Chemical constituents from the acetone extract of twigs of Manglietia hookeri were isolated and purified by various column chromatographic methods over silica gel and sephadex LH-20, and preparative TLC. The structures of these compounds were identified on the basis of physicochemical properties and spectral analysis, including NMR and MS spectra. Six eudesmane sesquiterpenes were obtained and their structures were identified as trans-eudesmane-4, 11-diol(1), β-eudesmol(2), (-) -10-epi-5β-hydroxy-β-eudesmol (3), epi-carrisone (4), 6-hydroxy-eudesm-4(14) -ene(5) and gynurenol(6). All the compounds were isolated from this plant for the first time. Furthermore, the 13C-NMR data of compound 3 were reported for the first time.
Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Magnetic Resonance Spectroscopy ; Magnolia ; chemistry ; Molecular Structure ; Plant Stems ; chemistry ; Sesquiterpenes, Eudesmane ; chemistry ; isolation & purification ; Spectrometry, Mass, Electrospray Ionization

OBJECTIVETo evaluate the therapeutic effect and security of CT guided unilateral percutaneous vertebroplasty (PVP) for the treatment of osteoporotic vertebral compression fracture (OVCF) in senile patients.

METHODSFrom April 2009 to June 2010, 26 patients undergoing CT guided unilateral percutaneous vertebroplasty were analyzed retrospectively. There were 9 males and 17 females,ranging in age from 60 to 85 years with an average of (67.50+/-6.76) years, ranging in course of disease from 2 to 30 days with an average of (8.92+/-4.36) d. The affected segments involved 35 vertebras. The major clinical manifestations of OVCF were lumbar-back pain (especially when turning over or stooping down) and unable to bear. The needle was punctured into vertebral of lesions through unilateral puncture under the CT guidance; and then 3-5 ml bone cement was injected into vertebral. Antibiotic was used 3 days to prevent postoperative infections. Postoperative complications were observed after operation, such as local leakage of bone cement, penetrating spinal cord and/or segmental spinal nerve injuries and pulmonary embolism. X-ray was used to measure the height of anterior, middle and exterior of vertebral before and after treatment. A visual analog scale (VAS) scoring was applied to evaluate pain score preoperative, 48 hours postoperative and the terminal follow-up.

RESULTSTwenty-six patients achieved success in punctuation without serious complications. Local leakage of bone cement occurred in 6 cases, but without clinical symptoms or signs. One patient suffered from acute intraoperative reactions to bone cement and relieved by 5 mg dexamethasone and oxygen. All patients were followed up for 6 to 12 months [averaged (8.4+/-1.6) months]. The postoperative vertebrae height was higher than preoperative,but there was no statistical difference between postoperative and preoperative (P>0.05). Preoperative VAS scores was 7.63+/-0.92, postoperative score was 3.00+/-1.09, the final follow-up score was 2.38+/-1.17; there was significant difference between preoperative and postoperative at 48 hours (P<0.05), but there was no statistical difference between final follow-up and postoperative at 48 hours (P>0.05).

CONCLUSIONUnilateral PVP under CT guided can increase the vertebral strength and stabilize vertebral body,and the procedure is a safe and effective method for OVCF in elderly patients.

Aged ; Aged, 80 and over ; Female ; Fractures, Compression ; surgery ; Humans ; Male ; Middle Aged ; Osteoporotic Fractures ; surgery ; Retrospective Studies ; Spinal Fractures ; surgery ; Tomography, X-Ray Computed ; methods ; Vertebroplasty ; methods

A group of 25 rabies viruses (RABVs),recovered from 24 dogs and one human case,were collected from various areas in China between 2004 and 2006.Genetic and phylogenetic analyses of the G-L intergenic region were carried out in 25 street RABV isolates and CTN vaccine strains of 7 generations.The study was based on the comparison of a 519 bp nucleotide sequence,encompassing the G-L intergenic region.The nucleotide sequence homologies of Chinese street strains were from 95.5% to 100%.The phylogenetic analysis showed that all Chinese isolates clearly supported the placement of all Chinese viruses in Lyssavirus genotype 1 and they were distributed according to their geographical origins.All of the Chinese strains were closely related but they could still be divided into two groups:group of street strains and group of CTN strains.This study presents details about the molecular epidemiology of rabies viruses based on the sequences of the G-L Intergenic region.

Objective:To evaluate the effect of preoperative oral carbohydrate on gastric emptying in the patients undergoing laparoscopic cholecystectomy.Methods:One hundred patients of both sexes, aged 18-64 yr, with body mass index of 18-30 kg/m 2, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, were divided into 2 groups ( n=50 each) using the random number table method: control group (group C) and preoperative oral carbohydrate group (group P). Patients underwent solid food fasting after 20: 00 on the night before surgery in both groups and drinking fasting after 21: 30 on the night before surgery in group C. Group P received 800 ml of 12.5% oral carbohydrate at 21: 30 on the night before surgery and 400 ml of oral similar carbohydrate from 5: 00 to 5: 30 in the morning before surgery.All the patients underwent ultrasound examination of the gastric sinus at 7: 30 on the operation day (2 h after oral carbohydrate, T 1) to determine the nature of gastric contents according to the qualitative analysis of images, and Perlas grade was performed, and the cross-sectional area (CSA) of the gastric sinus in a semi-sitting position and right lateral decubitus position was calculated, and gastric volume (GV) and gastric volume to weight ratio (GV/W) were calculated.For solids in the stomach or GV > 1.5 ml/kg was defined as a full stomach.Patients assessed as a full stomach at T 1 underwent antrum ultrasonography again before induction of anesthesia (at 3 h after oral carbohydrate, T 2). The occurrence of satiety at T 1 and T 2 in each group was recorded.The patient′s hunger score, thirst score, and satisfaction score during fasting were recorded at T 2.The reflux aspiration, occurrence of nausea and vomiting at 24 h after operation, postoperative time to first flatus and postoperative total length of hospital stay were recorded. Results:Compared with group C, the CSA in a semi-sitting position, CSA, GV and GV/W ratio in a right lateral decubitus position, incidence of satiety, and Perlas grade were significantly increased at T 1 ( P<0.05), no significant change was found in the incidence of satiety at T 2 ( P>0.05), preoperative hunger and thirst scores were significantly decreased, satisfaction scores were increased, the incidence of nausea and vomiting was decreased at 24 h after surgery, and the postoperative time to first flatus was shortened ( P<0.05), and no significant change in the postoperative total length of hospital stay was found in group P ( P>0.05). Conclusions:Oral carbohydrates before laparoscopic cholecystectomy may result in delayed gastric emptying in the patients with cholelithiasis, and the time window for oral carbohydrates can be appropriately shifted forward (3 h before surgery).

Objective:To evaluate the effects of controlled low central venous pressure (CLCVP) on the cerebral blood flow in the patients undergoing open hepatectomy.Methods:Thirty American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ patients of either sex, aged 18-60 yr, with body mass index of 18-30 kg/m 2, with Child-Pugh classification A and expected operation time of 2-4 h, undergoing elective open hepatectomy, were enrolled.After anesthesia induction, patients were placed at head-up tilt position, nitroglycerin 0.5-1.5 &mu;g·kg -1·min -1 was infused, and furosamide 5-10 mg was intravenously injected when necessary to maintain CVP less than 5 cmH 2O during hepatectomy.After the end of hepatectomy, CLCVP was stopped, the infusion rate was increased to 10 ml·kg -1·h -1 with a crystalline gel ratio of 1∶2 to restore CVP to more than 5 cmH 2O.At 5 min after anesthesia induction (T 0), 5 min after head-up tilt (T 1), 5 and 15 min after CVP reaching the target (T 2, 3) and 5 min after the end of CLCVP (T 4), the blood flow of internal carotid artery was detected by ultrasound, and peak systolic velocity(IBVs), end diastolic velocity (IBVd)and vessel diameter of the internal carotid artery (ID)were measured by doppler ultrasound.Mean velocity [IBVm=(IBVs+ IBVd×2)÷3] and internal carotid artery blood flow [IBF=IBVm×π×(ID/2) 2×HR] were calculated.Heart rate (HR), mean arterial blood pressure (MAP), cardiac output (CO), stroke volume (SV), end-tidal pressure of carbon dioxide (P ETCO 2) and maximum airway pressure (P max) were recorded at each time point. Results:Compared with the baseline at T 0, MAP, CO, SV, IBVm and IBF were significantly decreased at T 2, 3 ( P<0.001), and no significant change was found in HR, P ETCO 2 and P max at T 1-4 ( P>0.05). The results of linear mixed-effects model analysis showed that the regression coefficients for CO, MAP, HR, and SV were 0.600 3, 0.022 88, 0.363 7, and 0.614 8, respectively ( P<0.05 or 0.01). Conclusions:CLCVP can decrease the cerebral blood flow in the patients, which is closely associated with decreased CO, MAP, HR and SV when used for open hepatectomy.

OBJECTIVETo study the clinical and pathologic features of Churg-Strauss syndrome (CCS).

METHODSThree cases of Churg-Strauss syndrome, including 1 autopsy case and 2 cases with open thoracoscopic lung biopsy, were retrospectively reviewed. All the tissue samples were formalin-fixed, paraffin-embedded and stained with hematoxylin and eosin.

RESULTSThe first patient was a 68-year-old man who had history of asthma for 4 years, with recent exacerbation and chest pain for 2 weeks. Patient died 1 day after admission due to myocarditis and myocardial infarction. He did not have peripheral eosinophilia, skin or paranasal sinus pathology. CSS represented an incidental autopsy finding and he had never been treated with corticosteroid before. The other 2 patients were a 58-year-old male and a 12-year-old female, respectively. Both had history of asthma, peripheral eosinophilia and lung consolidations on computed tomographic examination. Pathologically, all cases showed vasculitis, perivascular allergic-type granulomas, eosinophilic pneumonia and asthmatic bronchitis.

CONCLUSIONSThorough understanding of the clinical and pathologic criteria is essential for arriving at a correct diagnosis of CSS. Although some patients may present with atypical symptoms, lung biopsies often reveal the classic histologic findings which include vasculitis and perivascular allergic granuloma formation.

Aged ; Churg-Strauss Syndrome ; pathology ; Eosinophilia ; pathology ; Female ; Granuloma ; pathology ; Humans ; Lung Diseases ; pathology ; Male ; Middle Aged ; Pulmonary Eosinophilia ; pathology ; Vasculitis ; pathology

For epidemiological investigation of the rabies virus carrier rates of domestic dogs, cats and wild animals like rodent animals and bats,three kinds of regions where rabies had higher incidence (Hunan and Guizhou Provinces), lower incidence (Jiangsu Province, Wuhan City) and provisionally rabies-free (Shenyang City) were selected. Then the antigenic types, the genovariation of the isolaled viruses and the currently vaccine matching of the virus strains were analyzed. The results showed that in China the principal host of rabies is dog,the total virus carrier rate of the captured dogs was 2.56%, and the highest positive isolation rate was 20.0% in some monitoring site. However,there was no evidence about the rabies virus carrier rate in rodent animals,bats or other wild animals. The rabies vaccines which prepared from aG and CTN strains have already been produced successfully in China. The research showed that the nucleotide sequences of the newly isolated viruses were more similar with the glycoprotein gene of CTN strain. In order to evaluate the safety and the efficacy of the vaccines currently used, two groups (50 people each) were injected with vaccine of aG strain and CTN strain respectively in five surveillance points. The neutralizing antibody tested were 0.49 IU/mL-0.52 IU/mL and 6.7 IU/mL-7.53 IU/mL after the 7 and the 14 days of vaccine injection respectively. In addition, the rates of antibody positive seroconversion were 45.1%-47.9% and 100% respectively, and there was no moderate or severe adverse reactions observed. These data showed the vaccines have satisfactory effect on safety and protection.
Animals ; Antibodies, Viral ; blood ; Carrier State ; epidemiology ; veterinary ; Cats ; virology ; Cercopithecus aethiops ; Dogs ; virology ; Enzyme-Linked Immunosorbent Assay ; Fluorescent Antibody Technique ; Rabies Vaccines ; immunology ; Rabies virus ; classification ; genetics ; isolation & purification ; Vero Cells

BACKGROUND: Intensive phototherapy (IPT) and exchange transfusion (ET) are the main treatments for extreme hyperbilirubinemia. However, there is no reliable evidence on determining the thresholds for these treatments. This multicenter study compared the effectiveness and complications of IPT and ET in the treatment of extreme hyperbilirubinemia. METHODS: This retrospective cohort study was conducted in seven centers from January 2015 to January 2018. Patients with extreme hyperbilirubinemia that met the criteria of ET were included. Patients were divided into three subgroups (low-, medium-, and high- risk) according to gestational week and risk factors. Propensity score matching (PSM) was performed to balance the data before treatment. Study outcomes included the development of bilirubin encephalopathy, duration of hospitalization, expenses, and complications. Mortality, auditory complications, seizures, enamel dysplasia, ocular motility disorders, athetosis, motor, and language development were evaluated during follow-up at age of 3 years. RESULTS: A total of 1164 patients were included in this study. After PSM, 296 patients in the IPT only group and 296 patients in the IPT plus ET group were further divided into the low-, medium-, and high-risk subgroups with 188, 364, and 40 matched patients, respectively. No significant differences were found between the IPT only and IPT plus ET groups in terms of morbidity, complications, and sequelae. Hospitalization duration and expenses were lower in the low- and medium-risk subgroups in the IPT only group. CONCLUSIONS In this study, our results suggest that IPT is a safe and effective treatment for extreme hyperbilirubinemia. The indication of ET for patients with hyperbilirubinemia could be stricter. However, it is necessary to have a contingency plan for emergency ET as soon as IPT is commenced especially for infants with risk factors. If IPT can be guaranteed and proved to be therapeutic, ET should be avoided as much as possible.
Child, Preschool ; Exchange Transfusion, Whole Blood/adverse effects* ; Humans ; Hyperbilirubinemia, Neonatal/therapy* ; Infant ; Infant, Newborn ; Kernicterus/therapy* ; Phototherapy/methods* ; Retrospective Studies