This study was aimed to improve the drug activity of three kinds of isoflavones from Chickpeas.Biochanin A,formononetin and genistein were used as raw materials.Acetone was used as solvent.Potassium carbonate was used as catalyst.The etherification reaction was with 1,3-dibromopropane,1-bromopropane and 3-bromopropene.The results showed that 9 isoflavone ramifications were synthesized.This method was simple,easy to control with high yield.It was concluded that the product structure was confirmed by 1H-NMR,13C-NMR and ESI-MS analysis.It laid a foundation for the structural study basis in the further research of its drug activity.

Purpose To evaluate the clinical and pathological features of extramammary Paget’ s disease ( EMPD) and to investigate the related prognostic factors. Methods The clinical and pathological data of 30 patients with EMPD were reviewed retrospectively. The HE slides in the file were rechecked. Immunohistochemical stains were performed on archival paraffin-embedded sections with En-Vision method in 20 cases. Follow-up data were recorded. The relationship between the clinicopathological parameters and prognosis was statistically analyzed. Results Among the 30 patients, there were 26 males and 4 females, aged from 53 to 88 years with median age 70. Macroscopically, typical presentations of EMPD were eczematoid lesions. Microscopically, Paget’s cells were distributed sin-gly or in groups ( as glandular or nests patterns) within the epidermis. Immunohistochemical stains showed that Paget’ s cells were pos-itive for CK7, and negative for CK5/6 and p63. Follow-up data were available in 23 cases, 8 cases recurred resection, among them, 6 patients had positive resected margin and 4 died. The recurrent rate and mortality between the groups of dermal invasion and no der-mal invasion (P<0. 01 and P<0. 05), the groups of lymphatic metastasis and no lymphatic metastasis (P<0. 01), and the groups of positive and negative resected margin (P<0. 01 and P<0. 05) were statistically different. There were no statistically different with age and extent of lesion (P>0. 05). Conclusions CK7 is a sensitive and specific marker of Paget’s cells. Dermal invasion, lymphatic metastasis and positive resected margin are poor prognostic factors in EMPD.

Objective To explore the change characteristics of physiological indexes between infants and children during living-donor liver transplantation and discuss methods of regulation and control.Method In this study,42 patients were selected and assigned into two groups according to age:infants group (＜1 year,n =25),and children group (1-16 years,n =17).The preoperative and peri-operative characteristics,intra-operative operation conditions,internal environment changes before and after re-perfusion,postoperative mechanical ventilation time,ICU time,hospital time,infection rate,additional surgery,complications and survival were analyzed.Result PELD (MELD) score,historical surgery rate and hematokrit were lower in children group than in infants group (P＜ 0.05).Serum creatinine and lactate concentrations increased significantly in children group as compared with infants group (P＜0.05).Intra-operative an-hepatic phase and cold ischemia time were shortened significantly (P ＜ 0.05),and incidence rate of re-perfusion syndrome was reduced in children group as compared with infants group (P＜0.05).As compared with pre-re-perfusion,blood lactate concentrations were significantly raised only in infants group and glucose concentrations significantly raised only in children group (P＜0.05).The blood levels of K + were decreased after reperfusion in both two groups,and those in infants group were lower than in children group (P＜ 0.05).Postoperative intensive care unit time was longer in children group than in infants group (P＜ 0.05),and there was no significant difference in survival rate between two groups.Conclusion There are many differences and change characteristics to physiological indexes between infants and children during the operation of living-donor liver transplantation.Timely management and regulation are critical for the success of surgery according to the differences.

Total 52 patients with breast lesions underwent dynamic contrast-enhanced breast MRI; and the breast vascularization was scored on the MRI vascular maps with a range of 0 to 3. The mean number of vessels per ipsilateral breast in malignant cases was higher than that of benign cases (3.8±2.0 vs. 1.3± 1.0; P=0.000). When the breast vascularity score 0-1 was defined as benign and 2-3 was defined as malignant, the sensitivity and specificity was 79% and 83%, respectively. Results indicate that dynamic contrast-enhanced breast MRI is of value in diagnosis of malignant breast lesions.

Objective To analyze the differentially expressed genes in esophageal squamons cell carcinoma (ESCC), para-cancerous tissue (PCT) and normal esophagus tissue (NET) using oligomicroarray and to identify the target genes related to the development and progression of esophageal carcinoma. Methods The total RNAs isolated from ESCC, PCT or NET using one step Trizol method were purified and reversely transcribed into cRNAs. The cRNAs were then fluorescence labeled and hybridized with Agilent oligomicroarray (21 074 probes). The fluorescence intensity features were detected by Agilent scanner and quantified by feature extraction software. The selected candidate genes were confirmed by real time real time fluorescent quantitative RT-PCR immunohistochemistry andWestern blotting.Results ① The oligomicroarray demonstrated that there were 38 up-regulated genes and 61 down-regulated genes. ② The real time fluorescent quantitative RT-PCR revealed that five genes (CTHRC1, INHBA, SPP1 ,LUM, HRK)were more differentially expressed in up-regulated genes. Of which, CTHRC1 displayed more disparity.③ Immunohistochemistry examination showed that the higher expression of CTHRC1 (56.5 %, 26/46) was observed in ESCC. There was significantly difference in expression of CTHRC1 between patients with or without lymph node metastasis (P<0.05). ④ CTHRC1 protein was expressed in both TE-13 and Eca-109 cell lines. Conclusion CTHRC1 is probably one of the most significant biomolecules in ESCC.

A biomedical entity association evolution network was constructed by mining the implicit associations in PubMed-covered literature, which can help scientific researchers to form new scientific hypotheses, to analyze the topological features of associated network, to study the scientific literature-enriched knowledge structure, associa-tions, development rules, to introduce new visual angles and methods for literature-based knowledge discovery, and to improve the knowledge discovery efficiency.

BACKGROUND:Pedicle screw implantation is a common method to repair many kinds of diseases of the lower cervical spine. Three-dimensional (3D) reconstruction visualization system can be used in order to improve the accuracy of the implant and improve the prognosis.
OBJECTIVE:To investigate the effect of 3D reconstruction visualization system on the accuracy of cervical pedicle screw implantation.
METHODS: The clinical data of 89 patients with cervical spine dislocation, who underwent cervical pedicle screw implantation, were analyzed retrospectively. Patients were divided into control group (46 cases) and observation group (43 cases) according to the navigation method. Patients in the control group underwent C arm X ray two dimensional navigation. Patients in the observation group underwent three-dimensional reconstruction visualization system navigation. Intraoperative placement time was observed, and the accuracy of screw placement was assessed in both groups. The cases were folowed up for 12 months, and the adverse events were recorded and compared.
RESULTS AND CONCLUSION: (1) Intraoperative implantation time was shorter in the observation group than in the control group, but no significant difference was found (P> 0.05). (2) Accuracy rate: There were no three types of nail cases in the observation group, and the accuracy rate was 93% (40/43). In the control group, two cases affected three types of nailing, and the accuracy rate was 81% (37/46). The accuracy rate was significantly higher in the observation group than in the control group (P < 0.05). (3) Postoperative folow-up: None suffered from nerve tissue injury to vertebral artery, blood vessel and spinal cord. The screws of the two groups were in stable condition, without screw breakage or loosening. (4) Results suggested that in lower cervical pedicle nail implantation, 3D reconstruction navigation system can effectively improve the accuracy of screw placement, and does not increase nailing time or lead to adverse events. It is a safe and effective navigation mode.

Objective To identify objective methods for medical service performance evaluation,and means to improve the efficiency of medical services.Methods By means of collection of medical records from 10 tertiary hospitals in Yunnan in 2012,and Diagnosis-related groups of Beijing version(BJDRGs)as a risk-adjustment tool,medical service performance was made to such hospitals.Results The capacity,efficiency and medical safety of hospital of the hospitals were subject to a comprehensive evaluation of their medical service capabilities.In terms of discharged inpatients and total weight,hospital A were found to be the highest(77 458 cases,104 227.5 respectively),and hospital I the lowest(25 450 cases,38 162.28)among these hospitals in 2012; compared with other hospitals,DRG groups of hospitals A,b and D were found higher,while the case mix index(CMI)of hospitals e and I were higher.The expenditure index of hospital C is the lowest(0.9359,0.8514); the mortality in cases of low risk of hospitals B,c and D were the lowest,while hospital F was the highest.Conclusion DRGs as a risk adjustment tool,can significantly improve the reliability,science and continuity of medical service performance evaluation,providing reliable basic data for hospitals accreditation in Yunnan.

Objective To explore the influencing factors of degenerative lumbar spondylolisthesis (DLS).Methods Sixty-one DLS patients (DLS group) were enrolled in this study.The control group was formed by 61 patients with same gender and age matched.The lesion position was L4 in two groups.The correlation of intervertebral joint angle,degeneration degree,lumbosacral angle and lumbar spondylolisthesis were analyzed.Results The intervertebral joint and sagittal angle in DLS group was less than that in control group[(37.11 ± 7.52)° vs.(42.44 ± 7.61)°] (P ＜ 0.01).The lumbosacral angle between two groups had no significant difference (P ＞ 0.05).The degeneration degree between two groups had significant difference (P ＜ 0.01).Conclusion Intervertebral joint and sagittal angle and intervertebral joint degeneration degree have important roles in DLS.

Objective To explore the diagnostic value of axial diffusion tensor imaging(DTI) for gliomas grading at 3 .0T MRI , analyze the characteristics of different grades gliomas of axial DTI in order to improve diagnostic accuracy .Methods A retrospec‐tive analysis was performed involving a group of 37 cases of high grade glioma and 26 cases of low grade glioma confirmed by the pathological results in affiliated hospital of Luzhou medical college ,observation analysis was obtained in axial DTI ,peritumoral neu‐rofibrillary was divided into three types :displacement ,interruption and neurofibrillary tangles(NFT) .Results among the 26 cases of low grade glioma ,there were 18 cases of displacement ;8 cases of interruption ,no NFT ;among the 37 cases of high grade glio‐mas ,there were 9 cases of displacement ,21 cases of interruption ,and 7 cases of NFT (1 case of frontal lobe ,6 cases of temporal lobe);ordinal variables rank sum test in two independent samples between high grade glioma group and low grade glioma showed significant differences(Z= -3 .756 ,P<0 .05);χ2 test showed no significant difference(P>0 .05) ,frontal lobe appeared NFT in 1 case ,accounting for 2 .7% (1/37) ,temporal lobe appeared NFT in 6 cases ,accounting for 16 .2% (6/37) .Conclusion Peritumoral neurofibrillary of the low grade gliomas more performed displacement ,the high grade gliomas show more interrupts and NFT at 3 .0T MRI ,NFT in high grade gliomas is often seen in the temporal and frontal lobe .