Objective To emphasize the importance of embolization of nonbronchial systemic arteries in treatment of acute and life-threatening massive hemoptysis.Methods In a series of 146 patients with hemoptysis who underwent bronchial artery embolization,we found 12 cases whose blood supply were from 17 nonbronchial systemic arteries and hemoptysis was more than 300 ml blood within 24 hours.Embolic materials included absorbable gelatin sponge(GS),kelp micro gelatin(KMG),polyvinyl alcohol(PVA) particles and metal coils. Results In the 12 cases with 17 nonbronchial systemic arteries (4 were intercostal,3 internal mammary,3 thyrocervical trunk,3 inferior phrenic,1 left gastric,2 originated from the inferior aortic arch,and 1 originated from anterior abdominal aortic wall).Five cases were embolized by GS alone,2 cases by KMG,3 cases by GS+PVA,and 2 cases by GS+PVA+metal coils.Eight cases were performed embolization once,3 cases were performed twice and 1 case was performed three times.No significant complications developed related to embolization,except that 1 patient had transient eyesight decrease after embolization of thyrocervical trunk and 2 patients had chest pain after embolization of intercostal artery which resovled without any treatment.Conclusions During bronchial artery embolization for hemoptysis patients,all supplying artery should be searched and found.Even after successful embolization of bronchial arterys for hemoptysis patients,nonbronchial systemic arterial supply should still be taken into account.

Objeetive To investigate the effectiveness and safety of agomelatine for the treatment of elderly patients with post-stroke depression.Methods A total 80 elderly patients with post-stroke depression were randomly divided into either an agomelatine group or a sertraline group.The Hamilton Depression Scale (HAMD),National Institutes of Health Stroke Scale (NIHSS) and Barthel Index were used to evaluate the patients before and after 1,2,4,and 6 weeks,respectively.Results HAMD,NIHSS,and Barthel index scores were improved significantly after treatment in the agomelatine group (n =38) and the sertraline group (n =42).There were significant improvement in the scores of HAMD,NIHSS and Barthel Index with time in both groups (all P ＜0.001).There were no significant difference in the scores of HAMD and NIHSS at different time points after treatment between the agomelatine group and the sertraline group,and the Barthel Index scores began to have significance difference from the fourth week after treatment (all P ＜ 0.05).Conclusions The efficacy of agomelatine for the treatment of PSD is almost the same as sertraline,and the effect of improving activities of daily living is better than sertraline.The safety of both agomelatine and sertraline is good.

The military healthy information management system follows No.1,No.2 and No.3 military medical projects.This paper introduces the methods of revising receipt printing program in seven parts.

Objective To explore the technology and curative effect of thoracic endovascular aortic repair (TEVAR) for Stanford type B aortic dissection.Methods The clinical data of 85 patients with Stanford type B aortic dissection,who were admitted to authors' hospital during the period from January 2010 to April 2016 to receive TEVAR,were retrospectively analyzed.Conventional left brachial artery puncture and straight incision of right femoral artery were employed in all 85 patients,and DSA of ascending aorta was performed to find out the position of rupture,the position of the true and false lumens,and their relationship with the vascular openings of important organs.Endovascular covered stent was implanted to seal off the primary rupture;reexamination of ascending aorta angiography was adopted to check the sealing-off condition of the proximal rupture and the changes of blood flow in the aortic branches as well as in the true and false lumens.Results Successful TEVAR was accomplished in 84 patients.One patient died of sudden rupture of aortic dissection during preoperative anaesthesia.The technical success rate was 100％.In 9 patients the covered stent partially overlapped the left subclavian artery,in one patient the left subclavian artery “chimney” stem completely obstructed both the left common carotid artery and the left subclavian artery,and bypass surgery between left common carotid artery and left subclavian artery was carried out in 2 patients.After the treatment,internal leakage of type Ⅰ was detected in 2 patients.No death occurred during hospitalization period.After the surgery the patients were followed up for 3 months to 3 years,and all patients survived.New rupture at the distal site occurred in 2 patients.Conclusion For the treatment of Stanford type B aortic dissection,TEVAR is safe and effective.Strict observance of surgical indications,careful operative manipulation,and strengthening postoperative management after discharge from hospital are the key points to ensure a successful surgery as well as to improve the long-term survival rate.

This paper introduces the construction,function and application of the system of mediacl information virtual rerence desk based on ASP.NET consists of FAQ,E-mail and real-time service.

An improved and practical synthesis of racemic 11-demethylcalanolide A [(±)-1] was developed. This improved process involved Pechmann reaction on phloroglucinol with ethyl butyrylacetate to give 5, 7,-dihydroxy-4-n-propylcoumarin(3). Poly phosphoric acid (PPA) catalyzed acylation of compound(3) with crotonic acid, then intramolecular cyclization was achieved simultaneously in one step to afford the key intermediate chromanone(4). A microwave assisted synthetic method preparing chromene(6) using chromenynation of chromanone(4) with 1, 1-diethoxy-methyl-2-butene was conducted. Luche reduction of chromene(6) using NaBH<,4> with CeCl3·7H2O preferably gave (±)-1. The overall yield of this four step synthesis of (±)-1 was around 32% increasing one fold more than that of the previous method. An in vitro investigation showed that (±)-1 exhibited inhibitory activities against both wild-type and drug-resistant HIV-1 in HIV-1 RT and cell culture assay, and significant synergistic effects in combination with AZT, T-20, and indinavir. Its LD50 of acute toxicity in mice by intragastric administration and by intraperitoneal injection were 735.65mg·kg-1 and 525.10mg·kg-1, respectively. The C<,max> and AUC<,0-∞> were 0.54μg·mL-1 and 1.08(μg·mL-1)·h, respectively. The dynamics study of the inhibition of mice sera on HIV-1 RT showed that mice treated with 100mg·kg-1 (±)-1 once intraperitoneally were similar to that of 5mg·kg-1 of known clinical effective anti-HIV-1 drug neverapine. The results suggested that further investigation of the anti-HIV candidate (±)-1 was warranted.

Herb-glycosides are main active elements of Zhongcaoyao (Chinese traditional medicines, Chinese medical herbs). However, the herb-glycoside structures are not optimal active structure for the human bodies. After orally taken up, the herb-glycosides of Zhongcaoyao could be changed into other more active structures by the digestive system such as enzymes and intestinal microorganisms; then degraded and absorbed in the human body and play the real role of pharmic effect; but only a small amount could be changed and controlled by circadian state of the human body. If this biochange of herb-glycosides to more active structures in vivo was finished in vitro, it is very useful for the development of the Chinese traditional medicines, new plant medicines, health food, and function cosmetics. To biotransformate herb-glycosides to more active structure, this paper introduced the studies of author's team on the new microorganism isolation of the special herb-glycosidases and enzyme fermentation, the special enzyme purification and characterization.
Bacteria ; enzymology ; metabolism ; Drugs, Chinese Herbal ; chemistry ; Fermentation ; Ginsenosides ; metabolism ; Glycoside Hydrolases ; metabolism ; Glycosides ; isolation & purification ; metabolism ; Saponins ; metabolism

Purpose: C-X-C motif chemokine receptor 4 (CXCR4) and integrin αvβ6 play important roles in the malignant progression of multiple cancers. However, it remains unclear whether the expression of one or both proteins in breast cancer (BC) is of clinical significance. In this study, we investigated the expression of CXCR4 and integrin αvβ6 in BC tissues and their correlation with clinicopathological characteristics, including survival. Methods: CXCR4 and αvβ6 expression in 111 BC tissues was examined by immunocytochemistry. Correlations between the expression of the 2 proteins and patient clinicopathological characteristic were investigated using the Kaplan–Meier method and the Cox proportional hazards model. Results: CXCR4 and αvβ6 were overexpressed in BC tissue compared with normal breast tissue. Overexpression of both molecules was related to lymph node status (p = 0.013 and p = 0.022, respectively). αvβ6 overexpression was also associated with tumor size (p = 0.044). A positive correlation was detected between the expression of CXCR4 and αvβ6 (r = 0.649, p = 0.001), and co-overexpression of both molecules was associated with tumor size (p = 0.018) and lymph node metastasis (p = 0.015). Kaplan–Meier analysis revealed that overexpression of CXCR4, αvβ6, or both molecules was associated with short overall survival (OS; p < 0.001, p < 0.001, and p = 0.009, respectively) and disease-free survival (DFS; p < 0.001, p = 0.005, and p = 0.019, respectively). Multivariate analysis indicated that lymph node metastasis was an independent prognostic factor for unfavorable OS and DFS (p = 0.002 and p = 0.005, respectively), whereas co-overexpression of CXCR4 and αvβ6 was an independent prognostic factor only for OS (p = 0.043). Conclusion CXCR4 and αvβ6 may play synergistic roles in the progression of BC, and co-targeting of CXCR4 and αvβ6 could be a potential strategy for the prevention and treatment of BC.

Objective To analyze the spatiotemporal characteristics of the clustered epidemics of common infectious diseases in primary and secondary schools and kindergartens in Hongshan District, Wuhan from 2015 to 2022, and to provide a basis for scientific development of control measures. Methods Descriptive epidemiological methods were used to describe events. Mean center method and standard ellipse method were used to reflect the overall distribution characteristics of the events, and hot spot analysis and nuclear density analysis were used to explore and analyze the spatiotemporal characteristics of clustered epidemics at annual and seasonal scales. Results From 2015 to 2022, a total of 1563 clustered outbreaks of infectious diseases were reported in primary and secondary schools and kindergartens in Hongshan District of Wuhan. The top three clustered epidemic diseases were hand-mouth-foot disease (HFMD)/herpangina, influenza like cases, and varicella, respectively. Primary schools were prone to influenza like cases (76.00%), kindergartens were prone to HFMD/herpangina (92.06%), and primary schools and middle schools were prone to varicella (69.70% and 21.21% respectively). As the years grew, the clustered epidemics showed a trend of spreading towards the northeast and southwest direction. Compared with other places, Luonan Street and Hongshan Street had a higher incidence density of clustered epidemic events (21.81% and 15.86% respectively), which requires special attention. The areas with the highest nuclear density value in each season were mainly concentrated in the middle of Hongshan District. There were two clusters of HFMD/herpangina concentrated in Luonan Street, Liyuan and Heping Street, which was different from other diseases. Conclusion When deploying medical resources and epidemic prevention and control work in schools within the jurisdiction, more emphasis should be placed on key streets and places to achieve the best cost-effectiveness.

Objective To compare the clinical efficacy and safety of agomelatine and paroxetine for the senile depression. Methods A total of 98 cases of elderly patients diagnozed with depression were randomly divided into two groups, one group were treated with agomelatine,the other group were treated with paroxetine,treated for 6 weeks, using Hamilton depression scale(HAMD), adverse reaction scale(TESS) to evaluate the efficacy and adverse reactions. Results After 6 weeks of treatment, the HAMD scores showed that there were no significant differences in clinical efficacy of two groups, and the TESS showed the agomelatine had less adverse reaction than the paroxetine. Conclusion Agomelatine is a safe and effective antidepressant , suitable for elderly patients.