Through several years of exploration in Shanghai Chongming region, the team from Chongming Branch of Xinhua Hospital has established the initial multidisciplinary diagnosis and treatment model of cancer pain, which includes the department of oncology, anesthesiology, pain, rehabilitation, psychology and so forth. By means of medical informationization, they take cancer pain management as the starting point and have initially real-ized a new model of the real-time assessment and treatment of cancer pain, which has helped patients effectively reduce the physical and psychological suffering, improved the quality of life, developed a healthy self-manage-ment of patients, and has reference significance to palliative care.

OBJECTIVETo investigate the chemical constituents from the whole plants of Senecio chrysanthemoides.

METHODThe chemical constituents were isolated and purified by chromatographic techniques over silica gel, Sephadex LH-20, preparative TLC and preparative HPLC. Structures of the compounds were identified by NMR and MS spectroscopic methods.

RESULTTwenty five compounds were obtained and their structures were elucidated as seneciphyline (1), senecionine (2) , 1,2-dihydrocacalohastine (3) , eu-desm-4( 15)-ene-1beta,6alpha-diol (4), 7,11,15-trimethyl- 3methylidenehexadecane-1,2-diol (5), faradiol 3-O-palmitate (6),maniladiol 3-O-palmitate (7), faradiol (8), maniladiol (9), beta-amyrin (10), alpha-amyrin (11), betulin (12), loranthol (13), (+)-syringaresinol (14) , 1-hydroxy-4-oxo-cyclohexane-1-acetate (15), 2, 6-dimethoxy-p-benzoquinone (16), stigmasta-5, 22-dien-3beta-hydroxy-7-one (17) , stigmasta-5, 22-dien-7-one (18) , stigmasta-4-en-3-one (19), stigmasta-4,22-dien-3-one (20), beta-sitosterol (21), stigmasterol (22), daucosterol (23), glycerol 1-hendecanoate (24), and methyl hendecanoate (25).

CONCLUSIONCompounds 5-9,13, 17-20 and 24 were obtained from the genus Senecio for the first time.

Acetates ; chemistry ; Chemical Fractionation ; Plant Extracts ; analysis ; isolation & purification ; Senecio ; chemistry

Objective To investigate the pathological features of ovarian tumors in elderly women.Methods We retrospectively analyzed clinical data of 124 elderly patients with ovarian cancer who were admitted to our hospital from January 2015 to December 2017.Results Among the 124 elderly patients with ovarian tumors,there were 6 borderline tumors,19 malignant tumors,and 99 benign tumors.Postmenopausal vaginal bleeding and lower abdominal pain were the main symptoms of ovarian cancer in elderly patients.The incidence of abdominal pain in patients with benign ovarian tumors was significantly higher than in patients with malignant tumors (x2 =5.813,P ＜0.05);the incidence of postmenopausal vaginal bleeding in malignant tumors was significantly higher than in benign tumors(x2=8.123,P ＜0.05);the major pathological type of benign ovarian tumors was mucinous cystadenoma,while serous cystadenoma was the most common type of malignant tumors.Analysis of related factors showed that menopausal age was positively correlated with,and menarche age and number of pregnancies were negatively correlated with ovarian tumors;and there was no correlation with number of abortions.Conclusions Malignant ovarian tumors are common in elderly women.Clinically,attention to risk factors,early detection and diagnosis will help further reduce the malignant transformation rate and improve the quality of life for patients.

OBJECTIVETo investigate the chemical constituents from the whole plants of Senecio chrysanthemoides.

METHODConstituents were isolated by using a combination of various chromatographic techniques including column chromatography over silica gel, Sephadex LH-20, and ODS C18, as well as reversed-phase HPLC. Structures of the isolates were identified by spectroscopic and chemical methods.

RESULTEighteen glycosides were obtained from a H2O-soluble portion of an ethanolic extract of the whole plants of Senecio chrysanthemoides and their structures were elucidated as 5'-methoxyligusinenoside B (1), hyuganoside III b (2), citrusin A (3), alaschanioside A (4), citrusin B (5), dehydrodieoniferyl alcohol 4, gamma'-di-O-beta-D-glucopyranoside (6), osmanthuside G (7), syringin (8), dehydrosyringin (9), 2-(4-hydroxy-3,5-dimethoxyphenyl) ethanol 4-O-beta-D-glucopyranoside (10), 2-phenylethyl beta-gentiobioside (11), phenethyl beta-D-glucopyranoside (12), nikoenoside (13), benzyl beta-D-glucopyranoyl (1 --> 6 ) -beta-D-glucopyranoside (14), 3,5-dimethoxy-4-hydroxybenzyl alcohol 4-O-beta-D-glucopyranoside (15), icariside B2 (16), sonchuionoside C (17), and 1-[(beta-D-glucopyranosyloxy) methyl] -5,6-dihydropyrrolizin-7-one (18).

CONCLUSIONCompound 1 was a new lignan glycoside, and the remaining compounds were obtained from this plant for the first time.

Chromatography ; methods ; Glycosides ; chemistry ; isolation & purification ; Lignans ; chemistry ; isolation & purification ; Plant Extracts ; chemistry ; Plants, Medicinal ; chemistry ; Senecio ; chemistry

Objective:To explore the clinical characteristics and treatment outcomes of patients with lightning injury on plateau in Tibet Autonomous Region, and to analyze the risk factors for heart injuries in these patients.Methods:A retrospective case series study was conducted. From January 2008 to July 2023, 55 patients with lightning injury who met the inclusion criteria were admitted to the General Hospital of PLA Tibet Military Area Command. The gender, age, ethnicity, time of injury, location of injury (average altitude), activity at the time of injury, the occurrence of thermal burns on the body surface, the occurrence of complication, the occurrence of combined injury, underlying disease or physiological process before injury, length of hospital stay, treatment outcome, and effective rate of treatment were recorded. The patients were divided into juvenile group (11 cases), young group (28 cases), middle-aged group (14 cases), and elderly group (2 cases) according to age bracket, then the gender and ethnicity distribution of patients in the 4 groups were compared. According to the occurrence of heart injuries at admission, the patients were divided into heart injury group (44 cases) and non-heart injury group (11 cases), then the gender, age, ethnicity, average altitude of location of injury, length of hospital stay, the occurrence of complication, the occurrence of combined injury, site of thermal burns on the body surface, and area of thermal burns on the body surface in patients were compared between the two groups. Data were statistically analyzed with Mann-Whitney U test, chi-square test, or Fisher's exact probability test. The multivariate logistic regression analysis was conducted to screen the independent risk factors for heart injury in patients with lightning injury. Results:Among the 55 patients aged 10-68 years, 39 were male and 16 were female, including 47 Tibetans and 8 Hans. There were no statistically significant differences in gender or ethnicity distribution of patients among the 4 groups with different age brackets ( P>0.05). Lightning injuries occurred from May to September, which mostly occurred in June and July. The incidence of lightning injury was higher in Chengguan District of Lhasa City (average altitude of 3 650 m) and Baqing County of Naqu City (average altitude of 4 500 m), being 20.0% (11/55) and 16.4% (9/55), respectively. A total of 96.4% (53/55) of the patients were engaged in outdoor activities when injured, such as grazing, digging Cordyceps, and harvesting highland barley. Among the 55 patients, 46 (83.6%) cases had thermal burns on the body surface, with burn area mainly being not more than 10% total body surface area and burn depth mainly being deep partial-thickness. Fifty-two (94.5%) patients had complications, with heart injury being the most common complication (44 cases, 80.0%). Twenty-two (40.0%) patients had 11 combined injuries, and traumatic brain injury was the most common combined injury. Seventeen (30.9%) patients had 11 underlying diseases or physiological processes before injury. The length of hospital stay of patients was 9 (5, 17) d. Among the 55 patients, 14 cases were cured and discharged, 40 cases were improved, and 1 case died, with effective rate of treatment of 98.2%. Compared with those in non-heart injury group, the proportion of complication occurrence ( χ2=12.28), the proportion of trunk burns ( χ2=5.15), and the average altitude of location of injury ( Z=-2.38) of patients in heart injury group were increased significantly ( P<0.05), while there were no significant changes in the other indicators ( P>0.05). Multivariate logistic regression analysis showed that the average altitude at the location of injury was the independent risk factor for heart injury in patients with lightning injury (with odds ratio of 3.28, 95% confidence interval of 1.35-7.99, P<0.05). Conclusions:Lightning injuries on plateau in Tibet Autonomous Region mainly occur from May to September, with an average altitude of 4 500 m at the location of injury. Patients with lightning injury are injured when participating outdoor activities, and the affected patients are mainly mainly young male Tibetans. Most of the injuries are mild burns. Lightning injuries are complex and have many complications, with heart injury being the most common one. The average altitude at the location of injury is the independent risk factor for heart injury in patients with lightning injury.

ObjectiveTo analyze the epidemiological characteristics of pathogens in foodborne disease cases in Haining City， Zhejiang Province， and to provide a basis for the prevention and investigation of foodborne diseases and outbreak events. MethodsInformation on foodborne disease patients from 2014 to 2023 was collected， and stool or anal swab samples were tested for relevant pathogens. The χ² test was used to compare the differences in pathogen detection rates among different groups， and multivariate logistic regression analysis was used to analyze the risk factors for pathogen detection. ResultsA total of 5 814 samples were tested， with a positive detection rate of 15.36%. The detection rates were 4.95% for norovirus， 4.49% for Escherichia coli， 3.59% for Salmonella， 2.22% for Vibrio parahaemolyticus， and 0.11% for Shigella. The positive detection rates showed seasonal characteristics， with a minor peak in March-April dominated by norovirus and a major peak in July-September dominated by bacteria. The three groups with the highest detection rates were workers， white-collar workers and other groups. Multivariate logistic regression analysis showed that age， season， and antibiotic use before consultation were significant influencing factors for pathogen detection （P<0.05）. Total pathogen detection risk was lower in the group that took antibiotics before visiting the clinic compared to those who did not （OR=0.29， 95%CI： 0.15‒0.49）. The detection risk for norovirus was lower in the preschool age group （OR=0.19， 95%CI： 0.04‒1.00）， in summer and autumn （OR range 0.23‒0.41）， and in the group taking antibiotics （OR=0.42， 95%CI： 0.15‒0.92）， but higher in the adolescent group （OR=1.40， 95%CI： 1.05‒1.88）. The detection risk for enteropathogenic Escherichia coli was higher in summer （OR=1.82， 95%CI： 1.30‒2.60）. The detection risk for Salmonella increased in the elderly group and in summer （OR range 1.44‒2.21）， but decreased in the adolescent group， in winter， and in the group taking antibiotics （OR range 0.22‒0.65）. The detection risk for Vibrio parahaemolyticus increased in summer and autumn （OR range 1.80‒1.90）， but decreased in the primary and secondary school student group and in winter （OR range 0.10‒0.32）. ConclusionThe prevalence of foodborne disease pathogens in Haining City is relatively high. Age， season， and antibiotic use before consultation are independent influencing factors for pathogen detection. These findings suggest that specific hypotheses regarding pathogenic factors can be proposed based on the time of occurrence and the age distribution of cases during field investigations of foodborne outbreaks.

Sugar-sugar glycosyltransferases play important roles in constructing complex and bioactive saponins. Here, we characterized a series of UDP-glycosyltransferases responsible for biosynthesizing the branched sugar chain of bioactive steroidal saponins from a widely known medicinal plant Paris polyphylla var. yunnanensis. Among them, a 2'-O-rhamnosyltransferase and three 6'-O-glucosyltrasferases catalyzed a cascade of glycosylation to produce steroidal diglycosides and triglycosides, respectively. These UDP-glycosyltransferases showed astonishing substrate promiscuity, resulting in the generation of a panel of 24 terpenoid glycosides including 15 previously undescribed compounds. A mutant library containing 44 variants was constructed based on the identification of critical residues by molecular docking simulations and protein model alignments, and a mutant UGT91AH1^Y187A with increased catalytic efficiency was obtained. The steroidal saponins exhibited remarkable antifungal activity against four widespread strains of human pathogenic fungi attributed to ergosterol-dependent damage of fungal cell membranes, and 2'-O-rhamnosylation appeared to correlate with strong antifungal effects. The findings elucidated the biosynthetic machinery for their production of steroidal saponins and revealed their potential as new antifungal agents.