Eight previously undescribed lanostane triterpenoids, including five nortriterpenoids with 26 carbons, ganothenoids A-E (1-5), and three lanostanoids, ganothenoids F-H (6-8), along with 24 known ones (9-32), were isolated from the fruiting bodies of Ganodrma theaecolum. The structures of the novel compounds were elucidated using comprehensive spectroscopic methods, including electronic circular dichroism (ECD) and nuclear magnetic resonance (NMR) calculations. Compounds 1-32 were assessed for their neuroprotective effects against H₂O₂-induced damage in human neuroblastoma SH-SY5Y cells, as well as their inhibitory activities against protein tyrosine phosphatase 1B (PTP1B) and α-glucosidase. Compound 4 demonstrated the most potent neuroprotective activity against H₂O₂-induced oxidative stress by suppressing G₀/G₁ phase cell cycle arrest, reducing reactive oxygen species (ROS) levels, and inhibiting cell apoptosis through modulation of B-cell lymphoma 2 protein (Bcl-2) and Bcl-2 associated X-protein (Bax) protein expression. Compounds 26, 12, and 28 exhibited PTP1B inhibitory activities with IC₅₀ values ranging from 13.92 to 56.94 μmol·L^-1, while compound 12 alone displayed significant inhibitory effects on α-glucosidase with an IC₅₀ value of 43.56 μmol·L^-1. Additionally, enzyme kinetic analyses and molecular docking simulations were conducted for compounds 26 and 12 with PTP1B and α-glucosidase, respectively.
Humans ; Fruiting Bodies, Fungal/chemistry* ; Triterpenes/isolation & purification* ; Neuroprotective Agents/isolation & purification* ; Protein Tyrosine Phosphatase, Non-Receptor Type 1/metabolism* ; Ganoderma/chemistry* ; Apoptosis/drug effects* ; Hypoglycemic Agents/isolation & purification* ; Molecular Structure ; alpha-Glucosidases/metabolism* ; Cell Line, Tumor ; Reactive Oxygen Species/metabolism* ; Oxidative Stress/drug effects* ; Hydrogen Peroxide/toxicity* ; Molecular Docking Simulation

Idiopathic macular hole (IMH) refers to full thickness defects of retinal neuroepithelial layer in macular area without clear reasons,and the combination of pars plana vitrectomy (PPV) with internal limiting membrane peeling (ILMP) is a standard procedure for macular hole.This technique can improve anatomical success and reduce the tangential forces,and thus accelerating the macular hole closure.With increasing use of ILMP and vital dye,the controversial issue of the intentional ILMP has arisen.First,the earliest change in the macula after ILMP is postoperative swelling of the arcuate retinal nerve fiber layer and dissociated optic nerve fiber layer occurs later in the postoperative period;second,retinal thickness modification,such as the thinning of retinal nerve fiber layer (RNFL),ganglial cell layer (GCL) and inner plexiform layer (IPL);third,displacement of foveal area toward optic disc and decrease of the foveal avascular zone area decrease retinal sensitivity and changes of the focal macular electroretinogram.This article reviewed the effects of ILMP during macular hole surgery on retinal anatomical and functional outcomes.

Objective: To compare the mutation status of epidermal growth factor receptor (EGFR) between different lesions and clini-cal characteristics of synchronous multiple ground-glass nodules (SMGGNs). Methods: A retrospective analysis was conducted using clinical data from 35 patients with SMGGNs who were admitted to and received surgery at The Fourth Hospital of Hebei Medical Uni-versity Hospital from January 2017 to December 2018. Next generation sequencing (NGS) was performed for all surgical specimens to detect the mutation status of exons 18, 19, 20, and 21 of the EGFR gene to analyze the relationship between the EGFR mutation sta-tus of the lesions and patient gender, age, lesion location, imaging manifestation of nodules, and adenocarcinoma pathological type . Results: The EGFR mutation rate was 65.7% (23/35 patients). Non-smoking patients and females had higher EGFR mutation rates (P=0.015, P<0.001). The EGFR mutation rate of invasive adenocarcinoma nodules was higher than those of atypical adenomatous hyper-plasia, adenocarcinoma in situ, and minimally invasive adenocarcinoma ( P<0.001). Exon 19 deletion and L858R mutation were the most common mutations of the EGFR gene. There was no significant difference between the pathological subtypes of adenocarcino-ma and the EGFR mutant subtype (P=0.707). Among the 27 patients with multiple nodules with detectable EGFR mutations, the EGFR mutation rate was 85.2% (23/27 patients). Conclusions: The EGFR gene mutation status is different in patients with multiple pulmo-nary ground-glass nodules, suggesting that the occurrence and development of each nodule are independent events. EGFR gene muta-tion is closely related to the development of ground-glass nodules, especially in the invasion of tumors.

Objective: To summarize the measures and experience of treatment in mass extremely severe burn patients. Methods: The clinical data and treatment of 8 extremely severe burn patients in August 2 Kunshan factory aluminum dust explosion accident who were admitted in the 100th Hospital of PLA on August 2nd, 2014, were retrospectively analyzed. There were 4 males and 4 females, aging 22-45 (34±7) years, with total burn area of 55%-98% [(89±15)%] total body surface area (TBSA) and full-thickness burn area of 45%-97% [(80±21)%] TBSA. All the 8 patients were accompanied with severe shock, inhalation injury, and blast injury. According to the requirements of former PLA General Logistics Department and Nanjing Military Command, a treatment team was set up including a special medical unit and a special care unit, with Chai Jiake from the First Affiliated Hospital of PLA General Hospital as the team leader, Zheng Qingyi from the 175th Hospital of PLA (the Affiliated Dongnan Hospital of Xiamen University) as the deputy leader, the 100th Hospital of PLA as the treatment base, and burn care, respiratory, nephrology, nursing specialists from the First Affiliated Hospital of PLA General Hospital, and the burn care experts and nursing staff from the 180th Hospital of PLA, 118th Hospital of PLA, 98th Hospital of PLA, and 175th Hospital of PLA, and nurses from the 85th Hospital of PLA, 455th Hospital of PLA, 101th Hospital of PLA, 113th Hospital of PLA as team members. Treatment strategies were adopted as unified coordination by the superior, unified responsibility of team leader, division of labor and cooperation between team members, and multidisciplinary cooperation led by department of burns. With exception of one patient who received deep vein catheterization before admission, the other 7 patients were treated with deep vein catheterization 0.5 to 3.0 hours after admission to correct hypovolemic shock as soon as possible. Eight patients received tracheotomy, and 7 patients were treated with mechanical ventilation by ventilator in protective ventilation strategy with low tide volume and low volume pressure to assist breathing. Fiberoptic bronchoscopy was done one to three times for all the 8 patients to confirm airway injuries and healing status. Escharectomy and Meek dermatoplasty in the extremities of all the 8 patients were performed 3 to 6 days after injury for the first time. Escharectomy, microskin grafting, and covering of large pieces of allogeneic skin on the trunks of 4 patients were performed 11 to 16 days after injury for the second time. The broad-spectrum antibiotics were uniformly used at first time of anti-infective therapy, and then the antibiotics species were adjusted in time. The balance of internal environment was maintained and the visceral functions were protected. One special care unit was on responsibility of only one patient. Psychological intervention was performed on admission. The rehabilitative treatment was started at early stage and in company with the whole treatment. Results: Acute renal injury occurred in 5 patients within 36 hours after injury and their renal function was restored to normal 4 days after injury due to active adjustment of fluid resuscitation program. No pulmonary complications, such as severe pulmonary infection and ventilator-associated pneumonia, occurred in the survived patients. One of the 8 patients died, and the other 7 patients were cured successfully. The wounds were basically healed in 2 patients in 26 or 27 days by 2 or 3 times of operation, and in 5 patients by 4 or 5 times of operation. The basic wound healing time was 26-64 (48±15) days for all the 7 patients. Conclusions Treatment strategies of unified coordination by the superior, unified responsibility of team leader, division of labor and cooperation between team members, and multidisciplinary cooperation led by department of burns are the bases to successful treatment. Correcting shock as soon as possible is the prerequisite and closing wound as soon as possible is the key to successful treatment. Comprehensive treatment measures, such as maintaining and regulating the function of viscera, improving the body immunity, and preventing and treating the complications, are the important components to successful treatment. It is emphasized that in the treatment of mass extremely severe burn patients, specialist burn treatment should always be in the dominant position, and other related disciplines may play a part in auxiliary function.

Depression is a common psychiatric disorder characterized by emotional and depressive symptoms. At present, western medicine treatment time is longer, having certain side effects, the treatment is incomplete and easy to recur, and not suitable for preg-nant women and the elderly and other special populations. The Chinese ancient"hysteria" Gan Mai Datzao decoction was used for the modern treatment of depression and achieved better effect. This article attempts from the clinical application and pharmacological stud-ies, for the past ten years of Gan Mai Dazao decoction decoction to prevent depression in the systematic review and analysis, the rea-sonable use of clinical thought to provide reference.

Depression is a common psychiatric disorder characterized by emotional and depressive symptoms. At present, western medicine treatment time is longer, having certain side effects, the treatment is incomplete and easy to recur, and not suitable for preg-nant women and the elderly and other special populations. The Chinese ancient"hysteria" Gan Mai Datzao decoction was used for the modern treatment of depression and achieved better effect. This article attempts from the clinical application and pharmacological stud-ies, for the past ten years of Gan Mai Dazao decoction decoction to prevent depression in the systematic review and analysis, the rea-sonable use of clinical thought to provide reference.

Objective To estimate the gene mutation and the protein expression of v-Raf murine sarcoma viral oncogene homolog B1 (BRAF) in esophageal cancer.Methods From February 2014 to September 2015,75 patients with esophageal cancer who received operation were enrolled.Tissues of cancer,adjacent to cancer and far from cancer were taken.The mutation and protein expression of BRAF were detected.The relationship between BRAF protein positive expression and clinical characteristics of patients with esophageal cancer was analyzed.The enumeration data was compared by chi-square test.Results The mutation of exon 11 and exon 15 of gene BRAF was not found in the tissues of esophageal cancer.Among 75 esophageal cancer,a base C or T inserted in the exon 11 was found in five Ⅲb TNM stage cases,and the expression of BRAF at protein level was positive in 46 cases (61.3％).Among 57 tissues adjacent to cancer,nine cases (15.8 ％) was BRAF positive at protein level.Among 75 tissues far from cancer,five(6.7％) was BRAF positive at protein level.The difference among three groups was statistically significant (x2 =61.098,P＜0.05).The positive rates of BRAF expression at protein level in patients with esophageal cancer at Ⅰ,Ⅱ and Ⅲ TNM stage were 21.7％ (5/23),70.8％ (17/24) and 85.7 ％ (24/28),respectively.The positive rates of BRAF expression at protein level in patients with and without lymph node metastasis were 81.6％ (31/38) and 40.5％ (15/37).The positive expression of BRAF at protein level was related with TNM stage and lymph node metastasis (x2 =23.136 and 13.313,both P＜0.01),however it was not related with gender,age and the degree of tumor differentiation (all P＞0.05).Conclusions There is base insertion in the exon 11 of gene BRAF in esophageal cancer,but gene mutation is not found.BRAF is highly expressed in esophageal cancer,which is related with TNM stage and lymph node metastasis,and BRAF could be an indicator of assessment of degree of malignancy and prognosis of esophageal cancer.

Objective To evaluate the bone healing effect of vascularized tissue-engineered bone induced by endothelial progenitor cells(EPCs)in repair of large segmental radius defects in rabbits.Methods A total of 68 healthy New Zealand white rabbits were enrolled in the study and randomized into three groups,ie,experimental group(EPCs group):EPCs plus bone marrow mesenchymal stem cells (BMSCs)plus decalcified bone matrix(DBM);control group:BMSCs plus DBM;sham control group:pure DBM.Materials mentioned above were implanted into middle radius defects for 15 mm.At 12 and 16 weeks post-operatively,X-ray test,bone mineral density test,histological light microscopic test,osteocalcin immunohistochemical staining test and biomechanical test were carried out.Results Growth and plasticity of callus,speed of medullary cavity recanalization,bone healing speed and biomechanical intensity in the experimental group were all significantly better than those of control group.Conclusions Vascularized tissue-engineered bone induced by EPCs has strong osteegenic ability,can accelerate bone healing and hence is an effective method for repair of large segmental bone defects.