Objective: To investigate the chemical constituents in the shells of Juglans sigillata. Methods: The chemical constituents were isolated by silica gel, RP18, Sephadex LH-20, and MCI column chromatography and semi-preparative HPLC and so on. The structures were identified on the basis of spectroscopic analysis and chemical evidence. Results: Fifteen compounds were isolated and identified in the 70% ethanol extract from the shells of J. sigillata including seven phenolic glycosides: tachioside (1), mudanoside A (2), 4-O-β-D-glucopyranosylvanillc acid (3), breynioside A (4), 1-O-vanilloyl-β-D-glucose (5), 6'-O-vanilloyltachioside (6), and 6'-O-vanilloylisotachioside (7); three phenylpropanoide acid glycosides: 6-O-feruloyl-D-glucopyranose (8), methyl-4-O-coumaroylquinate (9), and 5-p-cis-coumaroylquinic acid (10); two tetralone glycosides: juglanin A (11) and juglanin E (12); one norsesquiterpenes glycoside: roseoside (13); one flavone: toxifolin (14); and one glucosylated abscisic acid derivate: (1'R, 3'R, 5'R, 8'S)-epi-dihydrophaseic acid β-D-glucoside (15). Conclusion: Except compound 14, the other compounds are isolated from the shells of J. sigillata for the first time. And compounds 1-4, 13, and 15 are reported for the first time from the plants in genus of Juglans L.

ObjectiveTo investigate the surgical method, experience, and skills in clipping anterior communicating artery aneurysm (ACoAA) via supraorbital keyhole approach.MethodsThe ACoAA case data of selectively clipping via non-dominant supraorbital keyhole approach according to the A2 open plane formed by the anterior communicating artery and the bilateral A2 segments were analyzed retrospectively.The surgical method and experience were analyzed.The indications and advantages and disadvantages of this method were summarized.ResultsACoAA in 12 patients were completely clipped via supraorbital keyhole approach from the side of non-dominant A1, and the dominant A1 segment arteries were well exposed.The patients were followed up for 4-29 months after procedure.No recurrence or rupture of the aneurysms was found.The Glasgow Outcome Scale score was 5 in 11 patients and 4 in 1 patient.Conclusions ACoAA can be completely clipped via supraorbital keyhole approach from the side of non-dominant A1.It is a minimally invasive surgical approach with good efficacy.

Objective To identify the risk factors for early postoperative cognitive dysfunction (POCD) in the elderly patients undergoing spinal surgery.Methods One hundred and fifty ASA Ⅱ or Ⅲ patients,aged ≥65 yr,undergoing elective spinal surgery under general anesthesia,were studied.Venous blood samples were taken at 1 day before operation and 7 days after operation to determine the concentration of serum S-100B protein.Cognitive function was assessed by Mini-Mental State Examination (MMSE) at 1 day before operation and 7 days after operation.The patients were diagnosed as having POCD if MMSEpre-MMSEpost ≥ 3.The patients were divided into POCD group and non-POCD group.Age,body weight,sex,education,type of operations,complications,preoperative TCM syndrome type,MMSE score at 1 day before operation and 7 days after operation,duration of operation,emergence time,and intraoperative blood loss,cardiovascular events,and amount of fluid infused per hour were recorded.The risk factors for POCD were analyzed using multivariate logistic regression analysis.Results Thirty-eight patients developed early POCD (25.3％).The resuhs of logistic regression analysis showed that age ≥ 70 yr,elementary education or below,duration of operation ≥5 b,and the number of hypotension occurred during operation≥3 were the risk factors for early POCD.Conclusion Age≥70 yr,elementary education or below,duration of operation ≥ 5 h,and the number of hypotension occurred during operation ≥ 3 are the risk factors for early POCD in the elderly patients undergoing spinal surgery.

Objective To compare the prevalence and genotype distribution of human papillomavirus (HPV) between human immunodeficiency virus (HIV)-positive and-negative populations.Methods Patients with condyloma acuminatum or persons who recently had sexual contact with patients with condyloma acuminatum were enrolled into this study,and classified into HIV-positive group (n =62) and HIV-negative group (n =2 716).GeneChip analysis was performed to detect HPV and determine HPV genotypes in mucocutaneous samples collected from the external genitalia of these subjects.Statistical analysis was carried out by chi-square test using the SPSS software version 19.0.Results The prevalence rates of HPV infection,high-risk HPV types and low-risk HPV types were significantly higher in HIV-positive persons than in HIV-negative persons (74.19％ (46/62) vs.42.30％ (1 149/2 716),67.74％ (42/62) vs.29.57％ (803/2 716),58.06％ (36/62) vs.24.71％ (671/2 716),respectively,all P＜ 0.01).The detection rate of HPV was also increased in HIV-positive men compared with HIV-negative men (92.11％ (35/38) vs.37.38％ (382/1 022),x2 =45.98,P ＜ 0.01).Although the top three genotypes of low-risk HPV were types 6,43 and 11 in both HIV-positive and-negative groups,the prevalence rate of HPV 6 was 37.10％ (23/62) in HIV-positive group,but only 11.12％ (302/2 716) in HIV-negative group.The top five genotypes of high-risk HPV were types 16 (22.58％,14/62),52,66,58 and 18 in HIV-positive group,and types 16 (7.77％,211/2716),58,56,66 and 52 in HIV-negative group.Coinfections with multiple HPV subtypes were common in both groups,and the number of concurrent HPV genotypes was as high as 8 in HIV-positive group,and 9 in HIV-negative group.The prevalence rate of coinfections with three or more HPV genotypes in HIV-positive group was significantly higher than that in HIV-negative group (65.21％ (30/46) vs.16.71％ (192/1 149)).Conclusions Compared with HIV-negative populations,HIV-positive populations show elevated prevalence of HPV infection,high-risk HPV genotypes and low-risk HPV genotypes.Moreover,the prevalence of HPV is higher in HIV-positive men than in HIV-negative men.These findings are worthy of further attention in clinic.

Objective To investigate the effects of long-term glucocorticoid administration on neuromuscular block of cisatracurium in elderly patients undergoing general anesthesia. Methods Forty ASA Ⅱ or Ⅲ patients,aged≥65 yr,with BMI of 18-24 kg/m2 ,scheduled for elec-tive operation were studied.According to the history of using or not long-term glucocorticoid,patients were assigned into two groups (n = 20 each):control group(group C),glucocorticoid group(group J).Midazolam 0.03 mg/kg was injected,mask inhalation of 8% sevoflurane and flow rate of oxygen 8L,every 30 s decline 2%,until the 4%.After the disappearance of eyelash reflex,cisatracurium 0.1 5 mg/kg was injected intravenously.After 1 min intravenous injection of remifentanil 2 g/kg and 30 s after stop of sevoflurane inhalation anesthesia, endotracheal intubation for mechanical ventilation,target controlled infusion of propofol and remifentanil anesthesia,using TOF-Watch SX acceleromyography monitoring of muscle relaxation,and onset time,clinical duration and recovery in-dex(for T1 to return from 25% to 75% of the control twitch)were recorded.Results Compared with group C,the onset time was significantly prolonged,clinical duration and recovery index were short-ened in group J (P <0.05 ).Conclusion Long-term glucocorticoid admininstration could reduce the neuromuscular blocking effect of cisatracurium in elderly patients.

Objective To evaluate the effect of domestic wire-reinforced epidural catheter on the occurrence of adverse events during epidural block.Methods Three hundred ASA Ⅰ or Ⅱ patients of both sexes,aged 18-64 yr,weighing 41-78 kg,scheduled for elective operations under combined spinal-epidural anesthesia,were randomly divided into 3 groups (n =100 each):polyvinyl chloride epidural catheter group (group A),imported wire-reinforced epidural catheter group (group B) and domestic wire-reinforced epidural catheter group (group C).Combined spinal-epidural anesthesia was performed routinely.The corresponding epidural catheter was inserted in each group.The catheterization without difficulty,paresthesia during catheterization,the number of patients in whom blood or cerebrospinal fluid was withdrawn from the epidural catheter,intravascular catheter insertion,injection obstruction,easiness during removal of the catheter,bleeding after removal,postoperative paresthesia and epidural hematoma within 1 week after operation were recorded.Results Compared with A group,the incidences of paresthesia during catheterization,the number of patients in whom blood or cerebrospinal fluid was withdrawn from the epidural catheter,injection obstruction and postoperative paresthesia were significantly decreased (P ＜ 0.05),and no significant change was found in the other parameters in B and C groups (P ＞ 0.05).There was no significant difference in all the parameters between B group and C group (P ＞ 0.05).Conclusion Domestic wire-reinforced epidural catheter can decrease the occurrence of catheterization-induced damage to the nerve and blood vessels and the efficacy is comparable with that of imported wire-reinforced epidural catheter.

Objective: To explore the features of close contacts of coronavirus disease 2019 ( COVID-19 ) cases in Jiulongpo District, Chongqing, so as to provide evidence for the management of close contacts and the control of the epidemic. Methods: Demographic characteristics, contact history and medical records of close contacts of COVID-19 cases in Jiulongpo District from January 22 to April 10, 2020 was collected according to the COVID-19 Prevention and Control Program ( sixth version ) . Descriptive statistical analysis was performed. Results: Totally 602 close contacts were found, and 30 of them were infected, with an attack rate of 4.98%. Twenty-seven cases were diagnosed before February 10. The close contacts mainly aged from 20 to 59 years ( 457, 75.91% ) ; most were relatives of COVID-19 cases ( 219, 36.38% ) , and 64 (10.63%) were medical staff. Most contacted occasionally ( 338, 56.15% ), at home ( 190, 31.56% ) , and through the same meal ( 181, 30.07% ) . The attack rate of close contacts aged 40 years and over was 7.49%, which was higher than 2.37% of those aged under 40 years ( P<0.05 ). The attack rate of close contacts increased with contact frequency ( P<0.05 ) . The attack rates of close contacts were significantly different in different relations with cases, contact places and contact modes ( P<0.05 ); the attack rates of colleagues and relatives were 20.41% and 8.68%; the attack rates of close contacts in the workplace settings and family were 17.54% and 10.00%; the attack rates of sharing the same bed, living in the same room and working in the same room were 44.44%, 18.60% and 17.24%. Conclusions The close contacts of COVID-19 cases in Jiulongpo District, Chongqing who aged 40 years or above, exposed in family settings and in the workplace were associated with higher risk of infection.

Objective To evaluate the effects of long?term glucocorticoid administration on cisatra?curium?induced neuromuscular blockade in the patients undergoing laparoscopic operation. Methods Six?ty?four patients of both sexes, aged 40-64 yr, with body mass index of 18-22 kg∕m2 , of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, scheduled for elective laparoscopic operation under general anesthesia, were assigned into 4 groups ( n=16 each) according to whether or not glucocorticoid was used for a long?term period: control ( non?hormone and non?laparoscopic operation ) group ( group C ) , hor?mone + laparoscopic operation group ( group HL ) , non?hormone + laparoscopic operation group ( group NHL) and hormone +non?laparoscopic operation group ( group HNL) . Midazolam 0.03 mg∕kg was injected intravenously, 8% sevoflurane was inhaled by mask, and the concentration of sevoflurane was decreased by 2% every 30 s until the concentration of 4% was reached. After loss of eyelash reflex, remifentanil 2μg∕kg was injected intravenously over 1 min, and 30 s later sevoflurane inhalation was stopped. The patients were tracheally intubated and mechanically ventilated. Anesthesia was maintained with propofol and remifentanil given by target?controlled infusion. Neuromuscular blockade was monitored with accelerograph TOF?watch
SX. At 20 min of pneumoperitoneum in NHL and HL groups or 20 min after intubation in C and HNL groups, cisatracurium 0. 15 mg∕kg was injected intravenously. The onset time, maximal degree of N?M block, clinical duration and recovery index of cisatracurium were recorded. Results Compared with group C, the onset time was significantly prolonged, the maximal degree of N?M block was decreased, the clini?cal duration was shortened, and the recovery index was decreased in HL and HNL groups ( P<0.05) , and the clinical duration was significantly prolonged, the recovery index was increased ( P<0.05) , and no sig?nificant change was found in the onset time in group NHL ( P>0.05) . Compared with group HNL, the clin?ical duration was significantly prolonged, the recovery index was increased (P<0.05), and no significant change was found in the onset time in group HL ( P>0.05) , and the onset time was significantly shortened, the clinical duration was prolonged, and the recovery index was increased in group NHL ( P<0.05) . Com?pared with group NHL, the onset time was significantly prolonged, the maximal degree of N?M block was decreased, the clinical duration was shortened, and the recovery index was decreased in group HL ( P<0.05) . Conclusion Long?term glucocorticoid administration can weaken cisatracurium?induced neuromus?cular blockade in the patients undergoing laparoscopic operation.

Objective To evaluate the feasibility of using ultrasound-guided lumbosacral plexus block combined with nasopharyngeal airway in hip replacement in elderly patients with pulmonary and lumbar diseases.Methods Eighteen elderly patients who were diagnosed as having puhnonary and lumbar diseases before operation,aged 75-97 yr,with body mass index of 18-22 kg/m2,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,scheduled for elective unilateral total hip replacement,were enrolled in this study.Unilateral lumbosacral plexus block was performed under the guidance of ultrasound.After completion of block,mild sedation was carried out with propofol,nasopharyngeal airway was implanted,oxygen was inhaled by mask,and sedation was maintained with small doses of propofol during operation.Bispectral index value was maintained at 60-75 during operation.Mean arterial pressure and heart rate were recorded before block,at 15 min after completion of block,before implantation of nasopharyngeal airway and at 1 min after implantation of nasopharyngeal airway.The postoperative nasopharyngeal airway removal time,development of cognitive dysfunction within 7 days after operation and recurrent puhnonary complications and mortality within 30 days after operation were recorded.Results All the patients underwent operation successfully,and vital signs were stable during operation.Nasopharyngeal airway was removed within 5 min after the end of operation,recurrent pulmonary complications were not found,and no patients developed cognitive dysfunction within 7 days after operation.No patient died within 30 days after operation.Conclusion Ultrasound-guided lumbosacral plexus block combined with nasopharyngeal airway produces reliable efficacy and fewer complications when applied to hip replacement and is suitable for elderly patients with pulmonary and lumbar diseases.

OBJECTIVETo investigate the inhibitory effect of polypeptide K237 on the proliferation of human hormone refractory prostate cancer cell line PC-3M and its possible mechanism.

METHODSPC-3M cells were divided into three experimental groups and a control, treated with polypeptide K237 at the concentration of 50, 100, 200 and 0 micromol/L, respectively, for 48 hours. The effects of K237 on the proliferation of different groups of the PC-3M cells were analyzed by MTF, and the mRNA expression levels of bax and bcl-2 were detected by RT-PCR.

RESULTSAfter polypeptide K237 treatment, the PC-3M cells became round, small and less transparent in cytoplasm, and some shed and suspended in the culture medium. The growth inhibition rates of the PC-3M cells were (12.6 +/- 0.95)%, (17.8 +/- 0.99)% and (27.2 +/- 1.12)% in the 50, 100 and 200 micromol/L concentration groups. RT-PCR analysis showed that the bax/beta-actin values of the 50, 100, 200 and 0 micromol/L groups were 0.919 +/- 0.071, 0.971 +/- 0.083, 0.992 +/- 0.102 and 0.889 +/- 0.067, and the bcl-2/beta-actin values of the four groups were 0.896 +/- 0.085, 0.791 +/- 0.084, 0.764 +/- 0.702 and 0.922 +/- 0.097, respectively, both with significant differences between the experimental and the control groups (P < 0.01). The mRNA expression of bax was upregulated and that of bcl-2 downregulated in a dose-dependent manner.

CONCLUSIONPolypeptide K237 may induce apoptosis of PC-3M cells by affecting the expressions of bax and bcl-2, and thus suppress the proliferation of prostate cancer cells.

Apoptosis ; drug effects ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Humans ; Male ; Peptides ; pharmacology ; Prostatic Neoplasms ; metabolism ; Proto-Oncogene Proteins c-bcl-2 ; genetics ; metabolism ; RNA, Messenger ; genetics ; bcl-2-Associated X Protein ; genetics ; metabolism