AIM: To establish ()~1H NMR fingerprint of Radix Daphne genkwa to disclose its chemical composition of the secondary metabolites and provide a quick and credible assay for the detoxicated extraction of the active constituents. METHODS: The ()~1H NMR spectrum of petrol-acetone-methanol extract from Radix Dephne genkwa was detected using CDCl_3/DMSO-d_6(1∶1) as the deuterium reagent. The resonance intensity of the proton in the spectrum was indicated in relative integral area of peaks referenced by the resonance intensity of methyl signal in DMSO. The ()~1H NMR of cascade extraction of Radix Dephne genkwa by the reagent in sequence of petrol→acetone→methanol or chloroform→aether→acetyl acetate→methanol was utilized for observing the variation on their chemical compositions. RESULTS: The ()~1H NMR of Radix Dephne genkwa clearly expressed the information of the protons from long chain aliphatics or genkwadaphnin derivatives, aromatic coumarins or flavonoids as well as glycosides with moiety(ies) of pyran saccharide, symbolizing the existence of aliphatics, genkwadaphnin derivatives, coumarins and flavonoids. Remarkable difference was observed in ()~1H NMR spectrum of the extract by different cascade reagent. As the increase in the polarity of reagent, the intensity of the proton signals in upper field was quickly reduced concomitantly with the rapid enhancement of active proton signals from hydroxyls and saccharides in glycosides in down field. CONCLUSION: The ()~1H NMR fingerprint of Radix Dephne genkwa possesses its own characteristics and can be used as a reliable assay for studying the extraction of active constituents with minimum content of toxic diterpenoids. (Key

Aim To investigate the chemical constituents of the secondary metabolites of the roots of Daphne genkwa. Methods The roots of D. genkwa were extracted with 95% ethanol at 60 - 70 ℃ for 7 days to obtain the crude extract. The crude extract was purified by silica gel and Sephadex LH-20 column chromatography as well as the HPLC techniques. The structures of the isolates were elucidated by combined spectroscopic methods including 1D and 2D NMR, MS, UV, IR and CD. Results Three new biflavonoids were isolated from the ethanol extract of the roots of D. genkwa and their structures were identified as daphnodorin H-3-methyl ether (1), daphnodorin H-3"-methyl ether (2) and daphnodorin G-3"-methyl ether (3). Conclusion Compounds 1, 2 and 3 are three new biflavonoids.

BACKGROUND: In recent years, it has been reported that peroneus longus tendon can be used as a new graft material for anterior cruciate ligament reconstruction and can achieve the same effect as hamstring tendon. Therefore, it is necessary to systematically evaluate the two graft materials for anterior cruciate ligament reconstruction. OBJECTIVE: To evaluate the clinical effect of reconstruction of anterior cruciate ligament with peroneus longus tendon and hamstring tendon by meta-analysis. METHODS: We retrieved controlled clinical trials which compared the long peroneal tendons and hamstring tendons in reconstructing anterior cruciate ligament respectively in Chinese database (WanFang, CNKI, VIP, Chinese biological medicine) and English database (Ovid, PubMed, Web of Science, Embase, the Cochrane library). The retrieval time was from database creation to March 2019. Literature screening and evaluation and data extraction were performed by two evaluators. Meta-analysis was evaluated using Revman5. 3 software. RESULTS AND CONCLUSION: (1) A total of 413 Chinese or English literatures were retrieved and 10 of them were included in the final analysis. Among 647 patients receiving anterior cruciate ligament reconstruction, 271 patients used peroneus longus tendon reconstruction and 376 patients used hamstring tendon reconstruction. (2) Meta-analysis results: Postoperative functional score: There was significant difference in Lysholm score at postoperative 12 months (MD=1. 23, 95%C/[0. 31, 2. 51], P=0. 000 9) and IKDC score at postoperative 6 months (MD=3. 19, 95%C/[0. 07, 6. 31], P=0. 02) between peroneus longus tendon reconstruction and hamstring tendon groups. The occurrence of postoperative complications in the peroneus longus tendon group was significantly lower than that in the hamstring tendon group (OR=0. 15, 95%C/[0. 03, 0. 69], P=0. 01). However, there were no significant differences in Tegner scores, degree of joint motion, degree of joint relaxation at postoperative 6 and 12 months between peroneus longus tendon reconstruction and hamstring tendon groups. No significant difference was found in Lysholm score at postoperative 6 months and in IKDC score at postoperative 12 months between these two groups. The results showed that the clinical effect of peroneus longus tendon in reconstruction of anterior cruciate ligament was comparable to that of hamstring tendon; in the peroneus longus tendon reconstruction group, the Lysholm score at postoperative 12 months and IKDC score at postoperative 6 months were significantly superior to those in the hamstring tendon group. The incidence of postoperative complications in the peroneus longus tendon reconstruction group was lower than that in the hamstring tendon group. The peroneus longus tendon can be clinically recommended to substitute hamstring tendon in the reconstruction of the anterior cruciate ligament. However, the quality of included literatures is limited; therefore higher quality of evidence is required to validate this conclusion.

Objective To elucidate the analgesic activity of the ethanol extracts from the root of Daphne genkwa (EERD). Methods The analgesic activity of EERD was evaluated by the effects on adjuvant-induced nociceptive response and paw swelling, the formation of PGE_2 and IL-1? in adjuvant arthritis (AA) rats, the activities of SOD and CAT, the levels of NO/iNOS in serum and brain tissue as well as by the effects on c-Fos protein expression in spinal cord of AA rats. Results EERD at used doses significantly delayed the adjuvant-induced nociceptive response and eased the paw swelling in AA rats. EERD also evidently inhibited the production of PGE_2 and IL-1?, and enhanced the activities of SOD and CAT in the tissue of paws being injected by adjuvant. Furthermore, it remarkably reduced the content of NO and inactivated the activity of iNOS in brain tissue of AA rats. In addition, EERD at used doses exhibited prominent inhibition on adjuvant-induced expression of c-Fos protein in the spinal cord of AA rats. Conclusion EERD is an effective agent for analgesia. The possible mechanisms for its analgesia might be the actions of inhibiting the production of PGE_2 and the release of IL-1?, reducing the activity of iNOS and hence the generation of NO in brain tissue, and blocking superoxidation through enhancing the activity of SOD and CAT.

Objective To explore the effects of blood conservation management on rapid rehabilitation in patients with total hip replacement.Methods A total of 120 patients who have undergone primary unilateral total hip replacement from November 2016 to June 2017 in the People's Hospital of Guangxi Zhuang Autonomous Region were selected and randomly divided into experimental group and control group, with 60 cases in each group. The patients in the control group were given hemostatic drugs and routine nursing care during perioperative period. The experimental group was treated with rapid rehabilitation nursing during perioperative period under blood protection management, including the protection of core body temperature, blood dilution, hemostatic, autotransfusion, controlled hypotension, iron drugs. The intraoperative blood transfusion rate, blood loss, postoperative drainage, the removal time of drainage tube and the average length of hospitalization were compared between two groups.Results The blood transfusion rate of the experimental group was 3.33％, and that of the control group was 26.67％, with statistical significance (χ2=12.810,P<0.01). In the experimental group, the amount of intraoperative blood loss was (240.86±65.78) ml, postoperative drainage (433.95±72.26) ml, the removal time of drainage tube was (36.2±6.5) h and the average hospitalization day was (6.9±2.1), which were all lower than those of the control group [(320.32±70.48)ml,(511.71±85.66)ml, (50.4±2.8)h,(8.1±3.4)d], and the differences were statistically significant (t=-3.659, 3.800, -2.860,3.800;P<0.01).Conclusions The application of rapid rehabilitation surgery blood protection management in patients with total hip replacement during the perioperative period is significant, which is beneficial to the early rehabilitation of patients, and opens a new concept for the rapid rehabilitation of joint replacement surgery.