Noted her hemorrhoids are acting up. 
 The patient does not had dilated blood vessels near the anus. 
(ROOT (S (VP (VBN Noted) (SBAR (S (NP (PRP$ her) (NNS hemorrhoids)) (VP (VBP are) (VP (VBG acting) (PRT (RP up))))))) (. .)))
(ROOT (S (NP (DT The) (NN patient)) (VP (VBZ does) (RB not) (VP (VBN had) (NP (VBN dilated) (NN blood) (NNS vessels)) (PP (IN near) (NP (DT the) (NN anus))))) (. .)))
( ( Noted ( ( her hemorrhoids ) ( are ( acting up ) ) ) ) . )
( ( The patient ) ( ( ( does not ) ( ( had ( dilated ( blood vessels ) ) ) ( near ( the anus ) ) ) ) . ) )