OBJECTIVETo summarize the pharmacological function of oleanolic acid.

METHODBased on the documents and related achievements, the pharmacological function and its mechanism including its clinical use were summed up.

RESULT AND CONCLUSIONOleanolic Acid is a natural chemical which has wide-ranging function and abundant source. But we should place the emphasis on improving its biotic utilization and effect on clinical treatment.

Adjuvants, Immunologic ; pharmacology ; Animals ; Antineoplastic Agents, Phytogenic ; pharmacology ; Antiviral Agents ; pharmacology ; Hepatitis, Viral, Human ; drug therapy ; Humans ; Hypoglycemic Agents ; pharmacology ; Oleanolic Acid ; isolation & purification ; pharmacology ; Phytotherapy ; Plants, Medicinal ; chemistry

OBJECTIVETo investigate the chemical constituents from the root and rhizome of Rheum rhizastachyum.

METHODThe compounds were isolated by column chromatography on silica gel, Sephadex LH-20, MCI-gel CHP-20P separately and their structures were elucidated by chemical and spectral technology.

RESULTSix compounds were isolated and identified as chrysophanol, emodin, gallic acid, sucrose, 1-O-beta-D-glucopyranosyl-chrysophanols, 1-O-beta-D-glucopyranosyl-emodin.

CONCLUSIONAll the compounds were obtained from this plant for the first time.

Anthraquinones ; chemistry ; isolation & purification ; Emodin ; chemistry ; isolation & purification ; Gallic Acid ; chemistry ; isolation & purification ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Rheum ; chemistry ; Rhizome ; chemistry

OBJECTIVETo study the chemical constituents in the root of Hedysarum polybotrys Hand.-Mazz..

METHODThe constituents were isolated by Sephadex LH-20 and silica gel column chromatography, and their structures were identified on the basis of spectral analysis.

RESULTFive compounds, medicarpin (I), 3-hydroxy-9-methoxycoumestan (II), 3, 9-dihydroxycoumestan (III), beta-sitosterol (IV), beta-sitosterol-3-O-beta-D-glucoside (V) were obtained.

CONCLUSIONCompounds II, III, V were obtained from the plant for the first time.

Fabaceae ; chemistry ; Molecular Structure ; Plant Extracts ; chemistry ; isolation & purification ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Pterocarpans ; chemistry ; isolation & purification

OBJECTIVETo study the chemical constituents of Hedysarum polybotrys.

METHODChromatographic methods were used to isolate compounds from H. polybotrys and chemical and spectral methods were used to elucidate the structures of the isolated compounds.

RESULTFive compounds, N,N,N-trimethyl-tropaphone inner salt (hypaphorine) (1), octadecyl-3-methoxy-4-hydroxy-benzeneacrylate (2), 5,7,4'-trihydroxy-dihydroflavanone 5,7-di-O-beta-D-glucopyranoside (3), 3,4,5-trimethoxy cinnamic acid methy ester (4) and vanillic acid (5), were isolated from the roots of H. polybotrys.

CONCLUSIONCompounds 1, 2 and 3 were obtained from this plant for the first time, while compounds 1 and 2 were isolated from Hedysarum for the first time.

Acrylates ; chemistry ; isolation & purification ; Fabaceae ; chemistry ; Indoles ; chemistry ; isolation & purification ; Molecular Conformation ; Molecular Structure ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry

AIMTo study the chemical constituents of Hedysarum polybotrys Hand.-Mazz..

METHODSThe compounds were separated with Sephadex LH-20 and silica gel column chromatography, and their structures were identified on the basis of spectral analysis.

RESULTSFive compounds were identified as hedysalignan A (1), isoliquiritigenin (2), formononetin (3), calycosin (4) and ononin (5).

CONCLUSIONHedysalignan (1) is a new compound and the others were obtained from the plant for the first time.

Chalcone ; analogs & derivatives ; chemistry ; isolation & purification ; Chalcones ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Fabaceae ; chemistry ; Furans ; chemistry ; isolation & purification ; Glucosides ; chemistry ; isolation & purification ; Isoflavones ; chemistry ; isolation & purification ; Molecular Conformation ; Molecular Structure ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry

OBJECTIVETo investigate the protective effects on allografts and the possible mechanism of adeno-associated heme-oxygenase-1 (AdHO-1) gene therapy against chronic rejection injury.

METHODSEx vivo AdHO-1 gene therapy was performed in vascular and renal transplantation models. The structure and function, the expression of therapeutic genes and proteins, and the immune modulation were analyzed.

RESULTSAdHO-1 gene therapy protected renal transplant against chronic rejection, but the effect was not as remarkable as that in vascular transplant. The transfected empty vehicle aggravated chronic rejection damage in renal transplantation. AdHO-1 decreased the infiltration of macrophages and CD4(+) T cells.

CONCLUSIONSAdHO-1 gene therapy can lessen damage of chronic rejection in allografts. It plays roles by protecting transplants, down-regulating immune response and inducing immune deviation.

Adenoviridae ; genetics ; Animals ; Blood Vessels ; transplantation ; CD4 Lymphocyte Count ; Chronic Disease ; Genetic Therapy ; methods ; Genetic Vectors ; Graft Rejection ; etiology ; prevention & control ; Graft Survival ; Heme Oxygenase-1 ; genetics ; Kidney Transplantation ; adverse effects ; methods ; Macrophages ; pathology ; Male ; Rats ; Rats, Inbred Lew ; Transfection ; Transplantation, Homologous

Background::Accurate prediction of ischemic stroke is required for deciding anticoagulation use in patients with atrial fibrillation (AF). Even though only 6% to 8% of AF patients die from stroke, about 90% are indicated for anticoagulants according to the current AF management guidelines. Therefore, we aimed to develop an accurate and easy-to-use new risk model for 1-year thromboembolic events (TEs) in Chinese AF patients.Methods::From the prospective China Atrial Fibrillation Registry cohort study, we identified 6601 AF patients who were not treated with anticoagulation or ablation at baseline. We selected the most important variables by the extreme gradient boosting (XGBoost) algorithm and developed a simplified risk model for predicting 1-year TEs. The novel risk score was internally validated using bootstrapping with 1000 replicates and compared with the CHA 2DS 2-VA score (excluding female sex from the CHA 2DS 2-VASc score). Results::Up to the follow-up of 1 year, 163 TEs (ischemic stroke or systemic embolism) occurred. Using the XGBoost algorithm, we selected the three most important variables (congestive heart failure or left ventricular dysfunction, age, and prior stroke, abbreviated as CAS model) to predict 1-year TE risk. We trained a multivariate Cox regression model and assigned point scores proportional to model coefficients. The CAS scheme classified 30.8% (2033/6601) of the patients as low risk for TE (CAS score = 0), with a corresponding 1-year TE risk of 0.81% (95% confidence interval [CI]: 0.41%-1.19%). In our cohort, the C-statistic of CAS model was 0.69 (95% CI: 0.65-0.73), higher than that of CHA 2DS 2-VA score (0.66, 95% CI: 0.62-0.70, Z = 2.01, P = 0.045). The overall net reclassification improvement from CHA 2DS 2-VA categories (low = 0/high ≥1) to CAS categories (low = 0/high ≥1) was 12.2% (95% CI: 8.7%-15.7%). Conclusion::In Chinese AF patients, a novel and simple CAS risk model better predicted 1-year TEs than the widely-used CHA 2DS 2- VA risk score and identified a large proportion of patients with low risk of TEs, which could potentially improve anticoagulation decision-making. Trial Registration::www.chictr.org.cn (Unique identifier No. ChiCTR-OCH-13003729).

Catheter ablation has been recommended as a treatment option for paroxysmal atrial fibrillation (PAF) patients complicated with type 2 diabetes mellitus (T2DM). PAF patients with T2DM have a higher recurrence rate after catheter ablation. Prolongation of corrected QT (QTc) interval has been linked to poor outcomes in T2DM patients. Whether the abnormal QTc interval is associated with the ablation outcome in the PAF patients with T2DM remains unknown. In this study, 134 PAF patients with T2DM undergoing primary catheter ablation were retrospectively enrolled. Pre-procedural QTc interval was corrected by using the Bazett's formula. Cox proportional hazards models were constructed to assess the relationship between QTc interval and the recurrence of AF. After a 29.1-month follow-up period, 61 patients experienced atrial tachyarrhythmia recurrence. Recurrent patients had a longer QTc interval than non-recurrent patients (425.2±21.5 ms vs. 414.1±13.4 ms, P=0.002). Multivariate Cox regression analysis revealed that QTc interval [hazard ratio (HR)=1.026, 95% confidence interval (CI) 1.012-1.040, P=0.005] and left atrial diameter (LAD) (HR=1.125, 95% CI 1.062-1.192, P=0.003) were independent predictors of recurrent atrial tachyarrhythmia. Receiver operating characteristic analysis demonstrated that the cut-off value of QTc (418 ms) predicted arrhythmia recurrence with a sensitivity of 55.7% and a specificity of 69.9%. A combination of LAD and QTc was more effective than LAD alone (P<0.001) in predicting arrhythmia recurrence after the procedure. QTc interval could be used as an independent predictor of arrhythmia recurrence in T2DM patients undergoing AF ablation, thus providing a simple method to identify those patients who likely have a better outcome following the procedure.
Aged ; Atrial Fibrillation ; complications ; physiopathology ; surgery ; Catheter Ablation ; adverse effects ; Diabetes Mellitus, Type 2 ; complications ; physiopathology ; surgery ; Electrocardiography ; Female ; Heart Atria ; physiopathology ; Humans ; Male ; Middle Aged ; Proportional Hazards Models ; Risk Factors ; Tachycardia ; physiopathology ; Treatment Outcome

Objective: This study explored the thromboembolism risk of low-risk atrial fibrillation (AF) patients (CHA₂DS₂-VASc score of 0 or 1 for male and 1 or 2 for female) with different clinical characteristics to provide the basis for anticoagulation decision-making in these patients. Methods: We prospectively enrolled consecutive 2 862 nonvalvular low-risk AF patients between August 2011 to December 2018 in China-AF (China Atrial Fibrillation Registry) Study, their CHA₂DS₂-VASc score was 0 or 1 for male and 1 or 2 for female. According to their age, sex, presence or absence of hypertension, diabetes mellitus, congestive heart failure, and vascular disease at the time of enrolling, patients were divided into CHA₂DS₂-VASc score 0 score group, 1 score group, and 2 score group. Patients were followed up every 6 months by outpatient clinic visit or telephone interview. The outcome was a thromboembolic event, including ischemic stroke and systemic embolism. Univariate Cox regression analysis was used to compare the thromboembolism risk between the patients with different risk factors and CHA₂DS₂-VASc score 0 group. Results: A total of 2 862 low-risk atrial fibrillation patients were enrolled in this study. 915 patients (32.0%) were female, and age was (55.0±10.7) years old. There were 933 patients (32.6%) in CHA₂DS₂-VASc score 0 group, 1 401 patients (49.0%) in score 1 group and 528 patients (18.5%) in score 2 group. During follow-up (median 1.5 years, 5 811.82 person-years), 33 cases of thromboembolic events were recorded, the annual rate of thromboembolism was 0.57% (95%CI 0.40%~0.80%). The number of thromboembolic events in patients with CHA₂DS₂-VASc score 0, 1 and 2 were 8, 11 and 14, respectively, and the annual thromboembolism event rates were 0.40% (95%CI 0.20%-0.81%), 0.39% (95%CI 0.22%-0.71%) and 1.34% (95%CI 0.80%-2.27%), respectively. The risk of thromboembolism of CHA₂DS₂-VASc score 2 group (HR=3.53, 95%CI 1.48-8.44; P=0.005), especially female patients aged 65-74 years in CHA₂DS₂-VASc score 2 group (HR=2.67, 95%CI 1.63-4.38; P<0.000) was significantly higher than that in patients of CHA₂DS₂-VASc score 0 group. Conclusion: Low-Risk Atrial Fibrillation patients with CHA₂DS₂-VASc score 2, especially female patients aged 65-74 years old with CHA₂DS₂-VASc score 2 are at higher risk of thromboembolism in low-risk AF patients. For such patients, intensified oral anticoagulant therapy might be helpful to reduce the risk of thrombolism.
Adult ; Aged ; Anticoagulants ; Atrial Fibrillation ; China ; Female ; Humans ; Male ; Middle Aged ; Risk Assessment ; Risk Factors ; Stroke ; Thromboembolism

BACKGROUND: Patients with atrial fibrillation (AF) and prior stroke history have a high risk of cardiovascular events despite anticoagulation therapy. It is unclear whether catheter ablation (CA) has further benefits in these patients. METHODS: AF patients with a previous history of stroke or systemic embolism (SE) from the prospective Chinese Atrial Fibrillation Registry study between August 2011 and December 2020 were included in the analysis. Patients were matched in a 1:1 ratio to CA or medical treatment (MT) based on propensity score. The primary outcome was a composite of all-cause death or ischemic stroke (IS)/SE. RESULTS: During a total of 4.1 ± 2.3 years of follow-up, the primary outcome occurred in 111 patients in the CA group (3.3 per 100 person-years) and in 229 patients in the MT group (5.7 per 100 person-years). The CA group had a lower risk of the primary outcome compared to the MT group [hazard ratio (HR) = 0.59, 95% CI: 0.47-0.74, P < 0.001]. There was a significant decreasing risk of all-cause mortality (HR = 0.43, 95% CI: 0.31-0.61, P < 0.001), IS/SE (HR = 0.73, 95% CI: 0.54-0.97, P = 0.033), cardiovascular mortality (HR = 0.32, 95% CI: 0.19-0.54, P < 0.001) and AF recurrence (HR = 0.33, 95% CI: 0.30-0.37, P < 0.001) in the CA group compared to that in the MT group. Sensitivity analysis generated consistent results when adjusting for time-dependent usage of anticoagulants. CONCLUSIONS In AF patients with a prior stroke history, CA was associated with a lower combined risk of all-cause death or IS/SE. Further clinical trials are warranted to confirm the benefits of CA in these patients.