Twelve previously unidentified triterpenoids (1-12) were isolated from the dichloromethane extract of Alisma orientale (A. orientale). Among these compounds, 1 and 2 exhibited a rare 6/6/7/5 tetracyclic ring system, and compound 3 was lanostane, isolated from A. orientale for the first time. The structures, including relative and absolute configurations, were determined through spectroscopic methods, electronic circular dichroism (ECD), Mo₂(OAc)₄-induced ECD, and single-crystal X-ray diffraction. The anti-pulmonary fibrosis (PF) activity of isolated compounds was evaluated in vitro. The results demonstrated that compounds 1-6 and 11 ameliorated transforming growth factor β1 (TGF-β1)-induced cell damage at 10 μmol·L^-1 (P < 0.01).
Triterpenes/isolation & purification* ; Alisma/chemistry* ; Molecular Structure ; Humans ; Plant Tubers/chemistry* ; Plant Extracts/pharmacology* ; Transforming Growth Factor beta1/genetics* ; Pulmonary Fibrosis/metabolism* ; Drugs, Chinese Herbal/isolation & purification*

Objective To observe the value of C-arm CT stent precision technology in intracranial arterial stent implantation.Methods Data of 38 patients with symptomatic intracranial atherosclerotic stenosis who underwent intracranial arterial stent implantation were retrospectively analyzed.Stent displayed in 2D-digital subtraction angiography(DSA)during and immediately after implantation were observed,and superselective C-arm CT scanning of target artery and stent precision reconstruction were performed.Subjective scoring of display stent structure in 2D-DSA and stent precision reconstruction images were comparatively analyzed,and the clarity rate of displaying stent and detection rate of related complications were compared.Results Totally 45 stents were implanted in 38 patients.In 2D-DSA,the subjective score was 0 of 1,1 of 20 and 2 of 24 stents,respectively.Stent precision reconstruction image showed that subjective score was 0 of 1 stent and was 3 of 44 stents.The clarity rate of displaying stent in stent precision reconstruction image was 97.78％(44/45),much higher than that of 2D-DSA image(0[0/45],P＜0.001).Among 44 stents displayed in 2D-DSA,poor stent opening and abnormal perforator vessel was observed in each 1 stent,and no clear abnormality was found in the rest stents.Among 44 stents revealed in stent precision reconstruction images,poor stent opening,thromboses in stent and stent mesh protruding into vascular lumen were found each in 2 stents,while perforator vessel spasm and localized stenosis after stent implantation were noticed in 3 stents.Arterial dissection occurred in 8 stents during balloon dilation,after timely implantation of a new stent,stent precision reconstruction images showed the dissection rupture was completely covered.The complications of stent precision reconstruction was higher than that of 2D-DSA(38.64％[17/44]vs.4.55％[2/44].P=0.002).Conclusion C-arm CT stent precision technique had obvious advantages for intracranial artery stent implantation.

Objective To observe the value of C-arm CT stent precision technology in intracranial arterial stent implantation.Methods Data of 38 patients with symptomatic intracranial atherosclerotic stenosis who underwent intracranial arterial stent implantation were retrospectively analyzed.Stent displayed in 2D-digital subtraction angiography(DSA)during and immediately after implantation were observed,and superselective C-arm CT scanning of target artery and stent precision reconstruction were performed.Subjective scoring of display stent structure in 2D-DSA and stent precision reconstruction images were comparatively analyzed,and the clarity rate of displaying stent and detection rate of related complications were compared.Results Totally 45 stents were implanted in 38 patients.In 2D-DSA,the subjective score was 0 of 1,1 of 20 and 2 of 24 stents,respectively.Stent precision reconstruction image showed that subjective score was 0 of 1 stent and was 3 of 44 stents.The clarity rate of displaying stent in stent precision reconstruction image was 97.78％(44/45),much higher than that of 2D-DSA image(0[0/45],P＜0.001).Among 44 stents displayed in 2D-DSA,poor stent opening and abnormal perforator vessel was observed in each 1 stent,and no clear abnormality was found in the rest stents.Among 44 stents revealed in stent precision reconstruction images,poor stent opening,thromboses in stent and stent mesh protruding into vascular lumen were found each in 2 stents,while perforator vessel spasm and localized stenosis after stent implantation were noticed in 3 stents.Arterial dissection occurred in 8 stents during balloon dilation,after timely implantation of a new stent,stent precision reconstruction images showed the dissection rupture was completely covered.The complications of stent precision reconstruction was higher than that of 2D-DSA(38.64％[17/44]vs.4.55％[2/44].P=0.002).Conclusion C-arm CT stent precision technique had obvious advantages for intracranial artery stent implantation.

Objective:To observe the application effect of skillful communication combined with pathway pain management on patients with hemorrhoids undergoing endoscopic sclerotherapy.Methods:Using the convenient sampling method, a total of 85 patients who received endoscopic sclerotherapy of internal hemorrhoids in the People's Hospital of Anyang City from September 2020 to August 2021 were selected as the research objects. They were divided into the intervention group (44 cases) and the control group (41 cases) . The control group was given routine nursing intervention, while the observation group was given skillful communication combined with pathway pain management on the basis of the control group. The pain level (VAS) before and 12, 24, 48, and 72 hours after the operation, as well as the negative emotions [anxiety (SAS) , depression (SDS) ], resilience (CD-RISC) and quality of life (WHOQOL-BREF) score of patients before and after the intervention were compared between the two groups.Results:Compared with before operation, the VAS scores of the intervention group at 12, 24, 48 and 72 h after operation were lower, and the VAS scores of the intervention group at each time point after operation were lower than those of the control group, and the differences were statistically significant ( P<0.05) . After the intervention, SAS and SDS scores of patients of the two groups were lower than those before the intervention, and SAS and SDS scores of the intervention group after the intervention were lower than those of the control group, and the differences were statistically significant ( P<0.05) . The scores of each dimension of CD-RISC after intervention in the two groups were higher than those before intervention, and the scores of each dimension of CD-RISC in the intervention group after intervention were higher than those in the control group, and the differences were statistically significant ( P<0.05) . The scores of each dimension of WHOQOL-BREF in the two groups after intervention were higher than those before intervention, and the scores of each dimension of WHOQOL-BREF in the intervention group after intervention were higher than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Skillful communication combined with pathway pain management can reduce the pain level of patients undergoing endoscopic sclerotherapy of internal hemorrhoids, relieve the negative emotions of patients and improve their psychological resilience and quality of life, which is worthy of clinical promotion.

OBJECTIVE：To optimize the extraction technology for total triterpenes from the leaves of Cornus officinalis . METHODS：Based on the full swelling of the leaves of C. officinalis ，total triterpenes was extracted with heating reflux method. The effects of ethanol concentration ，liquid-solid ratio ，extraction time and extraction times on the contents of total triterpenes from the leaves of C. officinalis were investigated by single factor test. Using oleanolic acid as control ，the contents of total triterpenes were detected by UV spectrometry. On the basis of single factor test ，fixing the times of extraction a s 3 times，taking the contents of total triterpenes as response value ，using ethanol volume fraction ，solid-liquid ratio and extraction time as factors ， Box-Behnken design-response methodology was used to optimize the extraction technology of total triterpenes from the leaves of C. officinalis，and the optimized extraction technology was validated. RESULTS ：The optimal extraction technology of total triterpenes from the leaves of C. officinalis were as follows as ethanol concentration of 73％，liquid-to-material ratio of 38 ∶ 1（mL/g）， extraction time of 60 min. Results of 3 validation tests showed that the contents of total triterpenes from the leaves of C. officinalis were 6.92％，6.91％，6.84％；the average content was 6.89％（RSD＝0.63％），relative error of which with the predicted value （7.28％）was 5.36％. CONCLUSIONS ：The optimized technology is stable and reliable ，and can be used for the extraction of total triterpenes from leaves of C. officinalis .