱ ,Ald and PTH levels.

Objective To detect the expression of Toll-like receptor 9 (TLR9) in pancreatic cancer,and to explore its clinical significance. Methods The real-time PCR, Western blotting and immunohistochemistry were used to examine the expression of TLR9 in 30 samples of pancreatic cancer and the adjacent tissues, and 10 samples of normal pancreatic tissues. The relationships of TLR9 with clinicopathological parameters were analyzed. Results Compared with normal pancreatic tissues, the amplification value of TLR9 mRNA expression was 2.32 fold (1.41 ～ 3.22 ) in human pancreatic cancer, was 1.23 fold (1.18 ～ 1.28) in paracancerous tissues, respectively, and the difference was statistically significant (P ＜ 0.05 ). The percentage of positive cells expressing TLR9 protein in human pancreatic cancer tissues,paracancerous tissues and normal tissues were 73.3% (22/30), 33.3% (10/30) and 20.0% (2/10), and the relative expressions of TLR9 protein were 0.780 ±0. 026,0. 400 ±0.018,0. 173 ±0.043 ,respectively, and the difference was statistically significant( P ＜ 0.05 ). The highly expressed TLR9 was positively correlated with the degree of tumor differentiation, TNM stage and lymph node metastasis. Conclusions TLR9 was highly expressed in pancreatic cancer tissues. TLR9 expression plays a role in the canceration of pancreatic tissues.

Objective To investigate the relationship between rapists and related allele genes based on the analysis of 15 short tandem repeats (STRs) loci genetic polymorphism. Methods The method of Genome-wide scan was being used. Buccal swab samples of 129 rapists and 156 random populations were collected and PCR compound amplification was carried out with the aid of AmpFISTR Identifiler system. Then the products were subjected to electrophoresis and gene detection with AB13100 type gene analysis system so as to calculate and compare the alleles of 15 STRs gene frequency in the two groups. Results All the 15 STRs loci allele gene frequency in rapists and random population was found to coincide with Hardy-Weinberg law(P>0. 05). Allele 28 of D21S11 (rapists: 1.55% ,control group:5. 13%) ,allele22 of FGA(rapists:24.03% ,control group:16.99%),allele23 of FGA(rapists: 17.05% ,control group:26.28%) ,allele 10 of TH01(rapists:1.16% ,control group:4.17%) ,allele 8 of TPOX(rapists:55.77% ,control group:63.77%),allele 12 of TPOX(rapists:4.26% ,control group: 1.28%) were different between the two groups (P< 0.05) .while it is no differ significantly in other STRs loci allele gene(P >0.05). Conclusion Allele 28 of D21 S11,allele 22 and 23 of FGA, allele 10 of TH01, allele 8 and 12 of TPOX may be associated with the violent crime of rape. It is suggested that there are existing sensitive or resistance genes about the violent crime of rape in chromosome 2,4,11,21.

Objective]To investigate the influence of induced before or after the expected date of childbirth on maternal and neonatal outcome in patients with gestational diabetes mellitus which blood glucose well controlled.[Methods]We retrospectively analyzed 238 cases with mild gestational diabetes mellitus who had delivered in this hospital. Mild gestational diabetes mellitus cases were those who only need diet control,exercise therapy,no drug treatment. There were 120 cases who induced in 40 ~ 40+6 weeks was the research group,and 118 cases who induced in 39~39+6 weeks was the control group.[Results]The cesarean section rate be?tween the two groups was no difference(49.2%vs 55.9%,P=0.528);Postpartum hemorrhage rate of the two groups was no differ?ence(10.0%vs14.4%,P=0.299)Birth weight between the two groups was no difference(3.26 ± 0.33)kg vs(3.22 ± 0.34)kg,P =0.448). The incidences of the two groups including fetal distress,large for gestational age infants,neonatal pathological jaundice, neonatal hypoglycemia were no difference(P > 0.05).[Conclusion]Pregnant women with mild gestation diabetes mellitus induced before after 40 completed gestation weeks did not increase cesarean section rate. Pregnancy outcome between the two groups were no difference.It would be better to select the appropriate induction time according to the patient′s condition.

Objective To investigate the efficacy and safety of ultra-mini percutaneous nephrolithotomy for the treatment of renal or upper ureteral stones.Methods The data of 32 patients diagnosed as renal or upper ureteral stones were retrospectively reviewed,who underwent ultra-mini percutaneous nephrolithotomy from June to October,2015,including 29 kidney stones,3 upper ureteral stones,of which 21 single stone,7 multiple stones,and 4 staghorn stones.There were 8 cases with inferior calyx stones,10 with renal pelvis stones,3 with upper ureteral stones,10 with renal pelvis stones plus inferior calyx stones and 1 with renal pelvis stones plus upper calyx stones.The mean stone size was (20.1 ±7.6) mm (ranging from 10 to 41mm).The mean Hounsfield unit (HU) was (1 125.9 ±225.9) Hu (ranging from 520 to 1 550Hu).In this cohort,13 cases had mild hydronephrosis,2 moderate hydronephrosis,1 severe hydronephrosis while no hydronephrosis identified in the other 16 patients.One case had concomitant kidney and ureter duplication malformation,and 1 case had residual stones after laparoscopic nephrolithotomy.Results All of the patients were treated by single tract UMP.Among them,middle calyceal puncture was performed in 9 cases,and the other 23 cases underwent lower calyceal puncture,including 4 cases of intercostal puncture,and 28 subcostal puncture.The mean operating time was (30.3 ± 15.0) min (ranging from 10 to 90 min).The mean postoperative hospital stay was (1.9 ± 1.0)days (ranging from 1 to 5 days).The mean hemoglobin decrease was(14.6 ±8.4)g/L (ranging from 1 to 46 g/L).No analgesics were used.Peri-operative complication rate was 3.13％ (1/32) with 1 case of collection system perforation.There was no fever,severe bleeding,urinary extravasation,pleural injury,or blood transfusion.The SFR was 93.75％ (30/32) and 96.88％ (31/32) on the first day and the first month after the operation,respectively.Conclusions UMP could be a safe and effective method for the treatment of renal or upper ureteral stones,especially for inferior calyceal stones less than 2cm.It offers high stone clearance rate,minimally invasiveness,quick recovery,short length of hospital stay and improved quality of life.