Objective To apply the microbial transformation to transforming the total saponins in the fruit of Panax ginseng (SFPG) and preparing ginsenoside compound K (C-K). Methods The four microbial strains m14, m3, m8, and m9 were screened and isolated from the soil in the botanic garden planted for P. ginseng and they were used for the microbial transformation of SFPG to optimize the strains. Taking C-K contents as index the microbial transformation was detected and analyzed by TLC and HPLC. Results The strain m14 was found to transform the SFPG efficiently to C-K at first. The optimal culturing and transformation conditions of m14 were obtained: time, 6 d; temperature, 30 ℃; revolution of cradle, 160 r/min; initial pH value, 5.5; substratum concentration, 120 mg/mL. Under the optimal condition, the content of C-K was 41.65 times as much as before transformation by m14. Conclusion The m14 is the most effective strain among the four fungal strains. It is the new way available for the C-K industrialized production.

ObjectiveTo explore the relationship of blood volume changes and postoperative delirium in elderly patients undergoing surgery for hip fracture.Methods One hundred and fifty elderly patients who underwent surgery for hip fracture were enrolled in the study.Delirium was diagnosed by Confusion Assessment Method(CAM).Preoperative,intraoperative and postoperative data were collected,and the correlation of postoperative delirium and blood volume changes were analyzed by logistic regression analysis.ResultsA total of 59 patients(28 males and 31 females)had delirium after surgery and the occurrence rate of postoperative delirium was 39.3％ (59/150).The average age in delirium group was significantly older than that in the control group[ (77.71 ±6.63)years old vs(73.79 ±5.42) years old,t =-3.958,P ＜0.001 ].The average hemoglobin concentration and hematocrit in delirium group were both less than that in control group whether before surgery or at 7 days after surgery( before surgery:average hemoglobin concentration:[ ( 117.80 ± 16.59)g/L vs( 123.92 ±14.61 ) g/L,t =2.378,P =0.019; hematocrit:(0.355 ± 0.154) vs(0.372 ± 0.210),t =2.291,P =0.023 ;7days after surgery:average hemoglobin concentration:(98.15 ± 11.51 ) g/L vs ( 102.33 ± 9.88 ) g/L,t =2.369,P =0.019; hematocrit:(0.296 ± 0.040 ) vs (0.306 ± 0.030),t =-3.958,P ＜ 0.001 ].There was no significant difference on gender,fracture type,surgical approach,operative time,blood loss and hemoglobin concentration at 1,3 days after surgery between the two groups( P ＞0.05 ).Logistic regression analysis showed that age ( OR 3.280 ),education ( OR 0.389 ),and hemoglobin concentration at 7 days after operration ( OR 1.097) were significantly related to the occurrence of postoperative delirium ( P ＜ 0.05 ).Conclusion Our findings suggest that the risk for postoperative delirium is the result of more than one factor.Older age,continued postoperative low hemoglobin concentration and low degree of education present high risk of delirium in patients underwent surgery for hip fractures.

The protoplasts of original Aspergillus niger strain Uco-3 were treated with the cooperation of UV and ?-ray to obtain the high-yielding strain producing the thermostable ?-galactosidase. Under the optimum conditions of formation and regeneration protoplasts were prepared. According to the interaction of positive mutation rate and radiation dose,the optimum condition was determined. The optimum dose of UV was 4 minutes and the optimum dose of ?-ray was 500 Gy. After mutagenetic treatment of protoplasts and selection from a lot of mutants,a mutant DL116 producing the thermostable ?-galactosidase was obtained. The ?-galactosidase activity of DL116 was increased from 16.27 U/mL to 44.37 U/mL,which was higher than that of strain Uco-3.

Objective To study the association between clinical symptoms,psychosomatic factors and autonomic nervous function in patients with gastroesophageal reflux disease (GERD).Methods Thirty-four patients with GERD diagnosed by reflux disease questionnaire (RDQ) and endoscopy and 15 healthy control subjects were enrolled in this study.All the subjects were divided into two groups,one with normal scores of Zung's self-rating anxiety scale (SAS) and Zung's depression scale (SDS) as GERD (-) and the other with abnormal scores of SAS and SDS as GERD (+).Reflux symptom score was recorded for both groups at the same time.Autonomic nervous function was assessed by their heart rate variability (HRV) on dynamic electrocardiogram (DCG).The time domain parameters analyzed included standard deviation (SD) of average R-R interval during 24 hours (SDNN),SD of average 5-minute sinus heart rate (SDANN),mean square root of the difference of adjoining two R-R interval (rMSSD),and proportion of the heart beats with difference of R-R interval more than 50 ms from the total heart beats (PNN 50),and the frequency domain parameters analyzed included low-frequency (LF),high-frequency (HF) and ratio of LF to HF.Results Average scores of SAS and SDS were significantly higher in patients with GERD than those in healthy controls (48?9 vs 38?6 and 48?11 vs 41?6,respectively,P

Objective To evaluate the effect of endoplasmic reticulum stress in trophocytes,in patients with intrahepatic cholestasis of pregnancy (ICP).Methods Sixty-one pregnant women who were hospitalized in Women's Hospital,School of Medicine,Zhejiang University from January to December 2015 were recruited.Thirty-one women who were diagnosed as ICP were defined as the ICP group and 30 healthy pregnant women were defined as the control group.The localization and expression intensity of glucose regulated protein 78 (GRP-78) in placental tissues were detected by immunohistochemistry technique.Electronic microscope was used to observe ultra-microstructure change of the endoplasmic reticulum in trophocytes and cell line Swan71.Reverse transcription (RT)-PCR and western blot were used to investigate the expression of GRP-78 mRNA and protein in Swan 71 cell.Results (1) GRP-78 protein was mainly expressed in the cytoplasm of cytotrophoblasts and syncytiotrophoblasts.The protein expression of GRP-78 in placentas of the ICP group (13.2±2.4) was significantly higher than that in the control group (7.8±1.3,P＜0.01).(2) The volume of endoplasmie reticulum did not increase and the microvilli developed well,with no swelling and no expansion of endoplasmic reticulum in the control group.In the ICP group,microvilli injury,endoplasmic reticulum edema were found;the volume of endoplasmic reticulum increased,with dilation,vacuolation and significant degranulation.After treated with 100 μmol/L cholyglycine for 24 hours,universal dilatation of the endoplasmic reticulum were seen in the Swan71 cells.(3) In Swan71 cells,cholylglycine displayed a concentration-dependent up-regulation on the expression of GRP-78.The expressions of GRP-78 mRNA in 0,25,50,100 μmol/L cholylglycine experimental group were 1.01±0.17,2.17±0.16,5.47±0.36,5.65 ± 0.82,respectively.The expression of GRP-78 protein in 0,25,50,100 μmol/L cholylglycine experimental group were 1.01±0.04,1.17±0.15,1.33±0.13,1.73±0.13,respectively.The expression of GRP-78 mRNA and protein in 100 and 50 μ mol/L cholylglycine experimental group were significantly higher than 0 μmol/L (all P＜0.01).Conclusion The obvious expansion of endoplasmic reticulum and the increased expression of GRP-78 in trophocytes indicated that endoplasmic reticulum stress of trophocytes may be involved in the pathogenesis of ICP.

Objective To investigate the factors influencing therapy decision of surgery or pessary in patients with severe pelvic organ prolapse (POP). Methods Totally 419 cases ofⅢtoⅣdegree POP patients were studied retrospectively. Patients were divided into surgery and pessary groups according to their own choice. Clinical characters were compared such as age, body mass index (BMI), age of onset and disease duration, POP stage, complications. Results 67.5%(283/419) patients were in the surgical group and 32.5%(136/419) patients in the pessary group. Patients in surgical group had higher BMI [(25.1 ± 3.5) versus (23.8±2.6) kg/m2], elder age of onset [(62±12) versus (57±11) years old], longer disease duration [(5± 8) versus (11±11) years] and higher POP staging of middle compartment and less cardiac disease [20.1%(57/283) versus 30.9% (42/136)] than those in pessary group, all had significant difference (P<0.05). Logistic regression analysis on the above factors showed a statistically significant difference between two groups, BMI, disease duration and POP staging of middle compartment were independent factors (OR=1.141, 0.932, 1.389;all P<0.01). Conclusions Patients with higher BMI, higher POP staging of middle compartment and less cardiac disease tended to choose surgery. Patients with younger age of onset and longer disease duration tended to choose pessary. Factors as age, POP staging of anterior and posterior compartment, history of POP surgery, complicated with hypertension and diabetes, showed no influence on treatment choice.

The paper identified bottlenecks in establishing general practice departments at tertiary hospitals.With analysis of the importance of general practice education,medical service and research,as well as complete disciplinary building at such hospitals,the authors explored strategies and measures for talent training and development of general practice.

OBJECTIVETo compare the difference in the efficacy on low back pain of cold-damp pattern between electric-thermal Bian-stone therapy and moxibustion box therapy.

METHODSForty-one cases of low back pain of cold-damp pattern were randomized into an electric-thermal Bian-stone therapy group (group A, 26 cases) and a box moxibustion therapy group (group B, 15 cases). In the group A, the electric-thermal Bian-stone was placed over Shenshu (BL 23) and Weizhong (BL 40). The temperature of stone was adjusted in accordance with patient's comfort. In the group B, moxibustion box was used over Shenshu (BL 23) and Weizhong (BL 40). The treatment was given once every day or every two days. Ten treatments made one session. The symptom and physical signs score of low back pain and the score of cold-damp syndrome were observed before and after treatment in the patients.

RESULTSThe symptom and physical signs score of low back pain and the score of cold-damp syndrome were all improved in the two groups (all P < 0.01). The changing rate of symptom and physical signs and syndrome were (37.04 +/- 32.68)% and (22.85 +/- 29.95)% in the group A, and were (47.29 +/- 22.08)% and (23.89 +/- 22.53)% in the group B, respectively, without significant difference in comparison between the two groups (all P > 0.05).

CONCLUSIONThe efficacy on low back pain of cold-damp pattern treated with the electric-thermal Bian-stone therapy is similar to that of moxibustion box therapy. This therapy is characterized as more convenient, safer operation and less pollution.

Acupuncture Points ; Adult ; Aged ; Aged, 80 and over ; Combined Modality Therapy ; Female ; Humans ; Low Back Pain ; therapy ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Moxibustion

Objective:To obtain the prokaryotic expression product for the group 6 allergen of Dermatophagoides farine ( Der f 6) and detect its IgE-binding rates with sera from asthmatic children. Methods: By enzyme digestion of pET28a (+)-Der f 6 with BamHⅠ plus XhoⅠ,the target gene Der f 6 was obtained and linked into the vector pET32a (+) to construct the recombinant plasmid pET32a(+)-Der f 6, which was then transfected into E. coli BL21 cells for expression, induced with isopropyl-β-D-thiogalactoside ( IPTG) ,purified by affinity chromatography and identified by SDS-PAGE,Western blot and AMLDI-TOF,and tested by ELISA for IgE reactivity with sera from asthmatic children. Results:The plasmids pET32a(+)-Der f 6 were constructed,transformed into E. coli BL21 and expressed successfully. SDS-PAGE of the purification product showed a specific band,Western blot showed the successful binding between the purification product and the His-tag in the plasmids,and MALDI-TOF/TOF identified the identical structure to the allergen Der f 6. Using the ELISA method developed with the recombinant proteins as coating antigen,the positive rate was 41. 3% (19/46) in asthmatic children allergic to dust mite. Conclusion: The plasmids pET32a (+)-Der f 6 were constructed successfully,expressed in E. coli BL 21 (DE3). The recombinant fusion protein has a good reactivity with sera from asthmatic children.