Objective To study the chemical constituents from the stems of Acanthopanax gracilistylus.Methods Thechemical constituents of the plant were isolated and puried by column chromatography and their structures wereelucidated on the basis of physicochemical properties and spectral data.Results A new ent-kaurane glycoside,named kaurane acid glycoside A { 16α,17-dihydroxy-ent-kauran-19-oic 19-[β-D-glucopyranosyl-(1→2)-β-Dglucopyranosyl]ester}(1),was isolated from the n-butanol part.Conclusion Compound 1 is a new one.

OBJECTIVE： To find out the change of drug resistance of Shigella shigae in our hospital during recent five years.METHODS： To collect the stool of suspectable cases of clinical bacillary dysentery and to carry out bacterial culture and drug sensitive test.RESULTS： The resistance rates of Shingella shigae to ampicillin and fluoroquinolones raised obviously， but the bacilli were still sensitive to amikacine and cefobid.CONCLUSION： It is important to strictly control the indications in using antibiotics and to prevent the emergence of drug resistance of bacteria.

Objective To study the distribution characteristics of radon progeny at different air quality index (AQI) and evaluate health risks for the exposed population.Methods EQF3120 Monitor was used to monitor the concentration of radon and its daughters.The relevant air quality data was provided by the environmental monitoring station at Suzhou Industrial Park.SPSS 16.0 software was used for statistical description,principal component analysis and simple correlation analysis.Environmental radon exposure-caused effective dose to lung region was estimated by using the radon dose formulas.Results Radon progeny in fog haze weather in winter of Suzhou Industrial Park had relationships with NO2,SO2,O3,PM10 and PM2.5.The correlation coefficient of 214Bi were 0.741,0.681,-0.431,0.597 and 0.675.The correlation coefficient of radon progeny with PM2.5 was greater than that with PM10.When AQI ＞ 200,the effective dose to residents outdoor from radon and its short-lived progeny was 0.63 mSv/a.Conclusions Higher AQI results in higher concentration of attached radon progeny.There is little variation in concentration of unattached radon progeny.Fog and haze can increase exposure of the population to inhalated radon.

Objective To investigate the effects and possible mechanisms of decitabine on heat-shock protein 22 (HSP22) expression in hematopoietic tumor cell lines and bone marrow samples from patients with hematopoietic tumor.Methods The expression of HSP22 in 13 hematopoietic tumor cell lines,20 primary patients' samples and 10 normal donor' samples were detected by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR).After HSP22 induction with a demethylating agent decitabine (2 μmol/L),the methylation of the HSP22 promoters in hematopoietic tumor cell lines,healthy donors and bone marrow samples from patients with hematopoietic tumor were detected by methylation specific PCR (MSP).Results Expression of HSP22 was not detected in 13 hematopoietic tumor cell lines,20 primary patients' samples or 10 healthy donors' samples.Decitabine can induce the expression of HSP22 in hematopoietic tumor cell lines and bone marrow samples from patients with hematopoietic tumor.Decitabine can maintain partially demethylation of HSP22 promoters in hematopoietic tumor cell lines.HSP22 promoters were highly methylated in BMMC of the healthy donors and patients with hcmatopoictic tumor.Conclusion Decitabine can induce the expression of HSP22 in hematopoietic tumor cells partly by demethylation of HSP22 promoters.

Objective To explore the improvement of cardiopulmonary resuscitation (CPR) efficiency by rescue team through the clinical access to pre-hospital care.Methods Mter establishment of clinical approaches to cardiac arrest,the training program of first line personnel of rescue teams in the Hangzhou Emergency Center was carried out with practice on simulated patients and scenario.A total of 45 eligible teams were randomly enrolled for study by observing the performance of some essential resuscitation techniques before and after training.Result The efficiency of resuscitation performed by rescue team for cardiac arrest was generally not good enough before training evidenced by the shortage of application of ECG monitoring,endotracheal intubations and establishing intravenous line which were only 8 (17.8％),5(11.1％),6 (13.3 ％),respectively,and the interruption time of chest compression during the first three minutes was (102.13 ± 13.68) seconds and the successfully artificial respiration ratios by assistant members was (0.37 ± 0.09),and ratios of ECG forensics and written inform consent were 8 (17.8％) and 6 (13.3％) respectively,CPR and forensics done simultaneously was only 2 (4.4％).The efficiency of rescue for cardiac arrest was obviously improved after training by the clinical approaches proved by the increase in application of ECG monitoring,endotracheal intubations,intravenous line set up reached to 45 (100％),43 (95.6％),43 (95.6％),respectively,and the interruption time of chest compression during the first three minutes was shorten to (69.7 ± 7.7) seconds and the successfully artificial respiration ratios done by assistant members was (0.57 ±0.12) after training.The ratios of on-site ECG forensics and written inform consent were 40 (88.9％) and 43 (95.6％),respectively,and CPR and evidence obtained simultaneously was up to 36 (80.0％).The efficiency of work done by teams was obviously improved and the risk of miserable events was controlled.Conclusions The clinical approaches to cardiac arrest in prehosptial care is the efficient strategy to rescue the patient with cardiac arrest and it is worthy to popularize at present.

Objective To investigate the effects of overexpression of heat shock protein 22(HSP22) in hematopoietic malignant tumor cell lines.Methods A lentiviral system was used to mediate transduction of HSP22 complementary DNA-containing expression vector or empty vector into K562 and Namalwa cells.The transduction effeciency was tested by fluorescence microscope scan and flow cytometry.Semi-quantitative RT-PCR and Western blot were used to identify the expression levels of HSP22 mRNA and protein.Growth curve analysis,cell cycle analysis,colony-forming assay,tumor growth in nude mice and apoptosis analysis were used to evaluate the role of HSP22 in K562 and Namalwa cells.Results Lentivector expression systemmediated delivery of HSP22 into K562 and Namalwa cells can inhibit colony forming of K562 and Namalwa cells,the average numbers of colonies per well were 108,72,125 and 80 for K562-V,K562-H,Namalwa-V and Namalwa-H respectively (P =0.000 16 and 0.000 37 for K562 and Namalwa respectively).HSP22 transduction can also inhibit proliferation of Namalwa cells in vitro (P =0.015,0.042 and 0.048 for day 5,6 and 7 respectively) and K562 cells in vivo (P =0.022 for day 21).No significant difference in cell cycle and apoptosis was found in K562 and Namalwa cells compared with controls (all P ＞ 0.05).Conclusion Overexpression of HSP22 could inhibit the growth of hematopoietic malignant tumor cell lines K562 and Namalwa.

Objective:To conduct a systematic review on the implementation effects of National Essential Medi-cine System ( NEMS) since the new health care reform and provide some suggestions to further improve the NEMS. Methods:Databases and relevant international organization reports were searched to collect studies related to the im-plementation of NEMS in China. The database search occurred from January 2009 to December 2014. Results:A to-tal of 1 292 studies were finally included, encompassing 1,277 Chinese papers, 12 English papers, and 3 WHO/HAI reports. A lot of researches have been done on NEMS, but the techniques of NEMS evaluation are not perfect. The sample representativeness is poor, and the longitudinal follow-up studies of the microscopic view is insufficient. . Evi-dence-based evaluation research using big data has just started. Conclusions: The research on NEMS should be strengthened. The NEMS evaluation should not only be based on national conditions, but it should also be in combi-nation with an international, multidimensional evaluation framework in terms of availability, affordability and rational drug use, so as to provide evidences to perfect the NEMS.

Objective: To observe the effect of amlodipine on bone marrow endothelial progenitor cell (EPC) mobilization, neo-vascularization and cardiac function in diabetic rats after myocardial infarction (MI) with the possible mechanisms.
Methods: A total of 60 male SD rats were divided into 2 groups. Normal group, n=20. Diabetic group, n=40, the rats were fed with high fat diet (HFD) for 4 weeks and then received streptozotocin followed by left anterior descending coronary artery ligation to establish MI model, those rats were further divided into 2 sub-groups:Control group, the rats received sodium carboxymethylcellulose 1 ml/day with HFD and Treatment group, the rats received amlodipine 2 mg/kg/day with HFD, n=20 in each sub-group, all animals were treated for 4 weeks. The EPC level in peripheral blood CD45-/low+/CD133+/KDR+ at before and 1, 3, 5, 7, 14, 28 days after operation were examined by lfow cytometry, plasma vascular endothelial growth factor (VEGF) level was measured by ELISA, capillary density in MI area was determined by CD31 staining, EPC related protein expressions were detected by western blot analysis and the cardiac function was evaluated by echocardiography.
Results: EPC in CD45-/low+/CD133+/KDR+in Treatment group at 7 days after operation was increased than Control group at 5 days after operation (112 ± 30/106) vs (55 ± 10/106), plasma VEGF in Treatment group was higher than Control group (5.63 ± 1.33) ng/L vs (3.68 ± 0.98) ng/L; Treatment group presented increased expressions of protein kinase B, endothelial nitric oxide synthase (eNOS) and matrix metallopeptidase-9, increased capillary density in MI area, higher LVEF and left ventricular fractional shorting, all P<0.05-0.01.
Conclusion: Amlodipine improves EPC mobilization, neo-vascularization and cardiac function in diabetic-MI rats, it may be related to VEGF/eNOS cascade activation.

Objective:Effect of ICA (Icariin) was observed on immunosuppression mice caused by Cyclophosphamide(Cy).Methods:A total of 60 mice,expect control group mice,were injected Cy intraperitoneally [300 mg/(kg·d)],then randomly divided into modelgroup(saline),positive (shenqi,1 ml/d)groups,ICA groups[150,80,40 mg/(kg·d)].Saline,shenqi and ICA were perfused respectively for 10 successive days;All mice were sacrificed after 12 h of last administration for performing following experiments.Measuring SI and TI and calculating amounts of lymphocyte from spleen and peripheral blood;Proliferative reaction of splenic lymphocyte stimulated by ConA and LPS were detected by MTT assays.Killing activity of NK and CTL cells for colon26 and level of TNF-α production were measured by LDH method.Ratios of CD3~+ T and NKT in splenic lymphocyte (SPL) were studied by FACS.Results:ICA can recovery TI and SI of mice to normal level and boost the population of splenic lymphocyte (SPL) (P<0.01).After treatment with ICA,activities of NK cell and CTL cell were significantly improved,and the level of TNF-α was significantly elevated.The ratios of NKT and CD3+T in the ICA-treated group were increased obviously (P<0.01).Conclusion:ICA can enhance immunological function and alleviate the side effect of chemotherapy effectively.

Objective To investigate the influence of service-learning model on medical graduates' ethical behavioral tendency. Methods A self-designed questionnaire was conducted among 302 medical students who have graduated in the last five years including the basic information, ethical behavioral tendency and participation of service-learning. The acquired data was analyzed and com-pared using chi-square test and unconditional logistic multiple regression. Results 68.2%(206/302) undergraduates participated in service-learning. Undergraduates participated in service-learning be-haved more ethical than those did not participated when facing the situation of patient' vomits (P=0.037). There were statistical differences in taking bribes from patients between those participated in service-learning and those did not (P=0.031). According to the results of unconditional logistic multiple regression analysis, whether participating in the service-learning is one of significant factors influenc-ing undergraduates' attitude towards bride-taking. Conclusions Medical students educated by service-learning model will exhibited more ethically accepted medical behaviors after becoming doctors. Ser-vice-learning model, a new medical education model, is worth promoting.