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 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.

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.

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.

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.

There existed animal ethical issues in the process of functional experiment including poor breeding environment before animal experiment, insufficient prepare before class, not standard experimental operation, less attention paid to the study of anesthesia, disposal on animals after the experiment. Based on the analysis of these issues and combined with the thought of respect for animals′rights and attention to animal welfare, the authors put forward suggestions from the aspects including the schools′active attention and support, curriculum, standardizing the experimental design and operation steps, improving the animal experiment teachers′ethical consciousness, cul-tivating the students′experimental animal ethical consciousness. In addition, this paper put forward the thinking of further strengthening education:the domestic medical colleges generally need to strengthen medical ethics educa-tion, and should adopt various forms to cultivate medical students′medical ethics quality of treasuring life.

Objective To discuss the research status and hotspots related to breeding, planting, harvest, processing and storage of Lycium L. in China. Methods Relevant literature about breeding, planting, harvest, processing and storage of Lycium L. in CNKI from January 2004 to December 2013 was retrieved by computers. CiteSpaceⅡ was introduced to carry out key word analysis, high-frequency key word obtaining, co-occurrence network of high-frequency key words, and dendrogram of high-frequency words. Results Totally 759 articles were included. Key words about breeding were “genetic diversity”, “male sterile”, “its sequence”, “callus issue”, and“anther culture”. Key words about planting were“output”,“quality”,“hard twig cuttage”,“irrigation amount”. Key words about harvesting and processing were“picking machine of Lycium L.”,“drying kiln of Lycium L.”,“hot air drying”, and “combined drying”. Key words about storage were “pesticide residue”, “heavy metal”, and“organophosphorus pesticide”. Co-occurrence network of high-frequency key words showed that the research hotspots were pesticide residue, test of heavy metal and the storage of fresh fruits. Dendrogram of high-frequency key words showed that the high-frequency key words were “package”, “refreshment”, and “lycium barbarum polysaccharide”. Conclusion The research hotspots of planting of Lycium L. are planting skills effecting the output and quality of Lycium L.; In the field of harvesting and processing of Lycium L., design and research of picking machine has replaced traditional manual picking. Modern hot air drying has already replaced traditional drying in the sun or drying skills; In the aspect of storage of Lycium L., the study on the refreshment of Lycium L. has attached attention.

Objective To investigate the antibiotic resistance, virulence genes, and sequence types of Enterococcus faecium ( E. faecium) strains isolated from children under 3 years old in Sui county, Henan province. Methods Kirby-Bauer antibiotic testing was performed to analyze the antibiotic sensitivi-ties of E. faecium strains to 15 common antibiotics. PCR analysis was used to detect the virulence genes car-ried by the E. faecium strains. Multilocus sequence typing ( MLST) was performed for the typing of E. faeci-um strains. Results Forty-seven E. faecium strains were isolated from 120 stool samples collected from chil-dren under 3 years old in Sui county, Henan province, of which 95. 7% were antibiotic-resistant strains. Most of the isolated E. faecium strains were resistant to rifampicin, accounting for 91. 5% (43/47) of all isolates, followed by those resistant to erythromycin and tetracycline, which accounted for 68. 1% (32/47). Moreover, high resistance rates to those antibiotics commonly used in clinical treatments of E. faecium infec-tion including β-lactam and aminoglycosides antibiotics were observed. Those strains resistant to more than three kinds of antibiotics belonged to the same clonal complex including 12 strains of clonal complex 17 ( CC17) harboring the virulence gene of hyl. All of the isolated E. faecium strains were susceptible to vanco-mycin, linezolid, chloromycetin and nitrofurantoin. Conclusion The E. faecium strains isolated from chil-dren under 3 years old in Sui county, Henan province were multi-antibiotic resistant. There were drug-resist-ance strains belonging to the CC17 and carrying the virulence gene of hyl.

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.