Objective: To study the chemical constituents from the aereal parts of Symplocos chinensis. Methods: The chemical constituents were isolated and purified by various column chromatographies. Their chemical structures were identified by physicochemical properties and spectral analyses. Results: Fourteen compounds were isolated from the the aereal parts of S. chinensis and identified as daucosterol (1), quercetin (2), quercetin-3-O-α-L-rhamnopyranoside (3), isoquercetrin (4), rutin (5), kaempferol-3- O-α-L-rhamnopyranosyl-(1→6)-β-D-glucopyranoside (6), niga-ichigoside F1 (7), shimobashiraside C (8), bergenin (9), protocatechuic acid (10), chrysophanol (11), aralia cerebroside (12), 2α, 3β, 19α, 23- tetrahydroxy-12-en-28-ursolic cid (13), and 2α, 3β, 19α, 23-tetrahydroxy-12-en-28-olenolic acid (14). Conclusion: Compounds 3, 5, 6, 8-12 are obtained from the plants of genus Symplocos Jacq. for the first time, and compounds 2-6 and 8-12 were obtained from the aereal parts of Symplocos chinensis for the first time.

Objective To study the utilization of preoperative ultrasound-guided fine-needle aspiration(USFNA) for axillary lymphnode(ALN) metastasis in breast cancer and to evaluate the feasibility and accuracy of the technique. Methods Forty ALNs in 40 armpit negative palpation highly suspective breast cancer patients underwent USFNA. The cytopathological results were compared with the histopathological results of sentinel lymphnode(SLN) biopsy or axillary lymphnode dissection(ALND). The sensitivity, specificity, positive predictive value(PPV), negative predictive value(NPV) and diagnostic accuracy of USFNA for the ALN metastasis were analysed. Results All the 40 patients were confirmed with breast cancer by pathology. Sensitivity of USFNA was 52. 2%, specificity was 100%, PPV was 100%,NPV was 60. 7% and diagnostic accuracy was 72. 5%. 12(30% ) patients with positive cytology proceeded to ALND, avoiding SLN biopsy. Conclusions USFNA is a minimally invasive, highly specified technique for prediction of breast cancer ALN metastasis before operation.

International clinical trials register is one of the global measures to realize transparency in clinical trials and also one of a powerful measure to improve the quality of clinical trials. Many scholars studying the quality of TCM clinical trials find that they are poor in quality and lack transparency. Furthermore, they find that TCM clinical trial registry has many problems. We must base on the successful experiences of WHO and international clinical trial registry to establish technical specifications for registry of traditional Chinese medicine clinical study of their own. Then, it can effectively improve the overall level of TCM clinical studies. We have suggested some concrete and feasible measures to establish technical specifications for registry of traditional Chinese medicine clinical study of their own based on the problems of TCM clinical trial registry.
Biomedical Research ; Humans ; Medicine, Chinese Traditional ; standards ; Registries

In recent 10 years, clinical trials of Chinese medicine and pharmacy (cMP) at clinicalTrials.gov.(USA) are gradually increasing. In order to analyze features of CMP clinical register, ClinicalTrials.gov register database were comprehensively retrieved in this study. Included clinical trials were input one item after another using EXCEL. A final of 348 CMP clinical trials were included. Results showed that China occupied the first place in CMP clinical register, followed by USA. CMP clinical trials, sponsored mainly by colleges/universities and hospitals, mostly covered interventional studies on evaluating safety/effectiveness of CMP. The proportions of studies, sponsored by mainland China and companies, recruitment trials and multi-center clinical trials in interventional trials were increasing. The proportions of studies sponsored by Hong Kong and Taiwan, research completed trials, unclear research status, phase III clinical trials, and published research trials in interventional trials were decreasing. Published ratios of CMP clinical trials were quite low. There were more missing types and higher proportions in trial register information.
Biomedical Research ; China ; Clinical Trials as Topic ; Databases, Factual ; Humans ; Medicine, Chinese Traditional ; United States

Objective To analyze the correlation of hypersensitive C-reactive protein(hs-CRP),homocysteine(Hcy) and D-dimer(D-D) with pathological change degree of coronary heart disease(CHD),and to investigate the diagnostic specificity and sensitivity of joint detection in CHD.Methods A total of 100 cases of CHD patients(experimental group) and 100 healthy subjects(control group) were enrolled,.Patients of the experimental group were divided into four groups on the basis of complications,including simple CHD group(32 cases),amalgamating hypertension group(46 cases),amalgamating diabetes group(9 cases),amalgamating hypertension diabetes group(13cases).The levels of hs-CRP,Hcy and D-D in the five groups were detected and analyzed.Results The levels of hs-CRP,Hcy and D-D in the experimental group were all higher than the control group(P<0.05).Logistic regression confirmed that three indexes were the independent risk factors for CHD.Each indicator has a certain clinical significance to the diagnosis and treatment of CHD but the value of Hcy could be better.Joint detection of hs-CRP and Hcy could be an ideal combination of detection,and the three joint detection might not be suitable for early diagnosis and treatment of CHD.The levels of hs-CRP and D-D in simple CHD group,amalgamating hypertension group,amalgamating hypertension diabetes group were all higher than amalgamating diabetes group(P<0.05).Conclusion hs-CRP,Hcy and D-D could be the independent risk factors of CHD,and joint detection might be with important clinical value for diagnosis of CHD.

Objective:To evaluate the relationship between intraoperative concentration of C-X-C motif chemokine 13 (CXCL13) in peripheral blood and postoperative delirium (POD) in elderly patients under general anesthesia.Methods:Ninety-three patients of both sexes, aged 65-85 yr, of American Society of Anesthesiologists physical statusⅠor Ⅱ, scheduled for elective hip replacement under general anesthesia, were selected.Peripheral venous blood samples were collected to determine the concentrations of CXCL13 and interleukin-6 (IL-6) before anesthesia and during surgery (30 min after skin incision). The Confusion Assessment Method Scale in Chinese was used to detect the development of POD every day within 7 days after surgery in 2 groups.The patients were divided into POD group and non-POD group.Logistic regression analysis was used to identify the risk factors for POD.Results:Seventeen patients developed POD (19%). There was significant difference in ages, preoperative mini-mental state examination (MMSE) scores before surgery, hospital stay time and intraoperative concentrations of CXCL13 and IL-6 in peripheral blood between group non-POD and group POD ( P<0.05). The results of logistic regression analysis showed that preoperative MMSE scores, intraoperative concentrations of CXCL13 and IL-6 in peripheral blood and advanced ages were independent risk factors for the development of POD ( P<0.05). Conclusion:Preoperative MMES scores, intraoperative concentrations of CXCL13 and IL-6 in peripheral blood and advanced ages are independent risk factors for the development of POD.

Objective To verify the reference interval for D-dimer assay and analyze the influence of age and gender on the ref-erence interval.Methods Inclusion criteria for reference individuals were established.60 healthy males and 63 females were enrolled and divided to three groups by age,including 20 to 39 years old group (20 males and 20 females),40 to 59 years old group (20 males and 23 females)and above 60 years old group (20 males and 20 females).Blood samples were drawn in cit-rate sodium anticoagulated tubes and D-dimer concentration was determined by three different coagulation analyzers using o-riginal reagents.According to CLSI guideline C-28-A3,the reference interval for each measurement system from reagent manufacturer was verified and the difference of D-dimer concentration between different age-group and sex-group was ana-lyzed using non-parameters tests.Results All reference intervals were verified for people under age 40,while one reference interval cannot be verified for people from 40 to 59 years old as same as one for people above 60 years old.D-dimer concen-tration increased with age and there was significantly different between 20~39 years old group and 40~59 years old group or above 60 years old group(P<0.05).There was only a significant difference between sex-group for people under age 60(P<0.05).Conclusion D-dimer concentration was associated with age and sex.For people under age 40,the reference inter-val from reagent manufacture can be verified and directly used in laboratory,while for people above age 60,the reference in-terval from reagent manufacture cannot be verified.The cause should be investigated and a new reference interval should be established separately when necessary.

Objective The study was to evaluate the behavioral differences in learning and memory abilities among three ani -mal models of Alzheimer′s disease. Methods Three SD rat models(n=20) were used in this study.The first SD rat model was es-tablished by intracerebral injection of Aβ25-35 into the bilateral hippocampus , the second mouse model was induced by intraperitoneal in-jection of scopolamine and the third was a senescence accelerated mouse model .Morris Water maze test was performed to investigate behavioral differences by comparison to corresponding blank control groups ( sham operation group , blank group and P8 group ) . Results The learning and memory abilities of senescence accelerated rats and scopolamine -treated rats were worse than those of the corresponding control groups, especially the scopolamine-treated rat ([35.47 ±3.78]s vs [50.61 ±3.94]s, P<0.01).There was no significant difference between Aβrats and sham-operated rats(P>0.05). Conclusion The model of Alzheimer′s disease in-duced by intraperitoneal injection of scopolamine represents more distinct changes in learning and memory abilities .Morris water maze test can be used to well evaluate whether the scopolamine-induced model is successfully established or not .

Objective:To evaluate the frequency and predictive factors of nipple involvement in a large contemporary cohort of pa-tients and to improve patient selection for the preservation of the nipple-areolar complex. Methods: This retrospective study re-viewed the medical charts of 1,190 patients who underwent traditional mastectomy in Peking University People's Hospital between October 2008 and March 2014. Nipple involvement incidence was compared between the cases of clinically abnormal and clinically normal breasts. Other clinicopathological features and nipple status were analyzed to evaluate the association between these factors and occult nipple involvement. Univariate and multivariate analyses were conducted to identify predictive factors. Results:Nipple in-volvement was detected in 6.0%of the mastectomy specimens. Meanwhile, incidence was 40.7%(22 out of 54) in clinically abnormal nipple cases and 4.3%(49 out of 1,136) in clinically normal nipple cases (χ2=121.9, P<0.001). Univariate analysis revealed that tumor lo-cation, tumor to nipple distance (≤2 and>2 cm), lymphovascular invasion, diameter (including carcinoma in situ;≤3.5 and>3.5 cm), T stage, N stage, and TNM stage were associated with occult nipple involvement. By logistic regression analysis, tumor location, tumor to nipple distance, T stage, and N stage were determined to be the independent predictors of nipple involvement. Conclusion:Clinical abnormalities of the nipples are reliable and potent predictors of nipple pathology. The cases with peripheral tumor, T1-T2 stage, and N0-N1 stage have lower probability of occult nipple involvement.

Objective To study how to improve the safety of the operation for abdominal aortic aneurysm(AAA).Methods Forty-six cases of AAA received resection of AAA plus artificial blood vessel transplantation in recent three and a half years in our 2 hospitals.The lesions involved only the abdominal aorta in 20 cases,and extended to unilateral common iliac and internal and external iliac arteries in 8 cases,to bilateral common iliac and external and internal iliac arteries in 16 cases,and involved the renal artery in 2 cases.Emergency operation was done in 3 cases.Results In these 46 cases,45 were cured and 1 died,and no operative complications occurred.Conclusions Surgical operation is the best way to treatment AAA.