OBJECTIVE: To investigate the chemical constituents from the leaves of Jatropha curcas and evaluate their inhibition on lipopolysaccharide (LPS)-activated BV-2 microglia cells. METHODS: The n-BuOH extract of the leaves of J. curcas was isolated by macroporous adsorption resin, silica gel, ODS, column chromatography and semi-preparative HPLC. The structures of the compounds were identified by MS, NMR, ECD, and other spectroscopic methods. In addition, anti-neuroinflammatory effects of isolated compounds were evaluated by measuring the production of nitric oxide (NO) in over-activated BV-2 cells. RESULTS: Seventeen compounds, including (7R,8S)-crataegifin A-4-O-β-D-glucopyranoside ( 1), (8R,8'R)-arctigenin ( 2), arctigenin-4'-O-β-D-glucopyranoside ( 3), (-)-syringaresinol ( 4), syringaresinol-4'-O-β-D-glucopyranoside ( 5), (-)-pinoresinol ( 6), pinoresinol-4'-O-β-D-glucopyranoside ( 7), buddlenol D ( 8), (2R,3R)-dihydroquercetin ( 9), (2S,3S)-epicatechin ( 10), (2R,3S)-catechin ( 11), isovitexin ( 12), naringenin-7-O-β-D-glucopyranoside ( 13), chamaejasmin ( 14), neochamaejasmin B ( 15), isoneochamaejasmin A ( 16), and tomentin-5-O-β-D-glucopyranoside ( 17) were isolated and identified. Compounds 2, 4 and 8 significantly inhibited the release of NO in BV-2 microglia activated by LPS, with IC₅₀ values of 18.34, 29.33 and 26.30 μmol/L, respectively. CONCLUSION Compound 1 is a novel compound, and compounds 2, 3, 8, 14- 17 are isolated from Jatropha genus for the first time. In addition, the lignans significantly inhibited NO release and the inhibitory activity was decreased after glycosylation.

【Objective】 To investigate the effect of cold agglutination on blood group typing. 【Methods】 37℃ water bath, absorption elution test and 2-mercaptoethanol method were used to eliminate the influence of cold agglutination. Forward and reverse blood group typing, cross matching, DAT and IAT experiments were then performed on red blood cells and serum after treatment. 【Results】 Before treatment, obvious discrepancy in forward /reverse typing and nontypable cross matching in 16 blood samples were noticed due to cold agglutination. After corresponding treatments, all samples were consistent or negative in forward/reverse typing, cross matching and antibody screening. No adverse reactions to cross matching blood transfusion occurred in patients, and the increase of hemoglobin was in line with the effective standard of transfusion. 【Conclusion】 37℃ water bath, absorption elution test and 2-mercaptoethanol method can be used to eliminate the interference caused by cold agglutination to obtain correct typing results. The strong reactivity caused by cold agglutination in AIHA patients were different from other cases, which deserved our attention.

Objective:To evaluate the effect of edaravone on long-term cognitive function in elderly patients undergoing hip replacement.Methods:A total of 160 patients, aged≥65 yr, undergoing elective hip replacement, were divided into 2 groups ( n=80 each) using the random sequence generated by the McLeod-modified Wichmann-Hill pseudo-random number generator: edaravone group (group E) and control group (group C). Spinal-epidural anesthesia was applied in two groups.Edaravone 60 mg (in 100 ml of normal saline, infusion rate 200 ml/h) was intravenously infused from the time point immediately after achieving the anesthesia plane until the following 30 min.Serum chemokine ligand 13 (CXCL13) and interleukin-6 (IL-6) concentrations were detected by enzyme-linked immunosorbent assay before anesthesia, during surgery (30 min after skin incision), and at postoperative days 1, 3 and 7.The Confusion Assessment Method Scale in Chinese was used to detect the postoperative delirium at postoperative days 1, 2, 3 and 7, and the Telephone Interview for Cognitive Status-Modified and ADL score were adopted to assess the cognitive function and quality of daily living, respectively, and the occurrence of cognitive impairment was recorded at 1 and 12 months after surgery. Results:Compared with group C, the total Telephone Interview for Cognitive Status-Modified score and ADL score were significantly increased, the incidence of postoperative delirium and cognitive impairment was decreased, and the serum CXCL13 and IL-6 concentrations were decreased during surgery and at each time point after surgery in group E ( P<0.05). Conclusion:Edaravone can reduce inflammatory responses and improve long-term cognitive function in elderly patients undergoing hip replacement.

Objective To evaluate the correlation between the concentrations of matrix metalloproteinase-9 (MMP-9) and adiponectin (ADP) and postoperative delirium (POD) in perioperative serum of elderly patients undergoing lobectomy. Methods Seventy-three elderly patients undergoing lobectomy under general anesthesia, 38 males and 35 females, aged 65-80 years, BMI ＜ 24 kg/m2, falling into ASA physical status Ⅰ or Ⅱ, were selected in some suitable period. All patients were divided into POD group and non-POD group according to the Chinese Version of Consciousness Assessment Scale at 24 hours, 48 hours, and 72 hours after operation, and their blood samples were collected 5 minutes before induction of anesthesia (T0), at the time of tracheal extubation (T1) and at postoperative 24 hours (T2), 48 hours (T3), and 72 hours (T4) to determine the concentrations of MMP-9 and ADP in their serums. Results POD occurred in 19 patients, with the incidence rate of 17.8％. The concentrations of MMP-9 at T1-T4 were significantly higher than those before lobectomy in serums in POD group, while the concentrations of ADP in serums were significantly lower than those before lobectomy (P ＜ 0.05). The concentrations of MMP-9 in serums at T1 were significantly higher than those before lobectomy in non-POD group, while the concentrations of ADP in serums were significantly lower than those before lobectomy (P ＜ 0.05). In the comparison between the two groups, the concentrations of MMP-9 in POD group at T1-T4 were significantly higher than those in non-POD group, while the concentrations of ADP in POD group were significantly lower than those in non-POD group (P ＜ 0.05). Conclusion The serum level of MMP-9 is increased and ADP is decreased in perioperative, wich maybe involved in the pathophysiological process of POD in elderly patients undergoing lobectomy.

Objective To evaluate the relationship between perioperative peripheral blood Type 17 helper (Th17) cells and Th17-related cytokines and postoperative cognitive dysfunction (POCD) in elderly patients undergoing general anesthesia.Methods Ninety-six patients of both sexes,aged 65-86 yr,of American Society of Anesthesiologists physical status Ⅱ or m,scheduled for elective hip replacement under general anesthesia,were selected.At 3 days before operation and 1,2,3 and 7 days after operation,Montreal Cognitive Assessment (MoCA) was used to evaluate the cognitive function,and fasting venous blood samples were taken for determination of the percentage of Th17 cells and serum interleukin-17 (IL-17) and IL-22 concentrations.The patients were divided into POCD group and non-POCD group according to whether the patients developed POCD at day 7 after operation or not.Pearson linear correlation of the percentage of Th17 cells and serum IL-17 and IL-22 concentrations with MoCA scores was analyzed.Results Twenty-six patients developed POCD (27.1％).The percentage of peripheral blood Th17 cells and serum IL-17 and IL-22 concentrations were significantly higher at each time point after operation than before operation in POCD group and at 1 and 2 days after operation than before operation in non-POCD group (P＜0.05).The percentage of peripheral blood Th17 cells and serum IL-17 and IL-22 concentrations were significantly higher at each time point after operation in POCD group than in non-POCD group (P＜0.05).The percentage of peripheral blood Thl7 cells was negatively correlated with MoCA scores (r =-0.867,P＜0.01) and serum IL-17 and IL-22 concentrations were negatively correlated with MoCA scores (r=-0.662 and-0.638,P＜0.01) in group POCD.Conclusion The development of POCD is related to the increase in the percentage of peripheral blood Th17 cells and concentrations of Th17-related cytokines IL-17 and IL-22 in elderly patients undergoing general anesthesia.

Objective To explore the effect and mechanism of Toll-like receptor 4 (TLR4) on cerebral ischemia/reperfusion injury. Methods Rats were divided into a sham group, MCAO group, and MCAO+TAK group. Cerebral cortices were removed on day 1, 3, 7, and 14 post surgery. Morphological staining and Western blotting were used to detect pathological changes and TLR4 and P-IKKα/β expression in brain tissues. Results The pathological changes in the MCAO+TAK group were more severe than in the MCAO group on day 1 post surgery. However, the MCAO group exhibited more severe damage at the other time points. TLR4 expression was lowest in the cerebral cortices of the sham group. On day 1 and 14 post surgery, TLR4 expression was lower in the MCAO group than in the MCAO+TAK group, while on day 3 and 7 post surgery, TLR4 expression was higher in the MCAO group than in the MCAO+TAK group. P-IKKα/β expression was highest in the cerebral cortices of the MCAO group at all time points except for day 1. Conclusion TLR4 may alleviate cerebral ischemia reperfusion injury in rats on day 1 post surgery; however, TLR4 may exacerbate ischemia repeifusion injury 3 to 14 days post surgery. The mechanism may be due to the effect of P-IKKα/β expression in the cerebral cortex.

Objective To evaluate the effect of thoracic paravertebral block combined with general anesthesia on postoperative cognitive dysfunction (POCD) in elderly patients undergoing pulmonary lobecto-my. Methods A total of 120 elderly patients of both sexes, aged 65-81 yr, of American Society of Anes-thesiologists physical status Ⅱ or Ⅲ, with New York Heart Association Ⅰor Ⅱ, were divided into 3 groups (n＝40 each) using a random number table method: anesthesia group (group GA), epidural block combined with general anesthesia group (group EG), and paravertebral block combined with general anes-thesia group (group PG). In group PG, paravertebral block was performed under ultrasound guidance, 0. 25% ropivacaine 20 ml was injected after the paravertebral catheter was placed, and anesthesia was in-duced after confirming the plane of block. In group EG, epidural block was performed with 2% lidocaine 3 ml after epidural puncture was successfully performed at L6,7interspace, epidural 0. 375% ropivacaine 8-15 ml was intermittently injected, and anesthesia was induced after confirming the height of block. Anes- thesia was induced with IV midazolam 0. 05-0. 10 mg∕kg, etomidate 0. 3 mg∕kg, sufentanil 0. 4 μg∕kg and rocuronium 0. 6 mg∕kg. The patients were tracheally intubated and mechanically ventilated. The develop-ment of POCD was recorded at 1 day before operation and 7 days after operation. Blood samples were col-lected from the internal jugular vein before anesthesia, at 15 min after skin incision and at 7 days after oper-ation for determination of serum adiponectin ( ADP) and S-100β protein concentrations. Results Com-pared with group GA, the incidence of POCD was significantly decreased, and the serum S-100β protein concentrations were decreased and serum ADP concentrations were increased at 15 min after skin incision and 7 days after operation in PG and EG groups ( P＜0. 05). Compared with group EG, the incidence of POCD was significantly decreased, and the serum S-100β protein concentrations were increased and serum ADP concentrations were decreased at 15 min after skin incision and 7 days after operation in group PG (P＜0. 05). Conclusion Thoracic paravertebral block combined with general anesthesia induces better efficacy in decreasing the occurrence of POCD than general anesthesia alone or combination of epidural block and general anesthesia in elderly patients undergoing pulmonary lobectomy, which is related to the decreased concentrations of blood ADP in elderly patients undergoing pulmonary lobectomy.

Objective To evaluate the effects of different depths of sedation on serum adiponectin (ADP) concentrations in elderly patients undergoing general anesthesia.Methods A total of 120 elderly patients of both sexes,aged 65-83 yr,weighing 45-75 kg,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,undergoing elective noncardiac surgery under general anesthesia,were divided into Ⅰ and Ⅱ groups (n =60 each) using a random number table.Propofol was given by closed-loop target-controlled infusion,and bispectral index value was maintained at 40-50 in group Ⅰ and at 50-60 in group Ⅱ.The cognitive function was assessed by the Montreal Cognitive Assessment at 1 day before operation ant 1 and 7 days after operation.Blood samples were collected from the internal jugular vein immediately before surgery,at 2 h after the beginning of surgery and at 1 and 7 days after surgery for determination of serum ADP and S-100β protein concentrations.Results Compared with group Ⅰ,Montreal Cognitive Assessment scores were significantly increased at 1 and 7 days after surgery,the serum concentrations of ADP were increased and S-100β protein concentrations in serum were decreased at 1 and 7 days after surgery,and the intraoperative requirement for ephedrine and atropine and incidence of postoperative cognitive dysfunction were decreased during surgery in group Ⅱ (P＜0.05).Conclusion Maintaining BIS value at 50-60 can reduce the development of postoperative cognitive dysfunction,which is related to the increased concentration of serum ADP in elderly patients undergoing general anesthesia.

Aim To establish the rat model of Spleen-Qi deficiency, analyse the metabolic pathways and investigate the connection between the changed urinary metabolites and Spleen-Qi deficiency, in order to explore the potential mechanisms of Spleen-Qi deficiency.Methods With the binding methods of diarrhea induced by bitter and cold, abnormal of starvation and excessive tiredness, the rat Spleen-Qi deficiency model was established.Then the activity of creatine phosphokinase(CPK) was detected.The endogenous metabolites in the urine were detected by NMR, and the data were analyzed with multivariate and statistical methods.Then the metabolites were selected that could be clearly distinct in the two groups with the fold change value(>1.2) and the P<0.05 of Student′s t-test.Both the pathway analysis and enrichment analysis were performed with Metabo Analyst 3.0.Results Compared with the normal rats, the activity of CPK decreased significantly in model rats(P<0.05).A significant separation appeared in the principal components analysis(PCA) score plot when the control group and the model group were compared, indicating that the Spleen-Qi deficiency model was successfully duplicated.The 33 differential metabolites, which mainly involved in the metabolic pathways, were distinguished from the comparision of Spleen-Qi deficiency model group and control group.The metabolic pathways was related to energy metabolism, amino acid metabolism, nucleotide metabolism and disturbance of gut microbes.Conclusions The main energy metabolic pathways (tricarboxylic acid cycle, glycolysis and liquid oxidation) may be disturbed in Spleen-Qi deficiency rats.The energy supply function is suppressed, which leads to the fatigue and weight loss in rats.

Objective: To study the therapeutic effect of hyaluronic acid chitosan?based microemulsion ( HAC?ME) and carboplatin in a Wistar rat model bearing cerebral C6 glioma xenografts. Methods:C6 rat glioma cells were cultured normally. A total of 30 Wistar rats bearing orthotopic C6 glioma xenografts were randomly divided into 3 groups, and administrated with physiological saline, carbopl?atin or HAC?ME and carboplatin in each group. There are 10 rats in each group. The rat apoptosis changes and survival time were ob?served after treated with physiological saline, carboplatin or HAC?ME and carboplatin in each group. Results:Glioma cells were nega?tive in saline group with TUNEL staining, the nuclei of individual glioma cells in glioma tissue were stained with brown, indicating ap?optosis occur in carboplatin group, the apoptosis of glioma cells in glioma tissue significantly increased in HAC?ME and carboplatin group with TUNEL staining. The survival time in HAC?ME and carboplatin group was longer than that in saline group and carboplatin group ( P<0?05) . Conclusion:Administration of HAC?ME and carboplatin can suppress the growth of C6 glioma in rats and may pro?vide experimental basis for clinical treatment of glioma.