Two new compounds Ⅰ and Ⅱ were isolated from Sparganium stoloniferum Buch. -Ham.. On the basis of chemical evidences and spectral analysis (UV,IR, 1H and 13CNMR,FAB-MS),the structure of l was elucidated as 5-ene-methyl-cholate-3-O-?-D-glucuronopyranosyl- (1→4 )-?-L-rhamnopyranoside,Ⅱ was 5-enemethyl-cholate- 3-O-?-D-glucopyranoside

Objective To observe the B- ultrasonic (B-US) renal changes of chronic aristolochic acid nephropathy (CAAN) patients and to determine its value in disease diagnosis. Methods The renal B-US data of 124 CAAN patients were retrospectively studied. The relationship between the B-US characteristics and the renal function was tested. Clinicopathological data of 19 CAAN patients underwent renal biopsy were compared with those of 18 patients with chronic tubulointerstitial nephropathy due to none-aristolochic acid causes (non-AAN-CTIN). Results The characteristics of renal B-US changes in CAAN patients included diminished parenchyma thickness (90.3%), atrophy of the kidney (62.90%) and asymmetrically shrinked kidneys (17.74%). The renal B-US markers, including the longitude, the volume and the parenchyma thickness, were closely associated with the level of Scr, eGFR and the function of renal tubules (P

Objective To investigate the clinical effect and the prospect of Infliximab in treatment of intravenous immunoglobulin (IVIG)-resistant Kawasaki disease (KD) patients.Methods Clinical features,inflammatory markers and coronary changes were observed in 2 cases of IVIG-resistant KD patients hospitalized in Peking University First Hospital,who were treated effectively by Infliximab.Relevant researches on the mechanism and progress of the Infliximab treatment for IVIG-resistant KD in the last 10 years were reviewed at the same time.Results Two KD patients hospitalized in Peking University First Hospital had been treated with 2 g/kg IVIG for 2 times and followed by methylprednisolone treatment.However,fever and other clinical manifestations occurred again after 2 days and 6 days when temperature returned normal.They both defervesced and all the symptoms were improved after 1 dose of Infliximab (5 mg/kg) by laboratory examinations.Four published literatures of the basic research and 9 retrospective or prospective clinical researches of Infliximab treatment of KD showed that Infliximab alleviated the inflammatory level in the KD patients significantly.Complete remission was up to 72.73％-92.11％.Those KD patients defervesced within 12 h,with dramatic improvement of symptoms and signs.Arthralgia also disappeared in the patients with arthritis.Only 1 case was complicated with hepatitis in the acute phase and cholecystitis in recovery time.A phase 3 randomised,double-blinded,placebo-controlled trial had been done to assess the addition of Infliximab to the standard therapy.Conclusions Infliximab is a feasible choice for IVIG-resistant KD patients.Efficacy and safety of Infliximab for KD treatment have been proved in the literature.However,Infliximab for KD treatment has not been indicated in the drug instruction,so the informed consent from the guardians and Ethics Committee is needed.

Objective To analyze hepatitis B virus ( HBV)-specific T lymphocyte responses dur-ing different stages of HBV infection.Methods Eighty-four patients with HBV infection were recruited in this study.They were divided into four groups including acute HBV infection group (8 cases), chronic HBV infection group (39 cases), hepatocirrhosis group (17 cases) and hepatocellular carcinoma group (20 ca-ses) .HBV-specific T cell responses were detected by using ELISPOT assay in combination with magnetic beads sorting assay.Results (1)The magnitudes of HBV-specific T cell responses in patients with acute HBV infection ,chronic HBV infection , hepatocirrhosis and hepatocellular carcinoma were respectively (2067.00±1029.00) SFU/106 PBMCs, (288.50±57.69) SFU/106 PBMCs, (96.25±31.06) SFU/106 PBMCs and (71.47±14.26) SFU/106 PBMCs.The differences with the magnitudes of HBV-specific T cell responses among patients from the four groups were significant (P<0.01).(2)HBV Core (HBV C) protein induced the strongest T cell responses[ (323.90±130.30) SFU/106 PBMCs] in patients with acute HBV infection in comparison with HBV-surface ( HBV S ) protein, HBV P protein and HBV X protein ( P=0.0037).The strongest T cell responses in patients with chronic HBV infection were induced by using HBV P protein [(127.20±54.42) SFU/106 PBMCs], followed by using HBV S protein, HBV C protein and HBV X protein (P=0.0159).(3)The magnitudes of IFN-γreleasing induced by HBV X protein, HBV P protein, HBV S protein and HBV C protein showed no significant differences in patients with either hepato-cirrhosis or hepatocellular carcinoma, but were lower than those induced in patients with chronic HBV infec-tion.Conclusion HBV-specific T cell responses were gradually reduced along the progression of HBV in-fection from acute HBV infection to chronic HBV infection, liver cirrhosis and hepatocellular carcinoma.The HBV-specific T cell responses induced by viral proteins might play different roles in different stages of HBV infection.

Objective To study the correlation between individual gene polymorphisms of transforming growth factor (TGF)-β1 + 869 T/C,tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) + 1525 G/A genes and nodular thyroid disease.Methods From September 2007 to December 2009,a total of 544 patients with nodular thyroid disease diagnosed in the Department of Endocrinology,The First Affiliated Hospital of Baotou Medical College,Inner Mongolia University of Science and Technology were selected,including 136 cases of nodular goiter patients (node group),132 cases of thyroid tumor (adenoma group),146 cases of Graves patients (GD group),and 130 cases of Hashimoto's thyroiditis (HT group).One hundred and thirty-five healthy subjects were enrolled as control group.Two milliliters of fasting venous blood of all subjects were collected.Polymorphisms of the TGF-β1 + 869 T/C and the TRAIL 1525 A/G genes were identified by the polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) and the restriction fragment length polymorphism (PCR-RFLP) methods.Results TGF-β1 + 869 T/C:The CC genotypes and C allele frequencies of nodular goiter group [47.0％(64/136),63.2％(172/ 272)] were significantly higher than those of normal control group [18.0％(22/135),45.2％ (122/270); x2 =30.76,17.79,all P ＜ 0.05].The genotypes and allele frequencies of adenoma group[42.4％ (56/132),59.1％ (156/264)] were significantly higher than those of the normal control group (x2 =24.40,10.34,all P ＜ 0.05).The risk of population carrying the C allele suffering from nodular goiter was 2.086 times of those carrying the T allele (OR =2.086; 95％ CI:1.480-2.943).The risk of population carrying the C allele suffering from adenoma was 1.752 times of those carrying the T allele (OR =1.752,95％ CI:1.244-2.469).TRAIL + 1525 G/A:the genotypes and allele frequencies of nodular goiter group [40.4％ (55/136),62.9％ (171/272)] were significantly higher than those of normal control group [12.0％ (16/135),48.5％ (131/270); x2 =9.176,11.307,all P ＜ 0.05].The genotypes and allele frequencies of adenoma group[53.3％ (70/132),73.1％ (193/264)] were significantly higher than those of the normal control group (x2 =9.806,33.82,all P ＜ 0.05).The risk of population carrying the G allele suffering from nodular goiter was 1.796 times of those carrying the A allele (OR =1.796,95％ CI:1.275-2.531).The risk of population carrying the G allele suffering from adenoma was 2.884 times of those carrying the A allele (OR =2.884,95％ CI:2.009-4.142).Conclusions TGF-β1 + 869 T/C and TRAIL + 1525 G/A gene polymorphisms may be related to the incidence of nodular thyroid diseases; G allele of TRAIL and C allele of TGF-β1 may be predisposing genes of patients with nodular goiter.

Objective: To select suitable conditions for prokaryotic expression and purification of rhIL-17. Methods: rhIL-17 was expressed in E. coli host under heat induction. After compared among the expression amounts in different media under different heat induction time, the most suitable conditions was selected. The target protein was present in the form of inclusion body. The precipitate of inclusion was obtained and purified after 6M guanidine solublization or 2% SDS solublization. Results: Either protocol could yield rhIL-17 with high purity and stable activity. The SDS solublization mehthod gives rise to much more higher productivity than the guanidine solublization method. Conclusion: rhIL-17 were expression in E. coli system and purified to homogenicity by SDS solublization methods with high productivity.

Objective To estimate the feasibility of QOL score in functional assessment of or-thotopic neobladder after radical cystectomy. Methods Questionnaire survey,QOL score sheet and urodynamic examination were done in 22 patients with orthotopic neobladder.Investigations were fo-CUS on the micturition interval during daytime and nighttime.Micturition time,degree of incontinence and their relationship with QOI.scores and urodynamic parameters wete also analyzed. ResuIts There were 3,6,7,1,2,3 and 0 cases which QOI.score were 0 to 6 accordingly.In the dav time,2 patients complained a light incontinence while 1 patient of moderate incontinence.In the nighttime.3 patients had the complaint of moderate incontinence while 4 patients of light incontinence.The average daytime mlcturltlon interval was 136 min(45-210 rain).The average maximum urinary flow rate,maximal urethral closure pressure and postvoid residual were 12.9 ml/s(2.7-22.1 ml/s),69.3 cm H2O(33-114 em H20)and 91.8 ml(5-300 m1)respectively.QOL scores had D.sitive correlation with the degree of incontinence during daytime and nighttime(daytime:r-0.510,P=0.015,night time:r=0.911,P<0.001).The QOL scores had negative correlation with daytime micturition inter-val(r=-0.749,P<0.001).The factors which influenced the QOL scores included the maximaI ure-thral closure pressure,postvoid residual and the maximum urinary flow rate. Conclusions QOL score reflects the patients"continent ability,subjective feelings on quality of life.It is correlated with the common urodynamic parameters.QOI.score might be used as a new index to estimate the function of orthotopic neobladder.

Objective To investigate the techniques of laparoscopic retroperitoneal lymph node dissection(LRPLND)through extraperitoneal approach. Methods Seven non-seminomatous germ cell testicular tumor(NSGCT)patients of clinical stage Ⅰ underwent LRPLND through extraperitoneal approach.The average age was 31(27-39 years old),the average weight was 62 kg(weight 58-72 kg).Pathological examination revealed 2 testis mixed carcinoma(major of embryonal carclnoma and seminoma),2 yolk sac tumor,1 ehoriocarcinoma,2 teratoma with seminoma.Two of them were in right side,and 5 in left.All the chest X-ray,abdominal CT and bone scanning of them were normal before operation.All patients were general anesthetized.Three or 4 trocars were placed,from 2 of them two gasbags were used to expand the retroperitoneal space at volume of 800-900 ml.The retroperitoneal fat was cleared off from the surface of Gerota's fascia to iliac fossa and the plane spance betwwwn anterior rena fascia and posterior peritoneum was separated In the same way the Plane between dorsal renal and the surface of psoas major and quadratus lumborum unto iliae lossa was exposed.Abdominal aorta or vena cava was exposed,then divided and dissected free from surfaee of psoas maior.The conflux of renal vein and testicular vein at the deep face of renal artere(left)was exposed,then testicular vein was ligated and divided it at its end.Fat and lymph tissue between ureter and vessels was dissected to the crotch of abdominal aorta or inferior vena cava.The primary inguinal incision of testectomy was then excided.Normal antegrade ejaculation recovered in 1 month postoperatively. Results The initial 2 operations were converted to open way as the peritoneum were penetrated largely.The other 5 operations were successful.The average operating time was 285 min(245-350 min),intraoperative blood loss was 100-250 ml.Four patients'pathologic results accorded with clinical staging,and 2 positive lymph nodes were found in the other one.The average number of lymph node resected was 25.6 counts(22-31).Follow-up for 3-20 months,chest X-ray and abdominal CT revealed no evidence of recurrence or distant metastasis,and serum tumor markers were in normal range.Normal antegrade ejaculation recovered in 1 month postoperatively. Conclusions The technique through extraperitoneal approach could be applied for LRPLND.It might be an approach for diagnosis and treatment of stage Ⅰ NSGCT.

Objective To report a modified radical inguinal lymphadenectomy the aim of which is to reduce the incidence of the complication of skin necrosis.Methods One hundred and twenty-six modified radical inguinal dissections were performed in 63 patients with penile carcinoma from June 2002 to June 2010.A modified radical inguinal dissection characterized by an S-shaped incision and precisely separating layers using an anatomical mark was performed.The boundaries of dissection were the same as classic radical inguinal lymphadenectomy.The incidences of complications of skin flap necrosis were retrospectively analyzed.Results The follow-up time ranged from 12 to 93 months.A total of 37 complications occurred,including 7 minimal skin necroses (5.6％),3 wound infections (2.4％),19 lymphedemas (15.1％),2 seroma formations (1.6％),5 lymphocele (4.0％),and 1 deep venous thrombosis (0.8％).There were no complications in 106 dissections (84.1％ ),and 20 dissections had one or two minor complications ( 15.9％ ).Conclusions The complication of skin necrosis related to groin dissection in patients with penile carcinoma could be reduced by using this modified inguinal dissection technique,which characterized by an S-shaped incision and precisely separating layers with using an anatomical landmark.

Objective To investigate the penetrative ability of amlodipine gels and to evaluate their effect on the survival of rat dorsal ischemic random skin flaps.Methods 0.5 ％,1.0 ％,1.5 ％,2.0 ％,and 2.5 ％ amlodipine gels were made.The accumulative penetrative quantities of amlodipine through rat skin were assayed with a modified Franz's diffusion cell in vitro.Pure gel without amlodipine,0.5 ％ and 1.5 ％ amlodipine gel were respectively applied on rat random ischemic skin flap once a day for 7 days.The viable area was measured on the seventh postoperative day and the quantities of amlodipine within skin flap were also detected at 2 and 6 hours after application of amlodipine gel.Results The accumulative penetrative quantities of amlodipine increased in time-and concentration-dependent manner (P＜0.05).Accumulative quantities of 0.5 ％ and 1.0 ％ amlodipine gel were lower than those of 1.5 ％,2.0 ％,and 2.5％ gel,respectively (P＜0.05).The quantities of amlodipine within flap tissue in 1.5 ％ amlodipine gel was higher than that of 0.5 ％ amlodipine gel (P＜0.05).The survival area of flap in 0.5 ％ amlodipine gel group (391.4±65.4) mm2 was higher than those of the pure percutaneous gel group (192.9±56.8) mm2 and the control group (191.0±50.2) mm2(P＜0.05),but no significant difference was seen between 1.5 ％ amlodipine gel group (265.7+88.3) mm2 and control group (P＞0.05).Conclusions Amlodipine could penetrate into skin tissues.0.5 ％ amlodipine gel could significantly increase survival area of ischemic random skin flap.