Objective To study the chemical components from the pericarps of Juglans mandshurica with anti-tumor activity.Methods It showed that pericarps of J.mandshurica had a good performance in treating cancer and low toxicity from CHCl3 and EtOAc portions by a lot of pharmacological experiments and modern clinical application in the past.Compounds were isolated by chromatography on silica gel columns and AB-8 macroporous resin.On the basis of spectral evidences including 1D-NMR and 2D-NMR,the structures of these compounds were determined.Results These compounds from CHCl3 portion were identified as 20(S)-protopanaxadiol-3-one(1),dammara-20,24-dien-3?-ol(2),galeon(3),juglanin A(4),2?,3?,23-trihydroxy olean-12-en-28-oic acid(5),2?,3?,23-trihydroxy urs-12-en-28-oic acid(6),oleanolic acid(7),ursolic acid(8).Conclusion Compound 1 is a new natural product.Compounds 2 and 5-8 are isolated firstly from the plants of Juglans L.which are due to pentacyclic triterpane.Compound 3 is isolated from the pericarps of J.mandshurica for the first time.

Objective To investigate the effects of different head positions during operation on wake-up time and quality among ankylosing spondylitis (AS) patients with thoracolumbar kyphosis following pedicle subtraction osteotomy (PSO).Methods Sixty patients were included in this study.All of them,treated with intravenous anesthesia,took the bow-prone position.The patients were randomly divided into two groups:the experiment group where the head was elevated by 10° and the control group where the head was not elevated.The two groups were compared in respect of wake-up time and quality of wake-up test.Results The wake-up time in the experiment group was significantly shorter as compared to that of the control group (1 3.7±2.0 min vs.24.2±2.7min,P＜0.05).The wake-up quality was better as well.Conclusion Elevation of the head by 10° can shorten wake-up time and improve the quality of wake-up test during the procedure of PSO for AS patients with thoracolumbar kyphosis.

Objective To investigate the anti-inflammatory impacts of in the progression of Alzheimer' s disease (AD) in the rat model induced by β-amyloid 1-42 (Aβ1-42 ). Methods Sixty healthy male Wistar rats (weight 250--300 g) were randomly divided into 4 groups: control group, model group, statins control group and statins treatment group, 15 in each group. Rats model were established via intracerebroventricular injection of A13, and then atorvastatin (5 mg·kg-1·d-1) were given to the treatment group for 3 weeks, saline to the control group. Water Maze was used to observe learning and memory ability changes in rats, and expression of inflammatory eytokines IL-1β, IL-6 and TNF-α in the hippocampus were repectively detected by immunohistochemical technique. Furthermore, HE staining patterns, hippoeampns neurons and glial cells in the small ultra structural changes were observed under light microscope and electron microscope respectively. Results The model rats resulted in decreased learning and memory abihties ( the escaping latency: 12. 0 ± 1.2, 41.3 ± 3.4, t = 18. 0363, P < 0. 01 ) and increased secretion of the brain inflammatory factor compared with the controls with statistically significant difference (IL-1β:53.5 ± 2.4, 101.0 ± 3. 8, t = 23. 8246, P < 0. 01 ). Atorvastatin treatment group improved learning and memory performance ( the escaping latency: 25. 7 ± 1.6, 41.3 ± 3.4, t = 9. 1076, P < 0. 01 ), reduced the secretion of inflammatory factors in the hippocampus, compared with the model rats (IL-1β:60.0±3.4,101.0±3.8, t = 18.0231, P <0.01). There were less injured nerve cells and proliferated glial cells in the atorvastatin treatment group than in the model group. Conclusions Atorvastatin plays an anti-inflammatory role in the progression of Alzheimer's disease, reducing the nerve cell damage and improving learning and memory ability.

A total of 526 team members from 28 community health service (CHS) centers in 5 pilot cities were surveyed by a questionnaire.All CHS centers developed team service.And 275 service teams were established and the coverage rate of area resident committee was 100％.The teaming modes were mainly divided into four kinds:medical-nursing-prevention classic combination,big team professional expansion,small team medical combination and non-health technology extensive participation.The team services showed multiple advantages of professionism,energy and time complementing.We should strengthen team construction,improve perfect team service mode and policy support and create a good environment for CHS development.

Objective To study the effects of steaming Orange Magnoliavine Fruit with vinegar on the lignan metabolism in rats.Methods The rats were fed with same amount of extracts:Orange Magnoliavine Fruit before and after steaming processing with vinegar. Then plasma samples were collected at different times and determined contents of schisantherin A and deoxyschizandrin by HPLC to draw drug concentration in blood-time curve. The pharmacokinetic parameters were calculated with DAS2.0 analysis software.Results Pharmacokinetic model of schisantherin A and deoxyschizandrin in rats accorded with one compartment model. Plasma concentration in rats under the condition of Orange Magnoliavine Fruit samples before and after steaming processing with vinegar was:Tmax of schisantherin A was determined with (4.250±1.523), (5.750±1.784)h respectively, Cmax with (2.197±0.995), (2.815±0.842)μg/mL respectively, T1/2 with (2.654±0.377), (3.504±0.856)h respectively. Tmax of deoxyschizandrin was determined with (3.250±1.836), (4.250±1.471)h respectively, Cmax with (1.922±0.773), (2.307±0.602)μg/mL, T1/2 with (2.111±1.185), (3.242±2.126)h. Orange Magnoliavine Fruit before and after steaming processing with vinegar exhibited differences in pharmacokinetic parameters in rats.Conclusion The pharmacokinetic parameters of schisantherin A and deoxyschizandrin showed that the steaming processing with vinegar on Orange Magnoliavine Fruit can slow down lignan metabolism in vivo.

ObjectiveTo collect and analyze patients' evaluation of basic medical services in Tianjin community health service institutions and to suggest improvements.MethodsA total of 15 community health service centers and 15 community health service stations in six urban districts of Tianjin were selected by stratified sampling and 300 randomly intercepted patients were surveyed by questionnaire.ResultsApproximately half ( 157/300, 52. 3％ ) the patients selected community health service institution as their first choice to seek medical attention. The most important reason for this, with 89.2％ patients responding yes, was that the community health service institution was close to home and very convenient.One quarter (79/300, 25.3％ ) of the patients regularly consulted the same doctor and 17.7％ (53/300)seldom went to see a doctor. The proportion of patients expressing a high degree of satisfaction to service standards and health professionals was 78. 7％, of which satisfaction with physicians' explanation about the patients' illness ranked highest at 83. 7％ (251/300). Patients' confidence level of doctors' diagnosis,physical examination, and auxiliary examination was 92. 0％. Moreover, most (87. 0％ ) patients reported that doctors communicate well with them; 85.0％ (255/300) patients received health instruction from doctors during visits, and 82. 0％ patients reported that doctors pay attention to protecting patients' privacy.The overall satisfaction of patients to environmental facilities and process management of community health service institutions was 73.6％. On the other hand, patient satisfaction with medicine types, service price,instrumentation and equipment, and environment were all lower than the average satisfaction. Conclusions Patients were basically satisfied with medical service in community health service institutions. Three main problem areas were identified: patients' use of community health services is deficient, medical service ability is partially lacking, and the service feature of general practitioners (GPs) is not obvious. Improvements of basic medical service ability in the community, cultivation of GPs, and basic medicine regulation are advocated.

Objective To observe the changes of intraocular pressure(IOP)in surgical treatment of Arnold-Chiari malformation.Methods The IOP of 20 patients who underwent surgical treatment of ArnoldChiari malformation were detected by Tono-Pen tonometer at 5 min utes after general anesthesia(T0),5 minutes after prone position(T1),30 minutes after prone position(T2),60 minutes after prone position(T3),prone position before the end of operation(T4),5 minutes after recovery prostration position(Ts)and 30 minutes after prostration position(T6),mean aortic pressure(MAP),heart rate(HR)and partial pressure of carbon dioxide in end tidal(PETCO2)were recorded at the same time.With the prone position,head was fixed bead-holder with skull pin.Results There was no statistical difference in MAP,HR,PEtCO2 at each time point(P＞ 0.05).The IOP significantly increased at T1[(20.9 ±2.5)mm Hg(1 mm Hg =0.133 kPa)],T2[(17.7 ± 1.7)mm Hg],T3[(23.9 ±2.4)mm Hg],T4[(26.3 ± 1.0)mm Hg]compared with IOP at T0 [(9.5 ± 1.5)mm Hg](P ＜ 0.05),there were significant differences between T2 and T3,T3 and T4(P ＜ 0.05).Recovery prostration position,the IOP decreased gradually,IOP at T5[(18.6 ± 1.8)mm Hg]was significantly lower than that at T4(P ＜ 0.05),but T5 was still higher than T0(P ＜ 0.05).The IOP at T6[(10.3 ± 1.7)mm Hg]was no difference compared with T0.Inserting of skull pin might be increase IOP for a moment,the IOP at T; was significantly higher than that at T2(P ＜ 0.05).Conclusion IOP gradually increases as the patients prone position changes in surgical treatment of Arnold-Chiari malformation,and inserting of skull pin maybe increase IOP for a moment.

To explore the value of acoustic radiation force impulse (ARFI) technique in the differential diagnosis of benign and malignant hepatic neoplasms.Retrospective analysis of touch tissue quantification (VTQ) and general ultrasonic examination of interesting region were performed for hepatocellular carcinoma (HCC),hepatic hemangioma,focal nodular hyperplasia (FNH) and controls.Significant differences existed between HCC and hepatic hemangioma,hepatic FNH and controls (all P ＜0.01).No significant difference existed between primary and metastatic HCC (P ＞ 0.05).There was no significant difference between hepatic hemangioma,FNH and controls (all P ＞ 0.05).With a cut-off VTQ value of 1.95 m/s,the sensitivity and accuracy rate in the differentiation of benign and malignant hepatic neoplasms was 90％ and 83％ respectively.The sensitivity and accuracy rate in general ultrasound examination of hepatic neoplasms was 88％ and 70％ respectively.Significant differences existed in accuracy rate between two methods (P ＜ 0.01).It was confirmed that ARFI could reflect the stiffness of liver neoplasm noninvasively.Compared with general ultrasonography,ARFI is better at differentiating benign and malignant hepatic neoplasms.

Objective To investigate the clinical effect of mosapride combined acupoint massage on diabetic gastroparesis(DGP)in elderly patients with type 2 diabetes.Methods 150 cases of DGP in our hospital from April 2015 to May 2016 were collected and randomly divided into three groups:the conventional treatment group(n=35,in insulin treatment),the control group(n=52,in mosapride treatment),and the experimental group(n=63,in mosapride combined with acupoint massage treatment).All patients received the conventional diabetic therapy.Clinical efficacy,gastric emptying rate and the levels of serum gastrin and fasting blood glucose were observed and compared before versus after treatment among the three groups.Results After treatment,the total effective rate was 92.1% in the experimental group,versus 51.4% and 73.1% in the conventional treatment group and control group respectively,showing a statistically significant difference(P<0.05).There were significant differences in gastric emptying rate,the levels of serum gastrin and fasting blood glucose among the 3 treatment groups before versus after treatment.And gastric emptying rate,the levels of serum gastrin and fasting blood glucose were improved in the experimental groups compared with the conventional treatment and control groups(all P<0.05).The follow-up results showed that the adverse reactions and the recurrence rates were significantly lower in the experimental group than in conventional treatment group and control group(all P<0.05).Conclusions Mosapride combined with acupoint massage in the treatment of diabetic gastroparesis have significant clinical effect,low recurrence rate and high safety,and is worthy of promotion.

The teaching method of critical thinking was introduced in the course of medical physics for undergraduate students by means of case teaching,PBL teaching,Bio-Physics teaching and research-oriented teaching patterns.The teaching quality and both the abilities of critical thinking and innovation of the students were enhanced.