ObjectiveTo study the ent-kaurane diterpenoids from Rabdosia rubescens.MethodsThe compounds were isolated by chromatographies and their structures were identified by spectral analyses.ResultsFour compounds were isolated,and they were identified as bisrubescensin E (1),2α,3α,24-trihydroxyurs-12-en-28-oic acid (2),2α,3α,24-trihydroxyurs-12,20-(30)-dien-28-oic acid (3),and 6,7-dihydroxycoumarin (4).ConclusionCompound 1 is a new asymmetric ent-kauranoid dimer.Compound 2 is isolated from the plant for the first time.Compounds 3 and 4 are isolated from the plants ofRabdosia (B1.) Hassk for the first time.

Objective To assess the efficacy of interventional bronchoscopic techniques used to treat stenosis of bronchial anastomosis after lung transplantation.Methods A retrospective study of 24 cases who underwent lung transplantation from September 2003 to August 2005 in our Unit was done. All recipients were subjected to surveillance bronchoscopy with biopsy at predetermined intervals and when clinically indicated. Endobronchial electrocauterization with microwave therapy apparatus and endobronchial electrocoagulation with high-frequency electrotome were performed for the management of bronchial stenosis or granuloma formation.Results There were 2 of 24 recipients (2/24,8.3 %) with stenosis of bronchial anastomosis. Airway stenosis appeared in 3 of 28 anastomoses (3/28,10.7 %): 2 on the left and 1 on the right. These patients with airway stenosis responded to interventional bronchoscopy,and their respiratory function was improved significantly.Conclusions Despite the improvements in surgical technique and immunosuppression strategies,a small number of patients still had airway complications after lung transplantation. Interventional bronchoscopic techniques,i.e. endobronchial electrocauterization with microwave therapy apparatus and endobronchial electrocoagulation with high-frequency electrotome will be effective in the treatment of airway complications after lung transplantation and with good response in respiratory function.

Viral myocarditis (VMC) is a clinical frequent cardiovascular disease with extremely high mortality and disability rate ,which seriously impairs the health of children and young adults ,and its pathogenesis has not been fully elucidated .It is generally believed that VMC pathogenesis is mainly related to direct damage on myocardial cells ,immune damage ,cell apoptosis and cytokines .The present article made a summary about the research progress of its pathogenesis .

Objective To compare early enteral with parenteral nutrional support in patients after hepatectomy. Methods In this study, 59 patients were randomized into 2 groups to respectively receive enteral or parenteral nutritional support beginning the first day post-op for a week. The general nutrition condition, liver function, gut function, dosage of albumin, mortality, complication rate and expense were recorded. Results Patients were given same quantity of heat and nitrogen. At the end of the study, serum albumin, body weight and upper arm circumference had not reached the preoperative level in patients receiving enteral mutrition while all except for serum prealbumin had not reached the level in parenterally nutritional patients. Furthermore, the time of gut begins functional (29?12) h in enterally nutritional patients was shorter than in parenterally nutritional patients (38?14) h. Enteral nutrition was more economic than parenteral nutrition (P

Objective To discuss the therapeutic efficacy of bidirectional subintimal angioplasty in the treatment of atherosclerotic occlusive of lower limbs.Methods Five patients with long segment of obstructed artery in lower limb were enrolled in the study.Of five patients,occlusion of the lower segment of abdominal aorta and bilateral iliac artery was seen in one,occlusion of iliac artery in 2 and occlusion of superficial femoral artery in the remaining two.Antegrade subintimal angioplasty procedure was unsuccessful in all five patients as the wire could not be placed into the true lumen,so retrograde subintimal angioplasty by puncturing the distal segment of the occlusive artery was employed.Through the newly created channel the retrograde guide wire was manipulated to be pulled out of vessel through the antegrade catheter.The subintimal tract was dilated with angioplasty balloon and the stent implantation was performed.Results Bidirectional subintimal angioplasty was successfully accomplished in all five patients,with a total of nine stents being implanted.Conclusion Bidirectional subintimal angioplasty is a safe and effective procedure for bringing the subintimal recanalization to success,this technique can be regarded as a remedial measure when unidirectional subintimal angioplasty ends up in failure.

Objective To investigate the diagnostic value of DSA for micro hepatocelluar carcinoma(MHCC)in patients with hepatic cirrhosis. Methods Three hundred and fourty cases of hepatic cirrhosis who were going to receive bone marrow stem cells transplantation via hepatic artery underwent hepatic arterial DSA. No definite evidence of hepatoma had been found during the former CT scan and ultrasound test in these patients. Multi-angle projection DSA was performed to display the characteristics of MHCC and super-selective TACE treatment was given in cases of the diagnosed MHCC. Results MHCC were found by DSA in 20 cases who were all of post-hepatitis B cirrhosis and with single-lesion of sized 0.4 - 1.0 cm. DSA showed the characteristics of nodular stains in early or middle arterial phase in angiography. 18 lesions were in the right lobe and 2 in the left lobe. AFP were negative in 16 cases and positive in 4 cases. Super-selective segmental TACE were performed with micro catheter system for the treatment. Conclusions DSA is more sensitive to detect MHCC in the patients with hepatic cirrhosis, comparing with regular contrasted CT scan or ultrasound.

Objective To evaluate interventional techniques for the treatment of visceral aneurysms. Methods A total of 11 aneurysms were found in 9 patients with visceral aneurysms who received interventional treatment. Of the 9 patients, single aneurysm at both superior mesenteric artery (SMA) and right colonic artery was seen in one, 2 aneurysms at same splenic artery in one, one aneurysm at splenic artery in 5, aneurysm at right gastric artery in one and pseudoaneurysm at hepatic artery in one. In 9 patients the transcatheter endovascular coil embolization was successfully carried out for 10 aneurysms, including splenic (n = 7), right colonic artery (n = 1), right gastric artery (n = 1) and hepatic pseudoaneurysm (n = 1). One stent-graft was used for the SMA aneurysm. Results Technical success was achieved in all cases without any serious complications. Conclusion Interventional embolization with coils can successfully occlude most visceral aneurysms, while stent-graft should be used when the aneurysm is difficult to be occluded with coil.

Objective To explore the feasibility and proper technique of subintimal racanalization in treating chronic aorto-iliac artery occlusion. Methods Subintimal racanalization via right brachial artery access was performed in a 57-years-old man with chronic total occlusion of aorto-iliac artery. Subintimal pathways were created with two hydrophilic guidwires (Teromo), which were inserted into the subintimal space from the occluded end of the abdominal aorta and got into the right and left external iliac arteries separately. Subintimal arterial flossing with antegrade-retrograde intervention was employed in left side to overcome the difficulty in reentering the true lumen. The exchange guidwires were conducted out of the femoral artery puncture sites on both sides in sequence, in this way the bilateral femoral pathways were established. Aorto-iliac artery balloon angioplasty and retrograde stent implantation, including one aortal and 5 iliac stents, were carried out by kissing technique from the femoral site. Results The aorto-iliac artery lumen was successfully reopened after the procedure. The internal lumen shape of the stents was satisfactory and the blood flow was unobstructed. The ischemic symptoms of the lower extremities disappeared completely. The ankle brachial index (ABI) rose from 0.32 to 0.96, and the condition remained stable in a follow-up period of 10 months. Conclusion Subintimal racanalization therapy is practical and safe for treating total aorto-iliac artery occlusion, especially for the patients with chronic arterial sclerosis.