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.

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 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.

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

ObjectiveTo study the water/fat ratio of patients with pancreatic ductal adenocarcinoma (PDAC) and mass-forming focal chronic pancreatitis (MFP),and to provided guide for the clinicians.MethodsThirteen patients with PDAC,8 patients with MFP and 20 healthy volunteers were scanned by GE 3.0T MR IDEAL sequence.The signal strength of outcome images was measured; the water/fat ratio analysis was performed.Two kinds of formula were applied,the first was WF1 =SW/SF,the second was WF2 =( SIP + SOP) / ( SIP - SOP).SW was the signal strength of water,SF was the signal strength of fat,and SIP was the signal strength of in-phase,while SOP was the signal strength of opposite phase.ResultsBy using the WF1 formula,the water/fat ratio of normal pancreas,PDAC,MFP was 7.97 ±0.95,9.94 ±1.19,5.08 ±0.49,respectively.By using the WF2 formula,the water/fat ratio of normal pancreas,PDAC,MFP was 11.51 ± 1.62,13.87 ±1.84,5.73 ±0.65,respectively.The difference among the three groups was statistically significant (P ＜ 0.05 ) under the same formula.The value of WF2 was higher than that of WF1,the difference in PDAC groups was also statistically significant ( P ＜0.05 ).ConclusionsThe water/fat ratio of pancreas among PDAC,MFP and normal pancreas is different.PDAC has the highest water/fat ratio,followed by the normal pancreas; MFP has the lowest ratio.

ObjectiveTo explore the methods and effectiveness of interventional revascularization of complex arteriosclerosis obliterans (ASO)of lower extremity arteries according to their imaging characteristics.Methods Seventy-eight patients with lower extremity ASO complex lesions classified as TASC Ⅱ C/D ( n =68 ) and TASC Ⅱ B ( n =10) underwent antigrade or combined antigrade-retrograde subintimal angioplasty.Their clinical situations were Fontaine stage Ⅲ/Ⅳ or severe stage Ⅱ.All the long occlusion,flush occlusion,multiple occlusion,popliteal artery occlusion,below knee artery occlusion and aortoiliac artery occlusion were identified as complex lesion imaging features and as the indication of interventional treatment if only there were visible outflow vessels and suitable puncture site.Statistical analysis was used to compare ankle-brachial index (ABI) pretreatment and post-treatment by t test.Results Successful revascularization was achieved in 73 patients technically.No obvious complications occurred.Ischemia symptoms improved quickly after accomplishment of recanalization.Average ABI increased from 0.45 ±0.07 to 0.76 ±0.11 after the treatment(t =- 19.78,P ＜0.01 ).Symptoms in 5 patients who failed to get arterial recanalization were stable.Follow up of 6 to 12 months in 47 patients showed stable improvement in 22 of them.Conclusion It is more practical to choose and expand application of interventional treatment for complex ASO according to imaging characteristics of lesions than according to TASC classification.

based on the theory of tree structure and followed the characteristics of medical talents growth,Wuxi No.2 People's Hospital carried out hospitalTalent Tree Project innovatively,which is to trained talents corresponding tobase-trunk-crown of a tree.The project has won the 2013 Human Resource Development Excellence Award of Asian hospital management awards.We fostered talents hierarchically according to the talents training echelon structure and this provided a way of guarantee and innovation for the sustainable development of hospital.

Objective To analyze the expression and clinical significance of tumor suppressor phosphatase -tension protein gene(PTEN)in differentiated thyroid carcinoma and the relationship with the V600E gene site muta-tion of murine sarcoma viral oncogene homolog B1(BRAF).Methods The expression of PTEN was assayed by im-munohistochemical staining in differentiated thyroid carcinoma and adjacent tissues.The differences were compared between clinical pathological features.The BRAF V600E gene mutation was detected by fluorescence quantitative pol-ymerase chain reaction(PCR)and to investigate the correlation between the expression of PTEN and BRAF V600E mutation.Results The negative rate of PTEN was 78.75%(63 /80)in differentiated thyroid carcinoma,13.75%(11 /80)in adjacent tissues(χ2 =27.236,P =0.000).There were significant differences in the expression of PTEN between I -II and III -IV in TNMstage,grade I and II,and lymph node metastasis(χ2 =10.395,6.948,9.263,P =0.000,0.006,0.000).The differences were not significant in the expression of PTEN between different gender,≤45 years and >45 years different pathological types and tumor diameter <2cm and ≥2cm(χ2 =1.113,0.941, 2.301,1.567,P =0.185,0.213,0.087,0.181).There was correlation between the expression of PTEN and BRAF V600E mutations(r =0.301,P =0.004).Conclusion The expression of PTEN is involved in the occurrence and development of differentiated thyroid cancer and is associated with BRAF V600E.The PTEN has the predictive value of prognosis in tumors.

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.