Objective To study the chemical constituents in the seeds of Zizyphus jujuba var.spinosa.Methods The compounds were isolated by silica gel column chromatography and their structures were established by spectroscopic methods.Results A new keto-dammarane type saponin,jujuboside H(Ⅰ),along with three known compounds protojujuboside A(Ⅱ),spinosin(Ⅲ),and betulic acid(Ⅳ)were isolated.Conclusion Compound Ⅰ is a new compound named jujuboside H.

Objective To understand the RHD gene profiles of RhD negative individuals in Hainan Han population,and provide reference to establish the right method for RHD genotyping.Methods RhD was tested by anti-globulin test, and RhDel and genuine RhD-negative phenotype were identified by absorption/elution method. RhD negative samples were further tested for RHD exons by PCR-SSP.The RhD negative samples with intact RHD genes were further analyzed by PCR-SSP for RHD introns 2, 10 and RHD?gene. Results Thirty-one (29.25%)cases of RhDel individuals were identified among 106 apparent RhD-negative individuals. All RhDel samples had RHD genes;67 cases of genuine RhD-negative had no RHD genes and 8 cases were partial D. All 31 RhDel samples had Din2 and Din10 but none had RHD?. Additionally, We detected exons 1,3,4,6,7,9 and 10 in one case of ccdEe sample. Conclusion The proportion of RhDel phenotype is high among apparent RhD-negative Hainanese, and total RHD exons can be detected in all RhDel samples. Polymorphisms of RHD gene are present among genuine RhD-negative Hainanese. There is no exon 5 in all 8 cases of partial D, which suggests that exon 5 specific amplification may be very important in RHD genotyping for Hainan Han population.

The concept and methods of evidence-based medicine(EBM)has been evolved to impact almost all fields of health care and policy since it first appeared in 1992.but in the field of dentistry or stomatology,many problems remain to be solved in carrying out EBM.The necessity and feasibility of implementing evidence-based dentistry education in China were discussed in this paper for chnical evidence-based decision making and clinical research.The contenk teaching approach and accreditation tools for EBM in dental education were also proposed.

Objective To investigate the diagnostic value of quantitative analysis of the color change of iodine staining for early esophageal cancer.Methods A total of 58 patients with suspected esophageal diseases were recruited to this study.The lesions were stained with lugols iodine,and biopsies were performed.Quantitative analysis of color change under endoscopy was also performed by analysis software and the results were compared with pathological findings.Results A total of 62 iodine-unstained lesions in 58 patients were found,includiug 19 chronic inflammation,13 low-grade intraepithelial neoplasia,11 high-grade intraepithelial neoplasia and 19 squamous cell cancer.The color parameters of R/R'(red) and H/H'(hue) were significantly different among the four groups (P＜0.05).Conclusion Computerized chromoendoscopy is helpful in determining pathological characteristics of esophageal lesions,thereby improving the accuracy of endoscopic biopsy and the diagnosis rate of early esophageal cancer.

Objective To investigate the effects of amplitude dependent morphological and proliferative changes in human bladder smooth muscle cells (hBSMCs) undergoing physiological stretch in vitro.Methods The hBSMCs were cuhured on silicone membrane and stretched similarly to a bladder cycle at range of stretches and time.The elongation would increase up to 2.5％ every 3 h and 5％ (or 10％,15％,20％ and 25％ depending on the experiment design) in the next 1 h,followed by a rapid decrease,cyclically maintained for a total of 16 h.In subsequent 8 h (24 h cycles) the membrane was maintained in relaxed position.Immunofluorescence and confocal laser scanning microscope were employed to assess the morphological changes.Cell counting kit-8 (CCK-8) and flow cytometry were used to assess the cell proliferation.Results The hBSMCs showed contractile phenotype after application of mechanical strain.Compared with control,the strains at 5％,10％,15％,20％ and 25％ induced most of the cells to change from a more spread-out and stellate state with large cell surface contact areas to a typical spindle-like morphology.The orientation angle of BSMCs remarkably differed depending on the applied strain's magnitude.Absorbance value,which reflects the proliferation activity,analyzed by CCK-8 was improved from 0.471 ± 0.027 (control) to 1.320 ± 0.094 (5％ elongation group,P ＜ 0.0001),1.001 ± 0.029 (10％ elongation group,P ＜0.0001),0.821 ±0.032 (15％ elongation group,P＜0.0001),0.621 ±0.032 (20％ elongation group,P =0.0004) and 0.591 ± 0.056 (25％ elongation group,P =0.0268),respectively.Cell proliferation index increased from (29.35 ±0.55)％ (control) to (55.55 ± 1.05)％ (5％ elongation group,P ＜0.0001),(47.70 ±0.20)％ (10％ elongation group,P＜0.0001),(35.40 ±2.10)％ (15％ elongation group,P ＜0.0001),respectively.However,no significant difference was found in either 20％ elongation group (34.85 ±0.55)％ (P=0.1372) or 25％ elongation group (30.35 ±0.45)％ (P=0.5234).Conclusions Proliferative and morphological changes could be observed in hBSMCs in vitro.Maximal proliferative potential could be seen at 5％ of stretch.

Objective To explore the correlation between illness conception, health seeking behavior and mental health status in recruits. Methods 865 recruits were evaluated by Symptom Checklist 90 (SCL-90), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS) and Self-Rating Scale of Illness Conception and Health Seeking Behavior (SSICHSB) . Results (1) Except interpersonal sensitivity, depression and hostility, there were significantly differences in other factors of SCL-90 between recruit and the national norm. Somatization and anxiety scres were significantly higher ghan the military norm. The scores of SAS and SDS were significantly higher for recruits compared to national norm. (2) There was negative correlation between the total score, each factor score of SCL-90, the total score of SDS, the total score of SAS and SSICHSB; (3) Stepwise lines regression found three factors including anxiety, the total score of SAS and obsessiveness statistically significant, when the dependent variable was the total score of SSICHSB. Conclusion There are obvious somatization,anxiety and depression in recruits. The more obvious the symptoms are, the more passive the illness conception and health seeking behavior are.

Objective To investigate the drug resistant genes against carbapenems,aminoglycosides and quinolones and the molecular epidemiology of clinical isolates of Acinetobacter baumannii.Methods Forty non-duplicate strains of Acinetobacter baumannii were collected from clinical specimens in First Affiliated Hospital of Wenzhou Medical University.The identification of strains was conducted by Vitek 2 Compact system.The susceptibilities to antimicrobials commonly used were determined by agar plate dilution method and broth microdilution method.The presence of class B metalloenzyme-encoding genes (blaIMP,blaVIM,blaNDM,blaSIM,blaGIM),class D cabapenemase-encoding genes (blaOXA-23,blaOXA-48,blaOXA-58),16S rRNA methylase genes (armA,rmtB) and quinolone resistance-determining regions (QRDR) in gyrA and parC were detected by polymerase chain reaction (PCR) and sequenced.Chromosomal or plasmid location of blaOXA-23 and armA genes were assessed by Southern blot.Multiple loci sequence classification (MLST) was performed to analyze the molecular epidemiology of these strains.Results All of the 40 isolates were multi-drug resistant Acinetobacterbaumannii (MDR-AB) and showed high level resistance to all of the tested antimicrobial agents excluding colistin and tigecycline.The positive rates of blaOXA-23 and armA were 90％ and 95％,respectively.All of the 40 isolates carried QRDR mutations in gyrA and parC genes,leading to the Ser83→ Leu and the Ser80→ Leu amino-acid substitutions,respectively.Southern blot showed the chromosomal location of blaOXA-23 and armA genes.Six different ST (ST191,ST381,ST373,ST426,ST208 and ST207) were assigned for these isolates by MLST and the most dominant clones were ST191 (23/40) and ST381 (10/40).Conclusions The predominant cabapenemase-encoding gene and 16S rRNA methylase gene of Acinetobacter baumannii isolates in First Affiliated Hospital of Wenzhou Medical University are blaOXA-23 and armA,respectively,which may be located on the chromosome and vertically transmit the drug resistance.ST191 MDR-AB with blaOXa-23 and armA gene clonally spread in this hospital.

Objective To examine loss of heterozygosity (LOH) and microsatellite instability (MSI) of locus D8S532 on chromosome 8 and their influence on the expression of sFRP1 in the hepatocellular carcinoma (HCCs), which may provide an experimental evidence for clarifying the mechanism of sFRP1 gene and tumor development. Methods DNA was extracted from formalin-fixed paraffin-embedded tissues. Polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) and ordinary silver stain were used to study LOH and MSI of locus D8S532. Envision immunohistochemistry, Leica-Qwin computerized imaging system and Image-Pro PluS (IPP) version 4.5 professional imaging analysis software were used to assess the expression of sFRP1. Results The detection rates of LOH and MSI of locus D8S532 in the 36 specimens of HCC were 11.11% and 8.33% respectively. The down-regulation of sFRP1 was observed in 31 of 36 HCCs (86.11%) compared with non-carcinoma liver tissues, and the positive rate of sFRP1 protein of the HCCs was 52.78%( 19/36 ). The frequency of LOH was lower in the cases with positive expression of sFRP1 protein than those negative (0 vs 23.53%, P <0.05). Conclusion It was a common phenomenon that expression of sFRP1 protein is negative or low in Chinese with HCCs. The genetic instability of sFRP1 gene was one of causes, which lead to HCCs. LOH may play a major role in negative expression of sFRP1.

Objective To investigate the prevalence and plasmid size of qnrD determinant in Morganella morganii (M.morganii) isolates.Methods A total of 100 non-duplicated M.morganii clinical isolates were collected from inpatients.Standard ager dilution method was used to determine the minimum inhibitory concentrations (MICs) of fluoroquinolones against M.morganii isolates.PCR were performed to detect plasmid-mediated quinolone resistance determinants (PMQRs) in M.morganii isolates and the prevalence of extended-spectrum β-lactamase (ESBL) genes and AmpC β-lactamase genes in PMQRs-positive M.morganii strains.The homology analysis among qnrD-positive M.morganii strains were conducted by using pulsed-field gel electrophoresis (PFGE).The location of qnrD gene and the size of plasmid carrying it were determined by southern hybridization.The transferability of qnrD gene was determined by conjugation experiment.Results Thirty out of 100 M.morganii isolates (30％) were found carrying PMQRs including 17 qnrD-positive strains,14 aac (6')-Ib-cr-positive strains and 5 qepA-positive strains.PCR and sequencing confirmed that thirty PMQRs-positive isolates carried blaDHA-1.Among them,six isolates were positive for ESBLs genes (four for blaCTX-M-14,one for blaCTX-M-3 and one for blaCTX-M-24) and four isolates were positive for blaTEM-1.Almost all PMQRs-positive M.morganii isolates showed reduced susceptibility to fluoroquinolones.Moreover,seventeen qnrD-positive M.morganii isolates harbored blaDHA-1 including five (29.4％) harboring aac(6')-Ib-cr gene,four (23.5％) harboring blaCTX-M-14,two (11.8％) harboring blaTEM-1 and one harboring aac(6')-Ib-cr gene,blaCTX-M-14 and blaDHA-1.PFGE analysis showed that the 17 qnrD-positive M.morganii isolates were divergent from each other and not clone-related.Southern hybridization analysis showed that qnrD genes of all M.morganiiis isolates were mainly located in a 2.7 kb plasmid,but only a few of them were located in a size of 5.1 kb plasmid.M.morganiiis isolates failed to transfer qnrD gene to E.coli EC600 through conjugation.Conclusion PMQRs were widely distributed in M.morganiiis isolates.qnrD gene was the predominant determinants with a high prevalence rate of 17.0％,followed by aac(6')-Ib-cr gene.qnrD gene was located on a non-conjugative plasmid of approximately 2.7 kb or 5.1 kb.One qnrD-positive M.morganii isolate carrying aac(6')-Ib-cr gene,blaCTX-M-14 and blaDHA-1 was detected.

In order to successfully develop the effective population pharmacokinetic model to predict the concentration of propofol administrated intravenously, the data including the concentrations across both distribution and elimination phases from five hospitals were analyzed using nonlinear mixed effect model (NONMEM). Three-compartment pharmacokinetic model was applied while the exponential model was used to describe the inter-individual variability and constant coefficient model to the intra-individual variability, accordingly. Covariate effect including the body weight on the parameter CL, V1, Q2, V2, Q3 and V3 were investigated. The performance of final model was assessed by Bootstrapping, goodness-of-fit and visual predictive checking (VPC). The context-sensitive half-times and the infusion rates necessary to maintain the concentration of 1 microg x mL(-1) were simulated to six subpopulations. The results were as follows: the typical value of CL, V1, Q2, V2, Q3 and V3 were 0.965 x (1 + 0.401 x VESS) x (BW/59)(0.578) L x min(-1), 13.4 x (AGE/45)(-0.317) L, 0.659 x (1 + GENDER x 0.385) L x min(-1), 28.8 L, 0.575 x (1 + GENDER x 0.367) x (1 - 0.369 x VESS) L x min(-1) and 196 L respectively. Coefficients of the inter-individual variability of CL, V1, Q2, V2, Q3 and V3 were 29.2%, 46.9%, 35.2%, 40.4%, 67.0% and 49.9% respectively, and the coefficients of residual variability were 24.7%, 16.1% and 22.5%, the final model indicated a positive influence of a body weight on CL, and also that a negative correlation of age with V1. Q2 and Q3 in males were higher than those in females at 38.5% and 36.7%. The CL and Q3 were 40.1% increased and 36.9% decreased in arterial samples compared to those in venous samples. The determination coefficient of observations (DV)-individual predicted value (IPRED) by the final model was 0.91 which could predict the propofol concentration fairly well. The stability and the predictive performance were accepted by Bootstrapping, the goodness-of-fit and VPC. The context-sensitive half-times and infusion rates necessary to maintain the concentration of 1 microg x mL(-1) were different obviously among the 6 sub-populations obviously. The three-compartment model with first-order elimination could describe the pharmacokinetics of propofol fairly well. The involved fixed effects are age, body weight, gender and sampling site. The simulations in 6 subpopulations were available in clinical anesthesia. The propofol anesthesia monitor care could be improved by individualization of pharmacokinetic parameter estimated from the final model.