To study the chemical constituents of Rabdosia japonica var. glaucocalyx and their anti-complementary activity on the basis of preliminary studies. Target isolation guided by anti-complementary activity test, compounds in the chloroform and n-butanol fractions were isolated and purified by silica gel and Sephadex LH-20 column chromatographies, and preparative HPLC. The structures were identified by various spectroscopic data including ESI-MS, 1H-NMR and 13C-NMR data. The compounds were evaluated for anti-complementary activity in vitro. Eleven compounds were isolated from the chloroform and n-butanol soluble fractions and identified as stigmasterol (1), stigmas-9 (11) -en-3-ol (2), glaucocalyxin D (3), kamebakaurin (4), maslinic acid (5), corosolic acid (6), minheryins I (7), diosmetin (8), caffeic acid ethylene ester (9), caffeic acid (10) and vitexin (11). Isoquercetrin, rutin, quercetin, 3-methylquercetin, luteolin, 7-methylluteolin, and apigenin which were isolated from the preliminary studies together with compounds 9 and 10 showed inhibition of the complement system by the classical pathway. Compounds 2, 4, 6-9 and 11 were obtained from this plant for the first time. Caffeic acid (10) showed the strongest activity in vitro with a CH50 value of 0.041 g x L(-1).
Animals ; Antioxidants ; pharmacology ; Caffeic Acids ; pharmacology ; Chromatography ; Chromatography, High Pressure Liquid ; Complement Hemolytic Activity Assay ; methods ; Complement Inactivating Agents ; chemistry ; pharmacology ; Cricetinae ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Erythrocytes ; drug effects ; Esters ; Ethylenes ; pharmacology ; Female ; Isodon ; chemistry ; Magnetic Resonance Spectroscopy ; Male ; Plant Components, Aerial ; chemistry ; Plant Growth Regulators ; pharmacology ; Sheep ; Spectrometry, Mass, Electrospray Ionization

BACKGROUNDResection of petroclival meningioma (PCM) is difficult for neurosurgeons and usually brings poor performance status. In this study, we evaluated the possible risk factors for unfavorable clinical outcomes of surgical treatment of PCM, and tried to explore the optimal surgical strategies for better postoperative quality of life.

METHODSWe recruited 57 patients (14 male, 43 female, mean age, 50.5 years) who underwent surgical resection of PCM in Huashan Hospital during 2002 - 2006. The primary outcomes including postoperative neurological deficits, modified Rankin scale (mRS) score and recurrence rate were evaluated, and all potential risk factors were assessed by the χ(2) test. Odds ratio and 95% confidence interval were calculated by univariate Logistic regression. The mean follow-up time was 34 months.

RESULTSGross total resection was achieved in 58% of patients. One patient died during the perioperative period because of intracranial hemorrhage. Sixty-seven percent of patients experienced new postoperative neurological deficits and 26% had a higher mRS score at follow-up assessment. Postoperative complications were observed in 24 patients. Within the follow-up period, radiographic recurrence occurred in 12.3% of patients at a mean follow-up of 42 months. Postoperative radiosurgery was administered to 19 patients who had residual tumors or recurrence and no further progression was found. Tumor adhesion, hypervascularity and engulfment of neurovascular structures were three risk factors for increased mRS score (P = 0.0002; P = 0.0051; P = 0.0009). Tumor adherence to adjacent structures clearly affected the extent of resection (P = 0.0029). The risk of postoperative cranial nerve deficits increased with tumor engulfment of neurovascular structures (P = 0.0004).

CONCLUSIONSIntraoperatively defined tumor characteristics played a critical role in identifying postoperative functional status. An individual treatment strategy after careful preoperative evaluation could help improve quality of life.

Adult ; Aged ; Cranial Fossa, Posterior ; Female ; Humans ; Male ; Meningeal Neoplasms ; physiopathology ; psychology ; surgery ; Meningioma ; physiopathology ; psychology ; surgery ; Middle Aged ; Neurosurgical Procedures ; methods ; Quality of Life

OBJECTIVETo evaluate the detection of cytomegalovirus (CMV) by polymerase chain reaction (PCR) for predicting the development of CMV disease.

METHODSOne hundred and thirty one allo-HSCT patients performed in the past 2 years were analyzed retrospectively. PCR-CMV was used to monitor CMV viremia and vireuria once a week after transplantation.

RESULTSIn the dynamic detection, CMV viremia was positive for at least one chance in 89 patients, vireuria did in 99 patients. Thirty-seven patients developed CMV disease with an accumulative incidence of 32.5%. The incidence of CMV disease was 15.6% in plasma CMV-PCR negative group, 31.3% in positive once group, and 47.3% in positive over twice group. There was significant difference among the three groups (P = 0.0126). The incidence of CMV disease was 24.8% in urine CMV-PCR negative group, 43.5% in positive once group, and 33.0% in positive over twice group, being no significant difference among them (P = 0.845). On analysis, viremia could predict the development of CMV disease: the PPV (positive predictive value) is 40.5%, NPV (negative predictive value) is 84.4%, sensitivity is 75.0%, and specificity is 69.2%.

CONCLUSIONSDetected by CMV-PCR, MCV viremia may predict the development of CMV disease, but MCV vireuria cannot.

Adolescent ; Adult ; Child ; Child, Preschool ; Cytomegalovirus ; genetics ; isolation & purification ; Cytomegalovirus Infections ; diagnosis ; etiology ; DNA, Viral ; blood ; urine ; Female ; Hematopoietic Stem Cell Transplantation ; adverse effects ; Humans ; Male ; Middle Aged ; Polymerase Chain Reaction ; methods ; Retrospective Studies ; Sensitivity and Specificity ; Transplantation, Homologous ; adverse effects

OBJECTIVETo develop an HPLC method for determination of saponin I in bulb extracts of Allium macrostemon.

METHODThe extract was refluxed by methanol and then filtrated. The filtrate was concentrated and the bioactive saponin was measured by HPLC-RID.

RESULTThe calibration curve was in good linearity over the range of 5-100 microg with the regression equation of Y= 9.35 x 10(4) X - 2.78 x 10(4) (r = 0.9998) and the average recovery was 101.1% (n = 5, RSD 1.6%).

CONCLUSIONThe method is simple, quick and reproducible and can be applied in the quality control of A. macrostemon.

Allium ; chemistry ; Chromatography, High Pressure Liquid ; methods ; Plant Extracts ; chemistry ; isolation & purification ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Quality Control ; Reproducibility of Results ; Saponins ; analysis ; Sterols ; analysis

Objective To observe the effect of intracoronary transfer of autologous HO-1 overexpressed MSCs in porcine model of myocardial ischemia ( 1 h)/reperfusion. Methods Apoptosis was assayed and cytokine concentrations in supernatant were measured in cells exposed to hypoxia-reoxygen in vitro. In vivo, Chinese male mini-pigs were allocated to the following treatment groups; control group (saline), MSCs group (MSCs), MSCs transfected with pcDNA3. 1-nHO-l (HO-1-MSCs). 1 x 107 of autologous stem cells or identical volume of saline was injected intracoronary into porcine hearts 1 h after ischemia. MRI assay and postmortem analysis were assessed 3 months after stem cell transplantation. Results In vitro, cell apoptosis rate post hypoxia-reoxygen was significantly reduced in HO-1- MSCs group ( 30. 30% ±7. 64% ) compared with that in MSCs group (56. 93% ±4. 68% , P <0. 001) and LacZ- MSCs group (55. 88% ± 4. 38% , P < 0. 001) , VEGF was also significantly upregulated in HO-1-MSCs group [(768.44±78.38)pg/ml] compared with that in MSCs group[ (555. 27 ±67. 67)pg/ml, P<0.001] and LacZ-MSCs group [ (522. 97 ± 71. 45 ) pg/ml, P < 0. 001 ] . In vivo, cardiac function was significantly improved in both MSCs transplantation groups compared to saline group (all P<0. 05 vs. saline) and the left ventricular ejection fraction was significantly higher in HO-1-MSCs group compared with that in MSCs group at 3 months after transplantation ( 53. 50% ± 2. 09% vs. 49. 54% ± 2. 74% , P = 0. 017 ), capillary density in the peri-infarct area was also significantly higher in HO-1-MSC group than that in MSCs group [ (14.59 ± 2. 39 )/HPF vs. (11.78 ± 2.48 )/HPF, P = 0.033 ] . Conclusions Efficacy of HO-1 overexpressed MSCs on improving cardiac function and promoting angiogenesis was greater than those by MSCs in this porcine ischemia/reperfusion model.

OBJECTIVETo analyze the features, causes, treatments and outcomes of severe gastrointestinal (GI) bleeding after allogeneic hematopoietic stem cell transplantation (allo-HSCT).

METHODSFifteen patients suffered from massive GI bleeding (blood loss leading to hemorrhagic shock) or subacute GI bleeding (at least 1 or more units of red blood cell transfusion on each of two consecutive days) were observed and analyzed after allo-HSCT.

RESULTSSeventeen severe GI bleeding episodes occurred in 15 patients. The severe bleeding occurred in three periods of time: within 1 week, 1 to 2 months and 4 to 7 months after transplantation. The main manifestation was hematemesis and hematochezia in the first period, and hematochezia alone in the second and third periods. Platelet counts at the onset of severe bleeding were < or = 50 x 10(9)/L in the majority of patients. Causes of bleeding were conditioning regimen-related toxicity in 2 patients/episodes, graft versus host disease (GVHD) or/and intestinal cytomegalovirus (CMV) or fungal infections in 11 patients/12 episodes, intestinal CMV infections in 1 patient/episode, acid-peptic ulcer in 2 patients/episodes, and cause unknown in 1 patient/episode. Supportive care such as transfusions of platelet, red blood cell and fresh frozen plasma, H2 receptor blockers and omeprazole were given to all patients, immunosuppressive drugs to patients developed GVHD and antiviral drugs to patients with complicated CMV infection. Eight patients/9 episodes of bleeding were controlled. Eight patients continued severe GI bleeding and died of acute GVHD or related serious complications.

CONCLUSIONSSevere GI bleeding after allo-HSCT are mainly caused by regimen-related toxicity, GVHD or/and intestinal CMV infection. Bleeding caused by conditioning regimen-related toxicity is self-limited and has a better prognosis. However, treatment failure and mortality are high if the patient's bleeding resulted from GVHD and intestinal CMV infection.

Gastrointestinal Hemorrhage ; etiology ; therapy ; Hematopoietic Stem Cell Transplantation ; Humans ; Postoperative Complications ; therapy ; Prognosis

OBJECTIVETo explore the incidence, prognosis and risk factors of the acute graft versus host disease (aGVHD) after allo-hematopoietic stem cell transplantation (allo-HSCT).

METHODSThe clinical data of 118 cases undergone 120 times of allo-HSCT were analyzed.

RESULTaGVHD was observed in 63 cases (52.57%) including 17 severe cases (14.17%). The patients with aGVHD had a poor outcome, the 2-year overall survival rates were 61.40%, 64.08% and 17.65% for the non aGVHD, mild (degree I-II) and severe (degree III-IV) aGVHD groups respectively (P < 0.01). However, the relapse rates were 12.48%, 20.53% and 0% with no statistic significance. Unrelated transplantation and HLA-mismatch were the risk factors for aGVHD.

CONCLUSIONaGVHD is a common complication after allo-HSCT, the earlier it takes place, the poorer the prognosis.

Acute Disease ; Adolescent ; Adult ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Graft vs Host Disease ; epidemiology ; etiology ; pathology ; Hematopoietic Stem Cell Transplantation ; adverse effects ; Humans ; Incidence ; Male ; Middle Aged ; Prognosis ; Risk Factors ; Severity of Illness Index ; Survival Analysis ; Time Factors ; Transplantation, Homologous

Adult ; Anemia, Aplastic ; mortality ; therapy ; Bone Marrow Transplantation ; Female ; Graft vs Host Disease ; etiology ; Granulocyte Colony-Stimulating Factor ; pharmacology ; Hematopoietic Stem Cell Mobilization ; Humans ; Male ; Middle Aged ; Peripheral Blood Stem Cell Transplantation ; Transplantation, Homologous

BACKGROUNDThe definitive treatment for myocardial ischemia is reperfusion. However, reperfusion injury has the potential to cause additional reversible and irreversible damage to the myocardium. One likely candidate for a cardioprotection is adenosine. The present study aimed at investigating the effect of intravenous adenosine on clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI).

METHODSPatients with STEMI within 12 hours from the onset of symptoms were randomized by 1:1:1 ratio to receive either adenosine 50 µg×kg(-1)×min(-1) (low-dose group, n = 31), or 70 µg×kg(-1)×min(-1) (high-dose group, n = 32), or saline 1 ml/min (control group, n = 27) for three hours. Drugs were given to the patients immediately after the guide wire crossed the culprit lesion. Recurrence of no-reflow, TIMI flow grade (TFG) and TIMI myocardial perfusion grade (TMPG), and collateral circulation were recorded. The postoperative and preoperative ST segment elevation sum of 18-lead electrocardiogram (ECG) and their ratio (STsum-post/STsum-pre) were recorded, as well as the peak time and peak value of CK-MB enzyme. Serial cardiac echo and myocardial perfusion imaging were performed at 24 hours and 6 months post-stenting. The primary endpoint was left ventricular function, and infarct size. The secondary end-point was the occurrence of cardiac and non-cardiac death, non-fatal myocardial infarction, and heart failure.

RESULTSA total of 90 STEMI patients were studied. No-reflow immediately after stent procedure was seen in 11 (35.5%) patients in the control group, significantly different from 6.3% in the low-dose group or 3.7% in the high-dose group (both P = 0.001). STsum-post/STsum-pre in the low-dose and high-dose groups was significantly different from the control group (low-dose group vs. control group, P = 0.003 and high-dose group vs. control group, P = 0.001), without a dose-dependent pattern (P = 0.238). The peak value of CK-MB enzyme was significantly reduced in the high-dose group compared to the control group (P = 0.024). Compared to the left ventricular ejection fraction (LVEF) in control group, LVEF in the low-dose group increased by 5.8% at 24 hours (P = 0.012) and by 10.9% at 6 months (P = 0.007), LVEF in the high-dose group increased by 9.5% at 24 hours (P = 0.001) and by 10.0% at 6 months (P = 0.001), respectively. Significant reduction of infarct size by 24.2% was detected in the high-dose group vs. low-dose or control groups (P = 0.008). There was no significant difference regarding secondary endpoints at 6 months among the treated groups. Cardiac function by NYHA classification in both the low-dose and the high-dose groups was improved significantly (P = 0.013, P = 0.016).

CONCLUSIONIntravenous adenosine administration might significantly reduce the recurrence of no-reflow, with resultant improved left ventricular systolic function. High-dose adenosine was further associated with significant reduction of infarct size.

Adenosine ; administration & dosage ; therapeutic use ; Aged ; Angioplasty, Balloon, Coronary ; Echocardiography ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; drug therapy ; therapy ; Ventricular Function, Left ; drug effects

Background The definitive treatment for myocardial ischemia is reperfusion.However,reperfusion injury has the potential to cause additional reversible and irreversible damage to the myocardium.One likely candidate for a cardioprotection is adenosine.The present study aimed at investigating the effect of intravenous adenosine on clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI).Methods Patients with STEMI within 12 hours from the onset of symptoms were randomized by 1:1:1 ratio to receive either adenosine 50 μg·kg-1·min-1 (low-dose group,n=31),or 70 μgkg-1·min-1 (high-dose group,n=32),or saline 1 ml/min (control group,n=27) for three hours.Drugs were given to the patients immediately after the guide wire crossed the culprit lesion.Recurrence of no-reflow,TIMI flow grade (TFG) and TIMI myocardial perfusion grade (TMPG),and collateral circulation were recorded.The postoperative and preoperative ST segment elevation sum of 18-lead electrocardiogram (ECG) and their ratio (STsum-post/STsum-pre) were recorded,as well as the peak time and peak value of CK-MB enzyme.Serial cardiac echo and myocardial perfusion imaging were performed at 24 hours and 6 months post-stenting.The primary endpoint was left ventricular function,and infarct size.The secondary end-point was the occurrence of cardiac and non-cardiac death,non-fatal myocardial infarction,and heart failure.Results A total of 90 STEMI patients were studied.No-reflow immediately after stent procedure was seen in 11 (35.5％)patients in the control group,significantly different from 6.3％ in the low-dose group or 3.7％ in the high-dose group (both P=0.001).STsum-post/STsum-pre in the low-dose and high-dose groups was significantly different from the control group (low-dose group vs.control group,P=0.003 and high-dose group vs.control group,P=0.001),without a dose-dependent pattern (P=0.238).The peak value of CK-MB enzyme was significantly reduced in the high-dose group compared to the control group (P=0.024).Compared to the left ventricular ejection fraction (LVEF) in control group,LVEF in the low-dose group increased by 5.8％ at 24 hours (P=0.012) and by 10.9％ at 6 months (P=0.007),LVEF in the high-dose group increased by 9.5％ at 24 hours (P=0.001) and by 10.0％ at 6 months (P=0.001),respectively.Significant reduction of infarct size by 24.2％ was detected in the high-dose group vs.low-dose or control groups (P=0.008).There was no significant difference regarding secondary endpoints at 6 months among the treated groups.Cardiac function by NYHA classification in both the low-dose and the high-dose groups was improved significantly (P=0.013,P=0.016).Conclusion Intravenous adenosine administration might significantly reduce the recurrence of no-reflow,with resultant improved left ventricular systolic function.High-dose adenosine was further associated with significant reduction of infarct size.