The biologically active constituents in Gynostemma pentaphyllum are dammarane-type glycosides,called gypenosides.They are believed to be the highest contents of this herb,easy to obtain,and mainly active in anti-tumor,controlling the blood glucose,lipid-lowering,cardiovascular protection,etc.The saponins may change into sub-glucoside after hydrolysis,for the intemal acetal glucoside structure is vulnerable to acid,alkali,and enzyme degradation.Through searching the literatures in recent years,this paper summarized the chemical constituents in the hydrolyzed products of gypenosides,for providing references to discover novel and more active lead compounds.

Objective To study the functional mechanism of Naoxin tong Capsule (Ca psule for cerebral and heart diseases) on a cute coronary syndrome (ACS). Methods Totally 105 ACS p atients diagnosed with coro nary angiography were randomized into a treatment group (55 cases), and a control group (50 cases). The control group was treated routin ely with western medicine while the treatment group treated with Naoxintong Capsule, 2 capsules each time, 3 times a day, in addition to the routine western medicine. Before and 4 weeks after treatment, the serum hypersensitive C-react ive protein (hs-CRP) was measured. Before and six months af ter treatment, changes of carotid intima-media thickness (IMT) and carot id plaque were examined with Color Doppler Ultrasonography. Resu lts Four weeks after treatment, the hs-CRP level in the treatment grou p was significantly lowered than before treatmen t, and the effect was more significant than that of the control group (P

Objective To investigate the effect of acupuncture at Huatuo jiaji points plus virtual balancing game on balance function in stroke patients.Methods Fifty patients with poststroke balance dysfunction were randomly allocated: 25 cases to the treatment group and 25 cases to the control groups. The treatment group received acupuncture at Huatuo jiaji points plus virtual balancing game-based rehabilitation training and the control group, virtual balancing game-based rehabilitation training alone. The Berg Balance Scale (BBS) score, the Timed Up and Go Test (TUGT) score, the COP offset distance indices (EO2, EC2, EOTS and EO1) and the modified Barthel Index (MBI) score were recorded in the two groups before and after treatment.Results There were statistically significant pre-/post-treatment differences in the BBS score, the TUGT score, the COP offset distance indices and the MBI score in the two groups of patients (P<0.05). There were statistically significant post-treatment differences in the BBS score, the TUGT score, the COP offset distance indices and the MBI score between the treatment and control groups (P<0.05).Conclusion Acupuncture at Huatuo jiaji points plus virtual balancing game is an effective way to treat poststroke balance dysfunction.

Objective To explore the central mechanism of acupuncture at Baihui (GV20) for memory impairment after stroke. Methods 32 stroke patients were randomized to receive acupuncture at Baihui (GV20) (as observation group) and acupuncture at Yanglingquan (GB34) (as control group) for 8 weeks. At the meantime, all participants received routine treatment including physical and occupational therapies. They were scanned with resting-state functional magnetic resonance imaging (fMRI) to find functional connectivity and assessed with Wechsler Memory Scale (WMS) before and after treatment. The results of WMS and functional connectivity were analyzed with Pearson's correlation. Results The memory scores and memory quotient improved significantly after treatment in the observation group (P<0.05). The functional connectivity significantly increased occurred in the left hippocampus to right inferior frontal gyrus, right middle frontal gyrus and left inferior frontal gyrus; and right hippocampus to left middle frontal gyrus, left superior frontal gyrus and left parietal lobe. Significant correlations were found between memory quotient and functional connectivity of hippocampus to frontal lobe and left parietal lobe in the observation group. There was no statistical significance in memory scores and memory quotient in the control group. The functional connectivity significantly decreased in left hippocampus to right middle occipital gyrus, and right hippocampus to right superior temporal gyrus and right posterior lobe of cerebellum. There was no statistical correlation between functional connectivity and results of WMS. Conclusion The acupuncture at Baihui can improves memory ability of stroke patients, which may associate with the increase of functional connectivity of hippocampus with frontal lobes and parietal lobes.

Objective To observe the effect of digital acupressure plus mechanical sputum expectoration on the rehabilitation of patients with stroke-associated pneumonia. Method Forty-six patients with stroke-associated pneumonia were randomized into a treatment group of 22 cases and a control group of 24 cases. The treatment group was intervened by digital acupressure plus mechanical sputum expectoration, while the control group was by mechanical sputum expectoration alone. The simplified version of Clinical Pulmonary Infection Score (CPIS), Fugl-Meyer assessment scale, and modified Barthel Index (BI) were adopted for evaluation before and after intervention. Result After treatment, CPIS, Fugl-Meyer and BI scores were changed significantly in both groups (P<0.01). There were significant differences in comparing the CPIS, Fugl-Meyer and BI scores between the two groups after intervention (P<0.05). After intervention, the two groups showed a negative correlation between CPIS score and Fugl-Meyer score, as well as between CPIS score and BI score. Conclusion Digital acupressure plus mechanical sputum expectoration can effectively improve the pulmonary symptoms in patients with stroke-associated pneumonia, benefiting the rehabilitation of the post-stroke patients.

Objective To identify the imaging characteristics of calcifying pseudoneoplasms of the neuraxis (CAPNON) and do literature review.Methods Five patients of pathologically-proved CAPNON underwent preoperative MR examination,among which 4 underwent CT scan,2 underwent DSA examination and 1 underwent SPECT. All imaging data were retrospectively analyzed with the emphasis on imaging characteristics.Results Five patients of CAPNON with the diameter of 1.5 to 5.0 cm were found in five patients ( Male 4 ; Female 1 ; age 25 to 60 years old ).Three lesions were located in the skull base,one was located in the cervical spine and one in the foramen magnum and upper cervical segment. All patients underwent MRI examination and 4 of them also took CT scanning.On plain CT,all lesions showed obvious calcification.On T1WI all masses showed hypointensity,and on T2WI 4 of the lesions showed iso- or hypointensity and 1 heterogeneous signal intensity. On contrast-enhanced MR images, peripheral enhancement was demonstrated in 3 lesions,homogeneous enhancement was found in case and one lesion showed no enhancement. The pathologic analysis indicated that inside the lesions were abundant calcification,fibroepithelial tissue and mucoid matrix and no edema was detected around the lesions.Conclusions CAPNON displayed the predilection to male adults and the neuraxis was the predilection site.Calcification on CT images,hypointensity on MR images and peripheral enhancement will be helpful for the diagnosis of CAPNON,but the final confirmation still needs the pathologic results.

Objective To explore the effects of 75 mGy irradiation on the apoptosis of spermatogenic cells and antioxidant capacity of serum and testis and hormone levels in male rats with diabetes mellitus(DM).Methods Rats were injected intraperitoneally with streptozotocin(STZ)to develop diabetes.The diabetic rats were irradiated with 75 mGy X-rays every other day for 4 weeks.Their survival rate and body weight were recorded 12 weeks after development of diabetes.The apeptosis percentage of germ cells was measured with flow cytometry and TUNEL method.The changes of anti-oxidation and gonadal hormone levels in serum and testis were measured with kits.Results After the rats suffered from diabetes for 12 weeks,the survival rate in DM group was 25%(6/24),100% in normal control group(16116).The survival rate in 75 mGy + DM group(9/16,56.25%)was obviously higher than that in the DM group(X2= 4.00,P < 0.05).Meanwhile,the percentage of apaptotic spermatogenic cells in the diabetic rats was significantly larger than those in the normal control and irradiation groups(F = 5.496,P < 0.05).MDA and NO levels in serum and testis of diabetic rats were higher in varying degrees than that in the normal control,while the serum and testis MDA content in the 75 mGy + DM group were lower than those in the DM group especially in the testis(F = 10.644,P < 0.01).75 mGy X-ray irradiation decreased NO content in the diabetic rats serum significantly(F = 14.379,P < 0.05)and increased NOS activity and TS,FSH level(F = 9.676,43.194 and 5.282,respectively,P < 0.05 and P < 0.01).Conclusions LDR could decrease the MDA level and NO content,and increase the antioxidant enzyme activity and TS and FSH levels in testis and serum of diabetic rats.

Objective To construct the pshuttle-Egr-1-hSmac plasmid and transfect human breast cancer MDA-MB-435 cells,and to observe its radiotherapy enhancing effect on tumor cells.Methods The empty vector pshuttle and pshuttle-Egr-1-hSmac plasmid were transfected into MDA-MB-435 cells by liposomal.At different time(4,8,12,24 and 48 h)after irradiation with 2.0 Gy X-ray and 24 h after irradiation with 0.5 -5.0 Gy,the total RNA and protein were collected and extracted from these cells to analyze the Smac mRNA and protein expression levels with RT-PCR and Western blotting methods. The cells were divided into control, pshuttle, pshuttle-Egr-1-hSmac,2.0 Gy irradiation group, pshuttle + 2.0 Gy irradiation and pshuttle-Egr-1-hSmac+2.0 Gy irradiation groups.MTT method was used to evaluate cell proliferation,and the cell survival ability was measured with clone formation assay;Annexin Ⅴ/PI double staining and PI single staining were used to examine the apoptosis and cell cycle of MDA-MB-435 cells. Results There was no Smac mRNA expression in MDA-MB-435 cells in control and pshuttle groups,but the Smac mRNA expression levels in MDA-MB-435 cells in pshuttle-Egr-1-hSmac plasmid group were gradually increased with the time prolongation, and reached the maximum at 24 and 48 h;the Smac mRNA expression levels in MDA-MB-435 cells were increased gradually 24 h after irradiation of 0.5 - 5.0 Gy X-ray with the increasing of irradiation doses, and reached the maximum after 2.0 and 5.0 Gy irradiation. The Smac protein expression levels in pshuttle-Egr-1-hSmac plasmid group were increased gradually with the time prolongation,and reached the maximum at 24 h.The Smac protein expression lervels were increased 24 h afer irradiation of 0,0.5,1.0,2.0 and 5.0 Gy X-ray,especially in 5.0 Gy group. The MTT results showed that the A490 values in 2.0 Gy,pshuttle+2.0 Gy and pshuttle-Egr-1-hSmac groups 24, 48,and 72 h after irradiation were lower than those in control group(P<0.01);the A490 values of MDA-MB-435 cells in pshuttle-Egr-1-hSmac group after 1.0-5.0 Gy X-ray irradiation were lower than those in 0 Gy group (P<0.05 or P<0.01);the survival fraction(SF)in pshuttle-Egr-1-hSmac group was lower than those in control group (P<0.01).The percentages of the cells at G0/G1 and S phase in pshuttle-Egr-1-hSmac group were lower than those in 2.0 Gy group(P<0.01),the percentage of the cells at G2/M phase was higher than that in 2.0 Gy group (P<0.01);the apoptotic rate of the cells in pshuttle-Egr-1-hSmac group was higher than that in 2.0 Gy group (P<0.01).Conclusion X-ray irradiation can significantly increase the Smac mRNA and protein expression levels in MDA-MB-435 cells transfected with pshuttle-Egr-1-hSmac plasmid,inhibit the cell survival rate,and induce G2/M arrest and apoptotic increasing;Smac gene combined with radiotherapy could significantly increase the radiosensitivity of breast cancer cells.

Objective To evaluate the efficacy and safety of oral propranolol versus atenolol in the treatment of infantile hemangioma(IH). Methods A total of 75 infants with IH aged 5-24 weeks were randomly divided into two groups: propranolol group(n = 30)orally administrating propranolol 2 mg · kg?1 · d?1 in 3 divided doses daily for 24 consecutive weeks, atenolol group(n=45)orally administrating atenolol 1 mg · kg?1 · d?1 once a day for 24 consecutive weeks. After 1?, 4?, 12?, 24?week treatment, the infants with IH were followed and adverse reactions were recorded. In addition, the activity of IH was assessed by hemangioma activity score(HAS)before and after 24?week treatment, and changes of HAS were compared between the propranolol group and atenolol group. Results There was no significant difference in the proportion of patients experiencing satisfactory regression of hemangioma between the propranolol group and atenolol group(70%[21/30]vs. 75.6%[34/45], P>0.05). Treatment failure occurred in one patient in the propranolol group because of severe airway hyperreactivity, and in another patient in the atenolol group because of drug resistance. The incidence rates of gastrointestinal reactions, central nervous system adverse effects, chills on the extremities and bronchiolitis complicated by airway hyperreactivity were all significantly higher in the propranolol group than in the atenolol group(all P<0.05). None of hypotension, hypoglycemia and bradycardia occurred in the two groups. Conclusion Compared with propranolol, atenolol shows similar efficacy but less adverse effects in the treatment of IH.

Objective To apply the virtual reality in balance function training for Parkinson's Disease (PD). Methods From October, 2013 to January, 2016, 31 patients with balance disorders after PD were divided into two groups:the treatment group (n=17) received virtual reality balancing games training, while the control group (n=14) received routine balance training. They were assessed with Berg Balance Scale (BBS), Timed Up and Go Test (TUGT), static fall index (SFI), limits of stability (LOS), dynamic fall index (DFI) and modified Barth-el Index (MBI) before and four weeks after treatment. The frequency of falls in the next six weeks was recorded. Results The scores of BBS, TUGT, SFI, LOS, DFI and MBI improved significantly in both groups after treatment (P<0.05), and improved more in scores of BBS (t=2.095), TUGT (t=-2.091), DFI (t=-2.182), LOS scores (t=2.202) and MBI (t=3.036) in the treatment group than in the control group (P<0.05). There was positive correlation between scores of BBS and MBI (r=0.899, P<0.001). The frequency of falls was less in the treatment group than in the control group (P<0.05). Conclusion Virtual reality balance training can improve the balance function for PD.