Ginsenosides,which belongs to triterpenoid saponins of plant terpenoids,are the main active components of the valuable medicinal herbs ginseng and American ginseng.Recent studies show that ginsenosides have a variety of beneficial effects,including anti-inflamatory,antioxidant,and anticancer effects.Ginsenosides are synthesized by complicated modification of triterpenoid skeleton after cyclization of 2,3-oxidosqualene through triterpene saponin synthesis pathway in which they share common early steps with phytosterols synthesis.It outlines recent advances for the biosynthesis of ginsenosides,the cloning and characterization of genes encoding key enzymes in the pathway and the basal framework of ginsenosides biosynthesis pathway.The prospects of secondary metabolism engineering in the biosynthesis of plant natural products and its application in ginsenosides biosynthesis are also discussed.

OBJECTIVETo study the infrared (IR) fingerprint spectra of Coptis chinensis for different parts, ages, and heights, and to analyze the integrate rules about the content of berberine component in Coptis chinensis for different parts, ages, and heights.

METHODThe Fourier transform infrared (FTIR) spectroscopy was applied to detect the infrared spectra of Coptis chinensis samples rapidly and non-separately.

RESULTSThe IR spectra of the root, leafstalk, and fibre of Coptis chinesis have their unique features. The content of berberine component in Coptis chinensis was different for different parts and the sequence: root > leafstalk > fibre. When Coptis chinensis grows, the content of berberine component in leafstalk also increases. The content of berberine component in leafstalk which planting in 1 200 m was less than that in 1 300, 1 400, and 1 500 m. The ages and heights provide no obvious influences on the content of berberine in the root of Coptis chinensis.

CONCLUSIONUsing FTIR spectroscopy, the quality of Coptis chinensis can be controlled, which provides a useful method for the standardized planting of Coptis chinensis.

Altitude ; Berberine ; analysis ; Coptis ; chemistry ; Plant Leaves ; chemistry ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Quality Control ; Spectroscopy, Fourier Transform Infrared ; Time Factors

Objective To explore exenatide in the treatment of metformin(MET)alone,sulfonylurea (SU)alone or MET + SU combination therapy with poor glycemic control in type 2 diabetic pa-tients and to find effective nursing measures.Methods 24 patients were randomly divided into the con-trol group and the exenatide group with 12 patients in each group.In the exenatide group,exenatide 5μg twice a day for 4weeks,then 10μg twice a day for 12 weeks.Changes of HbAlc,body weight,BMI,FBG,P2hBG,and rate of adverse reaction were compared between two groups.Results Glycosylated hemoglobin (HbAlc),body weight,BMI,FBG,P2hBG in the control group before and after treatment showed no significant difference,while the exenatide group showed better results compared with those before treatment and the control group.Nursing intervention played evident effect on reducing adverse effect such as nausea,vomiting,diarrhea,low blood sugar,headache.Conclusions For patients with type 2 diabetes,using MET,SU alone or MET + SU combination therapy showed poor results of blood sugar control,addition of exenatide therapy can effectively control blood sugar,nursing intervention can significantly alleviate the adverse effects of patients.

Objective To respectively analyze the patterns and possible predictors of recurrent strokes among patients with initial ischemic stroke.Methods Three hundred and sixty-one patients with recurrent strokes (acute ischemic stroke or intracerebral hemorrhage) after initial ischemic strokes were collected from Jan 2004 to Dec 2009.The data about conventional risk factors such as smoking,heavy alcohol drinking,hypertension,diabetes,hyperlipidemia,heart diseases,head trauma,migraine,family history of cardiovascular disease,and the use of preventive medications were collected and analyzed among patients with different types of recurrent strokes.Results Patients (n =361) were divided into ischemic stroke group (n =321) and hemorrhagic stroke group (n =40) according to the recurrent stroke type.The ischemic stroke group was further divided into the anterior circulation stroke subgroup (n =234),the posterior circulation stroke subgroup (n =75) and watershed cerebral infarction or multiple infarction subgroup (n =12).Multivariate logistic regression analysis revealed that older age at initial stroke onset (OR =1.036,95 ％ CI 1.006-1.067,P =0.02) and hyperlipidemia (OR =2.253,95 ％ CI 1.092-4.647,P =0.028) were both the independent risk factors for the recurrent ischemic stroke.Comparing the subgroups,multivariate logistic regression analysis showed that atrial fibrillation (OR =4.217,95％ CI 1.489-11.942,P =0.007) was the independent risk factor for the recurrent ischemic stroke in the posterior circulation territory.Conclusion Aging and hyperlipidemia are possible predictors of recurrent ischemic stroke after the initial ischemic stroke which would be useful for individualized secondary prevention of stroke.

Abstract: Objective　To understand the density changes and seasonal fluctuation of larvae and adults of Aedes albopictus in Hainan Province from 2017 to 2021, and to provide a scientific basis for the prevention and control of dengue fever and other vector-borne diseases in Hainan Province. Methods　The Breteau index method was used to monitor the larvae of Aedes mosquitoes, and the breeding sites of all small indoor and outdoor water containers and their larvae was checked and recorded. The adult mosquitoes were monitored by double lamination and light trap. Results　A total of 1 962 adult female Aedes albopictus mosquitoes were captured in Hainan Province from 2017 to 2021, accounting for 2.17% of the total captured mosquitoes. There were significant differences in mosquito species composition in different habitats in different years (χ2=312.258, P<0.01). In 2017, the density of mosquitoes in livestock sheds was the highest (9.71 per lamp·night), but the composition ratio of Aedes albopictus was the lowest (1.29%). In 2020, the mosquito density in hospitals was the lowest (2.22 mosquitoes per lamp·night), and in 2019, the proportion of Aedes albopictus in residential areas and hospitals was the highest (3.27% on average).The mosquito density in different habitats was the lowest in 2020. The proportion of Aedes albopictus in residential areas and livestock sheds showed an increasing trend from 2017 to 2021, while the proportion of other habitats showed significant fluctuations. The proportion of Aedes albopictus in hospitals showed an obvious decreasing trend in 2020. From 2017 to 2021, the average mosquito density was 5.97, 4.26, 3.82, 3.39 and 3.68 mosquitoes per lamp·night, respectively, showing a decreasing trend year by year except 2021. Except for 2019, the lure index also showed a decreasing trend, with an average value of 1.5/(hour·net), showing a decreasing trend year by year. From 2017 to 2021, the annual average density of Aedes albopictus in Hainan Province was 0.09 mosquitoes per lamp·night, showing obvious seasonal fluctuation. The Breteau index showed a slow decline from 2017 to 2021, and its annual peak was between June and August, which was 1-2 months later than the peak of adult mosquito density. Conclusions　The population density of Aedes albopictus in Hainan shows obvious seasonal characteristics. Mosquito control activities should be carried out according to the seasonal characteristics of mosquitoes to reduce the risk of dengue fever and other infectious diseases.

Adolescent ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Infant ; Infant, Newborn ; Intensive Care Units, Pediatric ; statistics & numerical data ; Lung Diseases ; epidemiology ; mortality ; physiopathology ; Male ; Prognosis ; Prospective Studies ; Respiratory Function Tests ; Survival Rate

OBJECTIVETo explore clinical significance of rotational axis of distal femur on Chinese adults in total knee arthroplasty (TKA).

METHODSThere were 86 Chinese adults (106 normal knees) including 47 males (53 knees) and 39 females (53 knees), 54 knees were on left and 52 on right. The CT scan was employed in the distal femur. The scan direction was aligned to be on the plane perpendicular to the mechanical axis of the femoral. The CT images of cross sections across lateral and medial femoral epicondyle were moved to personal computer,lateral angle between anterior posterior line (APL) and surgical transepicondylar axis (STEA) (ATA),lateral angle between posterior condylar line (PCL) and APL (APA), angle between perpendicularity of APL and PCL (A-PA), posterior condylar angle (PCA), condylar twist angle (CTA), angle between clinical transepicondylar axis (CTEA) and STEA (CSA) were measured. These values were divided into different groups according to gender and side, the values of CTA, PCA, A-PA, angle PT (varus of tibia plateau), constant 3, ATA, APA and constant 90° were compared by statistically. A-PA and PCA, and CTA were analysed statistically with the liner regression, the relationship among CTEA, STEA ,PCL, APL and PLP were performed to assess by liner regression.

RESULTSATA was (89.79 ± 1.22)°, APA was (84.84 ± 1.83)°, A-PA was (5.16 ± 1.83)°, PCA was (4.80 ± 1.23)°, CTA was (8.23 ± 1.40), CSA was (3.45 ± 0.68)°. All the parameters had no differences on sex and side,but CSA had difference on male and female. There was no difference among angle PT, PCA, A-PA. There was significant difference in CAT, constant 30 and angle PT, PCA,A-PA. There was no difference between ATA and constant 90°, but there was difference between APA and constant 90°. There was relativity between PCA and CTA, and also PCA and A-PA, CTA and A-PA. There was significant relativity between STEA and CTEA, between STEA and APL, between STEA and PCL, and also between APLP, APL and PCL, but there was no significant relativity between PCL and CTEA.

CONCLUSIONTKA for Chinese, the section of femoral posterior condyle should be external 5° to obtain the optimum rotational orientation. The property is different entirely between STEA and CTEA, the rotational alignment is not performed according to parallel to the CTEA in distal femur. Among STEA, APL, PCL, the STEA is the most reliable mark ofrotational alignment of the distal femur, and the PCL is the less reliable mark.

Adult ; Arthroplasty, Replacement, Knee ; Female ; Femur ; anatomy & histology ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Rotation ; Tomography, X-Ray Computed

Objective To analyze the medical service pricing policy of 30 provinces and autonomous regions in China and recommend on problems and challenges, for reference of medical service pricing reform in the future.Methods Literature review and policy analysis were used for summary and performance appraisal of medical service pricing of China.Results Most of the areas surveyed followed the step-by-step approach to gradually adjust pricing, while a few areas completed it in a one-time adjustment manner.2015 witnessed most areas, up to 20 (66.67%), in price adjustment;their price adjustments focused on price reduction of large-scale medical equipment inspection fees and some medical tests.On the other hand, prices of diagnosis, nursing care, and treatment which are labor-intensive were increased.Conclusions Specifications of medical services are improving, yet there exist great gaps in the convergence of medical insurance.It is advisable to expedite the convergence of the new version specifications, to achieve value regression and dynamic price adjustment of medical services.

Objective To explore the clinical effect of modified frontalis muscle suspension for severe blepharoptosis correction. Design Retrospective case series. Participants Fifty-six cases (101 eyes) with severe blepharoptosis. Methods Modified frontalis mus- cle suspension was adopted. The technique included single blepharoplasty-type incision, dissecting the posterior gaps of frontalis muscu- lar fasciae ahead,then euthyphoria isolating anterior gaps of rontalis muscular fasciae, using frontalis muscle transfer without vertical incision. Main Outcome Measure The positon chang of the upper eyelid in the primary position gaze. Results The follow-up period ranged from 8 to 20 months (mean, 13.6 months). All the patients were deemed to have a good surgical outcome. Complications such as ectropion and corneal exposure were avoided. But ten eyes required reoperation for undercorrection, six eyes for overcorrection and two eyes for entropion. Conclusion This surgical technique is a useful procedure that results in substantial cosmetic and functional im- provement with few complications.

OBJECTIVETo study the clinical effect of development theory based acupuncture on early cerebral palsy (CP) infants with parafunctional sitting position.

METHODSTotally 120 early CP infants were randomly assigned to two groups equally, the treatment group and the control group. All received acupuncture combined with training rehabilitation. Patients in the treatment group adopted acupuncture based on infants development theory, while those in the control group were treated by head acupuncture. Sitting functional points in Gross motor function measure (GMFM) 88 were observed in different groups and infant patients of various types before and after treatment. Root mean square (RMS) signals of sitting correlated muscles (latissimus dorsi, erector spinae, rectus abdominis) were recorded by surface electromyography (sEMG). The effective rate was evaluated by Nimodipine method.

RESULTSCompared with before treatment, sitting functional points were significantly improved in the two groups (P<0.01). After treatment, it was higher in the treatment group than in the control group (P<0.01). The advance amplitude was higher in CP infants of the spastic type and the hypotonic type than other types (P<0.01). Along with sitting process, latissimus dorsi RMS signals were gradually tapered, erector spinae RMS signals were gradually enhanced, and rectus abdominis RMS signals were slightly weakened. Compared with the control group, latissimus dorsi RMS signals obviously decreased, and erector spinae RMS signals obviously increased in the treatment group after treatment (all P<0.01). The total effective rate was higher in the treatment group than in the control group (89.29% vs. 77.78%, P<0.05).

CONCLUSIONInfants development theory based acupuncture could effectively elevate dorsi-extensor muscles force, improve sitting position of 8 months to 1 year old CP infants with parafunctional sitting position.

Acupuncture Therapy ; methods ; Cerebral Palsy ; therapy ; Female ; Humans ; Infant ; Male ; Medicine ; Posture ; Research ; Spine