Objective: To investigate the chemical consituents from the active fraction in the roots and rhizomes of Cynanchum paniculatum with reversal activity of multidrug resistance. Methods: The active fraction was evaluated for reversing activities toward three human drug-resistance cell lines to clininally common used anticancer chemotherapeutic drugs. The compounds were isolated and purified by chromatography on ODS and preparative HPLC. Their structures were elucidated on the basis of chemical and spectroscopic methods, including MS, 1D, and 2D NMR spectral techniques. Results: The active fraction exhibited the significant effects in sensitization of human drug-resistance on gastric carcinoma cell line SGC-7901/VCR and human drug-resistance on colonic carcinoma cell line HCT-8/VCR to fluorouracil (5-FU). Nine compounds were isolated and identified as hancogenin B 3-O-β-D- oleandropyranoside (1), 3β,14-dihydroxy-14β-pregn-5-en-20-one (2), neocynapanogenin F (3), glaucogenin A (4), glaucogenin C (5), neocynapanogenin F 3-O-β-D-oleandropyranoside (6), glaucogenin C 3-O-β-D-thevetoside (7), glaucogenin A 3-O-β-D- oleandropyranoside (8), and 20-hydroxypregna-4,6-dien-3-one (9). Conclusion: Compound 1 is a new steroidal saponin named paniculatumoside D. C21 Steroids isolated from the active fraction in the roots and rhizomes of C. paniculatum have the potential value as multidrug resistance reversing agents.

Objective:To explore the effects of Bufalin on the growth and proliferation of human glioma cells U251. Methods:Methyl thiazolyl tetrazolium(MTT)assay was used to detect the effect of Bufalin on the proliferation of human glioma cells U251. An in-verted microscope was used to observe the changes of cell number,morphology and activity. AnnexinV/ PI was used to measure the in-duction of cell apoptosis caused by Bufalin. Results:Bufalin at different concentrations(0. 001 - 10. 0μmol·L - 1 )inhibited the pro-liferation of U251 cells in a dose and time-dependent manner. Compared with that of the control group,the apoptosis rate of Bufalin group was increased significantly(P < 0. 01). Conclusion:Bufalin can inhibit the growth and proliferation of U251 cells in a dose and time-dependent manner,and induce the apoptosis of U251 cells.

OBJECTIVETo observe effect and mechanism of n-Butanol lysate of alcohol extracts from Actinidia rufa root (monomer of R6,R8).

METHODTunel, Wright's stain with Giemsa's stain dyeing, and Hoechst 33258-PI double dyeing assay were used to detect the apoptosis of SGC7901 tumor cells treated with R6, R8. The SGC7901 tumor cells were randomly divided into control group and two treatment groups administered 0.05 g x L(-1) R6, R8, respectively, for 72 h). FCM assay was used to detect the apoptosis. Agarose electrophoresis assay was used to detect DNA strand break of tumor cells and reveal anti-tumor action mechanism.

RESULTThe apoptosis percentage of the tumor cell in 24 h, 48 h, 72 h was (17.08 +/- 2.78)% , (29.68 +/- 2.96)%, (52.46 +/- 3.81)%; (14.75 +/- 2.14)%, (27.35 +/- 3.79)%, (45.64 +/- 5.24)%, respectively, for the treatment group, significantly higher than that in the control group (1.94 +/- 1.55)%, (2.78 +/- 1.84)%, (11.8 +/- 2.79)% (P < 0.01) by tunnel assay. Wright's stain with Giemsa's stain dyeing assay, Hoechst 33258-PI and FCM double dyeing assay showed same action. R6 and R8 had the effect of inducing the DNA histogram of tumor cells (P < 0.01).

CONCLUSIONThe anti-tumor mechanisms may be associated with inducing the injury of DNA and stimulating apoptosis.

Actinidia ; chemistry ; Apoptosis ; drug effects ; Cell Line, Tumor ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; Flow Cytometry ; Humans ; Immunohistochemistry ; Plant Roots ; chemistry

Objective:To observe the effect of warm joint needling plus rehabilitation techniques on the balance function and quality of life (QOL) of patients with spastic hemiplegia after ischemic cerebral stroke.Methods:Ninety patients with spastic hemiplegia after ischemic cerebral stroke were randomized into a rehabilitation group,a warm joint needling group and an observation group,with 30 cases in each group.The rehabilitation group was intervened by Bobath therapy,the warm joint needling group was treated with joint needling on the affected side plus warm needling,and the observation group was given the same rehabilitation treatment as the rehabilitation group together with the same warm joint needling as the warm joint needling group.The three groups were treated once another day,1 month as a treatment course for 6 months.Before the treatment,and respectively after 2-week,1-month,3-month,and 6-month treatment,the modified Ashworth scale (MAS) was used to measure the anti-spasm ability of the lower limb,the Berg balance scale (BBS) was adopted to evaluate the balance function,and the stroke-specific quality of life scale (SS-QOL)was employed to estimate the QOL.Results:After 3-month and 6-month treatment,the lower-limb MAS scores in the observation group were significantly better than those in the rehabilitation group and the warm joint needling group (all P＜0.05).After 1-month,3-month and 6-month treatment,the BBS scores in the observation group were significantly better than those in the rehabilitation group and the warm joint needling group (all P＜0.05).After 2-week,1-month,3-month and 6-month treatment,the SS-QOL scores in the observation group were markedly better than those in the rehabilitation group and the warm joint needling group (all P＜0.05).Conclusion:Warm joint needling plus rehabilitation can effectively improve the lower-limb spasticity state,balance function and QOL in patients with spastic hemiplegia after ischemic cerebral stroke.

Objective:To analyze the effect of diagnosis-related groups prospective payment system(DRG-PPS) on medical service quality.Methods:Literature on DRG-PPS impact on medical service quality was searched in Chinese and English databases, and inclusion and exclusion criteria were formulated. Meta analysis was performed on the average length of stay, mortality and readmission rate, and the results of other indicators were described and integrated.Results:A total of 33 articles were included for analysis. Meta analysis showed that the implementation of DRG-PPS could shorten the average length of stay, WMD=-0.67(95% CI: -0.91 to-0.43); the implementation of DRG-PPS had no significant impact on the readmission rate( OR=0.97, 95% CI: 0.87-1.08); the implementation of DRG-PPS did not have a significant impact on the death rate of patients( OR=0.98, 95% CI: 0.93-1.03). The results of narrative integration showed that DRG-PPS had no significant effect on the incidence of complications, patient satisfaction, quality of life, service and operation process indicators. Conclusions:DRG-PPS can shorten the average length of stay, but has no significant effect on mortality and readmission rate.

Objective:To investigate the clinical characteristics of elderly patients with coronavirus disease 2019(COVID-19), in order to provide scientific evidence for the diagnosis and treatment of COVID-19 in elderly patients.Methods:Clinical data of 102 patients with COVID-19 admitted to the B11 East Ward of the Zhongfaxincheng campus and the E1-3 ward of the Guanggu Campus of Tongji Hospital affiliated to Huazhong University of Science and Technology in Wuhan from 1 February 2020 to 28 February 2020 were retrospectively collected and analyzed.Patients were categorized into 2 groups: the elderly group(≥60 years old)and the young and middle-aged group(<60 years old). Differences in epidemiological features, demographics, clinical symptoms, laboratory results and imaging findings between the two groups were retrospectively analyzed.Results:Among 102 patients with COVID-19, 58 were in the elderly group(≥60 years old), with a median age of 67.0(63.8, 71.0)years old, and 44 in the young and middle-aged group(<60 years old), with a median age of 47.5(38.0, 51.8)years old.There was no significant difference in gender ratio between the two groups( χ2=0.033, P=0.855). Of 102 patients, 42.0%(21/50)had close contact with an infected person, 14.0%(7/50)were from infection clusters, and 18.0%(9/50)had suspected hospital-acquired infections.Fever and cough remained the most common symptoms, but gastrointestinal symptoms such as nausea, poor appetite, diarrhea and muscle cramps were also warning signs.Fatigue and cough were the most common presenting symptoms in elderly male patients.Bilateral patchy infiltrates(57.9%, 22/38)and ground-glass opacities(42.1%, 16/38)were the main imaging features and 42.1%(16/38)patients had multiple areas of the lungs involved.Over 50% patients had increased levels of blood glucose, D-dimer, fibrinogen, C-reactive protein, procalcitonin, multiple cytokines and neutrophil-to-lymphocyte ratio, as well as decreased levels of albumin, hemoglobin, hematocrit, lymphocytes and serum calcium.Compared with the young and middle-aged group, the elderly group had higher rates of abnormality in levels of D-dimer and serum calcium( χ2=7.067 and 4.166, P=0.008 and 0.041). Conclusions:Fever and cough are the most common symptoms in elderly patients with COVID-19.Elderly patients with COVID-19 have multiple abnormalities in clinical laboratory test results, which show a certain level of specificity compared with young and middle-aged patients.

OBJECTIVETo evaluate coronary artery atherosclerotic plaque characteristics and changes post coronary stenting by optical coherence tomography (OCT).

METHODSOCT images were obtained in 22 diseased coronary vessels after coronary angiography or percutaneous coronary interventions (PCI) in 20 patients and in 23 stents [7 sirolimus-eluting stents (SES) follow up at 4-29 months post stenting and 8 bare mental stents (BMS) at 4-35 months post stenting, 8 stents immediately after PCI].

RESULTSAll 22 vessels and 23 stents OCT images were successfully acquired. Two thromboses, 8 fibrous, 9 lipid-rich and 3 calcium plaques as well as 3 plaque ruptures were visualized by OCT. No significant neointimal proliferation and restenosis were found in SES stents and some struts were not covered with neointima even at 29 months post stenting. Significant neointimal proliferation on surfaces of stent struts were visualized in all 8 BMS stents and restenosis was detected in 3 BMS stents. OCT images obtained immediately after PCI showed that 3 stents were well positioned, tissue prolapse between coronary stent struts occurred in 4 stents and stent dissociation with vessel wall could be seen in 1 stent.

CONCLUSIONSOCT imaging can clearly visualize different types of atherosclerotic plaques. By providing detailed information on plaque characteristics, this technique might help cardiologists in choosing suitable stents and guiding preventive therapy for patients with coronary heart disease.

Adult ; Aged ; Coronary Disease ; diagnostic imaging ; therapy ; Drug-Eluting Stents ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Radiography ; Sirolimus ; administration & dosage ; Stents ; Tomography, Optical Coherence

Objective To compare the characterization of coronary atherosclerotic plaques in patients with unstable angina pectoris (UAP) and stable angina pectoris (SAP) by optical coherence tomography (OCT). Methods OCT was performed in 47 patients (23 UAP and 24 SAP) undergoing coronary angiography. Lipid-rich plaque (defined by ≥ 2 quandrants of the cross-section area), thin cap fibroatheroma (TCFA), thickness of fibrous cap, plaque rupture, calcification and thrombus visualized by OCT were compared between UAP and SAP patients. Results OCT imaging was successfully in 44 out of 47 patients (22 UAP, 22 SAP). Proportion of lipid-rich plaques was similar between UAP and SAP groups [91% (20/22) vs, 73% (16/22),P =0. 741]. The minimum thickness of fibrous cap in the UAP group was significantly thinner than that in SAP group [(69.5±34.7) μm vs. (141.1±68.5) μm, P = 0.000] and the rate of fibrous cap erosion in the UAP group was significantly higher than that in the SAP group [59% (13/22) vs. 9% (2/22), P=0.000]. Percents of TCFA [73% (16/22) vs. 14% (3/22) ,P = 0.000] and plaque rupture [50% (11/22) vs.9% (2/22) , P = 0.003] were significantly higher in UAP group compared those in SAP group. Incidence of thrombus and calcification were similar between two groups. Conclusions OCT imaging can clearly define plaque characterization of coronary atherosclerosis. UAP patients have thinner fibrous cap, higher incidences of fibrous cap erosion, plaque rupture and TCFA compared patients with SAP.

OBJECTIVETo study the status of iron deposition in patients with β-thalassemia intermedia and major in mainland China.

METHODSThe status of transfusion and chelation was examined in 39 patients with β-thalassemia intermedia or major. Serum ferritin levels were measured. MRI T2* technique was used to detect cardiac and hepatic iron deposition.

RESULTSSerum ferritin levels ranged from the minimum of 1500 ng/mL up to a maximum of 11491 ng/mL. From liver MRI T2* measurement, 15 cases had severe hepatic iron deposition (38%) and moderate deposition was found in 15 cases (38%), mild in 7 cases (18%), and normal in 2 cases (5%). Heart MRI T2* showed severe heart iron deposition in 7 cases (18%), mild in 5 cases (13%), and normal in 27 cases (69%). One case had cardiac arrhythmia. Four cases were over 20 years of age, and presented with gonadal function hypoplasia. The majority of patients did not receive regular transfusion and they had delayed, suboptimal chelation due to financial problems. Serum ferritin level was closely related with timing and dosage of chelation.

CONCLUSIONSIn patients with β-thalassemia who do not receive early regular transfusion and iron chelation therapy, iron deposition may occur at an early age. Important organs and tissue functional lesions and related complications also result. Relevant agencies and family members should be aware of this trend and develop appropriate strategies to improve the medical condition and quality of life of patients with this disorder.

Adolescent ; Adult ; Blood Transfusion ; Child ; Female ; Ferritins ; blood ; Humans ; Iron ; metabolism ; Liver ; metabolism ; Magnetic Resonance Imaging ; methods ; Male ; Myocardium ; metabolism ; beta-Thalassemia ; metabolism ; therapy

Objective To study the risk factors of human cystic echinococcosis (CE) in Hobukesar Mongolian Autonomous County of Xinjiang (HMACX) and to discuss the related strategies for prevention and control. Methods A randomized sampling method was used to screen local residents for human CE in HMACX. CE related risk factors including ethnicity,age,sex,occupation and personal status on hygiene etc. were analyzed under multi-factor logistic regression. Results The prevalence rates of CE and alveolar echinococcosis (AE) were 3.7% (23/627) and 0.16%(1/627) respectively,with the seropositive rate as 12.4% (76/613). The main risk factors that significantly associated with CE were age (OR=7.6,95% CI: 2.481-23.579) and slaughtering livestock in the households (OR=3.2,95%CI: 1.297-7.809). Herdsmen had the highest prevalence of CE in all of the occupations in this study. Conclusion HMACX had been a highly endemic area for human CE,with age and family slaughtering-livestock-behavior appeared to be the main possible risk factors.