Objective To study the transformation mechanism of triterpenes in processing of Alisma orientalis. Methods The triterpene transformations of A. orientalis pre and post-processing were comparatively analyzed by techniques of HPLC and Packed Column Supercritical Fluid Chromatography (SFC). Results In baked processing (70 ℃) of A. orientalis, little alisol B 23-acetate was transformed into alisol A 24-acetate and alisol B.However, more alisol B 23-acetate was transformed into alisol A 24-acetate and alisol B, then both of them were further transformed into alisol A in processing under high temperature (160-200 ℃). Conclusion Transformation of alisol B 23-acetate has two routes when A. orientalis is processed under high temperature: For one, alisol B 23-acetate is rearranged into alisol A 24-acetate which could be deacetylated into alisol A; for the other; it is deacetylated into alisol B first, then transformed into alisol A.

Objective To study the clinical value of vaccum sealing drainage in plasma cell mastitis.Methods 59 patients with plasma cell mastitis admitted in our hospital were treated with vaccum sealing drainage (the experimental group) from Jan.2011 to Apr.2014.59 plasma cell mastitis patients were treated with traditional vaseline gauze drainage (the control group).Clinical data like hospitalization length,healing time,healing grade,scar size,dressing change frequency,one year recurrence rate and breast deformity were retrospectively analyzed.Results Patients treated with vaccum sealing drainage had shorter hospitalization length and healing time,lower one year recurrence rate and less breast deformity compared to patients treated with traditional Vaseline gauze drainage (P＜0.01),while there was no significant difference in terms of healing grade (P＞0.05).Conclusions Vaccum sealing drainage can significantly shorten the hospitalization time and incision healing time,reduce dressing change frequency and one year recurrence rate in patients with plasma cell mastitis.Because of the smaller scar caused by vaccum sealing drainage,the breast deformity is also less.It is of clinical value for plasma cell mastitis.

Objective To analyze drug resistance data of Enterococcus faecalis and Enterococcus faecium,submitted by member units of Chongqing bacterial drug resistance monitoring network,and to provide the basis for our city effective application of antimicrobial agents and the reference.Methods Target bacteria identification and drug susceptibility test were performed by member units,according to the national technology scheme of bacterial drug resistance monitoring network and the results were determined according to standards published by Clinic and Laboratory Standard Institute(CLSI) in 2015.WHONET5.6 software was used to analyze drug susceptibility,and drug resistance difference was analyzed by using SPSS21.0 software.Results A total of un-repeated 1 811 strains of Enterococcus faecalis and 1 601 strains of Enterococcus faecium,accounting for 13.1% of all positive strains.The resistant rates of the two kinds of bacteria to vancomycin were 0.5% and 1.8%,to rinathiazole amine were 2.5% and 0.5% respectively.Tigecycline resistant strains were not founded.The resistant rate of Enterococcus feaclis to ouinupristin/dalfopristin was 90.1%,to tetracycline was 78.8%,to high concentration of gentamicin was 43.0%,to penicillin,ampicillin and nitrofurantoin was less than 7%.Except ouinupristin/dalfopristin and tetracycline,the resistant rate of Enterococcus faecium to the other drugs were significantly higher than Enterococcus faecalis(P<0.05).Strains isolated from children and adult patients,Intensive Care Unit(ICU) and un-ICU patients were with differences of drug resistance(P<0.05).Conclusion Most of Enterococcus infection could be caused by Enterococcus faecalis and Enterococcus faecium.Monitoring of drug resistance might be helpful for rational and effective usage of antimicrobial agents.

Objective To investigate the effect of Tongqiao Yinao decoction ( TYD) on postoperative cogni-tive dysfunction in elderly patients and its underlying mechanisms .Methods 100 anesthetic patients for orthopedic surgery were randomly divided into the TYD-treated group and control group ,50 patients in each group .In TYD-trea-ted group,patients received 150mL TYD orally,twice daily for constitutive 15 days,beginning from the day of admis-sion in addition to conventional symptomatic and supportive treatment .While patients in control group received no TYD.Mini-mental state examination ( MMSE) was used to evaluate the patients′cognitive function before and after anesthesia.Meanwhile,blood samples of patients were also collected to test the expression levels of IL -6.Results There was no significant difference between the two groups before operation .However ,TYD-treated patients had signif-icantly lower incidence rate of POCD than the controls ( 20% in the control group , and 12% in the TYD-treated group;χ2 =4.332,P=0.037) 7 days after operation.The incidence rates of POCD in the TYD-treated group and control group were 30%and 38%1 day after operation ( P>0.05),28% and 20% 3 days after operation ( P>0.05),respectively.Compared with that before operation ,the blood levels of IL-6 in the two groups significantly increased 3 days after operation (control group,t=2.412,P=0.009;TYD-treated group,t=1.429,P=0.039).In contrast to the control group,the level of IL-6 in TYD-treated group declined to the baseline (the control group,t=0.851,P=0.049;TYD-treated group,P=0.404).Interestingly,compared with the controls,the TYD-treated patients had a significant lower level of IL-6 after operation (t=1.198,P=0.035).Furthermore,Pearson correlation analysis showed that change of IL-6 level in blood was negatively correlated with MMSE score (r=-0.782,P=0.022). Conclusion TYD can improve postoperative cognitive dysfunction in elderly patients ,presumably through decreasing the level of IL-6 in blood.

Objective To study the factors affecting the activities of daily life (AOL) of patients after the first stroke of cerebral infarction in order to formulate the intervention strategy for improving the capability of ADL of patients. Method A total of 149 patients with the first stroke of cerebral infarction admitted from Oct. 2008 to Dec.2008 were enrolled in this study. The demographics of patients, cerebral infarction risk factors, apopletic score as per National Institute of Health stroke scale (NIHSS), white blood cell count (WBC) and plasma glucose (PG) were recorded on the first day of admission, and many other laboratory examinations were done on the next morning. The occurrences of infection in lung and urinary tract, and atrial fibrillation were recorded during hospi-talization. The NIHSS score and score of Glasgow Coma Scale (GCS) were taken within 24 hours after admission, on the 14th day and at the end of the third month after cerebral infarction respectively. Barthel index (BI) was taken in the second week as well as at the end of third month by follow-up in the OPD or by telephone. The correlation analysis and multiple linear stepwise regression analysis were used to find the risk factors. Results The PG level, WBC count and NIHSS score were independently associated with ADL in the second week as well as at the end of the third month after cerebral infarction. Besides, the urinary tract infection during hospital stay was also independently associated with ADL at the end of the third month after cerebral infarction. Conclusions The plasma glucose level, WBC count, NIHSS score and urinary tract infection are the risk factors. Positive measures should be taken to control these risk factors so as to improve the capability of ADL of the patients after cerebral infarction.

Objective To identify if intraoperative injecting carbon nanoparticles (CNP) is a feasible,precise and safe method of sentinel lymph node mapping (SLNM).Methods In this study,63 colon cancer patients from July 2009 to March 2011 were included.1 ml (50 mg) CNP was locally injected into subserosa around the neoplasm intraoperatively.In comparison 90 colon cancer patients underwent radical resection without CNP injection (control group).After operation both SLN and non-SLN were collected and analyzed compared with the lymphnodes collected in control group.Clinical feasibility,detection rate,and sensitivity of the method were analyzed.The categorical variables were analyzed with the Pearson Chi-square or Fisher's exact test,whereas the continuous variables were analyzed with t test,significance was determined as P ＜ 0.05.Results 1640 lymph nodes were detected in 63 patients(with an average 26.0 per case),SLNs were identified in all cases(100％),481 SLNs were collected (with an average 7.6).Totally 198 metastatic lymph nodes were detected in 31 patients (average 3.1),including 34 metastatic SLNs.Total number of lymph nodes and number of metastatic lymph nodes detected in CNP group were higher than those of control group (P =0.000,P =0.001).The sensitivity,accuracy,specificity and false negative rate were 52％,76％,100％ and 48％ respectively.The sensitivity,accuracy,specificity and false negative rate were adjusted to 79％,90％,100％ and 21％ respectively if all T4 stage patients were excluded.Conclusions SLN detection can increase the number of lymph nodes harvested and improve the detection rate of lymph node metastasis.

Objective Paraquat(PQ) is an effective herbicide which is widely used in agricultural production .PQ poisoning is frequently seen in humans with the lung as the target organ ,but the poisoning mechanisms is not very clear .Studies show that endoplasmic reticulum stress(ERS) is closely associated with poisoning , but there are few reports on the relationship between ER stress and PQ poi-soning.This article was to investigate the effects of ERS-induced apoptosis and total flavonoids from astragalus complanatus (FAC) in a-cute lung injury(ALI) following paraquat poisoning in rats . Methods A total of 30 adult healthy Sprague-Dawley (SD) rats were ran-domly divided into 3 groups:control group, ALI group, ALI+FAC group and ALI+saline group.Biochemical method was applied to de-tect superoxide dismutase (SOD), catalase (CAT) and malondialdehyde (MDA) in lung tisssue,TdT-mediated dUTP nick end labeling (TUNEL) assay in observing lung apoptosis, Western blotting and real-time PCR(RT-PCR) in detecting the changes in expressions of C/EBP homologous peotein (CHOP), activating transcription factor 4 (ATF4) and X-box binding protein 1 (XBP) following ALI, and HE staining in observing the pathological changes of lung tissue . Results Compared with control group , the expression of MDA content was enhanced in ALI group ([3.26 ±0.24] vs [5.04 ±0.36],P<0.01), along with significantly decreased activity of SOD and CAT ([300.26 ±35.69] vs [187.21 ±25.66]), ([5.78 ±1.28] vs [2.15 ±1.12],P<0.01), increased cell apoptosis , upregulated pro-tain level of CHOP ([0.74 ±0.20] vs [0.23 ±0.07],P<0.01) and mRNA expression of ATF4, XBP1 and CHOP.However, FAC sig-nificantly attenuated ALI following PQ , as showed by reduced MDA content , enhanced activity of SOD and CAT , decreased cell apopto-sis, inhibited protain level of CHOP and mRNA expression of ATF 4, XBP1 and CHOP ([5.04 ±0.36] vs [3.99 ±0.27],P<0.01). Furthermore, the activity of SOD and CAT were higher in FAC pretreatment group than those in ALI group ([ 0.74 ±0.20 ] vs [0.42 ±0.11],P<0.01). Conclusion From the research, ERS-induced cell apoptosis is involved in ALI following PQ , and the protec-tive role of FAC in lung tissue following PQ is due to its effect in atten-uating ERS-induced apoptosis .

The paper summarized the explorations of public hospital pilots in the compensation mechanism and identified the following findings.For example,by means of fiscal support of public hospital infrastructure and development spending,cancellation of drug markup,higher service prices, and reformed payment mode of medical insurance,these hospitals have made initial changes at their business operating mechanism, motivation-guidance of compensation, and their makeup of medical revenue.In addition,such hospitals are found with lower cost of medical care per visit,and higher income of medical workers.The authors also pointed out such problems as inflated drug pricing and expenses,lack of scientific pricing mechanism for medical services,vague definition of policy-related losses,and old-fashioned practice of government investment and health insurance payment.Based on such findings,the paper advised to adjust health care prices by stages and to improve the management of health insurance and the coherence of compensation mechanism.

Metabolic syndrome is a clinical syndrome characterized by the co-existence of obesity, hyperglycemia, hypertension, dyslipidemia and other metabolic disorders.At present, the incidence of metabolic syndrome is increasing year by year.Metabolic syndrome is more common among the elderly, seriously threatening the quality of life in the elderly.Tea, as one of the most popular beverages in the world, has been found to have effects on lowering the levels of blood pressure, blood glucose and lipid and so on.This review summarizes the effects and possible mechanisms of tea drinking on metabolic syndrome and its components in the elderly.