Objective To study the chemical constituents from dry roots of Rubus pinfaensis. Methods The compounds were separated from alcohol extracts of the roots of Rubus pinfaensis with silica gel column chromatography,and identified using IR,1 H-NMR and EI-MS methods. Results Five compounds were isolated and identified as oleanolic acid (Ⅰ) ,3-keto,16α-hydroxy,24-noroleanolic acid (II) , 3 '-methoxy myricetin (Ⅲ) , 2 '-deoxyuridine (Ⅳ) and p-hydroxybenzoic acid (Ⅴ) . Conclusion CompoundsⅠ,II,Ⅲ,ⅣandⅤwere isolated from Rubus pinfaensis for the first time.

[Objective] This paper investigates the impact of early intervention of gestational diabetes mel itus(GDM) on pregnancy outcomes. [Methods] Samples are drawn from the GDM cases diagnosed in Zhejiang Tonglu Maternity and Child Care Hospital between Jan. 2010 and Dec. 2012. The treat-ment group includes 56 cases that were diagnosed with systematic prenatal examination and received early treatment, while the remaining 42 cases in the control group were detected only in later phase of pregnancy and stayed untreated, upon which comparisons of pregnancy outcomes are made. [Results] Early intervention of GDM greatly improves the prognosis of both the mother and the perinatal stage infant, as demonstrated in statistical y significant dif-ference of complications. [Conclusion] Early intervention of gestational diabetes mel itus can reduce the chance of gestational complications, and further im-prove pregnancy outcomes.

Objectiv To evaluate the usefulness of dot immuno-gold filtration assay(DIGFA) for the diagnosis of Paragonimus infection.Methods During 2003 to 2006,72 cases suspected of paragonimiasis in Zhejiang Province were examined with DIGFA for rapid detection of specific antibodies against Paragonimus(Pw-DIGFA).The diagnosis was primarily established with the presence of antibodies,experience of ingesting raw freshwater crabs or crayfishes and clinical presentations.The cases were treated with praziquantel and followed-up at 3 and/or 6 months post-treatment.Antibody level in patients(pre-and post-treatment) were detected in parallel and analyzed comparatively by Pw-DIGFA and ELISA.Results The result of detection by Pw-DIGFA was in agreement with that of ELISA.28 of 72 cases were antibody positive and 44 cases were negative.Among the 28 positives,26 cases had a history of eating raw freshwater crab or crayfishes and the other 2 cases drank freshwater from brook before.21 cases showed paragonimiasis-related clinical symptoms such as low-grade fever,cough,or changes in image examination,while the other 7 cases showed only eosinophilia in peripheral blood(15%-70%).The mean absorbance values(A450) of positive sera,negative sera and normal sera tested by ELISA were 1.7361,0.2973 and 0.2657 respectively.There was significant difference between the positive cases and the negative cases(t=12.047,P0.05).At 3 month post-treatment,serum antibody in 5 cases whose clinical symptoms and physical signs relieved or disappeared decreased 2-5 titers and that of one case who relapsed with new signs increased by one titer.In Pw-DIGFA,the dot color of 5 cured cases showed a little weaker than that of pre-treatment and the relapsed case displayed similar response.At 6 month post-treatment,7 sera of clinically cured cases showed significantly weaker response than that of pre-treatment.The antibodies of those sera dropped 3-6 titers.Conclusion Pw-DIGFA is of supplementary value for clinical diagnosis of paragonimiasis.Antibody detection by pre-and post-treatment using Pw-DIGFA shows potential for the evaluation of therapeutic effect.

After the important role of interoperability in health information construction , organizational interopera-bility and inter-organizational network studies were analyzed , the analyzing framework for inter-organizational net-work of medical and health organizations and its relevant study directions were proposed from the aspects of its nodes, dyads and overall structure.

Objective:To establish a method for the determination of organic residues ( hexane, benzene, toluene, xylene and sty-rene) in macroporous adsorption resins. Methods:Headspace-GC with a DB-624 column was used to determine the residues in macro-porous resins. The inlet temperature was 200℃ and the FID detector temperature was 240℃. The column temperature programming was as follows:the initial temperature was 40℃, maintained for 3 min, and then raised to 200℃ with the rate of 14℃/min and kept for 2 min. The solvent was methyl alcohol and the carrier gas was nitrogen. HPLC was applied to determine the contents of the five resi-dues. Results:The contents of the five organic residues were all below 20‰ in five macroporous resins in common use including D101, HPD100, AB-8, DM301 and NKA-9. Conclusion:The method is simple,accurate and reproducible. It can be used in the res-idue determination of macroporous resins.

Objective:To compare the level of dental anxiety and dental behavior between dental fear children with dental treatment under general anaesthesia ( GA) and those under restraint .Methods:The GA group included 31 dental fear children aged 4-6-year-old who received dental treatment under the GA.The restraint group included 31 dental fear children aged 4-6-year-old who received dental treat-ment under the restraint.Age, gender, parent’s education level, decayed-missing-filled tooth (dmft) and face version of the Modified Child Dental Anxiety Scale ( MCDASf ) score before treatment were matched between the two groups .The Chinese version of MCDAS f was used to evaluate the level of dental anxiety in each child before treatment , right after treatment and before examination at recall visit 2 -3 weeks after treatment .And the Chinese version of Venham Clinical Anxiety and Cooperative Behavior Scale was used to evaluate children ’ s dental behavior in each child before treatment and before examina-tion at recall visit 2-3 weeks after treatment .Results:The average scores of MCDAS f in GA group right after treatment and before recall were lower than that before treatment .The difference was statistically sig-nificant (P<0.05).Furthermore, the average score of MCDASf before recall was lower than those after treatment, and the difference was statistically significant (P<0.05).The average scores of MCDASf in restraint group right after treatment and 2-3 weeks after treatment were higher than those before treat-ment , but the difference was not statistically significant ( P>0 .05 ) .Children ’ s dental behavior was sig-nificantly improved at recall visit in both groups (P<0.01).Conclusion:Dental fear could be reduced by treatment under GA .The children ’ s dental behavior was improved after GA .Restraint did not result in the significant elevation of dental anxiety level , but dental behavior was improved after restraint during the short-term recall.

Objective To explore the related risk factors of severe mycoplasma pneumonia in children.Methods 86 children with mycoplasma pneumonia were selected as the observation group.At the same time,30 normal children were selected as the control group.The observation group included 33 cases of mild mycoplasma pneumo nia(A group) and 53 cases of severe mycoplasma pneumonia(B group).The clinical data of the three groups were ret rospectively analyzed,and the related risk factors of severe mycoplasma pneumonia in children were analyzed.Results The risk factors of severe mycoplasma pneumonia in children were age ＞ 5 years (x2 =28.776,P ＜ 0.05),immunoglobulin IgG(x2 =3.004,P ＜ 0.05),immunoglobulin IgM (x2 =2.147,P ＜ 0.05),immunoglobulin IgA (x2 =2.036,P ＜ 0.05),WBC (x2 =6.119,P ＜ 0.05),neutrophil percentage (x2 =8.374,P ＜ 0.05),the positive rate of CD8(x2 =11.665,P＜0.05),the positive rate of CD4(x2 =12.901,P＜0.05).Conclusion For children with risk factors of severe mycoplasma pneumonia should be early diagnosed,prevented and treated,thereby reducing the burden on patients.

Objective To explore the clinical value of plasma(1,3)-β-D-glucan detection(G test)in the diagnosis of invasive fun-gal infections(IFI).Methods The plasma samples were collected in 67 cases of IFI,61 cases of non-IFI and 48 healthy controls from January to September 2013.The level of(1,3)-D-glucan in plasma was detected by the kinetic turbidimetric assay and the opti-mal critical value of the G test was determined by receiver operating characteristic curve(ROC).Results The levels of(1,3)-β-D glucan in the IFI,non-IFI and healthy control groups showed the non-normal distribution.However,the median level of plasma(1, 3)-β-D glucan in the IFI group was 208.00pg/mL,which was significantly higher than 61.30 pg/mL(Z =-5.083,P <0.01)in the non-IFI group and 31.16 pg/mL(Z =-8.288,P <0.01)in the healthy control group.The area under ROC of the G test for diag-nosing IFI was 0.846 and the optimal critical value was 90.49pg/mL.The corresponding sensitivity,specificity,positive and nega-tive predictive values were 86.6%,77.1%,69.9% and 90.3%,respectively;at the same time,which of the fungal culture for diag-nosing IFI were 53.7%,94.5%,85.7% and 61.9% respectively.Conclusion Plasma(1,3)-β-D-glucan detection exhibits the high sensitivity and the better negative predictive value for the diagnosis of IFI.But the false positive results occur at times.It is sugges-ted that the G test can be dynamically conducted combined with the fungal culture for improving the efficiency of IFI diagnosis.

Treatment of gynaeeological cancer frequently results in the loss of ovarian function and menopausal syndrome.The most effective treatment is hormone replacement therapy (HRT).According to the current studies,HRT does not increase the risk of recurrence or death in patients with early stage endometrial cancer and uterine leiomyosarcomas. The safety of HRT in ovarian cancer patients is inconclusive. Cervical squamous cell carcinoma, vaginal cancer and vulvar cancer are not contraindications for HRT. Estrogen replacement therapy (ERT) is contraindicated for low-grade endometrial stromal sarcomas. Therefore,after integrated risk assessment and discussion,patients with severe menopausal symptoms can be treated with HRT to improve the quality of life.

Objective To analyze the consistency of transcutaneous perianal ultrasonography (TPUS) and pelvic magnetic resonance imaging (MRI) in diagnosing perianal lesions of Crohn's disease (CD), and to evaluate the value of transcutaneous perianal ultrasonography in detecting perianal lesions of CD. Methods A cohort of 102 patients diagnosed as Corhn's disease were enrolled from August 2008 to August 2010. Perianal abscess and fistula of these CD patients was diagnosed by ultrasonography and MRI system. Statistics was performed with SPSS 11.5 software for X2 test. The consistency was analyzed with Kappa test. Results The mean onset time of perianal lesions in CD was -0.443 year (95％CI:-1.659～0.773 year) before typical symptoms showed up. There was no significant difference in detecting perianal lesions of CD between transcutaneous perianal ultrasonography and pelvic magnetic resonance imaging (P ＝ 0.706, Kappa ＝ 0.541). If pelvic magnetic resonance imaging was considered as the golden standard in detecting perianal lesions of CD,the sensitivity (Sen), specificity (Spe), Youden's index, positive predictive value (PPV) and negative predictive value (NPV) of TPUS were 72.73％, 82.61％, 0.55, 66.67％ and 86.36％ respectively.Furthermore, there was no significant difference between transcutaneous perianal ultrasonography and pelvic magnetic resonance imaging in detecting perianal abscess ( P ＝ 0.706, Kappa ＝ 0.496) and fistula (P＝0.655, Kappa＝0.546) of CD. Conclusions Perianal lesions occur in the entire course of CD. There was favorable consistency between transcutaneous perianal ultrasonography and pelvic magnetic resonance imaging in detecting perianal abscess and fistula of CD. Transcutaneous perianal ultrasonography can be used as an additional method in detecting and evaluting perianal lesions of CD.