Objective To study the chemical constituents of Dysosma pleiantha.Methods Acidic resins were precipitated by 1% HCl solution, then the constituents were isolated and purified on repeated silica gel column.They were identified and structurally elucidated by physicochemical constants and spectral analysis.Results Ten compounds were obtained and identified: podophyllotoxone (Ⅰ), dehydropodophyllotoxin (Ⅱ), podophyllotoxin (Ⅲ), 4′-demethylpodophyllotoxin (Ⅳ), 4′-demethyldehydropodophyllotoxin (Ⅴ), kaempferol (Ⅵ), quercetin (Ⅶ), n-hexadecanoic acid (Ⅷ), ?-sitosterol (Ⅸ), and daucosterol (Ⅹ).Conclusion Compound Ⅴ is a new compound, compounds Ⅷ-Ⅹ are first separated from the plants of Dysosma Woodson and other compounds are first separated from D.pleiantha.

Background: Isolated systolic hypertension (ISH) is a common disease in elderly people, threatening their health. Traditional Chinese medicine (TCM) treatment or integrative treatment had advantages in improving quality of life and protecting target organs, but need to be proved by large evidence-based researches. Objective: To observe the effects of TCM treatment (Jiangya Capsule) or integrative treatment (combination of Jiangya Capsule and nimodipine) on blood pressure and vasoactive agents, and their safety in elderly ISH patients. Design, setting, participants and interventions: A multicenter, randomized, double-blind controlled trial was adopted. A total of 270 elderly ISH patients recruited from Xiyuan Hospital, and TCM Hospital and Community Health Service Centers of Yanqing County of Beijing were randomly divided into 3 groups: TCM group (Jiangya Capsule plus nimodipine simulation, 90 cases), integrative group (Jiangya Capsule plus nimodipine, 90 cases) and Western medicine (WM) group (nimodipine plus Jiangya Capsule simulation, 90 cases). They were all treated for 4 weeks. Main outcome measures: Before and after 4-week treatment, office blood pressure, 24-hour ambulatory blood pressure, serum nitric oxide (NO), and plasma endothelin-1 (ET-1), thromboxane B2 (TXB2) and 6-keto-prostaglandin 1alpha (6-keto-PGF1alpha) were detected, and safety evaluation was conducted. Results: After 4-week treatment, 5 patients in TCM group were lost to follow-up and another 5 patients were excluded, and 80 patients finished the trial; 7 patients in integrative group were lost to follow-up and another 7 patients were excluded, and 76 patients finished the trial; 2 patients in WM group were lost to follow-up and another 3 patients were excluded, and 85 patients finished the trial. After treatment, systolic blood pressure (SBP) decreased in each group (P<0.05), and integrative treatment was superior to TCM or WM treatment in decreasing SBP (P<0.05). Twenty-four hour average SBP and day average SBP decreased significantly in each group, and night average SBP decreased in integrative group, and integrative treatment was superior to TCM or WM treatment in decreasing day average SBP. Serum NO and plasma 6-keto-PGF1alpha levels were elevated and plasma ET-1 and TXB(2) levels were reduced after treatment, and integrative treatment was superior to TCM or WM treatment in reducing plasma TXB(2) level. Conclusion: TCM treatment or integrative treatment has affirmative effects and safety in treating elderly ISH patients, and integrative treatment has superiority in improving some indexes, and deserves further study.

Objective:To evaluate the curative effect of percutaneous transhepatic choledoscopy (PTCS) in the treatment of complex intrahepatic and extrahepatic bile duct stones.Methods:Clinical data of 120 patients with complex intrahepatic and extrahepatic bile duct stones admitted to Baiyin Second People's Hospital from January 2021 to December 2021 were retrospectively analyzed, including 74 males and 46 females, aged (53.3±2.4) years old. Patients were divided the control group ( n=60) who underwent routine laparotomy and the observation group ( n=60) who underwent PTCS. Perioperative outcomes, including the intraoperative blood loss, operation time, postoperative exhaust time, stress status, liver function index [serum level of alanine aminotransferase (ALT) and aspartate aminotransferase (AST)] and postoperative complications of the two groups were compared. Results:Compared with the control group, the observation group had a shorter operation time [(1.62±0.24) h vs. (2.35±0.28) h] and postoperative exhaust time [(1.80±0.25) d vs. (2.53±0.28) d], and a decreased intraoperative blood loss [(51.21±8.23) ml vs. (119.21±8.29) ml] (all P<0.05). The serum levels of adrenaline [(119.7±12.0) ng/ml vs. (130.5±14.2) ng/ml], ALT [(70.02±2.42) U/L vs. (87.30±2.56) U/L] and AST [(188.6±24.7) U/L vs. (201.7±28.5) U/L] were lower in observation group one day after surgery (all P<0.05). The total effective rate in observation group was higher than that in control group [96.7%(58/60) vs. 83.3%(50/60), P=0.005]. The rate of complications was also lower in observation group [6.7%(4/60) vs. 36.7%(22/60), P=0.005]. Conclusion:Compared to routine laparotomy, PTCS could be more feasible for complex intra- and extrahepatic bile duct stones, considering its minimal invasiveness, less stress reaction, enhanced postoperative recovery, less disturbance of liver function, and decreased complications.

Objective To study the relationship between the expression level of regulators of G-protein signalling 2(RGS2)in brain tissue around hematoma and inflammatory response,short-term prognosis of patients with hypertensive intracerebral hemorrhage.Methods A total of 124 patients with hypertensive intracerebral hemorrhage who underwent hematoma clearance in our hospital from May 2019 to May 2022 were selected as the cerebral hemorrhage group,22 patients with non cerebral hemorrhage who underwent autopsy were selected as the control group.The protein expression of RGS2,TNF-α,IL-1β were detected.The mRS scores of patients with intracerebral hemorrhage at 3 months after discharge were evaluated,patients were divided into patients with good prognosis and patients with poor prognosis.Pearson test was used to analyze correlation between RGS2 and TNF-α,IL-1β.Logistic regression was used to analyze the influencing factors of the short-term prognosis of patients with cerebral hemorrhage,ROC curve was used to analyze the predictive value of RGS2,TNF-α,IL-1β for the short-term prognosis of patients with cerebral hemorrhage.Results The relative expression level of RGS2 protein in brain tissue around hematoma of cerebral hemorrhage group was lower than that in control group,the relative expression level of TNF-α,IL-1β were higher than those of the control group(all P<0.05).There was a negative correlation between the relative expression level of RGS2 and TNF-α,IL-1β.The NIHSS score,random blood glucose level,cerebral hemorrhage volume and the relative expression level of TNF-α,IL-1β of patients with poor prognosis in the cerebral hemorrhage group were higher than those of patients with good prognosis,and the relative expression level of RGS2 was lower than that of patients with good prognosis(all P<0.05).Logistic regression analysis showed that NIHSS score,hematoma volume and the relative expression level of RGS2,TNF-α,IL-1β were influencing factors of the short-term prognosis of patients with cerebral hemorrhage.ROC curve analysis showed that the relative expression level of RGS2,TNF-α,IL-1β had predictive value for the short-term prognosis of patients with cerebral hemorrhage.Conclusion The decreased expression of RGS2 in the brain tissue around the hematoma of hypertensive intracerebral hemorrhage is related to the activation of inflammatory reaction and poor short-term prognosis.

Objective To estimate the incidence of drop out of treatment in patients with access to methadone maintenance treatment and explore the correlation and interaction between insufficient methadone dosage and morphine positive urine on the drop out in Guangxi Zhuang Autonomous Region.Methods Face to face interview was conducted in 1 031 patients at 3 methadone maintenance treatment clinics in Guangxi.Results The study included 1 031 participants,40.6％ of them (419/1 031) had stopped treatment.The drop out rates in urine morphine positive group and methadone dosage ＜ 100 mg/d group were 57.6％ (99/172) and 37.4％ (347/929) respectively,higher than those in urine morphine negative group and methadone dosage ≥ 100 mg/d group (42.3％,363/ 859,and 26.5％,27/102).Orderly logistic regression analysis results showed that after adjusted factors,such as gender,age,marital status,ethnic group,patients who received a dosage less than 1 00 mg/day (OR=3.05,95％CI:1.84-5.06) and had morphine positive urine (OR=2.25,95％CI:1.59-3.19) were more likely to drop out of the treatment.Interaction analysis showed that dosage less than 100 mg/d and morphine positive urine during treatment had additive interaction (RERI=256.46,AP=0.87,S=8.05) and multiplication interaction (OR=2.45,95％CI:1.71-3.49).Conclusion Insufficient dosage and morphine positive urine were significantly correlated with drop out of treatment in patients with access to methadone maintenance treatment.

Objective:To analyze and learn about the dose to the lens of the eye of interventional radiology workers in some hospitals in shaanxi province from 2018 to 2020.Methods:From 2018 to 2020, three tertiary hospitals in shaanxi province were selected to monitor the dose to the lens of the eye of interventional radiology workers for three consecutive years. Monitoring was made for 152 person times, lasting for a monitoring period of 3 months. Analysis and comparison were carried out of dose equivalents to the interventional radiology workers in terms of different sexes, positions and departments, together with associated influencing factors during the three years.Results:The difference in equivalent dose between the three years is statistically significant ( χ2=29.15, P<0.05), and a downward trend in the average annual equivalent dose was found from 2018 to 2020. The number of interventional radiology workers who received doses to the lens of the eye mainly between MDL and 5.0 mSv accounted for 69.08%. The difference in the average annual equivalent dose in different positions and departments was statistically significant ( H=18.44, 22.55, P<0.05). The average annual equivalent dose to doctor was higher than for nurses and technicians ( Z=-3.36, -3.02, P<0.05). The average annual equivalent dose in cardiovascular medicine department was higher than in other departments, with statistically significant difference ( Z=-2.58, -3.76, -3.40, P<0.05). Logistics regression analysis showed that radiation working hours, positions, routine personal doses, workload and exposure time are the factors that affect the average annual equivalent dose. Conclusions:The annual equivalent dose to the lens of the eye of interventional radiology workers in shaanxi province meets the relevant national standards. However, the annual dose to some radiological workers has a normal high value. Therefore, it is necessary to strengthen the continued monitoring of the dose to the lens of the eye of the interventional radiology workers, and adjust the types of work for the workers based on radiation work hours, position, routine personal dose, workload and exposure time, so as to effectively reduce the dose level of the eye lens.

Objective:To analyze the results of occupational health examinations of radiation workers in Shaanxi Province, and to provide basis and reference for effectively conduct occupational health monitoring.Methods:From April 2016 to January 2022, a questionnaire survey was conducted to collect the basic information on occupational health examinations of qualified radiation workers in Shaanxi Province from 2016 to 2021. Based on the abnormal rate of occupational health among radiation workers, 1018 people were randomly selected using a cluster stratified sampling method to analyze the occupational health examination results of different positions, types of work, gender, length of service, and exposure doses.Results:The chromosomal aberration rates of peripheral blood lymphocytes among radiation workers in Shaanxi Province from 2016 to 2021 were 0.26% (10/3876), 0.77% (27/3512), 0.16% (16/10153), 0.09% (13/14769), 0.10% (13/13399), and 0.12% (20/16671), respectively. The abnormal rates of thyroid ultrasound examination were 32.33% (150/464), 24.46% (649/2653), 55.24% (786/1423), 32.89% (888/2700), 35.69% (1475/4133), and 42.51% (1993/4688), respectively. There was a statistically significant difference in the abnormal rates among different years ( P<0.05). The abnormal rate of renal function examination in male radiation workers was higher than that in females ( P<0.05). Compared with non medical users, the abnormal rates of renal function, thyroid function, and blood routine examination in medical radiation workers were higher ( P<0.05), and the abnormal rates of renal function, thyroid function, and blood routine examination in medical applications were higher than those in radiation diagnosis, nuclear medicine, and radiation therapy ( P<0.05). The abnormal rates of electrocardiogram, chest X-ray, blood pressure, thyroid function, and blood routine increased with the length of service ( P<0.05). The abnormal rates of blood pressure, liver function, kidney function, thyroid function, and blood routine examination increased with the exposure dose ( P<0.05) . Conclusion:The occupational health status of radiation workers is not optimistic. Occupational health monitoring should be strengthened, especially interventional radiation diagnosis occupational health examination, as well as changes in the indicators of sensitive organs such as eye lens and thyroid, so as to ensure the health of radiation workers.

Objective:To analyze the results of occupational health examinations of radiation workers in Shaanxi Province, and to provide basis and reference for effectively conduct occupational health monitoring.Methods:From April 2016 to January 2022, a questionnaire survey was conducted to collect the basic information on occupational health examinations of qualified radiation workers in Shaanxi Province from 2016 to 2021. Based on the abnormal rate of occupational health among radiation workers, 1018 people were randomly selected using a cluster stratified sampling method to analyze the occupational health examination results of different positions, types of work, gender, length of service, and exposure doses.Results:The chromosomal aberration rates of peripheral blood lymphocytes among radiation workers in Shaanxi Province from 2016 to 2021 were 0.26% (10/3876), 0.77% (27/3512), 0.16% (16/10153), 0.09% (13/14769), 0.10% (13/13399), and 0.12% (20/16671), respectively. The abnormal rates of thyroid ultrasound examination were 32.33% (150/464), 24.46% (649/2653), 55.24% (786/1423), 32.89% (888/2700), 35.69% (1475/4133), and 42.51% (1993/4688), respectively. There was a statistically significant difference in the abnormal rates among different years ( P<0.05). The abnormal rate of renal function examination in male radiation workers was higher than that in females ( P<0.05). Compared with non medical users, the abnormal rates of renal function, thyroid function, and blood routine examination in medical radiation workers were higher ( P<0.05), and the abnormal rates of renal function, thyroid function, and blood routine examination in medical applications were higher than those in radiation diagnosis, nuclear medicine, and radiation therapy ( P<0.05). The abnormal rates of electrocardiogram, chest X-ray, blood pressure, thyroid function, and blood routine increased with the length of service ( P<0.05). The abnormal rates of blood pressure, liver function, kidney function, thyroid function, and blood routine examination increased with the exposure dose ( P<0.05) . Conclusion:The occupational health status of radiation workers is not optimistic. Occupational health monitoring should be strengthened, especially interventional radiation diagnosis occupational health examination, as well as changes in the indicators of sensitive organs such as eye lens and thyroid, so as to ensure the health of radiation workers.

Objective To reveal the prevalence and the related factors of hepatitis B (HepB) virus infection among HIV/AIDS patients.Methods We conducted a cross-sectional study in two HIV clinics,affiliated to local Centers of Disease Control and Prevention in Guangxi Zhuang Autonomous Regional.A face-to-face interview,with questionnaire was conducted to collect information on socio-demographic characteristics,drug use,and sexual behavior.Blood samples were used to test HBsAg.x2 test or Fisher's exact test and unconditional logistic regression models were used to identify the influencing factors.Results The prevalence of HBV and HIV co-infection was 13.85％ (113/816).Results from multivariate logistic regression analyses showed that age (25-45),family history of HBV and history of HepB vaccination were independent influencing factors for HBV and HIV coinfection,with OR (95％ CI) as 1.738 (1.031-2.931),2.898 (1.678-5.005) and 1.744 (1.052-2.892),respectively.Conclusion The prevalence of HBV among HIV/AIDS patients was significantly higher than that in general population.HIV/AIDS patients aged between 25 and 45 and with family history of HBV were more likely to be infected with HBV,while HepB vaccination was associated with the reduction of HIV/HBV coinfection.Specific comprehensive prevention and treatment programs on HIV/AIDS patients need to be set up.

Objective To understand the basic information on radiological health technical service institutions in Shaanxi Province, China and analyze the main problems, and to strengthen the capacity building of radiological health technical service institutions in Shaanxi Province. Methods The radiological health technical service institutions registered in Shaanxi Province were investigated and analyzed by means of a questionnaire and literature review. Results There were 20 radiological health technical service institutions in Shaanxi Province, including 7 state-owned ones and 13 privately owned ones; of all the institutions, there were 3 disease control institutions, and 15 institutions obtaining the qualification of radiation protection evaluation, radiation health protection testing, and individual dose monitoring at the same time. The total number of radiation workers in the institution was 237, including 48.5% aged less than 35, 68.8% with bachelor degree or above, 54.4% with intermediate professional title or above, 26.5% with a major related to radiation protection, and 79.3% with national and provincial training. The institutions were equipped with 309 testing instruments, of which the radiation diagnostic performance testing equipment accounted for the largest proportion (52.4%). Conclusion The service scope and capacity of radiological health technical service institutions in Shaanxi Province can meet the current needs of the province, but the institutions need to be improved in terms of personnel, equipment, and service quality. The quality control of institutions needs to be strengthened to standardize the service behavior in the whole province.