OBJECTIVETo study the chemical constituents in fresh fleshyscaleaf of Lilium lancifolium.

METHODThe constituents were separated. by various kinds of chromatography and their structures were identified on the basis of spectral analysis.

RESULTTen compounds were identified regaloside A (1), regaloside C (2), methyl-a-D-mannopyranosid (3), methyl-ca-D-glucopyranoside (4), (25R, 26R) -26-methoxyspirost-5-ene-3p-yl-O-ca-L-rhamnopyranosyl-(1-->2)-[beta-D-glucopyranosyl-(1-->6)]-beta-D-glucopyranoside (5), (25R)-spirost-5-ene-3beta-yl-O-alpha-L-rhamnopyranosyl-(1-->2)-[beta-D-glucopyranosyl-(1-->6)]-beta-D-glucopyranoside (6), (25R, 26R)-17alpha-hydroxy-26-methoxyspirost-5-ene-3beta-yl-O-alpha-L-rhamnopyranosyl-(1-->2)-[beta-D-glucopyra nosyl-(1-->6)]-beta-D-glucopyranoside (7), daucosterol (8), adenoside (9), berberine (10).

CONCLUSIONAll compounds except 1 and 3 were isolated from this species for the first time, and berberine was first reported in genus Lilium.

Berberine ; chemistry ; isolation & purification ; Lilium ; chemistry ; Plant Leaves ; chemistry ; Plants, Medicinal ; chemistry ; Saponins ; chemistry ; isolation & purification

ObjectiveTo investigate the correlation between neutrophil to lymphocyte ratio (NLR) and cerebral microbleeds (CMBs) in patients with acute ischemic stroke.MethodsThe consecutive inpatients with acute ischemic stroke were prospectively enrolled.Gradient echo-T2*-weighted imaging was used to evaluate CMBs and their quantity.Univariate analysis was used to compare the baseline data between the CMB group and the non-CMB group.Multivariable logistic regression analysis was used to identify the independent correlation between NLR and CMBs.ResultsA total of 218 patients with acute ischemic stroke were prospectively enrolled, including 66 (30.3%) with CMBs.The age (64.7±6.6 years vs.66.9±8.6 years;t=2.052, P=0.041), high sensitive C-reactive protein (7.0[2.3-13.9] mg/L vs.8.9[4.0-28.1] mg/L;Z=2.008, P=0.045) and NLR (1.9[1.4-2.9] vs.2.3[1.7-3.6];Z=2.071, P=0.038) in the non-CMB group were significantly lower than those of the CMB group.Multivariate logistic regression analysis showed that NLR (odds ratio 1.276, 95% confidence interval 1.008-1.670;P=0.045) and age (odds ratio 1.044, 95% confidence interval 1.002-1.087;P=0.040) were the independent risk factor for CMBs.Spearman correlation analysis showed that NLR was significantly positively correlated with the severity of CMBs (r=0.210, P=0.007).ConclusionsIn patients with acute ischemic stroke, NLR was associated with CMBs and their severity, suggesting that inflammatory reaction might be involved in the occurrence of CMBs.

Animals ; Brain-Derived Neurotrophic Factor ; Depression/drug therapy* ; Fluoxetine ; Mice ; Stress, Psychological ; Transcranial Magnetic Stimulation

OBJECTIVETo study the effects of the potential factors, including Chinese herbal decoction, on the long-term prognosis of acute myocardial infarction (AMI).

METHODSPrevious clinical data of 162 patients with AMI were collected, who were followed-up to observe the important events for prognosis, as death and cardio-cerebral episode, and the Cox proportional hazards regression model was used to assess the relative factors.

RESULTSThe degree of cardiac function (by New York grading) increased 1 grade when age increased for 10 years, and the relative hazardous degree (RHD) raised to 1.983 and 3.169. After treatment with Chinese herbal decoction and angiotensin converting enzyme inhibitor (ACEI), the RHD could be reduced to 0.177 and 0.161 respectively. Taking the important cardio-cerebral events, including death, as the endpoint, when age increased for 10 years, the cardiac function would increase for 1 grade and RHD of endpoint events increased to 2.021 and 1.863, if patients had history of anterior infarction, arrhythmia and diabetes mellitus, it increased to 2.903, 2.588 and 4.039 respectively. Chinese decoction and ACEI treatment could reduce it to 0.093 and 0.141 respectively.

CONCLUSIONAge, heart failure, anterior infarction, arrhythmia and diabetes mellitus are the hazardous factors of the long-term prognosis of AMI, Chinese herbal decoction and ACEI are the protective factors.

Adult ; Aged ; Aged, 80 and over ; Angiotensin-Converting Enzyme Inhibitors ; therapeutic use ; China ; epidemiology ; Cohort Studies ; Drugs, Chinese Herbal ; therapeutic use ; Follow-Up Studies ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Myocardial Infarction ; drug therapy ; epidemiology ; mortality ; Phytotherapy ; Prognosis ; Proportional Hazards Models ; Retrospective Studies

Objective To explore the significance of 18 F-fluorodeoxyglucose positronemission tomography/ computed tomography (18F-FDG PET/CT) scanning for childhood neuroblastoma clinical staging.Methods From December 2014 to December 2015,59 patients confirmed as NB in Beijing Children's Hospital,Capital Medical University,and finding or clinical features were selected by histopathology.Those patients underwent 18 F-FDG PET/CT,bone scan,cranial magnetic resonance image (MRI),bone marrow puncture (two sites) and biopsy,regional CT,ultrasound,serum tumor markers like lactic dehydrogenase and neuronspecific enolase.In comparison of 18F-FDG PET/CT image findings with other detective methods,the differences were analyzed between the primary sites and metastasis were analyzed.Results (1) General features:Out of 59 children with NB,31 were males,28 were females.Primary lesions were as follows:14 cases located in the postmediastinum,44 cases in the retroperitoneum (1 case in retroperitoneum + postmediastinum),1 case in left neck.International Neuroblastoma Staging System Ⅰ to Ⅳ:O,1,9 and 49 cases,respectively.(2)18F-FDG PET-CT manifestations:The maximum of standardized uptake value (SUVmax):before-treatment group was (2.34 ± 1.06) which was larger than the post-surgery group value of (1.08 ± 0.50),and the difference was significant(F =5.699,P =0.000);bone marrow metastasis ranged from 1.5 to 2.9,regional lymphatic metastasis ranged from 1.0 to 2.1.(3)18F-FDG PET-CT imaging compared with other detection:in bone metastases,the whole body bone scan finding were normal in 3 cases,while PET/CT showed disseminated bone and bone marrow involvement and bone scanning showed 2 cases had metastases,combined with 18 F-FDG PET/CT,which were considered as postoperative inflammatory reaction or residual tumor tissues invade adjacent intervertebral foramen.Bone cytology was positive in 30 cases,while PET/CT showed 34 patients with bone marrow metastasis,and 1 case was suspicious.In central metastasis,1 case of PET/CT showed epidural metastasis,while cranial MRI was negative;Cranial MRI showed 9 cases had skull metastasis,1 case had orbital metastasis,1 case had meningeal metastases;while 18F-FDG PET/CT showed no abnormality.All children had no parenchymal metastasis.Corresponding tumor markers as LDH was related to the maximum value of primary tumor focal SUVmax (rs =0.581,P ＜ 0.01).Conclusions 18 F-FDG PET/CT can fully display the distribution of primary sites and metastases,and can be served as medical imaging evidence for both the diagnosis and staging of neuroblastoma.But as for cranial bone and central metastasis,it has high false negative rate.Clinical practice should be combined with cranial MRI to improve relevance ratio.

Objective To analezk thk altkrations in blood urka nitrogkn( BRN)and skrum crkatinink( Scr) in childrkn with rktinoblastoma( Ab)bkfork and aftkr chkmothkrape and thk clinical significanck of thk chkmothkrape kffkct,and to providk thk kvidknck for thk furthkr improvkmknt of thk safkte of trkatmknt. Methods L total of 280 chil-drkn with Ab wkrk knrollkd in thk stude,and kach of thkm was trkatkd with CEV( Carboplatin+Etoposidk+Vincris-tink)mkthods. Thkrk subjkcts includkd 153 malks and 127 fkmalks,with a mkan trkatmknt of 4. 5 ceclks(rangk 2 to 12 ceclks)and a mkan agk of 21. 5 months(rangk 1 to 84 months). Lmong thkm,149 casks wkrk diagnoskd clinicalle,131 casks wkrk diagnoskd pathologicalle. Eight casks wkrk in thk kxtraocular stagk,3 casks wkrk in glaucoma and 269 casks in intraocular pkriod(101 casks of singlk keks and 168 casks of doublk keks). BRN and Scr wkrk dktkctkd bkfork thk first coursk of chkmothkrape and aftkr thk last coursk of chkmothkrape. ResuIts BRN and Scr valuks wkrk analezkd bk-fork and aftkr chkmothkrape. BRN was 3. 05 mmol╱F bkfork chkmothkrape and 3. 46 mmol╱F aftkr chkmothkrape in thk group agkd from 4 months to lkss than 12 months(73 casks),thk valuks of BRN aftkr chkmothkrape was highkr than that bkfork chkmothkrape,and onle in this group thk changk was statisticalle diffkrknt(t﹦ -2. 829,P﹦0. 006),but all BRN valuks in this group wkrk not bkeond thk highkst rkfkrknck valuk(1. 70 mmol╱F-7. 10 mmol╱F). Bkfork initial chkmothkrape,149 patiknts( 53. 2﹪)had Scr bklow thk rkfkrknck rangk( malk:30 -104 μmol╱F,fkmalk:30 -84 μmol╱F),and 20 casks(7. 0﹪)had thk BRN bklow thk rkfkrknck valuk. In 2 casks,BRN(7. 25 mmol╱F and 7. 34 mmol╱F, rkspkctivkle)bkfork thk initial chkmothkrape was slightle highkr than thk normal valuk,but thk valuk was normal(5. 01 mmol╱F and 4. 98 mmol╱F,rkspkctivkle)aftkr thk last chkmothkrape. In onk cask,thk BRN(5. 62 mmol╱F)was normal bkfork thk initial chkmothkrape,but it was klkvatkd(7. 33 mmol╱F)aftkr thk last chkmothkrape. In anothkr onk cask,thk BRN was normal bkfork and aftkr chkmothkrape,but thk valuk aftkr chkmothkrape was 4. 69 timks highkr than that bk-fork chkmothkrape. ConcIusions Aknal function of Ab childrkn bkfork trkatmknt is normal. Skvkn pkrcknt of thksk patiknts havk BRN undkr thk BRN rkfkrknck rangk,and 53. 2﹪ of thksk patiknts havk Scr undkr thk Scr rkfkrknck rangk. It suggkstkd that thk rkfkrknck valuks of BRN and Scr nkkd to bk adjustkd. BRN of infant Ab mae incrkask signifi-cantle aftkr chkmothkrape,but it doks not mkkt thk currknt diagnostic critkria of mild nkphrotoxicite. Still,thk karle rknal damagk nkkds to bk notickd.

Objective To summarizk clinical charactkristics,thkrapkutic kffkct and prognosis of rhabdomeosar-coma(AMS)childrkn of lkss-than-2 -ekar old and its rklatkd factors,to improvk thk awarknkss of this agk group with AMS. Methods Thk clinical information and thkrapkutic kffkct of 20 AMS patiknts of lkss-than-2-ekar old wkrk diagnoskd and trkatkd at thk hkmatologe -oncologe ckntkr in Bkijing Childrkn＇s Hospital( BCH),from Januare 2012 to Lpril 2017,and thk clinical data wkrk analezkd rktrospkctivkle. Lccording to thk intkrnational critkria for thk trkatmknt of solid tumors in childrkn,thk patiknts wkrk dividkd into a complktk rkmission group and a progrkss╱rklapsk group,and thk risc factors affkcting thk prognosis wkrk analezkd. ResuIts Twknte casks of lkss-than-2 ekar old chil-drkn with AMS wkrk collkctkd,accounting for 12. 4﹪ of all AMS during thk samk pkriod in BCH hkmatologe-oncologe ckntkr. Thk mkdian follow-up timk was(16. 1 ± 1. 8)months,5 patiknts got progrkss╱rklapsk at 9-12 months during trkatmknt and 2-3 months aftkr thkrape finishkd. Thk ratk of 2 -ekar-kvknt-frkk survival( EPS)ratk and ovkrall survival(OS)ratk wkrk 48﹪ and 61﹪,rkspkctivkle. Thk 2-ekar EPS ratk of kmbreonal AMS childrkn was significant-le highkr than that of alvkolar AMS childrkn,and thk diffkrknck was statisticalle significant(χ2 ﹦0. 854,P﹦0. 034). In thk progrkss╱rklapsk group and thk childrkn with complktk rkmission childrkn,factors lick boe,kmbreonal tepk,primare tumor location of not bad,and of mkdium risc might rkduck thk risc of progrkss╱rklapsk of AMS,whilk tumor diamktkr ＞5 cm and clinical stagk Ⅳ might incrkask thk risc of progrkss╱rklapsk of AMS,but thk diffkrknck was not statisticalle significant(P＞0. 05). ConcIusions Thk prognosis of AMS childrkn lkss-than-2-ekar old was vkre poor,and thk ratks of 2 ekars EPS and OS ratks wkrk lowkr than ovkrall indkx of childrkn with AMS. Thksk patiknts nkkd to undkrgo a varikte of trkatmknt mkthods flkxible,including dklaekd radiothkrape and 125 I radioactivk skkds brachethkrape,to improvk thkrapkutic kfficace and long-tkrm outcomks.

OBJECTIVETo study the major metabolites of ferulic acid and gallic acid compatible with Danggui Chishaoyao in rat plasma and urine.

METHODThe metabolites of ferulic acid and gallic acid in rat plasma and urine were analyzed after oral administration of compatible Danggui Chishaoyao using UPLC-Q-TOF-MS.

RESULTOn the basis of the mass information, it was inferred that in vivo metabolites of ferulic acid were be in the form of methylation products, sulfate conjugation products and glucuronidation conjugation products and so on; meanwhile, gallic acid was mainly transformed into eduction products and methylation products.

CONCLUSIONThere are kinds of phase I and phase II metabolites of ferulic acid and gallic acid in rat plasma and urine, which provide a basis for its efficacious materials and action mechanism.

Animals ; Coumaric Acids ; blood ; metabolism ; urine ; Drugs, Chinese Herbal ; metabolism ; Gallic Acid ; blood ; metabolism ; urine ; Herb-Drug Interactions ; Male ; Metabolome ; Rats ; Rats, Sprague-Dawley ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization

Objective Coronary arterial plaque rupture and secondary thrombosis are the major pathogenesis of acute coronary syndrome ( ACS) . Metalloprotease ( MMPs) secreted by monocyte/ macrophage was the main predisposing factor of the plaque rupture and peroxisotne proliferator-activated receptor-γ (PPAR-γ) is involved in a variety of inflammatory cytokine gene transcriptional regulations. We explored the possible role of PPAR-γ in the regulation of MMP-9 and TIMP-1 expressed by peripheral monocyte-derived macrophages (MDMs) from patients with ACS. Methods Peripheral blood mononuclear cells were isolated from 48 patients with ACS and 28 healthy controls and stimulated by macrophage colony-stimulating factor (0. 1 μg/ml for 24 hours) to form MDMs. MDMs were then incubated under various concentrations of rosiglitazone (0, 1, 10, 20 μmol/L) for 48 hours. The concentrations of MMP-9 and TIMP-1 in the supernatant were measured by enzyme linked immunosorbent assay, and the mRNA expression of PPAR-γ, MMP-9 by RT-PCR and nuclear factor-KB P65 ( NF-kB P65 ) expression by immunohistochemistry. Results PPAR-γ mRNA expression was significantly lower while NF-kB P65 and MMP-9 expression as well as MMP-9 and TIMP-1 concentrations in supernatant were significantly higher in ACS group than those in control group (all P <0. 05). After rosiglitazone intervention, PPAR-γ mRNA expression was significantly upregulated in both ACS and control groups in a dose-dependent manner. Both the MMP-9 concentration in the supernatant and MMP-9 mRNA expression were reduced post intervention with rosiglitazone in both groups. The TIMP-1 mRNA expression and concentration in supernatant were not affected by rosiglitazone in both groups. Rosiglitazone induced significant downregulation of NF-kB P65 expression in both groups. Conclusion Rosiglitazone intervention may downregulate MMP-9 expression by upregulating PPAR-γ expression, and by downregulaiting NF-kB expression in MDMs isolated from patients with ACS.

OBJECTIVETo summarize the methods, safety and efficiency of surgical resection for hilar cholangiocarcinoma.

METHODSThe clinical and follow-up data of 48 patients with hilar cholangiocarcinoma underwent surgical resection from January 2003 to December 2007 were analyzed retrospectively. There were 26 male and 22 female, aged from 38 to 72 years old with a mean of 63.6 years old.

RESULTSPerioperative management including percutaneous transhepatic biliary drainage applied in 19 cases and portal vein embolization applied in 2 cases. Eight patients were treated with extrahepatic bile duct resection with or without parital hepatic segment II resection, 10 cases with perihilar hepatic resection (segment IVB, partial V, partial VIII, I), 28 cases with extended hemihepatectomy and 2 cases with central hepatic resection (segment IVB, V, VIII, I). R0 resection rate was 89.5% and the operative mortality was 2.1%. The 1-, 3- and 5-year survival rate were 93.5%, 51.8% and 36.5%, respectively. Patients undergoing extended hepatic resection survived significantly longer than those undergoing partial hepatic resection (P = 0.034).

CONCLUSIONSExtended hepatic resection for hilar cholangiocarcinoma offers good outcomes with an acceptable mortality rate.

Adult ; Aged ; Bile Duct Neoplasms ; surgery ; Bile Ducts, Intrahepatic ; Cholangiocarcinoma ; surgery ; Female ; Follow-Up Studies ; Hepatectomy ; methods ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Treatment Outcome