Objective To compare the changes of blood coagulation system and the clinical interventional effect of low molecular weight heparin (LMWH) in elderly patients who had received thoracic surgery. Methods Ninety-six thoracic surgery patients (age≥70 years) were divided into control group ( 54 cases ) and experimental group ( 42 cases ) ( postoperative 1-7 days, subcutaneous injection with LMWH ) from September 2007 to December 2009 by random digits table. Observed perioperative changes in prothrombin time (PT),activated partial thromboplastin time (APTT),platelet (Plt),D-dimer (D-D),fibrinogen (Fib), anti- X a activity, and clinical performances. Also observed the influence of diabetes mellitus of surgery coagulation function. Results The preoperative indexes of coagulation function were no significant (P ＞ 0.05 ). In control group PT prolonged, Fib and D-D increased, the differences between preoperative and postoperative each time were significant (P ＜ 0.05 ). Fib and D-D in control group increased than those in experimental group postoperative each time (P ＜ 0.05 ). In experimental group anti- X a activity increased postoperative each time (P ＜ 0.05 ),compared with control group was also significant (P ＜ 0.05 ). Diabetes mellitus had no significant influence on coagulation function. One patient appeared pulmonary thromboembolism in control group,and no one appeared venous thromboembelism and bleeding adverse reactions in experimental group. Conclusion Thoracic surgery in elderly patients have high blood coagulation state, prone to venous thromboembolism, LMWH given early postoperative prophylactic treatment is beneficial to improve the hypercoagulable state and have better security.

Objective To observe the clinical effect of Shenwuyizhi capsule in the treatment of vascular dementia.Methods According to the digital table method,80 patients with vascular dementia were divided into the treatment group and control group,each group with 40 cases.On the basis of routine treatment,the control group was treated with piracetam tablets,and the treatment group was treated by the Shenwuyizhi capsule.60 d for 1 course.Before and after treatment,the simple mental state examination(MMSE) scale scores,Blessed behavior scale scores were compared between the two groups.Results Before and after treatment,the MMSE score,Bcessed behavior scale scores of the two groups were significantly improved (all P ＜ 0.05).After treatment,the MMSE score,Bcessed behavior scale scores of the treatment group were (19.83 ± 5.24) points,(7.18 ± 4.21) points,respectively,which were better than those of the control group [(20.01 ± 4.89) points,(7.23 ± 3.99) points] (t =4.148,2.141,all P ＜0.05).Conclusion Shenwuyizhi capsule can improve the light,moderate cognitive function in patients with vascular dementia,and improve memory and computing power,directional force,and enhance patient behavior ability,and reduce dementia symptoms,with good curative effect in the near future.

Objective To explore the value of the diagnosis and differential diagnosis of the sacral tumors with MRI. Methods Twenty nine patients with histologically proven sacral tumors were viewed, including sacral chordoma( n =5), giant cell tumor( n =1), neurilemmona( n =3), ganglioneuroma( n =2), malignant lymphoma( n =4), osteosarcoma( n =1), malignant neurilemmoma ( n =1), and secondary tumors ( n =12).All patients were examined with MR,CT and plain radiograph. MR findings were analyzed. Results (1) sacral tumors involved sacral bone with a regularity. Four patients with sacral chordoma involved usually above S3 level, not including S1 bone. One patient with giant cell tumor involved S2 S3. Six patients with neuromas involved S1 S3, including S1 bone. (2) signal intensity: moderate and/or low signal on T 1 weighted images, mottled signal on T 2WI. (3) sacral pores were destructed, disappeared, or enlarged. Sacral pores enlarged in six patients with neuromas, destructed in others. (4) sacral canal were destructed, disappeared, or enlarged. (5) tumors were classified into central ( n =16), centrifugal ( n =9), and mixed ( n =4) types. (6) sacral tumors were segmental on sagittal MR images. Conclusion MRI is superior to CT and plain X ray in assessing classification, segment and sacral pores and the like, so MRI is very important to the diagnosis and the differential diagnosis of the sacral tumors.

Objective To investigate the results of non dissecting thoracic duct ligation cutting in treatment of recurrent chylothorax.Methods 22 patients suffered from recurrent chylothorax after original thoracic duct ligation surgery were enrolled and their clinical characteristics were collected,including previous thoracic surgical procedure, previous surgical approach,recurrent chylothorax side and postoperative complications.The probable causes of chylothorax recurrence were analyzed and targeted improvements were made,based on the traditional mass ligation procedure of the thoracic duct.Through the previous approach,non dissecting thoracic duct ligation combined with transection of the posterior mediastinal tissue,except esophagus and thoracic aorta,was applied during the reoperation for the recurrent chylothorax.Results All the patients were recovery form chylothorax after reoperations.There were no severe postoperative complications except one patient suffered from respiratory failure.All the patients discharged evenly without chylothorax recurrence during one-year follow-up period.Conclusion Recurrent chylothorax could be successfully and safely treated by non-anatomical mass ligation combined with transection of the thoracic duct,for the anatomical foundation of chylothorax recurrence had been eliminated.

Objective: To investigate the chemical constituents from the roots and rhizomes of Rhodiola sachalinensis. Methods: The chemical constituents were isolated by repeated silica gel chromatography, medium pressure column chromatography, and semi-preparative liquid chromatography, and their structures were elucidated by chemical properties and spectroscopic analyses. Results: Eighteen compounds were isolated and identified to be gallic acid (1), p-hydroxybenzoic acid (2), salidroside (3), benzyl-O-β-D-glucopyranodide (4), phenylethyl-8-O-β-D-glucopyranodide (5), cinnamyl-β-D-glucopyranoside (6), sachalinol (7), quercetin (8), quercetin-3-O-β-D-glucopyranoside (9), kaempferol (10), kaemferol-7-O-α-L-rhamnopyranoside (11), kaempferol- 7-O-β-D-glucopyranoside (12), kaemnpferol-3-O-α-L-rhamnoside (13), kaempferol-3-O-β-D-glucopyranoside-7-O-α-L-rhamnoside (14), tricin (15), tamarixetin (16), herbacetin-7-O-α-L-rhamnoside (17), and herbacetin-3-O-β-D-glucopyranoside-7-O-α-L- rhamnoside (18). Conclusion: Compounds 9, 12, and 16 are obtained from the plants in Rhodiola L. for the first time. Compounds 2, 7, 8, 14, and 18 are obtained from this plant for the first time.

Objective The difficulty of full thoracoscopic Ivor-Lewis is the lack of a safe and low cost anastomosis.By improving the surgical process,to explore the application of circular stapler in the intrathoracic esophagogastric anastomosis.The thoracoscopic operation mode of esophageal cancer changes from simply following the McKoewn procedure to Ivor-Lewis and McKoewn procedure.Methods Retrospective analysis 123 cases of implementation thoracoscopic esophageal cancer from July 2009 to February 2013,which including the cases of intrathoracic anastomosis and cervical anastomosis.Divided it into two groups:intrathoracic anastomosis groups,which including thoracoscopic esophagectomy resection,gastroesophageal anastomosis and anastomotic pedicled omentum embedding,the cervical anastomosis groups,which including thoracoscopic esophageal free and gastroesophageal neck anastomosis.To comparing the incidence of ARDS,postoperative hoarseness,anastomotic complications (Anastomotic leakage and anastomotic strictures within two months after surgery),guardianship time of ICU and postoperative hospital stay between the two groups.Results All the patients were no deaths.The cervical anastomosis group operative time was significantly lower than the intrathoracic anastomosis group.The incidence of anastomotic fistula and anastomotic stricture of intrathoracic anastomosis group was significantly lower than that of the cervical anastomosis group,total hospitalization time of the intrathoracic anastomosis group were significantly lower than that of the cervical anastomosis group,there is no significant differences in postoperative hoarseness and ARDS incidence between the two groups.Conclusion For the lower esophageal carcinoma,it is technically mature and safe to apply the circular stapler for Ivor-Lewis surgery and sleeve omentumembedding anastomotic technique in full thoracoscopic,and the technology should be widely applied; for the upper esophagealcarcinoma,McKoewn procedure should be applied.

Objective To investigate the anti-inflammatory activity of the main active ingredients in the dried stem bark of Daphne giraldii Nitsche.Methods Severialchemical compounds like vladinol D, pinoresinol, daphneticin, daphnoretin, daphnetin, giraloid A and giraldoid B were isolated from the stem barks. The CCK-8 experiemnts were analyzed for the cytotoxicity study. The cells were divided into the control group, the model group and the treatment group according to random number table method. The control group and the model group were added with 50μl culture medium. Moreover, treatment group was added with different concentrations (50.00, 25.00, 12.50, 6.25, 3.12μg/ml) of the solutions of giraloid A, giraldoid B and daphneticin. Then, RAW264.7 cells were treated with 50μl LPS (4μg/ml) for 24 h in the model group and treatment group. Griess reagent was used to determine the amount of NO release, and the secretion of TNF-α was detected by ELISA kit.Results Cytotoxicity test indicated that giraldoid A (50.00μg/ml), giraldoid B (50.00μg/ml) and daphneticin (50.00μg/ml) showed noobvious cytotoxicity. Giraldoid B (12.50, 25.00, 50.00μg/ml) could inhibit the production of NO (271.86% ± 20.92%, 256.48% ± 20.92%, 199.31% ± 15.16%vs.358.62% ± 28.64%) and  TNF-α (647.87% ±115.79%, 618.42% ± 87.52%, 588.33% ± 87.94%vs. 1035.06% ± 58.29%) in RAW264.7 induced by LPS compared with the model group. Giraldoid A (25, 50μg/ml) could inhibit the production of NO (234.99% ± 34.28%, 167.36% ± 25.76% vs.358.62%±28.64%) and TNF-α (691.76% ± 60.37%, 534.01% ± 41.60% vs. 1035.06% ± 58.29%) in RAW264.7 induced by LPS compared with the model group. Daphneticin (12.5, 25, 50μg/ml) could inhibit the production of NO (283.89% ± 36.69%, 243.08% ± 48.19%, 225.92% ± 33.67% vs.358.62% ± 28.64%) and TNF-α (713.77% ± 121.96%, 670.62% ± 18.70% vs. 1035.06% ± 58.29%) in RAW264.7 induced by LPS compared with the model group.Conclusions Giraldoid A, giraldoid B and daphneticin exhi bited anti-inflammatory effect through inhibiting the release of NO and the production of TNF-α in RAW264.7 induced by LPS.

Objective To explore the effect of Xiongbiyihao mixture in the treatment of coronary heart disease with angina pectoris.Methods 90 coronary heart disease patients with angina pectoris were divided into the treatment group( 60 cases) and control group( 30 cases).The control group was given routine westerm medicine therapy,and the treatment group was administered with Xiongbiyihao mixture at the base of the control group.Ater treatment,the heart disease attack frequency,duration,and degree,clinical symptoms and electrocardiogram changes of the two groups were observed.Results The total efficiency symptoms of and electrocardiogram of the treatment group was 95.0％,90.0％,respectively,and was higher than that of the control group(76.7％,73.3％ ) ( x2 =9.7,x2 =7.8,all P ＜ 0.05).Conclusion Xiongbiyihao mixture could effectively improve the coronary blood,reduce myocardial ischemia,and alleviate the symptoms of angina pectoris,chest tightness,chest pain.It is safe and effective in the treatment of angina pectoris,and worthy of clinical application.

AIM　The purpose is to make a search for new antihypertensive agents with higher activity and lower side effect. METHODS　As DDPH a lead compound, ten 1-Phenylethyl (or 3,4-dimethyloxyphenylethyl)-4-substituted aryloxypiperidine compounds were designed and synthesized, keeping the two structural fragments of DDPH: phenylethylamine and aryloxyalkylamine. Their structures were confirmed by Elemental Analysis, IR, 1H-NMR and Mass Spectrum. RESULTS　The majority of the compounds possessed potent antihypertensive activity and the antihypertensive effect of I3 and I4 was stronger than that of DDPH. CONCLUSION　The experimental results were accordant with designed thought and provided useful information for modifying the structure of DDPH deeply.