Delivery of Health Care ; Government ; Humans ; Pneumoconiosis ; Social Values

Objective To discuss MSCT assessment of pulmonary arterial hypertension (PAH) in patients with IPF before lung transplantation.Methods Between Sep.2002 and Aug.2010,lung transplantation (LTX) was performed on 96 patients with end-stage lung disease.Thirty patients with IPF were found to have PAH,as defined by mean pulmonary artery pressure (mPAP) ≥25 mm Hg by cardiac catheterization.Fifteen control patients (mPAP ＜25 mm Hg) were also identified.The diameter of the principal pulmonary artery (PPA) and ratio of main pulmonary artery to aortic diameter (rPA) were assessed by MSCT.Results MSCT-determined PPA and rPA were (34.4 ±4.4) mm and 1.03 ± 0.09 in patients with PAH,and (25.3 ± 3.3) mm (P＜0.01) and 0.77 ± 0.12(P＜0.01) in controls.In our group of patients,PPA (28.5 mm) had a sensitivity of 86.7％ and specificity of 80％ for predicting PAH,and rPA 0.935 had a sensitivity of 96.7％ and specificity of 93.3％ for predicting PAH.There was a correlation between the degree of PAH and PPA (r =861,P ＜0.01 ),and between the degree of PAH and rPA (r =0.887,P＜ 0.01 ) in patients with IPF associated with PAH.Conclusion MSCT is useful for the detection of IPF with PAH,and CT determined rPA has an excellent diagnostic value.

From the chloroform-soluble fraction of the ethanol extracts of the whole plant of Taxus chinensis var. mairei (Lemee et Levl), four compounds were isolated by using repeated column chromatography on silica gel and Sephadex LH-20. Based on spectroscopic data (UV, IR, ESI-MS, 1H NMR and 13C NMR), the compounds were identified as taxamairin K (1), 2α, 4α-dideacetoxy-7β-benzoyloxy-5β,20-epoxy-9α,10β,13α,15-tetrahydroxy-11(15→1)abeotaxa-11-ene (2), 7β-xylosyl-taxol (3), 10-deacetoxy-7-xylosyl-taxol (4). Among them, taxamairin K is a new compound.

Objective To investigate the chemical constituents in the barks of Populus davidiana. Methods The constituent was isolated by column chromatography and its structure was determined on the basis of chemical and spectral data. Results Compound Ⅰ was identified as (E)-5-hydroxy-2-[3, 4, 5,-trihydroxy-6-(hydroxymethyl)-tetrahydro-2H-pyran-2-yloxy] benzyl 3-(4-hydroxypenyl) acrylate. Conclusion Compound I is a new phenolic glycoside named as davidianoside.

Objective To investigate the chemical constituents in the barks of Populus davidiana. Methods The constituents were isolated by column chromatography and their structures were determined on the basis of chemical and spectral data. Results Sixteen compounds were isolated and twelve of them were identified as 3?-acetoxyurs-12-en-28-oicacid (Ⅰ), ?-sitosterol (Ⅱ), 4-methoxyphenol (Ⅲ), 3-methoxyphenol (Ⅳ), sakuranetin (Ⅴ), scopoletin (Ⅵ), 2R, 3R-dihydro-7-methoxy-kaempferol (Ⅶ), salicyloyltremuloidin (Ⅷ), tremuloidin (Ⅸ), ?-sitosterol-3-O-glucoside (Ⅹ), salireposide (Ⅺ), and sakuranin ( ⅩⅡ ). Conclusion Compounds Ⅰ, Ⅴ, Ⅵ, and ⅩⅡ are isolated from the plants of Populus L. for the first time.

Objective To intensively investigate the chemical constituents in the heartwood of Taxus yunnanensis Cheng et L.K.Fu.Methods The heartwood was extracted with ethanol,the ethanol extract was subjected to the extraction with methylene trichloride,which was submitted to chromatography on sili-ca gel and Sephadex LH-20 column to isolate some compounds.And their structures were elucidated on the basis of spectral analysis(UV,IR,ESI-MS,1H-NMR,13C-NMR).Results The compounds were identified as 2?,5?,7?,9?,10?,13?-hexaacetoxy-4(20),11-taxadiene(Ⅰ),taxusin(Ⅱ),taxa-4(20),11-diene-2?,5?,10?-triacetoxy-14?,2-methybutyrate(Ⅲ),10?-hydroxy-2?,5?,14?-triacetoxy-4(20),11-taxadiene(Ⅳ),1-dehydroxybaccatin Ⅳ(Ⅴ),baccatin Ⅳ(Ⅵ),baccatin Ⅵ(Ⅶ),7,9-deacetylbaccatin Ⅵ(Ⅷ),10-deacetyltaxuyannine(Ⅸ),1?-accetoxy-5-deacetyl-baccatin Ⅰ(Ⅹ),baccatin Ⅰ(Ⅺ),taxuchin A(Ⅹ Ⅱ),secoisolariciresinol(Ⅹ Ⅲ),?-conidendrin(Ⅹ Ⅳ),isotaxiresinol(Ⅹ Ⅴ),lariciresinol(Ⅹ Ⅵ),sequoitol(Ⅹ Ⅶ),?-sitosterol(Ⅹ Ⅷ).Among them compounds Ⅰ,Ⅴ,Ⅵ,Ⅺ,Ⅹ Ⅱ,Ⅹ Ⅵ were obtained from the heartwood of T.yunnanensis for the first time.Conclusion The chemical constituents in the heartwood differ from the other parts of T.yunnanensis,but there is little difference within the species of Taxus L.

Lung transplantation is an effective treatment for end-stage lung diseases in children, and the only treatment for children with no response to conservative treatment.However, merely a few transplantation centers at home and abroad can provide lung transplantation at present.The mortality of pediatric lung transplantation is high, and it is difficult for donor matching.Besides, it has many complications.In recent years, pediatric lung transplantation has made positive progress and technological breakthroughs in many aspects.In this article, research progress in pediatric lung transplantation at home and abroad was reviewed.

Pulmonary fibrosis , an important cause of pulmonary diseases , has no effective protective and therapeutic meas-ures.Recent studies showed high mobility group protein B 1 (HMGB1) has an important role in the development of pulmonary fibrosis and many HMGB1 antagonists can alleviate pulmonary fibrosis in animal models .This paper summarizes the structure , function, intra-cellular signal transduction of HMGB1, the expression change of HMGB1 in pulmonary fibrosis and HMGB1 targeted therapy in pulmo-nary fibrosis in order to provide an effective basis for clinical treatment of pulmonary fibrosis .

Objective To study the influence of preoperative splenectomy on liver transplantation for portal hypertension and the management of complications.Methods From January 2008 to January 2013,a total of 136 patients underwent liver transplantation for portal hypertension (PHT) in Hepatobiliary Surgery Center,Fuzhou General Hospital of PLA Nanjing Military Region.Pre-liver transplantation splenectomy was carried out in 19 patients.We randomly selected according to the operation time 50 cases of liver transplantation as the control group.The operation time,bleeding,blood transfusion,infection,the incidence of acute rejection,biliary complication rate,survival rate,postoperative platelet recovery and arteriovenous thrombosis were analyzed.Results The preoperative group has longer surgical time,intraoperative blood loss,blood transfusion volume increased obviously,infection rate increased significantly compared with the control group.The accumulate survival rate of preoperative splenectomy group was significantly lower than that of the control group.The platelet count of the preoperative splenectomy group was significantly higher than that of the control group.The platelet count of both groups experienced the process of first rise after falling.Although the platelet count of the preoperative splenectomy group was higher than that of the control group,but there was no statistically significant difference.Conclusions Liver transplantation in PHT patients with previous splenectomy may lead to some unfavorable consequences including increases of technical diffculty of surgery,operative duration,intraoperative bleeding,postoperative infection and other serious complications,and surgical mortality.Therefore,splenectomy should be performed cautiously for the patients who may receive liver transplantation in the future.

Objective To discuss the feasibility of the lung transplantation as an effective treatment for end-stage pulmonary diseases domestically and to compare the major issues involving the practice of lung transplantation domestically and overseas.Methods After the foundation of group of lung transplantation in May 2002, lung transplantation models of porcine were set up. From September 2002 to April 2005, in the 18 cases undergoing lung transplantation, there were subjected to single-lung transplantion (SLT, 83.3%) and 3 bilateral sequential single lung transplants without CPB (DSSLT, 16.7%). Indications for SLT (n=15) included emphysema (n=9), pulmonary fibrosis (n=3), pneumosilicosis (n=1), lymphangioleiomyomatosis (n=1) and ventricular septal defect (VSD) induced Eisenmenger's syndrome (n=1); for DSSLT (n=3) bronchiectasis (n=1) and pulmonary emphysema (n=2). Among the 15 SLTs, there were 9 cases of left SLT and 6 right SLT. Among them, 2 cases shared one same donor's lung block, one case received contralateral lung transplantation―a left donor lung implanted in the recipient’s right thorax, and one case simultaneous right SLT and VSD repair. Results In hospital mortality (HM) was 3/18 ( 16.7%). Among SLTs, early death was due to severe rejection on the 30th postoperative day in one patient and acute rejection on the 15th postoperative day in other patients, and another patient died due to pulmonary vein embolism on the 36th day. There were 3 and 2 patients with the survival time longer than 1 and 2 years respectively. The median overall survival was 10 (2 to 32) months. Conclusions Our LT program shows similar results to those reported by the International Society for Heart and Lung Transplantation for developed countries. The key of successful operation depends on the establishment of group of lung transplantation and cooperation of multi-department. Ischemic-reperfusion injury, acute-rejection and infection are the major reasons of deaths shortly after the operations.