Factor Xa is a trypsin-like serine protease playing a pivotal role in the blood coagulation cascade.Factor Xa and its inhibitors are of great importance in the development of orally active antithrombotic agents and have aroused considerable attention from the pharmaceutical industry sector over the years.In this review,the structural characteristics of the factor Xa binding site are discussed and the X-ray information available together with the published structure-activity relationship data is used to identify the molecular interactions that are most important for tight enzyme-inhibitor binding,which would be useful in the structure-based drug design of novel factor Xa inhibitors.

Objective: To understand the relation between obesity and chronic diseases in Tianjin. Method: The data from Tianjin in the National Nutrition and Health Survey in 2002 were used, including questionnaires, physical examination and biochemical tests of blood sugar and lipids. Height, weight, and blood pressure were examined. Results: There were significant differences on blood pressure , TC, TG, HDL-C, FBG levels between obesity group and control group (P

Objective To compare the bone microstructure and osteoblast and osteoclast activity in different regions of osteonecrosis of the femoral head.Methods The osteonecrosis femoral heads were collected from 10 patients (Ficat Ⅳ) who had undergone total hip arthroplasty from March 2011 to May 2013.There were 6 males and 4 females.Their average age was 47.7 years old (range,40-57 years).The samples were divided into subchondral bone region,necrotic region,sclerosis region and healthy region according to radiographic results,then the bone microstructure,micro mechanism and osteoblasts/osteoclasts activity were analyzed byMicro-CT,RT-PCR,Nanoindentation,immunohistochemistry and Trap staining.Results According to the micro-CT results,the continuity of trabecular bone in necrotic region was damaged.The number of trabecular was increased and the gap was narrowed in sclerosis region.The shape and number of trabecular bone were normal in the healthy region.The elasticity moduli in different regions were:subchondral bone region 13.808±4.22 GPa,necrotic region 13.999±3.816 GPa,sclerosis region 17.266±3.533 GPa and healthy region 11.927±1.743 GPa.The hardness were subchondral bone region 0.425±0.173 GPa,necrotic region 0.331±0.173 GPa,sclerosis region 0.661±0.208 GPa,and healthy region 0.423±0.088 GPa.The trap staining of subchondral bone in healthy region and necrotic region were positive while other regions were negative.Immunohistochemistry staining showed that compared with necrotic region,the RANK and RANKL staining level increased significantly in subchondral bone and necrotic region,while Runx2 and BMP2 staining level increased significantly in sclerosis region.Conclusion The mechanical properties of trabecular have no significant difference between necrotic region and healthy region in the progress of the osteonecrosis,while the bone structure has obvious changes.An active bone resorption is observed in subchondral bone and necrotic region,while a higher bone formation activity is found in sclerosis region.

Objective To analyze factors influcing the surgical curative effect of hilar cholangiocarcinoma. Methods A retrospective clinical analysis was made on 198 patients with hilar cholangiocarcinoma, who were surgically treated in our hospital from 1997 to 2002. Jaundice (94.5%, 187 cases), pruritus (56.6%, 112 cases) and abdominal pain (33.8%, 67 cases) were the main symptoms. According to Bismuth-Corlette classification, there were 14 type Ⅰ cases, 19 type Ⅱ cases, 12 type Ⅲa caese, 15 type Ⅲb cases, 112 type Ⅳ cases and 26 unclassifiable cases. 144 patients received laparotomy, and tumor resection was performed in 120 cases, including radical resection in 59 caese (41.0%) and palliative resection in 61 cases. 54 cases were treated by endoscopic therapy or PTCD. 16 cases received postoperative adjuvant radiation. Results Occupation, preoperative maximum tatal serum bilirubin level, operative procedure and postoperative adjuvant radiation affected postoperative survival. The postoperative survival of ENBD group, ERBD or EMBE group, biliary exploration & drainage group, palliative resection group and radical resction group differed statistically as a whole (?2= 87.048?9, P

Objective To provide the new method for repairing degloving injury of the single finger.Methods From August 2007 to June 2010,eleven patients were repaired with the second free toe dorsal wrap around flap and fibula side flap of great toe.Patients including 9 men and 2 women.The mean age were 31 years(17-49 years).The finger including 6 index fingers,two middle fingers and 3 ring fingers,in which 4 patients were type I and 7 patients were type Ⅱ.All of them were emergency debridement VSD closed negative pressure attraction,surgical repair in 3-5 days after injury.The plantar digital nerve in the second free toe dorsal wrap around flap and fibula side flap of great toe with the digital nerve of the stump by end-to-end nerve anastomosis.The donor sites were covered with a free flap.Results All of 11 flaps survived,but 2 cases developed partial native second toe skin grafting necrosis,by dressing healed,one case of phalanges exposed through survival skin,the part of the exposed phalanx healed after surgical cut.All the 11 patients were followed up from 3 monthes to 3 years.The flaps survived completely with satisfactory cosmetic results and good sensibility.The sensation recovery was reached above S3.The great toe fibular flap for repair of finger pulp full,two-point discrimination was 6-9 mm,the mean was 7.0 mm.Finger flexion function by finger total activity (TAM) score assessment,excellent 9 cases,good 2 cases.Conclusion Transfer of the second free toe dorsal wrap around flap and fibula side flap of great toe to repair degloving injury of the single finger is an ideal method of treatment.

Objective To investigate the relationship between liver metastasis and prognosis in postoperative distal bile duct cancer patients Methods In this study 128 cases of distal bile duct cancer undergoing surgical procedures were analyzed retrospectively Using Kaplan meier method to calculate their survival rates, ? 2 test to analyze the difference of sample rates Logistic regression analysis was performed to determine the factors influencing liver metastasis and log rank univariate analysis was used to assess the role of liver metastasis in the long survival Results Liver metastasis is a major cause of postoperative death Pathological types of the carcinoma and pancreatic invasion are significant predictors of liver metastasis Conclusion Aggressive treatment of postoperative liver metastasis is an important strategy to improve the long survival of postoperative bile duct cancer patients

ObjectiveTo investigate the consistency between the results of passive particle agglutination test ( PPA ) and ELISA on Mycoplasma pneumonia ( M.pneumonia ) infection.Study the diagnostic value of both assays.Methods From November 2010 to May 2011,the serum samples of ]191 patients with respiratorysymptoms were collected fromAffiliatedHospitalof JiningMedical University.All samples were tested for antibody levels against M.pneumonia using PPA,and for IgM,IgG,IgA subclass using ELISA.The correlation between the results of two methods was evaluated by Kappa test and Spearman rank correlation analysis.The variances of the antibody subclasses among samples with different PPA titers and different age groups were analyzed by Kruskal-Wallis test.The infection status of patients was analyzed based on ELISA results and the clinical relevance of both assays was evaluated in comparison with clinical diagnosis for samples with high PPA titer.ResultsThe level of agreement between the results of PPA and ELISA was 84.3％,with Kappa value of 0.642 ( P ＜0.01 ).The prevalence of IgM and IgA antibody against M.pneumonia was significantly different among samples with various PPA titers ( P ＜0.05 ).The prevalence of IgM subclass was higher in chill and teeuager groups,while that of IgA and IgG were higher in elderly group.Antibody isotyping results suggested that 58.1％ of PPA positive samples (75 cases),especially 96.4％ of samples with high PPA titer ( 27 cases),were of current infection,which was in consistent with clinical diagnosis.ConclusionPPA showed good consistency with ELISA on diagnosis of Mycoplasma pneumonia infection.Antibody subclass determination hy ELISA indicates disease progression,thus to differentiate current infection from past.

Objective: To explore the mediating effect of sensation seeking and the moderating effect of parenting style at cumulative ecological risk on psychosexual health in left behind adolescents. Methods: Using convenience cluster sampling, 509 left behind adolescents in 12 middle and primary schools were selected from May to July 2020. Cumulative ecological risk, psychosexual health, sensation seeking and parenting style were evaluated at baseline (T1) and 1 year follow up (T2). Results: T1 accumulative ecological risk predicted T2 psychosexual health after sensation seeking at T1 was controlled ( β=0.37, P <0.01). T1 sensation seeking predicted T2 psychosexual health after controlled for psychosexual health at T1 ( β=-0.26, P <0.01), sensation seeking played a mediating role, indirect effect accounted for 35.85% of the total effect; T1 cumulative ecological risk ×T2 parenting style had predictive effects on T2 sensation seeking and psychosexual health ( β=0.17, -0.24, P <0.01). Conclusion The cumulative ecological risk influences psychosexual health through sensation seeking, parenting style moderates the associations between cumulative ecological risk, sensation seeking and psychosexual health. Left behind teenagers with high cumulative ecological risk can cultivate good sexual psychological level by reducing high seeking traits and optimizing parental rearing styles.

Objective ToexploretheclinicalvalueofMSCTcombinedwithultrasonographyinthediagnosisofacuteappendicitis. Methods 238patientswithsuspiciousappendicitisunderwentMSCTandultrasonographybeforesurgery.Allpatientsweredivided intoappendicitisgroupandnormalappendixgroupaccordingtoCTappearances.TheefficacyofMSCTcombinedwithultrasoundin diagnosingappendicitiswasanalyzedbycomparisonofsurgicalpathologicalfindings.Results Therewere220casesinappendicitis group,whichhad165casesofappendicitisconfirmedbypathology,and55casesofnormalappendix.Therewere18casesinnormal group,2caseswereconfirmedappendicitisbypathology,and16caseswerenormalappendix.Theoveralldiagnosticperformancesof theCTscanwere98.8%ofsensitivity,22.5%ofspecificity,82.5%ofpositivepredictivevalue,88.9%ofnegativepredictivevalue, and76.1%ofaccuracy.TheperformancesofMSCTcombinedwithultrasonographywere90.4%ofsensitivity,93.0%ofspecificity, 96.8%ofpositivepredictivevalue,80.5%ofnegativepredictivevalue,and91.2%ofaccuracy.Thedifferencewasstatisticallysignificant indiagnosisperformancesbeforeandafterMSCTcombinedwithultrasonography (P＜0.001).Conclusion MSCTcombinedwith ultrasonographyexaminationcouldimprovethediagnosticaccuracyofappendicitis,andmayreducethenegativerateofappendectomy.

OBJECTIVETo study the chemical constituents from the seeds of Notopterygium franchetii.

METHODEthanol extracts of seeds N. franchetii were separated and purified by such methods as normal and reversed phase column chromatographies and thin-layer chromatography and structurally elucidated by MS and NMR evidences.

RESULTTwenty nine compounds were separated, they were isoimperatorin (1), [3-sitosterol (2), phellopterin (3), bergapten (4), N-tetra, hexa, octacosanoylanthranilic acid (5-7), daucosterol (8), oxypeucedanin hydrate (9), umbelliferone (10), demethylfuropinnarin (11), (2S, 3S, 4R, 8E)-2-[(2'R)- 2'-hydroxydoco, trico, tetraco, entaco, hexaco sanosylamino] -octadecene-1, 3, 4-triol (12-16), (-)-oxypeucedanin (17), diosmetin (18), bergaptol-O-beta-D-glucopyranoside (19), nodakenin (20), 1'-O-beta-D-glucopyranosyl-(2R, 3S)-3-hydroxynodakenetin (21), uracil (22), decuroside V (23), 8-O-beta-D-glucopyranosyl-5-hydroxypsoralen (24), 8-O-beta-D-glucopyranosyl-5-methoxylpsoralen (25), diosmin (26), alaschanioside C (27), kynurenic acid (28) and mannitol (29).

CONCLUSIONAll of these compounds were separated from the seeds of N. franchetii for the first time. Of them, 18, 22, 26 and 29 were firstly obtained from genus Notopterygium.

Apiaceae ; chemistry ; Chromatography, Thin Layer ; Coumarins ; chemistry ; Diosmin ; chemistry ; Flavonoids ; chemistry ; Furocoumarins ; chemistry ; Glucosides ; chemistry ; Kynurenic Acid ; chemistry ; Magnetic Resonance Spectroscopy ; Mannitol ; chemistry ; Methoxsalen ; analogs & derivatives ; chemistry ; Seeds ; chemistry ; Sitosterols ; chemistry ; Uracil ; chemistry