OBJECTIVE:To study the chemical constituents of Zingiberis Rhizoma.METHODS:The compounds of Zingiberis Rhizoma were classified and purified by silica gel,Sephadex LH-20 column chromatography and thin layer chromatography (TLC).The structure of compounds were analyzed and identified according to chemical property and spectrum data.RESULTS & CONCLUSIONS:Five compounds were isolated from Zingiberis Rhizoma,i.e.methyl-6-gingerol (1),4-gingerol (2),β-eudesmol (3),2,5-dihydroxybisabola-3,10-diene (4),6-shogaol (5).The compounds 2,3,4 are isolated from Zingiberis Rhizoma for the first time.

Objective To study the chemical constituents of Dioscorea septemloba.Methods The compounds were isolated by GC-MS and chromatography on silica gel column and identified on the basis of physico-chemical constants and spectral analysis.Results Thirteen compounds were isolated and their structures were identified as 4,8-dimethyl-1,7-nonadiene(Ⅰ),5-isopropyl-2,8-dimethylcyclodeca(Ⅱ),3,7-dimethyl-6-octen-1-ol-formate(Ⅲ),dodecanoic acid methyl easter(Ⅳ),N,N'-dinitro-1,2 cyclohexanddiamine(Ⅴ),1-octyn-4-ol(Ⅵ),?-sitosterol(Ⅶ),palmitic acid(Ⅷ),stigmasterol(Ⅸ),6,7-dihydroxy-2-methoxy-1,4-phenanthrenedione(Ⅹ),diosgenin(Ⅺ),ruscogenin(ⅩⅡ),and stigmasterol-3-O-?-D-glucoside(ⅩⅢ).Conclusion Compounds Ⅰ—Ⅵ,Ⅸ,Ⅹ,ⅩⅡ,and ⅩⅢ are obtained from this plant for the first time.

Child ; Diabetes Mellitus, Type 1 ; complications ; Epilepsy ; etiology ; Humans ; Male

Genetic Heterogeneity ; Humans ; Magnetic Resonance Imaging ; methods ; Neoplasms ; diagnosis ; genetics ; pathology ; Positron-Emission Tomography ; methods ; Tomography, X-Ray Computed ; methods

Objective To investigate the effect of Zidan decoction containing serum on endometrial receptivity in uterine immunity environment,and then to discuss if it's effect on endometrial receptivity through its controlling the expression of cell factors which related to endometrial receptivity.Methods Mice's endometrium tissue samples and uterine Natural Killer (UNK) cells were obtained from pregnant mice on gd 4.5 days and gd 12.5 days.After endometrial glandular epithelial cells,endometrial stromal cells and UNK cells were separated through primary culture,epithelial cells and endometrial stromal cells at rate of 1 ∶ 1 a certain concentration UNK were mixed together and highly purified-cultured.Different concentrations of Zidan decoction was acted on the culture solution.FBS,black and aspirin control group were setup for contrast.The expression of LIF and VEGF which influenced by Zidan decoction in the immunity environment was assayed by Realtime-PCR.Results The expression of LIF and VEGF was significantly increased in the immunity environment of uterine (in 10％ Zidan decoction group,10％ aspirin group and 10％ blank control group:LIF was 2.10±0.20,1.98±0.14,0.90±0.05 separately,and VEGF was 3.17±0.31,2.52±0.09,0.92±0.06respectively,P＜0.05).Conclusion Zidan decoction could improve endometrial receptivity by increasing the expression of cell factor which related to endometrial receptivity with the help ofUNK paracrine.

Objective To investigate the clinical value of Fluorine-18-fluorodeoxyglucose (18 F-FDG) PET/CT examination to predict the prognosis of patients after colorectal cancer operation.Methods The retrospective cross-sectional study was adopted.The clinicopathological data of 80 patients with colorectal cancer who were admitted to the First Hospital of Nanjing Medical University from March 2007 to October 2015 were collected.Eighty patients received first preoperative 18 F-FDG PET/CT examination and underwent operations under decisions of patients and their families,and then adjuvant chemotherapy were performed according to the patients' condition.Observation indicators included:(1) preoperative imaging examination,(2) situations of treatment and follow-up,(3) analysis of prognostic factors.The patients were followed up by outpatient examination and telephone interview once every 3 months within postoperative 1 year,once every half a year within postoperative 2 years and then once a year up to May 2016.The follow-up included tumor recurrence or progression and survival of patients.Tumor-free survival time was from postoperative day 1 to tumor recurrence or progression and death or end of follow-up.Overall survival time was from postoperative day 1 to death or end of follow-up.Measurement data with skewed distribution were represented as M (Qn) and M (range).The optimal cutoff point of tumor-free survival of maximum standardized uptake value (SUVmax),mean standardized uptake value (SUV),metabolism of volume (MTV) and total lesion of glycolysis (TLG) were investigated using the ROC curve analysis,and calculating area under the curve (AUC).The median was used as a cutoff point if there was smaller AUC.The Kaplan-Meier method and Log-rank test were respectively used for survival analysis and univariate analysis,and COX proportional hazards model for multivariate analysis.Results (1) Results of preoperative imaging examination:results of PET/CT in patients with colorectal cancer showed there were circumscribed thickening of bowel wall,intestinal cavity strictures,fuzzy fat space around the some lesions,enlarged lymph node and 18 F-FDG uptake increased abnormally.The SUV SUV MTV and TLG of 80 patients were 11.83(4.26,35.42),7.06(2.38,20.92),20.47 cm3 (1.29 cm3,161.50 cm3) and 138.58 (14.17,857.89),respectively.ROC curve showed that the AUC of SUV SUV MTV and TLG were 0.453,0.448,0.815 and 0.749 [95％ confidence interval (CI):0.307-0.600,P ＞0.05;0.303-0.594,P ＞ 0.05;0.717-0.913,P ＜ 0.05;0.635-0.863,P ＜ 0.05],respectively.The median SUVmax (11.83) and SUV (7.06) were used as the cutoff points due to smaller AUC of SUVmax and SUV.The cutoff point of MTV was 18.79 cm3 (sensitivity =86.2％ and specificity =68.3％),and the cutoff point of TLG was 142.05 (sensitivity =75.9％ and specificity =70.7％).(2) Situations of treatment and follow-up:among 80 patients,13 underwent the radical resection of colorectal cancer and resection of liver metastasis and 67 underwent radical resection of colorectal cancer.Sixty-two patients received postoperative chemotherapy,including 45 with chemotherapy regimens of capecitabine and 17 with fluorouracil.Eighty patients were followed up for 41.8 months (range,6.5-109.1 months).During the follow-up,29 patients had tumor recurrence or progression,and 19 patients were dead.The median tumor-free survival time,1-,3-and 5-year tumor-free survival rates in 80 patients were 19.5 months (range,2.0-109.1 months),73.7％,36.3％ and 18.8％,respectively.The median overall survival time,1-,3-and 5-year overall survival rates were 31.8 months (range,3.3-109.1 months),76.3％,37.5％ and 20.0％,respectively.(3) Analysis of prognostic factors:results of univariate analysis showed that tumor location,N staging,M staging,clinical staging,postoperative chemotherapy,MTV and TLG were relative factors affecting postoperative tumor-free survival rate (HR =3.469,5.325,5.295,8.605,2.630,7.388,5.155,95％ CI:1.522-7.906,2.256-12.568,2.405-11.657,2.969-24.937,1.063-6.504,2.550-21.403,2.178-12.204,P ＜ 0.05).The tumor location,tumor differentiation,N staging,M staging,clinical staging,MTV and TLG were relative factors affecting postoperative overall survival rate (HR =2.697,2.814,3.083,2.916,4.193,5.450,4.876,95％ CI:1.011-7.197,1.121-7.062,1.166-8.149,1.140-7.454,1.386-12.678,1.581-18.786,1.727-13.766,P ＜ 0.05).In multivariate analysis,stage Ⅲ-Ⅳ of clinical staging and TLG≥ 142.05 were independent risk factors affecting postoperative tumor-free survival rate (HR =9.879,3.569,95％ CI:1.854-22.836,1.127-11.306,P＜0.05).The stage M1,stage Ⅲ-Ⅳ of clinical staging and TLG≥ 142.05 were independent risk factors affecting postoperative overall survival rate (HR =4.522,9.315,10.120,95％ CI:1.223-16.717,1.338-24.864,2.385-12.947,P＜0.05).Conclusion TLG through 18 F-FDG PET/CT examination is an independent prognostic factor affecting postoperative tumor-free survival rate and overall survival rate in patients with colorectal cancer after curative resection,and it has certainly reference value for prognosis.

Objective To investigate pathogenic factors,clinical characteristics,pathological changes in 6 patients with localized or disseminated intestinal neuronal dysplasia(IND).Methods The clinical retrospective study was performed in 6 cases with localized and disseminated IND.Results In 6 patients,constipation and partial intestinal obstruction were the major symptoms.Preoperatively,dia-gnoses were revaluated as intestinal stenosis in 2 cases,long sigmoid in 2 cases and long-segment aganglionosis and total gastrointestinal IND in the rest 2 cases,respectively.Exploratory laparotomy was performed on all these patients.Pathological study suggested that 4 of them were localized IND,on whom enterectomy and intestinal anastomosis were performed successfully.However,2 cases of disseminated IND died postoperatively.Conclusions Disseminated IND may be caused by congenital factors,while localized IND by the acquired factors which including intestinal obstruction,local ischemia or inflammation.The surgical interventions are effective for localized IND,and intestine transplantation might be prospective treatment for disseminated IND.

Objective To report a case of Majocchi's granuloma induced by var. raubitschekii of Trichophyton rubrum, and to evaluate the relationship between deep and superficial fungal infection with genotyping technique. Methods The patient underwent physical, pathological and mycologic examination,which included microscopic observation, fungal culture, and urease reaction. The sequence of intertranscribed spacer (ITS) of rDNA was analysed by PCR and sequencing. Isolates from affected toes and tissue as well as one reference strain and six clinical strains of T. rubrum, were subjected to analysis of the tandem repeat subelement(TRS-1) in nontranscribed spacer(NTS)of rDNA by PCR. Results A 48-year-old female patient presented with a 2-month history of red papules and nodular lesions on the back, buttock and thigh,as well as a 3-year history of onychomycosis which had become more severe after a liver transplantation 9 months before. Pathological and mycologic examinations confirmed the diagnosis of Majocchi's granuloma. The pathogen was identified as var. raubitschekii of T. rubrum by microscopic examination, fungal culture, positive urease reaction and the sequence of ITS. As shown by the amplications of TRS-1 of NTS, the genotypes of strains from affected nails and tissue were identical, but differed from those of other clinical strains of T.rubrum. Conclusions There is a polymorphism in TRS-1 of rDNA NTS of T. rubrum, with the genotypes of isolates from affected nails and tissue being identical, which suggests they are of the same origin.

Objective To study the mechanism of adaptive immunity against Rhizopus arrihizus (R. arrihizus) infections. Methods Bone marrow derived dendritic cells (BMDCs) were separated from C57BL/6 mice and Card9-/- mice and then were cultured in vitro. Resting spores and swollen spores of R. arrihizus were in vitro co-cultured with BMDCs with or without Syk inhibition. Secretion of cytokines ( IL-23, IL-1βand IL-12) was analyzed by ELISA after 24 hours of culture. Na?ve T cells derived from C57BL/6 mice were in vitro co-cultured with spore-stimulated BMDCs for four days. Levels of IL-17A and IFN-γ in supernatants of cell culture were analyzed by ELISA. Flow cytometry was performed to analyze T cell differ-entiation. Confocal microscopy was used to observe the images of stained β-glucan on the surface of resting and swollen spores. Swollen spores were co-cultured with Dectin-1, Dectin-2, TLR2 and mannose receptor ( MMR) , and the binding results were analyzed by flow cytometry. Results Swollen spores but resting spores could induce the maturation of BMDCs and promote the secretion of cytokines (IL-23, IL-1βand IL-12). Co-culturing T cells with swollen spore-stimulated BMDCs enhanced their differentiation to Th17 and Th1. In addition, swollen spores promoted the secretion of Th1-related cytokine ( IFN-γ) and Th17-related cytokine (IL-17A). Adding Syk inhibitor to Card9-/-BMDCs or wild type BMDCs significantly inhibited the secretion of cytokines and T cell differentiation, especially in the Card9-/- group. β-glucan was overserved on the surface of swollen spores, but not on resting spores. On the surface of swollen spores existed pathogen associated molecular patterns ( PAMPs) that could bind with Dectin-1 and TLR2. Conclusion Swollen spores of R. arrihizus could active BMDCs to secrete cytokines of IL-23, IL-1β and IL-12 and trigger T cell responses in vitro. The possible mechanism might be associated with β-glucan exposed on the surface of swollen spores that binds with Dectin-1. The responses between BMDCs and R. arrihizus are Syk-Card9-dependent.

Objective To observe the tolerance of contemporaneous multiplane operations in obstructive sleep apnea-hypopnea syndrome(OSAHS). Methods Twenty-three patients were enrolled. According to the different obstructive level, the different operations were chosen to complete upper airway reconstruction in contemporaneous operation group (group A, 13 patients). In the simple palatopharynx level obstructive group (group B, 10 patients), bilateral tonsillectomy and H-UPPP was chosen. Results The operation time in group A was significantly longer than that in group B:(121.0 ± 35.4) min vs.(80.7 ± 25.3) min, P<0.01. The hospital days and adverse events in two groups had no significantly difference (P>0.05). Conclusions Individual therapeutic schedule for OSAHS patients should be formulated. Operating the different obstructive levels simutaneously, which would solve upper airway occlusion and complete the upper airway reconstruction at the same time. No more adverse events happen, compared with the simple palatopharynx level obstructive group, though the operation time may be longer.