Objective: To extract and identify the chemical constituents in the roots and stems of Tabernaemontana divaricata. Methods: The solvent extraction and silica column chromatography were used to separate the chemical constituents, and their structures were identified by physicochemical properties and spectra analysis. Results: Six compounds were isolated and their structures were identified as his (2, 3-dihydroxypropyl) octacosanedioate (1), tetratriacontanol (2), palmitic acid (3), glycerol monopalmitatel (4), β-sitosterol (5), and β-daucosterol (6). Conclusion: Compound 1 is a new glyceroesters: compounds 2,3 and 4 are isolated from Tabernaemontana genus for the first time.

Objective: To investigate the loneliless situation of the elderly, and explore the relationship between loneliness,filial expectations and intergenerational social support among the elderly. Methods: Using UCLA Loneliness Scale, Intergenerational Social Support and Fealty Expectation Questionnaire, we investigated 423 samples of old people aged 60 ～94 of Changsha City. Results: The mean score of loneliness was 39.8 (s =7.3). Ordinal regression analysis indicated that the loneliness of the elderly was significantly related to received adult children social support (OR=2.208, P=0.006),afforded adult children social support(OR=2.056,P=0.01) and filial expectation(OR=1.872,P=0.027),controlled by age, sex, level of education, marriage, level of family income, and residence status. Filial expectation directly affected loneliness and indirectly affected loneliness through received adult children social support and afforded adult children social support. Conclusion: The loneliness of the elderly are significantly related to filial expectation and intergenerational support.

BACKGROUND:Now it has cooperation and facilitative effete between myogenic regulatory factors through a long time study. So, gene therapy of double genes of Myod1 and Myog can obtain better effect, and can provide a new way for preventing denervated skeletal muscle atrophy.
OBJECTIVE:To construct eukaryotic co-expression vector carrying Myod1 and Myog genes.
METHODS:Ful-length Myod1 gene and Myog gene cDNA were amplified by reverse transcription PCR, and then inserted into pVAX1 vector after digested to establish the recombined Myod1 and Myog eukaryotic co-expression vector pVAX1-Myod1-IRES2-Myog-IRES2-EGFP, and then identified with gene sequencing. The in vitro cultured 3T3 cel s were transfected with pVAX1-Myod1-IRES2-Myog-IRES2-EGFP, and the expressions of Myod1 and Myog genes in the 3T3 cel s were detected with western blot assay in order to identify whether the 3T3 cel s could express the target protein correctly.
RESULTS AND CONCLUSION:The sequencing results showed that the sequence length and base sequence of Myod1 and Myog cDNA in eukaryotic co-expression vector pVAX1-Myod1-IRES2-Myog-IRES2-EGFP were identical with the reported sequences. Myod1 and Myog protein band expressions were detected in 3T3 cel s by western blot after transient transfection. The pVAX1-Myod1-IRES2-Myog-IRES2-EGFP, a eukaryotic co-expression vector of Myod1 gene and Myog gene is successful y constructed.

Objective To study the effect of concentration of TCR-specific antigen peptides on priming naive CD4~+ T cells to develop into Th1/Th2 cells or naive CD8~+ T cells to develop into Tc1/Tc2 cells. Methods TCR-specific peptides with series of concentration were co-cultured with routine spleen DCs to activate murine naive CD4~+/CD8~+ T cells. The production of intracellular cytokines IFN-γand IL-4 were measured by flow cytometry. The dividing profile of activated T cells was analyzed by CFSE staining. Results Lower concentration of specific peptides favored Th2/Tc2 polarization while higher concentration benefited Th1/Tc1 polarization. The influence of peptides concentration on Th cells differentiation is higher than that on Tc cells. Conclusion Antigen peptides can stimulate activation of naive T cells in a wide range of concentration. However, with the increase of peptides concentration, activated T cells differentiated grad-ually from Th2/Tc2 to Th1/Tc1, which will provide significant value to control immunized dose of vaccine candidates in animal experiments.

In the health service field,health resources and health service supple capacity were related with the resource and capacity in economics.Health resources,health service supple capacity and their relationships were important factors for the cooperation and benign interaction of hierarchical medical institutions.However,inversion of health resources and health dislocation of service supply capacity exacerbated the agglomeration degree of patients in the tertiary medical institutions under the impact of residents' freely searching for medical service concept.Vicious interaction and mutual competition among hierarchical medical institutions had become an important obstacle for the implementation of hierarchical medical services.Therefore,its mechanism needed to be clarified while the corresponding policy recommendations should be proposed.

Objective: To extract and identify the chemical constituents in the roots and stems of Tabernaemontana divaricata. Methods: The solvent extraction approach and silica column chromatography were used for separation of the chemical constituents, and their structures were identified by physicochemical properties and spectra analysis. Results: Seven compounds were isolated and their structures were identified as α-amyryn (1), α-amyrin acetate (2), α-amyryl octadecanoate(3), taraxasterol acetate (4), calycosin (5), formononetin (6),and farnisin (7). Conclusion: Compound 1, 3, 4, 5, 6 and 7 are isolated from this plant for the first time, and Compound 3, 4, 5, 6 and 7 are isolated from Tabernaemontan genus for the first time.

Objective To observe and compare the incidence rate of hemolysis while venous blood specimen collecting with two types of venous indwelling needle. To summarize the attentions during blood samples collecting by venous indwelling needle. Methods From January 2014 to January 2015, a total of 400 patients in resuscitation room of emergency department were divided into control group and experimental group by random digits table method with 200 cases each. Type Y indwelling needle was used in control group, while straight type indwelling needle was used in experimental group. Both two types of indwelling needle were required to be connected with the disposable venous blood taking needle joint for blood sample collection. The incidence rate of hemolysis was observed. Results The incidence rate of hemolysis in experimental group was lower than that in control group: 8.0%(16/200) vs. 39.5%(79/200),and there was significant difference, χ2=34.317, P < 0.01. Conclusions The incidence rate of hemolysis during venous blood specimen collecting with straight type indwelling needle is significantly lower than that with Y type indwelling needle. Straight type indwelling needle is worthy of clinical use.

Objective To compare the therapeutic efficacy between medicinal cupping and collateral-pricking bloodletting therapy in treating lumbar intervertebral disc herniation (LIDH) and non-specific low back pain.Method Sixty LIDH patients were randomized into treatment group 1 and control group 1, 30 cases in each group. Sixty non-specific low back pain patients were randomized into treatment group 2 and control group 2, 30 cases in each group. Treatment group 1 and 2 were intervened by medicinal cupping, while control group 1 and 2 were by collateral-pricking bloodletting. The Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) were observed before and after intervention.Result The VAS and ODI scores were significantly changed after intervention in treatment group 1, treatment group 2, and control group 2 (P<0.05). The VAS score was significantly changed after intervention in control group 1 (P<0.05); the ODI score didn’t show significant change after intervention in control group 1 (P>0.05). After treatment, there was a significant difference in comparing the ODI score between control group 1 and control group 2 (P<0.05).Conclusion Medicinal cupping and collateral-pricking bloodletting are both effective in treating chronic low back pain, and medicinal cupping has its advantage in improving ODI compared to the bloodletting therapy.

Objective To investigate the clinical parameters,risk factors,treatment and clinical outcomes of pneumocystis pneumonia(PCP) in children without human immunodeficiency virus(HIV). Methods Retrospective a-nalysis was made for the clinical features,risk factors,treatment and prognoses of the non-HIV infected severe PCP pa-tients hospitalized at Pediatric Intensive Care Unit( PICU) of Children′s Hospital Affiliated to Capital Institute of Pedi-atrics. Results During April of 2010 to April of 2014,there were 10 cases of non-HIV infected severe PCP in PICU of Children′s Hospital Affiliated to Capital Institute of Pediatrics. All of the patients had predisposing diseases,in which 3 cases had connective tissue diseases,2 cases had acute leukemia,3 cases had severe pneumonia and 2 cases had con-genital immunodeficiency. The main clinical manifestations of those 10 patients were fever, cough, tachypnea and obvious dyspnea. All patients developed respiratory failure. The median value of Pediatric Critical Illness Score was 79. The median arterial oxygen pressure was 58 mmHg(1 mmHg=0. 133 kPa). The median oxygenation index was 103 mmHg. The median alveolo-arterial oxygen partial pressure difference was 43. 8 mmHg. The median CD4+T-lympho-cytes counts was 169 ×106/L. Eight patients on admission had mixed infection. Acute respiratory distress syndrome (ARDS) occurred in all of the patients,and 7 cases of them had multiple organ dysfunctions. All of the patients re-quired ventilation support. The median day for invasive mechanical ventilation days was 11 and the median day for non-invasive ventilation days was 6. The pneumothorax occurred in 5 patients. All patients received trimethoprim-Sulfame-thoxazole as initial therapy and Caspofungin treatment in combination in 7 cases of the patients. Six patients had nosoco-mial infection. The median time of PICU stay was 15. 5 days. Six patients survived and the mortality was 40%(4/10 cases) . Conclusions PCP is a kind of fatal diseases which occurred in patients with immunocompromised conditions and concurrent ARDS or multiple organ dysfunctions. Diagnostic suspicion and mechanical ventilation therapy with lung protective ventilation strategies may improve the clinical outcomes of non-HIV-infected PCP in children.

This article summarized the characteristics and rules of acupoints grouping recorded in Huang Di Nei Jing (Yellow Emperor’s Canon of Internal Medicine), holding that it had passed important concept of acupoints grouping, formed the embryonic form, and brought up basic grouping types including distant and proximal grouping, and interior-exterior grouping, despite the small number of involved acupoints. Besides, it also paid much attention to other factors that may influence the therapeutic efficacy of acupoints grouping. Therefore, Huang Di Nei Jing has played a crucial role in guiding the development of acupoints grouping theories.