Ginsenosides are the main active components of medicinal herbs including Panax ginseng and Panax quinquefolium, which have potent effects of anti-tumor, anti-inflammatory, antioxidant and apoptosis inhibition. But the low content of ginsenosides limits its development and usage. At present, how to improve the production of ginsenosides by biological technology has been a new research focus. Some advances in the biosynthesis of ginsenosides by tissue culture and biotransformation have been made in recent years. So far at least twenty genes related to the biosynthesis of ginsenosides from Panax genus plants have been cloned and functionally identified, which has laid a good foundation for the study on the synthetic biology of ginsenosides. This review outlines recent advances in several aspects and is expected to provide a theoretical support to the thorough research of the pathway and regulation of ginsenosides biosynthesis.

Objective The aim of this study is to verify the feasibility of transumbilical endoscopic cholecystectomy by using the tri-channel trocar technique.Methods Eight domestic pigs were submitted to transumbilical endoscopic cholecystectomy using the tri-channel trocar technique.After establishment of pneumoperitoneum,a tri-channel trocar was placed through an infra-umbilical incision.A fine grasper of 2 mm in diameter was inserted through a small skin incision on the right upper abdomen into abdominal cavity to grasp the fundus of the gallbladder.Then the cystic duct was dissected with a flexible hook.Once the cystic duct and artery were free,they were clipped by a clip fixing device,and the gallbladder was separated from the liver bed using flexible hook dissection.The specimen was then extracted through the umbilical trocar.Results All the gallbladders were removed successfully in the eight pigs without severe bleeding during dissection,or intraoperative and postoperative complications.The operation time was from 1.5 to 2.5 hours and decreased with experience.Postmortem examination revealed that the gallbladder fossa was clean,and the clips on the cystic duct and artery were secure.Neither bile leakage nor hemorrhage was found at the operative field.Conclusions Transumbilical endoscopic cholecystectomy is feasible and safe without leaving obvious abdominal scars.

Objective To compare the degree of trauma, postoperative pain, and cosmetic outcomes of endoscopic-assisted thyroidectomy (EAT), transthoracic endoscopic thyroidectomy (TET), and conventional thyroidectomy (CT), and to explore the characteristics of EAT and TET. Methods Forty-five patients with thyroid nodules were divided into three groups (n=15 in each) to underwent EAT, TET, or CT. The plasma levels of C-reactive protein(CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-?), and T-lymphocyte subgroups (CD3, CD4+, CD8+, and CD4+/CD8+) were determined before and 24 and 72 hours after the operations. The degree of operative trauma was compared after the operation. Postoperative pain and cosmetic outcomes were evaluated by visual analogue score (VAS) and 5-degree evaluation respectively. Results The VAS in the EAT group was 2.2?1.7 and 1.1?1.1 on the first and third day postoperation, which were significantly lower than those in the TET group (3.6?1.4 and 2.2?0.7, respectively; q=3.698, P0.05).Compared to preoperation, the level of CD4+/CD8+ lymphocyte in the CT group was decreased at 24 hours after the operation (q=4.076, P0.05). The levels of CRP determined at 24 and 72 hours postoperation were both significantly higher than that before the operation in the three groups (EAT group: m=21, P

Objective To evaluate the impact of hepatitis B e antigen (HBeAg) states and hepatitis B virus DNA loads on the prognosis of chronic severe hepatitis B.Methods A total of 406 hospitalized patients with chronic severe hepatitis B in Nanfang Hospital of Southern Medical University from January 2002 to December 2007 were retrospectively analyzed.The impact of HBeAg states and HBV DNA loads on the prognosis was evaluated.The measurement data were compared by t test and rates were compared by chi square test.Results Of all the 406 patients with chronic severe hepatitis B,208 (51.2%) patients were HBeAg-positive and the remaining 198 (48.8%) were HBeAgnegative.There was no significant difference of constituent ratio of male and female,average peak value of total bilirubin and average valley value of prothrombin activity between HBeAg-positive group and HBeAgnegative group.However,the average age of HBeAg-negative patients was (46.7±12.8) years old,which was significantly higher than that (38.3±13.5) years old in HBeAg-positive group (t = 6.43,P＜0.01 )the proportion of patients with liver cirrhosis in HBeAg-negative group (67.7%) was much higher than that in HBeAg-positive group (45.7%) (X2=19.97,P＜0.01);the improved rate in HBeAg-negative group (32.3%) was significant lower than that in HBcAg-positive group (44.7%) (X2=6.56,P＜0.05).Increasing HBV DNA levels was associated with lower improved rate in both 208 HBeAg-positive and 198 HBeAg-negative patients(X2=22.98,26.04,respectively,both P＜0.01 ).Conclusions HBeAg-negative patients with chronic severe hepatitis B has worse prognosis than HBeAg-positive patients;and the prognosis is getting worse with the increasing HBV DNA level regardless of the HBeAg status.

Objective To quantitatively assess the left ventricular systolic dyssynchrony in patients with varied degrees of chronic congestive heart failure after old myocardial infarction(OMI) by real-time three-dimensional echocardiography(RT-3DE) and investigate the clinical value of the systolic dyssynchrony index(SDI). Methods Forty patients with congestive heart failure after OMI (infarction group) were divided into the severe dysfunction group (LVEF ≤35 %) and the mild dysfunction group (35 % ＜ LVEF＜50%) ,and 30 normal subjects served as the control. RT-3DE was performed on all subjects to obtain the 17-segmental time-volumetric curves and global systolic function. SDI changes in above groups and the correlation between SDI and LVEF were analyzed. Results The SDI of the infarction group was significantly higher than that of the normal control group ( P ＜0. 01 ). The SDI of the severe dysfunction group was significantly higher than that of the mild group (P＜0.01). SDI and LVEF were negatively correlated ( r = -0.84, P ＜0. 01 ). The dyssynchrony rate in the infarction group was 85 %,in the severe dysfunction group was 100%, in the mild group was 75%. Conclusions Left ventricular systolic dyssynchrony is prevalent in patients with OMI, and it is negatively correlated with the LVEF. SDI is a sensitive indicator in assessing left ventricular systolic dyssynchrony. RT-3DE has a unique advantage in the evaluation of the left ventricular systolic dyssynchrony,especially in the patients with myocardial infarction.

The mortality and disability rates of stroke are very high.Stroke seriously threats to the human life and health.Hypertension is one of the most important risk factors for stroke.The management of blood pressure in acute stage is very important for stroke and is full of controversial.This article reviews advances in the management of blood pressure in acute stroke.

[ABSTRACT]AIM:Toinvestigatetheeffectofover-expressionofsmall-conductancecalcium-activatedpotassium channel subtype 2 (SK2) in the paraventricular nucleus (PVN) of hypothalamus on heart rate(HR), mean arterial pres-sure (MAP) and renal sympathetic nerve activity (RSNA) of the rats with chronic heart failure (CHF).METHODS:Adenovirus vector encoding SK2 (pDC316-mCMV-EGFP-rKCNN2) was constructed.The CHF model of the male Sprague Dawley ( SD) rats was established by the ligation of anterior descending coronary artery .Echocardiogram was used at the 6th week after the operation to identify the CHF model .Adenovirus vector encoding SK 2 ( pDC316-mCMV-EGFP-rKCNN2) or control adenovirus vector ( pDC316-mCMV-EGFP) were transfected into the PVN in vivo.The cardiac func-tion was monitored by echocardiogram .The expression of SK2 at mRNA and protein levels was determined by RT-PCR, Western blotting and immunofluorescence .The HR, MAP and RSNA were measured by PowerLab 8/30 in anesthetized rats with bilateral PVN microinjection of SK channel blocker apamin .RESULTS:Treatment with pDC316-mCMV-EGFP-rKC-NN2 significantly decreased the renal sympathetic nerve activity in the rat with CHF .Injection of pDC316-mCMV-EGFP did not change the renal sympathetic nerve activity in the rats in sham group .CONCLUSION:The expression and func-tion of SK channels in PVN in the heart failure rats were decreased , suggesting a reduced negative regulation of sympathetic activity in central neural system .Increased expression of SK 2 in the PVN leads to a reduction in sympathetic outflow under the condition of CHF , which may provide a new target for the treatment of heart failure .

This essay discusses the hot issues about the ethics of modern medical technology,by investigating the problems between medical research staff and doctors,medical technology and patients,the attitude of family members to the traditional medical ethics and modern high-tech medical ethics,under the guidance of the concept of scientific development.It also analyses the current ethical status of modern medical technology and interprets the ethical problems of life that due to modern medical development,taking the maintaining and enhancing human health as a bran-new value orientation and ethical choices.

Objective To obtain a simple method to treat segmental vitiligo. Methods The grafting was carried out as following: the epidermal cellular suspension was obtained from leg skin by razor blade after trypsinization. The suspension of epidermal cells were injected into depigmented lesion blisters which were produced by freezing with nitrogen. Results All of the patients which received treatment had successful repigmentation. Conclusion This technique is an effective and simple method for treating patients with segmental vitiligo.

Objective To evaluate immunogenicity of the recombinant protein GST-p55/570 of Pneumocystis carinii.Methods The fusion protein GST-p55/570 was expressed from the prokaryotic expression plasmid pGEX-570,and purified by using glutathione-agarose.The expressed product was analyzed by SDS-PAGE.Thirty-three mice were randomly divided into three groups,immunized with GST-p55/570,GST and PBS,respectively.Each group was immunized for four times at 2 week intervals.At the 7th day after final immunization,spleen was removed to obtain single cell suspension.Proliferation ability of lymphocytes was determined by MTT.Serum samples were collected at pre-immunizaton and two weeks after each immunization.Antibody level in sera of mice was determined by ELISA.The immune response to the recombinant GST-p55/570 recognized by sera of immunized mice was examined by Western blotting.Results The expressed fusion protein GST-p55/570 showed a Mr 47 000.Compared with GST group(1.134 5?0.073 5) or PBS group(1.124 8?0.041 6),a higher stimulation index(2.063 0?0.160 2) was revealed in GST-p55/570-immunized mice(P