Objective:To investigate the chemical constituents from Avicennia marina.Methods:The isolation and purification of the CH2Cl2 and n-BuOH fractions of this plant were performed,and the chemical structures were elucidated by spectral analysis as well as comparison of their spectral data with literature values.Results:Three novel compounds were obtained and identified as erythro-guaiacylglycerol-?-ferulic acid ether(1),marinnone A(16) and marinnone B(17),along with eighteen known compounds as threo-guaiacylglycerol-?-ferulic acid ether(2),eleutheroside E2(3),(+)-lirioresinol A(4),dihydroxymethyl-bis(3,5-dimethoxy-4-hydroxyphenyl) tetrahydrofuran-9-O-?-glucopyranoside(5),(+)-lyoniresinol 3a-O-?-D-glucopyranoside(6),(-)-lyoniresinol 3a-O-?-D-glucopyranoside(7),epi-pinoresinol(8),leucoseceptoside A(9),jionoside C(10),salsaside A(11),ilicifolioside A(12),acteoside(13),isoacteoside(14),ethyl ferulate(15),avicennone D(18),avicenone E(19),avicennol C(20),and stenocarpoquinone B(21).Conclusion:Three new compounds(1,16 and 17) were obtained and thirteen known compounds,2-12,14 and 15 were isolated from Avicennia genus for the first time.

Objective:To understand the responsiveness of community health service institutions in Henan Province. Methods:This research collected information through questionnaire investigations. The object of the investigations is key informants familiar with community health service institutions. Various dimensions of responsiveness within Henan province community health service institutions are determined through a multiple-input pecking order graph. The fuzzy comprehen-sive evaluation method is used to evaluate the level of responsiveness. Responsiveness inequality index is used to measure the distribution of reactions. Results:A total of 431 valid key informants were surveyed. The various dimensions of the questionnaire of Cronbach alpha coefficient was greater than 0. 623;the total scale of the Cronbach alpha coefficient was 0. 850;the correlation coefficient of each dimension of test-retest reliability were greater than 0. 907. The levels of responsive-ness and distribution index were 8. 33 and 0. 2744, respectively;each dimension by order of importance:timely attention>dignity>infrastructure>communication>confidentiality >social support >selective >autonomy. Approximately 50% of key informants considered that vulnerable groups in community health service institutions were sometimes or often treated unfairly. Conclusion:Key informants considered the responsiveness level of overall higher community health service institu-tions in Henan Province was high, and the distribution of responsiveness was relative equilibrium. However, there is a large shortage of infrastructure, privacy protection, doctor-patient communication, etc.

Objective:To evaluate the role of esophagogastric junction contractile index (EGJ-CI) in distinguishing patients with refractory gastroesophageal reflux disease (RGERD) from functional heartburn (FH).Methods:From March 2014 to January 2018, 82 patients with proton pump inhibitor (PPI) refractory heartburn and/or regurgitation, who visited the Outpatient Department of Gastroenterology at The First Affiliated Hospital with Nanjing Medical University were enrolled, among them 50 patients with RGERD (RGERD group) and 32 patients with FH (FH group). EGJ-CI of RGERD group and FH group were compared. The sensitivity and specificity of EGJ-CI to distinguish RGERD from FH patients. The correlation between EGJ-CI and high resolution esophageal manometry parameters, baseline impedance level and 24 h impedance-pH monitoring parameters were analyzed. Mann-Whitney U test, receiver operator characteristic curve analysis and Spearman correlation analysis were used for statistical analysis. Results:The EGJ-CI of RGERD group was lower than that of FH group (25.8 mmHg·cm (14.1 mmHg·cm, 35.9 mmHg·cm)(1 mmHg=0.133 kPa) vs. 39.2 mmHg·cm (23.0 mmHg·cm, 60.8 mmHg·cm)), and the difference was statistically significant ( Z=-2.833, P=0.005). When the cut-off value of EGJ-CI was 35.8 mmHg·cm, the sensitivity and specificity to distinguish RGERD from FH were 76.0% and 62.5%, respectively; area under the curve was 0.69 (95% CI 0.57 to 0.81). EGJ-CI was positively correlated with lower sphincter resting pressure, integrated relaxation pressure, distal contractile integral, distal esophageal pressure, and mean nocturnal baseline impedance ( r=0.812, 0.631, 0.451, 0.490 and 0.401, all P<0.01). EGJ-CI was negatively correlated with DeMeester score, acid exposure time, total reflux episodes, acid reflux episodes, long reflux episodes and longest reflux time ( r=-0.363, -0.372, -0.346, -0.318, -0.300 and -0.291, all P<0.01). Conclusions:EGJ-CI can help to distinguish patients with FH from RGERD.

Objective To explore the change of plasma D-dimer (DD),lactate dehydrogenase isoenzyme 3 (LDH3),tissue plasminogen activator (t-PA) in the early stage of acute pulmonary embolism and their clinical significance.Methods Forty-six patients with acute pulmonary embolism of early stage (pulmonary embolism group) and 50 cases of normal person (control group) were enrolled in this study.The patients in pulmonary embolism group were divided into low-risk(18 patients),middle-risk(15 patients) and higher-risk (13 patients).The levels of DD,LDH3 and t-PA were detected and compared.Results The levels of DD,LDH3 and t-PA in pulmonary embolism group were (2.95 ± 0.73) mg/L,(421.42 ± 63.29)U/L and (0.85 ±0.02) U/L,and significantly higher than those in control group [(0.03 ±0.01) mg/L,(198.17 ± 23.37) U/L and (0.59 ± 0.02) U/L] (P ＜ 0.05).The levels of DD,LDH3 and t-PA in low-risk patients [(1.49 ± 0.04) mg/L,(315.47 ± 38.24) U/L and (0.63 ± 0.01) U/L] were significantly lower than those in middle-risk patients [(2.22 ±0.27) mg/L,(382.41 ±54.36) U/L and (0.79 ±0.02) U/L] and higher-risk patients [(3.38 ± 0.98) mg/L,(583.93 ± 117.21) U/L and (0.92 ± 0.03) U/L] (P ＜ 0.05).The levels of LDH3 and t-PA in middle-risk patients were significantly lower than those in higher-risk patients (P ＜ 0.05).After treatment,the levels of DD,LDH3 and t-PA were significantly decreased [(2.95 ± 0.73)mg/L vs.(1.03 ±0.11) mg/L,(421.42 ±63.29) U/L vs.(223.24 ±25.04) U/L,(0.85 ±0.02) U/L vs.(0.62 ± 0.02) U/L] (P ＜ 0.05).Conclusions The levels of DD,LDH3 and t-PA in the early stage of acute pulmonary embolism are increased significantly,and with the remission of the patient's condition,the levels of DD,LDH3 and t-PA are decreased.United detection conduces to the diagnosis of acute pulmonary embolism.

Objective To analyze the clinical efficacy of psychological nursing on patients with pregnancy-induced hypertension (PIH) combined with obstructive sleep apnea hypopnea syndrome (OSAHS).Methods 96 patients with pregnancy-induced hypertension (PIH) combined with OSAHS from January 2009 to July 2012 were admitted.They were randomly divided into the experimental group and the control group with 48 cases in each group.All patients were given routine drug therapy,based on this,the control group received routine care,and the experimental group was given routine care and psychological nursing.The anxiety and depression score and the treatment effect were compared between the two groups.Results After eight-week treatment,in the experimental group,the scores of SAS,SDS declined obviously and the levels of blood pressure were significantly decreased compared with those in the control group.The difference was statistically significant.Conclusions Psychological nursing for patients with pregnancy-induced hypertension(PIH) combined with OSAHS played a positive role in nursing of these patients,it can remit their anxiety and depression emotion and also can significantly decrease the patients'blood pressure.

ObjectivePresent treatment in plastic surgery on giant congenital melanocytic nevus has always been a tough practice because it is difficult to achieve balance between effects and costs of treatment.This paper aimed to explore the concrete procedure of tangential excision and dermabrasion in treatment of adult giant congenital melanocytic nevus. Methods Taking into consideration pathological examination results before surgery,diseased regions,psychological expectancy and other factors,we used a humby knife or globe grinding head to remove giant congenital relanocytic nevus by wiping off the surface of it in 10 cases.After operation,the operated area of the skin underwent a process of healing in a moisturized state.In each case,surgical procedure was carried out by 1 2 sta ges,with the interval period ranges from 3 months to 6 months.ResultsOne to 3 years follow-ups showed that among those cases,5 cases obtained good results in which skin color of surgical area turned to normal and pathological examination showed that nevus cells disappeared,4 cases achieved improvement,and 1 case was relapsed.ConclusionsThe two alternative methods for treatment of giant congenital melanocytic nevus,either tangential excision or dermabrasion,with combination of pathological examination results,diseased regions,and psychological expectancy should be taken into consideration,which can remain a maximum balance between effects and costs of treatments.Tangential excision and dermabrasion are effective in some cases of giant congenital nevus where traditional methods do not work,or in order to reduce the cost of body appearance in treatment.Therefore,these two methods deserve to be adopted extensively in clinical therapy.But it still needs further accumulation of experience in practice and longer period of follow-up after operation.

Objective To analyze the clinical efficacy of nursing intervention on patients who were suffering from pregnancy-induced hypertension syndrome combined with obstructive sleep apnea hypopnea syndrome(OSAHS). Methods From April 2010 to December 2011,58 patients with pregnancy-induced hypertension combined with OSAHS were selected.They were randomly divided into the experimental group and the control group with 29 cases in each group.The control group received routine care and drug treatment,based upon this,the experimental group received pertinent nursing of OSAHS.The treatment effect was compared between the two groups. Results The total effective rate of the experimental group was significantly higher than the control group. Conclusions Pertinent nursing of OSAHS for patients with pregnancy-induced hypertension combined with OSAHS played a positive role in nursing of these patients,it can significantly decrease the blood pressure of patients.

Objective:To isolate the variable fragments of heavy chain(VH) against the terminal protein(TP) region of hepatitis B virus(HBV) DNA polymerase(Pol) with protein fragment complementation assay(PCA).Methods:The TP region of HBV secreted by the HepG2.2.15 cells was used as an antigen,and the antibodies were selected with PCA.In this assay,two interacting proteins(target and antibody) are genetically fused to the two halves of the dissected enzyme dihydrofolate reductase.Binding of the two partners reassembles this enzyme and reconstitutes its activity,thus allowing growth on minimal mediem.Results:There were three TP region antigen-specific VHs could be directly in vivo selected with PCA.Sequence analysis showed that each TP-specific VH had a different sequence.Conclusion:Our results show that TP region antigen-specific VH could be directly in vivo selected with PCA.This system were powerful as a routine system for generating antibodies,especially in functional genomics.

OBJECTIVEThis paper aimed to determine the mRNA expression of osteoclast-related factors interleukin-6 (IL-6), interleukin-12 (IL-12) p35, IL-12p40, matrix metalloproteinase-9 (MMP-9), nuclear factor of activated T-cells cytoplasmic 1 (NFATcl), receptor activator of nuclear factor-KB (RANK), and tumor necrosis factor-α (TNF-α) mRNA in murine macrophages infected by a periodontitis patient's own tissue nucleic acid. Another aim was to investigate the effects of a periodontitis patient's own tissue nucleic acid on the differentiation of macrophages into osteoclasts.

METHODSInflammatory periodontal tissue samples of chronic periodontitis patients were taken during periodontal flap surgery, and healthy gingival tissue samples were taken from orthodontic patients during tooth extractions. Total RNA from periodontal tissue was extracted and reversely transcribed into cDNA and then cryo-preserved until further use. First, specific sequence oligodeoxynucleotide MT0I at a concentration of 1 µg · mL⁻¹ was added in murine macrophage RAW264.7, and the cells were incubated for 3 hours. Cells with PBS (1 µg · mL⁻¹) were used as negative controls. The inflammatory periodontal tissue cDNA and healthy periodontal tissue cDNA (1 µg · mL⁻¹) was added subsequently. There were four experimental groups: healthy periodontal tissue cDNA+ RAW264.7, inflammatory periodontal tissue cDNA+RAW264.7, MT01+healthy periodontal tissue cDNA+RAW264.7, and MT01+inflammatory periodontal tissue cDNA+RAW264.7. Real-time quantitative polymerase chain reaction was used to detect the mRNA expression of osteoclast-related factors IL-6, IL-12p35, IL-12p4O, MMP-9, NFATcl, RANK, and TNF-α mRNA after 3, 6, 12, and 24-hours.

RESULTSThe mRNA levels of osteoclast-related factors NFATc1, MMP-9, TNF-a, IL-6, IL-12p40, IL-12p35, and RANK in RAW264.7 were markedly upregulated with the treatment of periodontitis patient's own tissue nucleic acid. However, the mRNA expression of osteoclast-related factors was inhibited by use of an immunosuppressant MT01.

CONCLUSIONThe periodontitis patient's own tissue nucleic acid could promote the differentiation of murine macrophage into osteoclasts.

Animals ; Cell Differentiation ; Cytokines ; metabolism ; Gene Expression ; Gingiva ; Humans ; Interleukin-12 Subunit p40 ; Interleukin-6 ; Macrophages ; Matrix Metalloproteinase 9 ; Mice ; Osteoclasts ; metabolism ; Periodontitis ; RNA, Messenger ; Tumor Necrosis Factor-alpha

Objective To evaluate the infection status and genotype distribution of high risk human papillomavirus (HPV) in Chongqing women with different healthy status of cervix .Methods A retrospective analysis including 3 118 cases from June 2013 to March 2014 were performed ,945 of which were carried out multiplex real time PCR ,and data of cervix healthy status and HPV positive cases were subjected to chi‐square test .Results The general positive percentage of high risk HPV was 27 .49% ,16 .35%in healthy check‐up group ,and 24 .42% in cervicitis group and 39 .87% in cervical neoplasia lesion ,there was a significant difference of HPV positive ratio between these three groups(P< 0 .05) ;and HPV positive ratio was higher in older women without significant difference .In Chongqing region ,the three most common HPV types were HPV52 (21 .97% ) ,HPV16 (20 .00% ) and HPV58 (14 .75% ) .However ,the three most common HPV types in various groups are different :HPV52 (26 .20% ) ,HPV58 (14 .3% ) and HPV51 (10 .70% ) in health check‐up group ; HPV52 (21 .10% ) ,HPV58 (20 .00% ) and HPV16 (18 .90% ) in cervicitis group while HPV16 (29 .00% ) ,HPV52 (19 .80% ) and HPV58 (11 .50% ) in cervical neoplasia lesion group .The multiple infec‐tion rate of HPV was 5 .86% ,as the cervix status gets worse ,HPV concurrent infection increases ,and concurrent HPV types vary :mostly with HPV 52 in healthy check‐up group while with HPV 16 in cervical neoplasia lesion group .Conclusion The prevalence and genotype distribution of HPV in Chongqing women with different healthy status of cervix are significant difference.