Objective To investigate the chemical constituents in the whole plant of Clerodendrum canescens. Methods The compounds were isolated by column chromatography over silica gel or Sephadex LH-20 gel and their structures were elucidated by chemical and spectroscopic methods. Results Seven triterpenoids were isolated and identified as: lupeol (Ⅰ), ?-amyrin 3-undecanotate (Ⅱ), lupeol acetate (Ⅲ), lupeol 3-palmitate (Ⅳ), melastomic acid (Ⅴ), ?-amyrin acetate (Ⅵ), betulinic acid (Ⅶ), respectively. Conclusion Among those compounds, compound Ⅱ is a new one, while compounds Ⅳ-Ⅵ are isolated from the plants of Clerodendrum Linn. for the first time.

Objective To investigate the ability of immune response of cotransfection of rat breast cancer cells with MIP-1αand B7-1 .Methods Tumor growth was observed every day after the SHZ-88 breast cancer cells were inoculated in the rats .The tumor-bearing rats were randomly divided into control group ,MIP-1αgroup ,B7-1 group and combination group ,which were injected with corresponding transgenic cells .The change of tumor volume in 1~4 weeks and the survival time were observed and compared .The peripheral blood was collected .CD4+ ,CD8+ percentage and CD4+ /CD8+ ratio and the levels of IL-2 and IFN-γof the peripheral blood were detected and compared .Results The tumorigenic rate were 100% ,20% ,30% and 0% after the SD rats were inoculated with SHZ-88 ,SHZ-88/MIP-1α,SHZ-88/B7-1 and SHZ-88/MIP-1α+B7-1 cells for 10 days .After the transgenic therapy ,the tumor volume of the combination group in 1~4 weeks were significantly smaller than the other groups .The survival time of the combina-tion group was significantly longer than the other groups .The CD4+ ,CD8+ percentage and CD4+ /CD8+ ratio and the levels of IL-2 and IFN-γof peripheral blood in the combination group were significantly higher than the other groups .The differences above were all statistically significant (P<0 .05) .Conclusion Cotransfection of MIP-1αand B7-1 could induce immune response in breast cancer rats and play anti-cancer effects .

Angioplasty, Balloon, Coronary ; Humans

Chronic kidney disease (CKD) is common worldwide and in Singapore. The primary care physicians play an important role in managing patients with CKD, especially in the early stages of CKD. The primary objectives of CKD management are (1) slowing down the progression of CKD, (2) managing the complications of CKD, and (3) establishing the longterm kidney care plan. The interventions to slow down the progression of CKD are to identify the cause of CKD, use the renin-aldosterone system blocker and the sodium-glucose cotransporter-2 inhibitor in suitable CKD populations, optimise blood pressure and glycaemic control, correct acidosis, avoid acute kidney injury and nephrotoxin, and modify dietary and lifestyle habits. For complications of CKD, the focus is on reducing cardiovascular risk, and managing anaemia, mineral bone disease, electrolytes imbalances and fluid overload. Lastly, there is a need to establish CKD patient’s treatment goals and initiate advanced care planning in a patient with progressive CKD to facilitate future care.

Genetic Engineering ; Humans ; Rabies ; virology ; Rabies virus ; genetics ; pathogenicity ; Viral Proteins ; genetics ; Virulence

Objective To investigate the clinical efficacy of surgical treatment for stage Ⅳ gastric cancer after conversion therapy.Methods The retrospective cohort study was conducted.The clinicopathological data of 50 stage Ⅳ gastric cancer patients who were admitted to the First Affiliated Hospital of Dalian Medical University between January 2012 and June 2016 were collected.All the 50 patients who were diagnosed with single distal metastasis underwent chemotherapy.After chemotherapy,21 patients with operation indication receiving gastrectomy (R0 or R1 resection) were allocated into the conversion surgery group and 29 without operation indication continuing to chemotherapy were allocated into the chenotherapy group.Patients received S-1 + oxaliplatin or S-1 + docetaxel regimen.Patients underwent open distal or total gastrectomy.Observation indicators:(1) response assessment of chemotherapy (complete remission,partial remission,stable disease and progressive disease),grading of of adverse reactions;(2) intra-and post-operative situations of conversion surgery group:operation procedures,intraoperative situations (operation time,volume of blood loss,number of lymph node dissected and surgical margin) and postoperative situations (complications and duration of hospital stay);(3)comparison of follow-up and survival between the 2 groups;(4) prognostic factors analysis affecting stage Ⅳ gastric cancer patients.Follow-up using outpatient examination,correspondence and telephone interview was performed to detect postoperative survival of patients up to September 2016.Survival time was from operation to the last follow-up or death.Measurement data with normal distribution were represented as x±s.Comparison of count data and univariate analysis were done using the chi-square test.Ordinal data were analyzed by the nonparametric test.The survival rate was calculated by the Kaplan-Meier method,and the Log-rank test was used for survival analysis.Multivariate analysis was done using the COX regression model.Results (1) Response assessment of chemotherapy:of 50 patients,24 received S-1 + oxaliplatin regimen and 26 received S-1 + docetaxel regimen.Twenty-one patients in the conversion surgery group underwent chemotherapy,with negative peritoneal metastasis,N2 and below of lymph node metastasis (No.16 lymph node disappeared or reduced),invasive depth ＜T4b and narrowing or disappeared hepatic metastasis.A median preoperative chemotherapy cycle was 4.2 cycles (range,2.0-9.0 cycles).Chemotherapy reaction of 21 patients:15 had partial remission and 6 had stable disease.Twenty-nine patients without operation indication in the chemotherapy group didn't receive surgery.The median cycle of first-line chemotherapy was 5.5 cycles (range,2.0-10.0 cycles).Chemotherapy reaction of 29 patients:13 had partial remission,11 had stable disease and 5 patient had progressive disease.Chemotherapy adverse reactions of 50 patients:26 had reduced white blood cells (WBCs),including 6 with grade Ⅲ-Ⅳ of adverse reactions;29 had reduced neutrophils,including 12 with grade Ⅲ-Ⅳ of adverse reactions;18 had anemia,including 6 with grade Ⅲ-Ⅳ of adverse reactions;12 had reduced platelets,including 2 with grade Ⅲ-Ⅳ of adverse reactions;27 had apositia,including 5 with grade Ⅲ-Ⅳ of adverse reactions;7 had stomatitis;9 had diarrhea;3 had elevated serum creatinin;4 had hand-foot syndrome;3 had abnormal sensory nerve.There was no chemotherapy-related death.(2) Intra-and post-operative situations of conversion surgery group:of 21 patients in the conversion surgery group,8 underwent radical total gastrectomy + D3 lymph node dissection,6 underwent radical distal gastrectomy + D3 lymph node dissection and 7 underwent radical distal gastrectomy + D2 lymph node dissection (including 4 combined with resection of hepatic metastatic tumors and 1 combined with radiofrequency ablation of hepatic metastatic tumor).Operation time,volume of blood loss,number of lymph node dissected and recovery time of gastrointestinal function of 21 patients were (216±31)minutes,(128±52)mL,31±8 and (3.0± 0.7)days,respectively.There were 17 patients receiving R0 resection and 4 receiving R1 resection (3 with positive gastric margin and 1 with positive hepatic margin).There was no death.Seven of 21 patients with complications were cured by conservative treatment,including 2 with pancreatic fistula,1 with intra-abdominal hemorrhage,1 with intestinal obstruction,1 with pneumonia,1 with intra-abdominal infection and 1 with wound infection.Duration of hospital stay of 21 patients was (13.0±3.0) days.(3) Comparison of follow-up and survival between the 2 groups:50 patients were followed up for 6-46 months,with a median time of 24 months.The 3-year cumulative survival rates in the conversion surgery and chemotherapy groups were respectively 33.3％ and 6.9％,with a statistically significant difference between the 2 groups (x2 =7.678,P＜0.05).Results of further analysis showed that R0 resection of 17 patients and R1 resection of 4 patients in the conversion surgery group were respecgtively (25.3±2.8)months and (8.3±0.9)months,with a statistically significant difference between the 2 groups (X2=16.242,P＜0.05).(4) Prognostic factors analysis affecting stage Ⅳ gastric cancer patients:results of univariate analysis showed that T stage,N stage,response assessment of chemotherapy,surgery after chemotherapy and degree of tumor radical resection were related factors affecting prognosis of stage Ⅳ gastric cancer patients (X2 =5.288,12.645,25.581,8.372,12.001,P＜0.05).Results of multivariate analysis showed that R1 resection after conversion therapy was an independent risk factor affecting prognosis of stage Ⅳ gastric cancer patients (HR=14.021,95％ confidence interval:1.928-10.938,P＜0.05).Conclusion Radical resection after conversion therapy can increase survival rate of stage Ⅳ gastric cancer patients,and R1 resection after conversion therapy is an independent risk factor affecting poor prognosis of stage Ⅳ gastric cancer patients.

Objective To evaluate the effect and feasibility of balloon dilatation for treatment of anastomotic stricture after biliary-intestinal anastomosis with percutaneous transhepatic cholangial drainage( PTCD) .Methods A total of 23 pa-tients with anastomotic stricture after biliary-intestinal anastomosis who had undergone PTCD+balloon dilatation were ana-lyzed retrospectively between Mar 2009 to Dec 2011.The patency of bile duct, jaundice index and liver function were recor-ded.Results PTCD+balloon dilatation was completed successfully in all cases, and a metallic stent was implanted in one case.Anastomotic stricture, postoperative jaundice index and liver function were improved significantly after operation.No serious complications occurred.Conclusion PTCD+balloon dilatation has good curative effect on anastomotic stricture. The complication rate is low.It is a safe, feasible and effective minimally invasive treatment.

OBJECTIVE In this study,nine different levels of known teratogenic embryos toxic com-pounds (aceta minophen,methi mazole,indo metacin,methotrexate,ascorbic acid,isoniazid,penicillin G,saccharin ,5-fluorouracil )were used to validate the established evaluation method of zebrafish e mbryo develop mental toxicity in our laboratory via zebrafish e mbryonic develop ment toxicity tests. METHODS By water bath method,zebrafish embryos of post-fertilization 2 h (2 hpf)were exposed to different concentrations of compounds.Observe and record the nu mber of malformations and dead e mbryo in 24,48,72,144 hpf.After three parallel experiments,get EC50 ,LC50 through software and calculate the teratogenic indices (TI =LC50 /EC50 )of the positive drug and recorded it as teratogens.If there is no teratogenic index recorded it as non-teratogens.Co mpare the results with the existing animal experiments and clinical trials to obtain the sensitivity and specificity.RESULTS Based on the results, exposure to aceta minophen (TI =2.07),methi mazole (TI =2.91 ),indo methacin (TI =1 .67),5-flu-orouracil (TI =8.31 ),methotrexate (TI =1 .31 ),showed various levels of teratogenic effects,and the corresponding TI′s were calculated.Methi mazole appeared more obvious skeletal deformities;indo m-ethacin toxicity is mainly reflected in abnormal heart,blood circulation and other endpoints;5-FU at lower doses that result in higher mortality rates,but also took place over the lacking of pig mentation;aceta min-ophen for the heart,liver and other target organ toxicity,pericardial cyst;methotrexate appears signifi-cant so mites,skeletal deformity.Since the IT′s for ascorbic acid,isoniazid,penicillin G,saccharin can-not be calculated,these compounds are considered to show negative results,indicating that the data fro m the nine compounds in zebrafish test are consistent with traditional animal experiments and clinical information,the sensitivity of 100% and specificity of 100%.CONCLUSION Though validation test,it has been de monstrated that the established zebrafish embryos develop mental toxicity evaluation method can be applied to early screening of drug toxicity.

Objective To observe the therapeutic effect of pericarpium zanthoxylum oil on experimental hyperlipemia in mice. Methods Hyperlipemia model was reproduced in mice, and then pericarpium zanthoxylum oil was garaged for 4 weeks. Blood samples were obtained from retro-ocular vessel. The levels of blood lipids were determined, the hemorrheology parameters were determined by hemorrheometer, and the pathological changes in the liver of mice were observed microscopically. Results Zanthoxylum oil could obviously reduce contents of TC, TG, LDL-C (P

Objective To study the characteristics of tongue pictures of the terminal stage patients of colorectal cancer.Method The changes of tongue pictures of 7 patients of the terminal stage and 62 patients of non-terminal stage were observed by The System of Tongue Inspection of TCM,then the tongue proper and coating RGB(redness,greenness,blueness) values were measured.Results In the group of the terminal stage patients,light red and red tongue proper were more,yellow thick tongue coating and without tongue coating were more.Red tongue proper and yellow thick tongue coating were more in the other group.In the group of the terminal stage patients' tongue proper,G values were lower,B values were lower(P0.05).Conclusion The tongue proper and coating of the terminal stage patients of colorectal cancer have certain characteristics.