Identification of natural products has been a big challenge because of their structural complexity and diversity. Recently, with the development of separation materials, more and more complex compounds have been found with small quantity, which causes difficulty in absolute configuration assignment. Now, the computational methods, such as to compute the 13C NMR data and compare them with experimental results, could be used for relative configuration study other methods, for example, to compute optical rotation (OR), or optical rotatory dispersion (ORD), electronic circular dichroism (ECD or CD) or vibrational circular dichroism VCD, could be efficiently used for absolute configuration determinations for chiral compounds, including the derminant computations for chiral acyclic compounds. Now, two or two more methods are applied for the absolute configuration study and exhibit very powerful reliability.

Objective To investigate the efficacy of medical therapy after conservative operation for endometriosis.(Methods)Endometriosis was confirmed in 89 patients by laparoscopic inspection,and conservative operations were performed to remove the adhesion,excise or destroy all the endometriotic tissues,including single excision of endo-(metriotic) masses or plus unilateral salpingoophorectomy,and to restore pelvic anatomy to the best possible condition.All the patients were divided into two groups randomly: treatment group(n=44),three months drug therapy of go-(nadotropin-)releasing hormone analogs(GnRHa) after operation;control group(n=45),no drug therapy after operation.Clinical symptoms,concentrations of CA-125,manual and ultrasonic pelvic check-up,as well as pregnancy rate to those who had a desire for future fertility(n=28)were followed up. Results All the patients experienced alleviation of clinical symptoms after the operation.The recurring rates: 0% in treatment group vs 4% in control group six months later;2% in treatment group vs 4% in control group 12 months later(P

Objective To evaluate the role of AMP-activated protein kinase (AMPK)-dependent autophagic signaling pathway in ketamine-induced reduction of diabetic neuropathic pain (DNP) in rats.Methods Sixty male Wistar rats,aged 3 months,weighing 200-250 g,were equally randomized into 5 groups using a random number table:control group (C group),normal saline group (NS group),ketamine group (K group),ketamine + Compound C group (KC group),and ketamine + 3-methyladenine (3-MA) group (KM group).DNP model was established by intraperitoneal injection of streptozocin (STZ)65 mg/kg in anesthetized rats.Four weeks later,the equal volume of normal saline,ketamine 10 mg/kg,ketamine 10 mg/kg + Compound C1 mg/kg,and ketamine + 3-MA 2 μl were injected intraperitoneally once a day for 7 consecutive days in NS,K,KC and KM groups,respectively.The mechanical paw withdrawal threshold (MWT) was measured on 8th day.The rats were then sacrificed,and the lunbar segment (L1-5) of the spinal cord was removed for determination of the expression of AMPKαt,Beclin-1,microtubule-associated protein 1 light chain (LC) 3B (by Western blot) and dendritic spine density in the dorsal root ganglia.Results Compared with group C,the MWT,expression of AMPKα,Beclin-1,and LC3B,and dendritic spine density were significantly decreased in group NS (P＜0.05).Compared with group NS,the MWT,expression of AMPKαt,Beclin-1,and LC3B,and dendritic spine density were significantly increased in group K (P＜0.05).Compared with group K,the MWT,expression of AMPKα,Beclin-1,and LC3B,and dendritic spine density were significantly decreased in KC and KM groups (P＜0.05).Conclusion Activation of AMPK-dependent autophagic pathway is involved in ketamine-induced reduction of DNP in rats.

Objective To evaluate the validity of GP proceptors in mini-CEX workshop.Methods Three mini-cex workshops for GP proceptors of standardized training of general practitioners in Shanghai were held during November 2009 to September 2012.In the workshops 82 GP proceptors gave the complete rating scores for the training videotapes and the assessment accuracy was analyzed.Results The accurate rates of all items including history taking,physical examination,communication,clinical judgement,consulting skills,organisation and overall clinical perfomance were lower than 50％ in 9-point scale and the completely accurate rate and completely error rate were 1.2％ and 30.5％,respectively.The accurate rates of 5 items were more than 50％ in 3-rank system and the completely accurate rate and completely error rate were 3.7％ and 9.8％,respectively.The accurate rates of 4 items were more than 50％ in standard score ± 1 system and the completely accurate rate and completely error rate were 8.5％ and 2.4％,respectively.Comparing with 9-point scale,3-rank system had higher accurate rate in 5 items (P ＜ 0.05) and standard score ± 1 system had higher accurate rate in all 7 items(P ＜ 0.05).Abnomal rating scores were found more common in medical interview (41,50.0％),clinical judgement (32,39.0％) and physical examination (13,20.7％).GP proceptors with more than five years teaching experience were more likely to give error scores than those with five or less years teaching experience in 9-point scale(OR =6.993) and 3-rank system (OR =4.902).Leniency and halo effects occurred in 11 (13.4％) and 8 (9.8％) GP proceptors,respectively; and 14 (17.1％) GP proceptors gave written feedback.Conclusions The rater accuracy of GP proceptors in mini-CEX workshop should be improved further.

Electrospinning is a new technique used to fabricate nanofibrous scaffold for guidance of tissue repair and regeneration. Electrospun scaffold simulates the structure and biological function of native extracellular matrix (ECM) and may provide an ideal engineered microenvironment for cell growth. In this paper, the principle of electrospinning technique and important processing parameters were briefly introduced. Investigations and developments in recent years regarding to the applications of tissue repair and regeneration were reviewed, several focusing issues of electrospinning were addressed as well. The significance and problems unresolved were discussed.

0.05). CONCLUSION: There are no significant differences in cell characteristics and transplantation outcome using OB-OEC and OM-OEC transplantation for repairing neurological function.

Thirty four residents of general practice and 11 students of junior college to undergraduate program were evaluated with the mini-clinical evaluation exercise (mini-CEX) when they were rotated to community clinics or the ward of general practice in Zhongshan Hospital from September 2009 to February 2010. The reliability and validity of mini-CEX for rotation examination in general practice training was assessed. Forty five trainees and 9 clinical faculty members completed 81 mini-CEX evaluations. The Cronbach's alpha coefficient was 0. 932. Criterion-related validity for mini-CEX overall competence with the end examination of rotation was O.53 ( P ＜ 0.001 ). The results indicate that mini-CEX may be an appropriate evaluation tool for rotation examination in general practice training.

Objective To evaluate laparoscopic appendectomy(LA) and open appendectomy(OA)in obese patients.Methods From January 2008 to November 2010,153 obese patients with appendicitis were operated on,92 cases were treated with initial LA and 61 cases with upfront OA.The operative time,intraoperative bleeding volume,intestinal recovery period,the rate of using acesodyne,major postoperative complications,the duration and hospital cost were studied.Results In LA group,4 cases were converted to open surgery.All the variables in LA group were better than those in OA group except the hospital cost and the differences were statistically significant (the operative time:t =14.0,P ＜ 0.001 ;intraoperative bleeding volume:t =19.7,P ＜ 0.00 1 ;intestinal recovery period:t =12.3,P ＜ 0.001 ;the rate of using acesodyne:t =21.01,P ＜ 0.001 ;main postoperative complications:x2 =40.138,P ＜ 0.001 ;the hospital stay:t=17.3,P＜0.001) except the in-hospital cost(t=1.434,P＞0.05).Conclusions Compared with OA,LA is a better choice for obese patients with appendicitis because of its advantages of minimal injury,early recovery,less complications and short hospital stay.

Objective To study needs of training of trainers(ToT)in mini-clinical evaluation exercise(mini-CEX)and its effectiveness.Methods One hundred and fourteen doctors involved in TOT for mini-CEX were interviewed with questionnaire before and after training for their satisfaction of training and fifty of them scored the training videos.Results Before the training.39%(44/114)of doctors involved in TOT knew mini-CEX and 97%(111/114)of them hoped to know how to carry out mini-CEX thronsh training.When the training finished,30%(34/114)tO 55%(63/114)of them could completely understand seven items of examinations of mini-CEX.Fifty doctors involved in TOT scored the training videos after the training.There was signifieant difference in scores between TOT and standard scoring on training video 1 for teaching of coronary heart disease and video 2 for teaching of hematochezia(P<0.05).No significant difference Was found in scores between TOT and standard scoring on the video 3 for teaching of abdomihal pain(P>0.05).as well as those between TOT with five or less years experience and those with more than five years experience(P>0.05).Conclusions Currently,doctors involved in TOT have more demands on mini-CEX.However,effectiveness of short-course training for mini-CEX is not satisfactory,and pattern of its training should be improved further.

Objective To develop an efficient method for the determination of activity of human lymphocyte kynureninase by high performance liquid chromatography. Methods Protein containing kynureninase was extracted from lymphocytes.The reaction was made with 3-hydroxyanthranilic acid as substrate and pyridoxal-5'-phosphate as coenzyme.The product was determined by high performance liquid chromatography and fluorescence detection.(Results)Standard curve of 3-hydroxyanthranilic acid was highly linear over the range from 2 to 400 nmol/L.The intra-day coefficient of variation(CV) was less than 3.0% and the inter-day CV was less than 3.2%. Conclusion(The developed) assay is efficient and can be used to determine the activity of kynureninase from kinds of tissues.