OBJECTIVETo investigate the chemical constituents of the leaves of Aquilaria sinensis, and provide a certain of basis for the comprehensive uses of the plant of A. sinensis.

METHODThe chemical constituents were isolated by various column chromatographic method. The structures were identified by spectral analyses of NMR, MS, et al.

RESULTThirteen compounds were isolated and identified as 7-hyroxy-5, 4'-dimethoxy flovone (1), 5-hydroxy-7, 4'-dimethoxy flavone (2), luteolin-7-3',4'-trimethyl (3), isocorydine (4), 4-hydroxybenzoic acid (5), triacontenoic (6), hentriacontane (7), alpha-stigmasterol (8), epifriedelanol (9), friedelan (10), friedelin (11), genkwanin (12), 5, 4'-dihyroxy-7, 3'-dimethoxy flovone (13).

CONCLUSIONCompound 4 was obtained from this genus for the first time, compounds 1, 6-11, 13 were obtained from this species for the first time.

Magnetic Resonance Spectroscopy ; Organic Chemicals ; analysis ; chemistry ; isolation & purification ; Plant Leaves ; chemistry ; Thymelaeaceae ; chemistry

Objective:To evaluate the prognostic value of combined detection of serum C-reactive protein(CRP), procalcitonin and lactic acid in elderly patients with community acquired pneumonia(CAP).Methods:Ninety-five elderly CAP patients in the emergency department of Shangqiu First People's Hospital were included as the case group, and 45 elderly healthy people in the emergency department of Shangqiu First People's Hospital were enrolled as the control group.Levels of blood lactic acid, procalcitonin and CRP were compared between the two groups.Meanwhile, blood levels of lactic acid, procalcitonin and CRP were compared between patients with different outcomes in the case group.The receiver operating characteristic(ROC)curve was used to evaluate the prognostic value of CRP, procalcitonin and blood lactic acid in elderly patients with CAP.Results:Compared with the control group, blood levels of lactic acid, procalcitonin and CRP were increased in the case group( t=20.77, 26.03 and 31.27, all P<0.01). During a 12-month follow-up, 13 cases(13.68%, 13/95)died and 82 cases(86.32%, 82/95)survived in the case group.Blood levels of lactic acid, procalcitonin and CRP were higher in the death group than in the survival group( t=25.56, 8.30 and 13.56, all P<0.01). ROC curve analysis showed that the sensitivity and specificity of serum lactic acid, procalcitonin and CRP in predicting the prognosis of elderly CAP patients were 76.92% and 73.17%, 84.62% and 78.05%, and 69.23% and 70.73%, respectively.The sensitivity and specificity of combined detection of the three indicators were 92.31% and 89.02%, respectively, higher than those of the individual indicators. Conclusions:Serum levels of lactic acid, procalcitonin and CRP are increased in elderly patients with CAP.Combined detection of the three indicators can improve the prognostic value and therefore has important clinical significance.

Objective To explore the effects of epithelial cell adhesion molecule(EPCM) expression downregulation on the proliferation,invasion and drug sensitivity of ECAM+/cluster of differentiation 44 (CD44) + colorectal cancer stem cells.Methods Colorectal cancer stem cells (ECAM) were obtained from human colorectal cancer cell line LoVo by the method of tumor microspheres.The specific markers of colorectal cancer stem cells were identified and studied.Lipofectamine 2000 liposome was used to complete the transfection,which was divided into three groups:blank group (ECAMhjgh/CD44 + LoVo),control group (transfection of common inhibitors,lipofectamine 2000-inhibitors) and experimental group (ECAM) according to different treatment methods.They were cultured in the same way,the three group of cells in logarithmic phase were treated with irinotecan (drug concentrations were 1,5,10,15,20,25,30,35,40,45,50 mg · L-1) and capecitabine (drug concentrations were 50,100,150,200,250,300,350,400,450,500,550,600mg· L-1).Then,they continued to be cultured.The expression levels of ECAM mRNA in three groups of ceils were detected by real-time fluorescence quantitative detection (RT-PCR).The thiazolyl blue tetrazolium bromide (MTI)assay was used to detect the proliferation and drug sensitivity of the three groups before and after treatment with irinotecan and capecitabine.Transwell cells were used to detect the invasion ability of three groups of cells.Results The percentage of ECAMhjgh/CD44 + colorectal cancer stem cell in LoVo cell line was 0.95％,85.78％ before and after enrichment,and the difference was significant (P ＜ 0.05).The expression of ECAM mRNA in blank group,control group and experimental group were 8.17 ±0.64,7.94 ±0.83,2.16 ±0.12.Compared with blank group,the difference had significantly in two groups (P ＜ 0.05,P ＜ 0.01).Compared with control group,the difference in experimental group had significantly in two groups (P ＜ 0.05).It indicated that model was succeed prepared.Invasive cell in the three groups were 79.22 ± 5.25,80.12 ± 4.89,31.23 ± 2.36.Compared with blank group,the difference had significantly in two groups (P ＜0.05,P ＜0.01).Compared with control group,the difference in experimental group had significantly(P ＜0.05).The IC50of irinotecan on colorectal cancer stem cells in the three groups were (20.25 ±4.35),(19.22 ±3.99),(10.24 ± 2.04) mg · L-1.The IC50of capecitabine on colorectal cancer stem cells in the three groups were (320.13 ± 23.65),(315.79 ± 21.03),(250.22 ± 15.45) mg · L-1.Compared with control group,the difference in experimental group had significantly(P ＜0.05).Conclusion Targeted down-regulation of ECAM can effectively inhibit the proliferation and invasion of colon cancer stem cells,and enhance their sensitivity to drugs at the same time.

OBJECTIVETo explore the regulative efficacy of Pu'er tea () extract on metabolic syndrome.

METHODSNinety patients with metabolic syndrome were randomly divided into two groups, the intervention group administered with Pu'er tea extract, and the placebo group with placebo capsules. After 3 months' treatment, body mass index, waist hip ratio, blood lipids, blood sugar, immune and inflammatory index, and oxidation index of the patients with metabolic syndrome were tested and analyzed.

RESULTSIn the intervention group, the body mass index, waist-hip ratio, fasting and 2 h postprandial blood glucose, serum total cholesterol, triglycerides, low density lipoprotein and apolipoprotein B-100 all decreased in the patients with metabolic syndrome, and also the high-density lipoprotein level increased and apolipoprotein A-1 showed the tendency to increase. Serum C-reactive protein, tumor necrosis factor-α, and interleukin-6 were decreased in the intervention group. Interleukin-10 level was increased, MDA was decreased and superoxide dismutase was increased. Compared with before treatment and the placebo group, there were significant differences (P<0.05, P<0.01).

CONCLUSIONSPu'er tea demonstrated excellent potential in improving central obesity, adjusting blood lipid, lowering blood sugar, regulating immunity and resisting oxidation. It can adjust the metabolic syndrome of different clinical phenotypes to different degrees, and is ideally fit for early prevention of metabolic syndrome.

Adult ; Aged ; Blood Glucose ; metabolism ; Body Mass Index ; Double-Blind Method ; Drugs, Chinese Herbal ; adverse effects ; therapeutic use ; Female ; Humans ; Inflammation ; blood ; complications ; Lipids ; blood ; Male ; Malondialdehyde ; blood ; Metabolic Syndrome ; blood ; complications ; drug therapy ; Middle Aged ; Oxidation-Reduction ; Placebos ; Plant Extracts ; therapeutic use ; Superoxide Dismutase ; blood ; Waist-Hip Ratio

Aim To investigate the effect of broneol on acute lung injury(ALI) induced by lipopolysaccharide (LPS). Methods Male C57 mice were randomly di-vided into saline group, model group, broneol group and dexamethasone group, then the ALI mouse model was induced by instilling intratracheally with LPS. The levels of tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),interleukin-6(IL-6) and keratinocyte-de-rived cytokine (KC) were measured at 6h, 12h and 24h after instillation of LPS, and the pathological changes of lung were observed. Mice alveolar macro-phages (MHS) and epithelial cells (MLE-12) were stimulated by LPS. After the stimulation of 1h, 3h, 6h,9h, 12h, 24h, the levels of TNF-α and IL-6 in MHS cells and the contents of KC and macrophage in-flammatory protein-2 (MIP-2) in MLE-12 cells were measured. Results Broneol could inhibit the secre-tion of TNF-α,KC and IL-1β;the early effect of bro-neol on IL-6 was not obvious,but the later effect after the treatment of 24 hours was obvious. After LPS instil-lation 6h and 12h,Broneol could significantly improve lung tissue pathological changes. Broneol had no effect on TNF-α secretion of MHS cells, but it obviously af-fected IL-6 secretion in the later stage. In addition, broneol significantly inhibited KC and MIP2 secretion in MLE-12 cells at the later stage of LPS stimulation. Conclusions Broneol can protect LPS-induced acute lung injury. The mechanism may be related to the inhi-bition of the release of inflammatory factors,the activa-tion of inflammatory cells and the aggregation of neutro-phils.

Background: Right upper lobectomy (RUL) for lung cancer with different dissecting orders involves the most vari-able anatomical structures, but no studies have analyzed its effects on postoperative recovery. This study compared the conventional surgical approach, VAB (dissecting pulmonary vessels first, followed by the bronchus), and the alter-native surgical approach, aBVA (dissecting the posterior ascending arterial branch first, followed by the bronchus and vessels) on improving surgical feasibility and postoperative recovery for lung cancer patients. Methods: According to the surgical approach, consecutive lung cancer patients undergoing RUL were grouped into aBVA and VAB cohorts. Their clinical, pathologic, and perioperative characteristics were collected to compare periop-erative outcomes. Results: Three hundred one patients were selected (109 in the aBVA cohort and 192 in the VAB cohort). The mean operation time was shorter in the aBVA cohort than in the VAB cohort (164 vs. 221 min, P < 0.001), and less blood loss occurred in the aBVA cohort (92 vs. 141 mL, P < 0.001). The rate of conversion to thoracotomy was lower in the aBVA cohort than in the VAB cohort (0% vs. 11.5%, P < 0.001). The mean duration of postoperative chest drainage was shorter in the aBVA cohort than in the VAB cohort (3.6 vs. 4.5 days, P = 0.001). The rates of postoperative complica-tions were comparable (P = 0.629). The median overall survival was not arrived in both cohorts (P > 0.05). The median disease-free survival was comparable for all patients in the two cohorts (not arrived vs. 41.97 months) and for patients with disease recurrences (13.25 vs. 9.44 months) (both P > 0.05). The recurrence models in two cohorts were also comparable for patients with local recurrences (6.4% vs. 7.8%), distant metastases (10.1% vs. 8.3%), and both (1.8% vs. 1.6%) (all P > 0.05). Conclusions: Dissecting the right upper bronchus before turning over the lobe repeatedly and dissecting veins via the aBVA approach during RUL would promote surgical feasibility and achieve comparable postoperative recovery for lung cancer patients.

Background: Genetic defects in the human thyroid-stimulating hormone (TSH) receptor (TSHR) gene can cause congenital hypothyroidism (CH). However, the biological functions and comprehensive genotype–phenotype relationships for most TSHR variants associated with CH remain unexplored. We aimed to identify TSHR variants in Chinese patients with CH, analyze the functions of the variants, and explore the relationships between TSHR genotypes and clinical phenotypes. Methods: In total, 367 patients with CH were recruited for TSHR variant screening using whole-exome sequencing. The effects of the variants were evaluated by in-silico programs such as SIFT and polyphen2. Furthermore, these variants were transfected into 293T cells to detect their Gs/cyclic AMP and Gq/11 signaling activity. Results: Among the 367 patients with CH, 17 TSHR variants, including three novel variants, were identified in 45 patients, and 18 patients carried biallelic TSHR variants. In vitro experiments showed that 10 variants were associated with Gs/cyclic AMP and Gq/11 signaling pathway impairment to varying degrees. Patients with TSHR biallelic variants had lower serum TSH levels and higher free triiodothyronine and thyroxine levels at diagnosis than those with DUOX2 biallelic variants. Conclusions We found a high frequency of TSHR variants in Chinese patients with CH (12.3%), and 4.9% of cases were caused by TSHR biallelic variants. Ten variants were identified as loss-of-function variants. The data suggest that the clinical phenotype of CH patients caused by TSHR biallelic variants is relatively mild. Our study expands the TSHR variant spectrum and provides further evidence for the elucidation of the genetic etiology of CH.

OBJECTIVETo retrospectively analysis the treatment characteristics of the systemic situation in patients with crush syndrome after Wenchuan earthquake happened in May 12th, 2008.

METHODSForty-nine patients with crush syndrome and subsequent acute renal failure (ARF) due to the earthquake were treated in West China Hospital. All of patients had been rescued from buildings that collapsed in Wenchuan earthquake. The major associated injuries were in the low extremities and upper extremities. 49 patients developed ARF with increased concentrations of serum creatinine (mean 64 022 U/L) had underwent haemodialysis. Hyperkalaemia was seen in 9 patients and four of them underwent haemodialysis. 49 patients were administered hemodialysis.

RESULTSNo patient died. All patients who suffered from the ARF were weaned from hemodialysis after admitted 7 to 35 days. Forty-five extremities underwent amputations and 52 extremities had fasciotomy.

CONCLUSIONSCrush syndrome requires urgent recognition and prompt surgical treatment with simultaneous measures to control hyperkalemia and ARF. The authors believe that immediate intensive care therapy and multi-subjective coordination would have improved the survival rate.

Acute Kidney Injury ; etiology ; surgery ; therapy ; Adolescent ; Adult ; Aged ; Amputation ; Child ; Crush Syndrome ; etiology ; surgery ; therapy ; Decompression, Surgical ; Earthquakes ; Female ; Humans ; Male ; Middle Aged ; Renal Replacement Therapy ; Retrospective Studies ; Treatment Outcome ; Wounds and Injuries ; complications

OBJECTIVETo evaluate the value of (18)F-FDG PET/CT in detecting residual disease and predicting relapse following first-line treatment in patients with diffuse large B cell lymphoma (DLBCL).

METHODSThe clinical data of 39 patients with DLBCL, who underwent PET/CT scan after first-line treatment, were analyzed retrospectively. Kaplan-Meier method was used to analyze the survival of patients.

RESULTSPET/CT findings were interpreted as negative, mild metabolism and positive. Seventeen patients' PET/CT findings were judged as negative, none of them relapsed with a median follow-up of 24.1 months, 13 were judged as mild metabolism, 2 of them relapsed with a median follow-up of 17.1 months. Of the rest 9 findings were judged as positive with a median follow-up of 16.3 months, 4 patients were considered as disease progression according to clinical manifestations and other radiographic results, 2 patients relapsed at the time points of 13.5 and 6.8 months after PET/CT scan respectively, the other 3 patients were diagnosed as negative by biopsy, none of them relapsed at the time points of 5.9, 9.6 and 20.0 months after PET/CT scan respectively. One-year progression-free-survival (PFS) for negative, mild metabolism and positive groups was 100%, 83% and 56%, respectively. Two-year PFS was 100%, 83% and 42%, respectively. Overall survival (OS) at 1 year for negative, mild metabolism and positive groups was 100%, 100% and 89%, respectively. Two-year OS was 100%, 100% and 63%, respectively (P = 0.004).

CONCLUSIONDLBCL patients with negative and mild metabolism PET/CT following first-line treatment had good prognosis, who needed no additional therapy. While patients with positive PET/CT had poor prognosis, those patients should receive biopsy before adjusting treatment regimen because of the high false-positive rate.

Aged ; Female ; Fluorodeoxyglucose F18 ; Humans ; Lymphoma, Large B-Cell, Diffuse ; diagnostic imaging ; therapy ; Male ; Middle Aged ; Positron-Emission Tomography ; methods ; Prognosis ; Retrospective Studies ; Treatment Outcome

Objective: To evaluate the prognostic value of (18)F-fluorodeoxyglucose positron emission tomography (PET)/computed tomography (CT) in patients with diffuse large B cell lymphoma (DLBCL) undergoing autologous hematopoietic stem cell transplantation (auto-HSCT). Methods: Forty-eight patients with DLBCL treated at Peking University Cancer Hospital between November 2010 and December 2014 were assessed. All patients underwent PET/CT scanning prior to or after auto-HSCT. Correlation analysis was done based upon patients characteristics, PET/CT scan results and survival. Results: ①Among 48 patients, 27 was male, 21 female, median age was 43 (17-59) years old. ② Patients with negative pre-auto-HSCT PET/CT assessment demonstrated significantly better 3-year progression free survival (PFS) (87.1% vs 53.3%, χ(2)=7.02, P=0.019) and overall survival (OS) (90.3% vs 60.0%, χ(2)=6.51,P=0.022) than patients with positive pre-auto-HSCT PET/CT assessment. Three-year PFS (94.1% vs 30.0%, χ(2)=22.75, P=0.001) and OS (97.1% vs 40.0%, χ(2)=21.09, P=0.002) were also significantly different between patients with negative and positive post-auto-HSCT PET/CT assessment. ③ Multivariate analysis indicated a significant association of PFS (HR=13.176, P=0.005) and OS (HR=20.221, P=0.007) with post-auto-HSCT PET/CT assessment. Number of prior treatment regimens was associated with PFS (HR=10.039, P=0.040). ④ Harrell's C index revealed that the value of combined use of number of prior treatment regimens and post-auto-HSCT PET/CT assessment was superior to either one used alone in PFS (Harrell's C values were 0.976, 0.869 and 0.927 in combined use, number of prior treatment regimens and post-auto-HSCT PET/CT assessment, respectively), and the combined use of ECOG performance status and post-auto-HSCT PET/CT assessment significantly increased the Harrell's C index in OS (Harrell's C values were 0.973, 0.711 and 0.919 in combined use, ECOG performance status and post-auto-HSCT PET/CT assessment, respectively). Conclusions: Post-auto-HSCT PET/CT assessment is the main predictor of outcomes in DLBCL patients receiving auto-HSCT. Combined use of post-auto-HSCT PET/CT assessment and number of prior treatment regimens and ECOG performance status is a better prognostic tool in patients with DLBCL undergoing transplantation.
Adolescent ; Adult ; Disease-Free Survival ; Female ; Fluorodeoxyglucose F18 ; Hematopoietic Stem Cell Transplantation ; Humans ; Lymphoma, Large B-Cell, Diffuse ; Male ; Middle Aged ; Positron Emission Tomography Computed Tomography ; Prognosis ; Retrospective Studies ; Transplantation, Autologous ; Young Adult