OBJECTIVE:To optimize the extraction process of Asiaticoside.METHODS:The extraction technique was optimized by single factor test and orthogonal design taking extraction rate of Asiaticoside as the indicator.RESULTS:The best extracting technical conditions were as follows:ultrasonically extracting 12 times amount of 60% ethanol for an hour.CONCLUSION:The extraction method is simple and feasible and by which high extraction rate of Asiaticoside was obtained.

OBJECTIVE: A HPLC-ELSD method was developed for determination of the content of astragaloside Ⅳ in Xin'an granules.METHODS: The separation was performed on Kromasil ODS C18 column(150 mm?4.6 mm,5 ?m) with the mobile phase consisted of acetonitrile-water(35∶65).The temperature of the drift tube was 40 ℃ and the flow rate of gas(air) was 2.1 L?min-1.RESULTS: The linear range of astragaloside Ⅳ was 1.32～7.95 ?g(r=0.998 9) and the average recovery was 97.84(RSD=1.01%,n=9).CONCLUSION: The method is simple,accurate and reproducible,and it can be used for the quality control of Xin'an granules.

Objective To investigate the effect of the extracts of Centella asiatica(L.) Urban (ECA) on the depressive-like behavior alteration in rats and mice. Method 60 Wistar rats were randomly divided into 6 groups (10 rats each), the normal group, model group, Fluoxetine group, ECA high dose group (component 10.08 mg+component 24.48 mg/kg), ECA middle dose group (component 1 0.04 mg+component 2 2.24 mg/kg) and ECA low dose group component 1 0.02 mg+component 2 1.12 mg/kg. Chronic unpredictable mild stress (CUMS) induced depression in rats and sugar consumption to detect the antidepressant effect of ECU. 60 Kunming mice were randomly divided into six groups as above. Locomotor activity, forced swim, tail suspension test were used to detect the effect of ECA on the behavioral alteration in mice. Results Compared with model group, sugar consumption in ECA groups was significant increased (P<0.01). ECA treatments also decreased duration of immobility in the tail suspension test and forced swim. Conclusion ECA could improve the depressive-like behavior in rats and mice.

Objectives To study the prevailing status of coal-burning type endemic fluorosis in Fuyuan County of Yunnan Province, and to provide a scientific basis for fluorosis control and prevention. Methods In 2013, five towns were selected from the villages and towns which the defluoridation stove project was implemented and by the end of 2007 defluoridation stove rate was higher than 95%(including 95%), and two natural villages were selected in each township to carry out the investigation. Dental fluorosis was examined of all children aged 8 to 12 of survey points. At least 20 people were selected in each village. At the same time, 20 copies of instant urine samples were collected from these children of half male and half female, and urinary fluoride was determined. Then five natural villages were sampled from all survey points, and permanent residents were divided into25-,35-,45-,55-and≥65groups according to age. Six people were selected from each group with male and female in half who were conducted examination of adult skeletal fluorosis by X-ray. Dental fluorosis diagnosis was based on theDental Fluorosis Diagnosis(WS/T 208-2011). Urinary fluoride determination was done in accordance withUrine-Determination of Fluoride-Ion Specific Electrode Method(WS/T 30-1996). Skeletal fluorosis diagnosis was carried out according to Diagnostic Criteria for Endemic Skeletal Fluorosis (WS 192-2008). Results A total of 556 children aged 8 to 12 were monitored, the detection rate of dental fluorosis was 41.55%(231/556), the dental fluorosis index was 0.78. The very mild, mild, moderate and severe proportions of children's dental fluorosis were 20.50%(114/556), 17.09%(95/556), 3.60%(20/556) and 0.36%(2/556), respectively, given priority to very mild. The prevalence of dental fluorosis in children was increased with increasing age (χ2=74.27, P<0.05). One hundred and ninety-three copies of child urine samples were tested, the geometric mean of urinary fluoride was 0.62 mg/L, and the urinary fluoride contents were between 0.10-2.93 mg/L. A total of 116 adults were examined, and the detection rate of skeletal fluorosis was 9.48%(11/116). Detected cases of skeletal fluorosis was given priority to mild (9 cases, accounted for 81.81%), more men cases [16.36% (9/55)] than those of women [3.28% (2/61), χ2 = 5.77, P< 0.05]. Conclusion The hazard of coal-burning type fluorosis has been reduced in Fuyuan County , the affect of defluoridation stove project is obvious.

OBJECTIVE:To investigate the effect and mechanism of Allii macrostemonis bulbus on blood lipid levels in hyperlipidemia model rats,and to provide reference for clinical use of Allii macrostemonis bulbus to reduce blood lipid. METHODS:A total of 10 normal rats were included in normal control group and given common diet. Other 50 rats were given hyperlipid diet to induce hyperlipidemia rat model. 40 model rats were randomly divided into model group(hyperlipid diet),Allii macrostemonis bulbus low-dose,medium-dose and high-dose groups(0.83,1.67,2.50 g/kg,fed by hyperlipid diet which containing 10%Allii macrostemonis bulbus 8.3,16.7,25.0 g/kg,fill with hyperlipid feed in patients with insufficient food intake). After fed for 45 d,the contents of TC,TG,LDL-C and HDL-C in serum of rats were detected. Liver,spleen,renal and cardiac indexes of rats were calculated. mRNA expression of low density lipoprotein receptor(LDLR)and liver X-receptor α(LXRα)were detected in liver tissue of rats. RESULTS:Compared with normal control group,the contents of TC and LDL-C in serum and liver index of rats were increased significantly in model group,while the content of HDL-C in serum and mRNA expressions of LDLR and LXR α in liver tissue were decreased significantly,with statistical significance(P<0.01). Compared with model group,the contents of TC and LDL-C in serum were decreased significantly in Allii macrostemonis bulbus groups,while the content of HDL-C was increased significantly. mRNA expressions of LDLR and LXR α in liver tissue were increased significantly in Allii macrostemonis bulbus medium-dose and high-dose groups,while liver and spleen indexes were decreased significantly,with statistical significance(P<0.05 or P<0.01). CONCLUSIONS:Allii macrostemonis bulbus shows good blood-lipid lowering effect,the mechanism of which may be associated with up-regulating mRNA expressions of LDLR and LXRα in liver tissue.

Objective To conduct an epidemiological investigation on a case of familial arsenic poisoning in Yunnan Province,to find arsenic poisoning source and create a archive of typical cases,in order to raise awareness of endemic arsenicosis and provide scientific materials for prevention and treatment of the disease.Methods In Xiaxiaoying Village of Yunnan Province,all members of a family with arsenic poisoning patients were investigated in 2013,their health examination and epidemiological survey of arsenic poisoning were carried out,and arsenic poisoning family profiles and personal files were established.Drinking water,hair and urine samples were collected for arsenic content determination,blood samples were collected for biochemical detection,excessively keratose skin was collected for pathological biopsy.Results A total of 33 family members were investigated.Among them 15 were exposed to arsenic and 18 were not exposed to arsenic.Fifteen people exposed to arsenic were found to be have skin lesions,and two eldest males died of skin cancer and cerebral hemorrhage in 1994 and 2009,respectively.The survey found out that 15 patients born in 1935-1983 had been drinking arsenic pesticides polluted well water for 5 to 16 years from 1973 to 1989.As of 2013,the arsenic exposure had been stopped for 24 years,the content of arsenic in the polluted wells was 0.624 mg/L,which was 62.4 times the recommended maximum limit (0.01 mg/L) of the World Health Organization.The median of hair and urinary arsenic in arsenic exposed population and non-arsenic exposed population was 4.2,3.7 mg/kg and 60.9,41.0 μg/L,respectively.There was no statistically significant difference in hair arsenic (Z =-1.905,P ＞ 0.05),but the difference of urinary arsenic was statistically significant (Z =-3.002,P ＜ 0.05).The median of aspartate aminotransferase (AST),gammaglutamyltransferase (γ-GT) and 24 hours urinary ereatinine (Cr) in arsenic exposed population and non-arsenic exposed population was 37.5,31.0 U/L,25.5,12.0 U/L,13 834.0,and 6 843.0 μmol/L,respectively.The differences between the two groups were statistically significant (Z =-2.776,-2.311,-2.502,P ＜ 0.05).Twelve cases of arsenic poisoned patients who were conducted health examination and epidemiological investigation showed typical triad of skin,among them 2 cases were moderate and 10 cases were severe.Pathological biopsy results showed 8 cases had basal cell carcinoma or squamous cell carcinoma.Conclusions Drinking arsenical pesticide contaminated water can induce chronic arsenic poisoning,even after the cessation of arsenic exposure.We should pay close attention to its long-term serious harmful effect.

Objective To comprehensively analyse the immunophenotype of primary pancreatic cancer,providing biological clues for treating pancreatic cancer.Methods The genome nap of 177 primary pancreatic cancer patients from the Cancer Genome Atlas (TCGA) database were enrolled.The overall immune infiltration score (IIS),T cell infiltration score (TIS) and antigen presenting machinery (APM) score were quantified for each specimen.By using unsupervised clustering,the patients were divided into immune-high group and immune-low group according to IIS,TIS,and APM scores.The differences on the inffiltration of immune cell subtype,expression of immune checkpoint and immunological function evaluation were compared between two groups.Results In the radiotherapy population,the survival rate of immune-high group was slightly higher than that of immune-low group with no statistical significance.The immune-high group had more infiltrated neutrophils (63.4％ vs 36.6％),eosinophils (75.5％ vs 24.5％),activated CD4 + memory T lymphocytes (80.7％ vs 19.3％),naive CD4 + T lymphocytes (81.2％ vs 18.8％) and naive B lymphocytes (59.5％ vs 40.5％) compared with immune low group;while the immune-low group had more activated NK cells (67.3％ vs 32.7％),regulatory T lymphocytes (68.9％ vs 31.1％),T follicular helper (67.7％ vs 32.3％),and activated mast cells (62.9％ vs 37.1％).Co-stimulatory molecules such as CD28,ICOS,CD40,CD40L,CD27,CD27L,4-1BB,OX40,GITR and co-inhibitory molecules including CTLA-4,PD-L2,PD-1,VISTA,LAG-3,TIGIT,Galectin-9,TIM-3,and IDO-1 were significantly higher expressed in the immune-low group (all P ＜ 0.05).The PC1 value of principal component analysis of chemokine expression levels and the cytolytic activity (CYT) in the immune-high group were significantly higher (all P ＜0.001).Conclusions Clustering on the three inmune quantification scores could be preliminarily used for immunophenotyping pancreatic cancer.The immune-high group may have synergistic effect with radiation therapy.Treatment with immune checkpoint inhibitor may be effective in immune-low group.

Objective To investigate the epidemic situation of drinking-water-borne endemic fluorosis in Yunnan Province,to evaluate the effect of prevention and control measures,to find out existing problems,and to guide the development of prevention and control measures in Yunnan Province.Methods All villages in 14 drinking-water-borne endemic fluorosis areas were selected in Yunnan Province in 2015,in which the progress and effectiveness of water-improving and defluoridation projects were investigated.Fluoride content of drinking water was determined by standard test method for drinking water (GB/T 5750.5-2006),and dental fluorosis of all children aged 8 to 12 was examined.Dental fluorosis diagnosis was based on "Diagnostic Criteria for Endemic Skeletal Fluorosis"(WS/T 208-2011).Results In the 143 disease affected villages,the water improvement projects were completed in 138 villages with accomplishment rate 96.50％ (138/143),127 water improvement projects were normal operated with the normal operation rate 92.03％ (127/138).Totally 126 water improvement projects were tested for fluorine content and 120 of them were qualified with qualified rate 95.24％ (120/126).A total of 3 449 children aged 8 to 12 were monitored,the detection rate of dental fluorosis was 4.00％ (138/3 449),the dental fluorosis index was 0.08.Totally 11 out of the 14 disease affected counties had met the disease control standards.Conclusion The prevalence of drinking-water-borne endemic fluorosis in Yunnan Province has been under control,but management and monitoring of the water improvement projects still should be strengthened.

Objective To investigate the clinical efficacy of pancreaticoduodenectomy using artery first approach and prior portal vein (PV)-superior mesenteric vein (SMV) shunting for complicated pancreatic head tumors.Methods The retrospective cohort study was conducted.The clinicopathological data of 91 patients with pancreatic head cancer who were admitted to the Changhai Hospital of Navy Medical University from February 2011 to December 2016 were collected.Among 91 patients undergoing pancreaticoduodenectomy combined with vascular resection and reconstruction,27 using artery first approach and PV-SMV shunting and reconstruction were allocated into the PD-PVR group,23 using conventional approach were allocated into the PD-CVR group,and 41 receiving pancreaticoduodenectomy with vascular resection were allocated into the PD-SVR group.Observation indicators:(1) comparison of intra-and post-operative situations among groups;(2) comparison of postoperative pathological results among groups;(3) comparison of postoperative survival among groups.Follow-up using outpatient examination and telephone interview was performed to detect postoperative survival up to December 2017.Comparisons among groups of count data were done by the chi-square test or Fisher exact probability.Measurement data with normal distribution were represented as x±s,comparisons among groups were analyzed using the ANOVA,and pairwise comparison was done using the LSD method.Measurement data with skewed distribution were described as M(Q),comparison among groups was analyzed using the Kurskal-Wallis rank sum test,and pairwise comparison was done using the paired comparison with adjusted P value.Ordinal data were compared using the nonparametric test.The survival rate and curve were respectively calculated and drawn by the Kaplan-Meier method,and Log-rank test was used for survival analysis.Results (1) Comparison of intra-and post-operative situations among groups:operation time,time of hepatic inflow occlusion,volume of intraoperative blood loss,cases with intraoperative blood transfusion,length of PV or SMV removal,cases with vascular grafts,grading 1,2,3,4 and 5 of Clavien-Dindo classification of postoperative complications and duration of hospital stay were respectively (274±36)minutes,(22±7)minutes,1 661 mL (110 mL,3 800 mL),20,(5.6±1.4)cm,6,11,1,1,1,1,(20±7)days in the PD-PVR group and (281±41)minutes,(27±5)minutes,1 888 mL (176 mL,4 162 mL),18,(5.4±1.5) cm,3,1,8,2,0,0,(21±7)days in the PD-CVR group and (201± 36)minutes,(16±6)minutes,1052 mL (74 mL,3 926 mL),17,(3.2±2.0) cm,5,15,2,3,1,1,(13± 6)days in the PD-SVR group,with statistically significant differences among groups (F=37.060,34.530,x2=13.771,14.015,F=32.260,x2 =39.309,F =19.880,P＜0.05).Patients with postoperative complications were improved by symptomatic and supporting treatment.(2) Comparison of postoperative pathological results among groups:mnaximum tumour dimension was respectively (3.6± 1.3) cm,(4.0± 1.3) cm and (2.6± 1.3) cm in the PD-PVR,PD-CVR and PD-SVR groups,with a statistically significant difference among groups (F =7.845,P＜0.05).Cases with high-differentiated,moderate-differentiated and low-differentiated tumors of tumor differentiation,staging Ⅱ A and Ⅱ B of tumor staging,nerve invasion,positive lymph node,positive resection margins in neck of pancreas,bile duct and SMV were respectively 0,13,14,17,10,17,21,0,0,0 in the PD-PVR group and 1,12,10,10,13,15,19,1,0,0 in the PD-CVR group and 1,29,11,17,24,30,29,2,1,1 in the PD-SVR group,with no statistically significant difference among groups (x2 =4.122,3.306,0.902,1.214,P＞0.05).(3) Comparisons of postoperative survival among groups:of 91 patients,52 were followed up for 3.0-69.3 months,with a median time of 18.0 months and follow-up rate of 57.1％ (52/91),including 16 in the PD-PVR group and 14 in the PD-CVR group and 22 in the PD-SVR group.The median survival time,1-,2-and 3-year overall survival rates in 52 patients were respectively 16.6 months,63.5％,35.7％ and 26.8％.The survival time in the PD-PVR,PD-CVR and PD-SVR groups were respectively 12.3 months (3.9-69.3 months),15.0 months (3.0-63.3 months) and 20.0 months (6.0-65.2 months),with a statistically significant difference in survival among groups (x2=6.201,P＜0.05),and between PD-PVR and PD-SVR groups (x2 =4.412,P＜0.05).There was no statistically significant difference in survival between PD-PVR and PD-CVR groups (x2 =0.001,P＞0.05).Conclusion Pancreaticoduodenectomy using artery first approach and PV-SMV shunting and reconstruction for complicated pancreatic head tumors can reduce the time of hepatic inflow occlusion,it also contributes to the risk control of surgery for complicated pancreatic tumors,increases surgical safety and improves patients' prognosis.

Objective:To analyze the risk factors of clinically significant bleeding in patients with severe acute pancreatitis (SAP).Methods:The clinical data of SAP patients who were managed at Changhai Hospital affiliated to Naval Medical University from January 1, 2014 to October 31, 2022 were retrospectively analyzed. Twenty-nine SAP patients with clinically significant bleeding were classified to form the bleeding group. There were 23 males and 6 females, aged (56.25±14.01) years old. Another 116 SAP patients with similar general data but with no clinically significant bleeding during the same hospitalization period were included to form the non-bleeding group based on a ratio of 1∶4. There were 94 males and 22 females, aged (56.14±13.96) years old in this non-bleeding group. The general data, modified CT severity index (MCTSI), bedside index for severity of acute pancreatitis (BISAP) and other clinical data of the two groups were collected to determine the risk factors of bleeding in SAP patients.Results:Of the 29 patients with bleeding, 6 had gastrointestinal bleeding, 14 had intra-abdominal bleeding, and 9 had mixed bleeding sites, 15 were cured and discharged, and 14 died. All the 29 SAP patients with bleeding received treatment using drugs. In addition, 8 patients underwent successful hemostasis using digital subtraction angiography, 3 underwent successful endoscopic hemostasis, 2 underwent successful surgical hemostasis, and 2 underwent successful conservative drug hemostasis. Multivariate logistic regression analysis showed that SAP patients with higher MCTSI ( OR=1.824, 95% CI: 1.187-2.802), longer prothrombin time (PT) ( OR=3.431, 95% CI: 1.470-8.007) and higher BISAP ( OR=2.286, 95% CI: 1.054-4.957) had an increased risk of bleeding (all P<0.05). Conclusion:The prognosis of SAP patients was compromised with bleeding. High MCTSI, prolonged PT, and high BISAP were independent risk factors for bleeding in SAP patients.