Objective: To investigate the chemical constituents of monoterpenes in the fruits of Gardenia jasminoides. Methods: Various column chromatographies were used in the isolation and purification, and the physicochemical constant determination and spectral analysis were adopted to identify the chemical structures of monoterpenes. Results: Twelve monoterpenes were isolated from G. jasminoides, such as jasminoside B (1), jasminoside G (2), jasminodiol (3), crocusatin-C (4), (7S)-6-(hydroxymethyl)-1, 1, 5-trimethylcyclohex-3-enone (5), bornyl-6-O-β-D-xylopyranosyl-β-D-glucopyranoside (6), (10R, 11R)-gardendiol (7), (10S, 11S)-gardendiol (8), (5S, 9S)-gardenate A (9), (5R, 9R)-gardenate A (10), jasminoside E (11), and 5, 6-dihydroxymethyl-1, 1-dimethylcyclohex-4-enone (12). Conclusion: Compounds 5, 6, 8, 10, and 12 are first isolated from this plant.

Objective To demonstrate the diffusion tensor imaging(DTI)characteristics of multiple sclerosis(MS)plaques,periplaque white matter regions and normal appearing white matter (NAWM)regions in patients with MS,and to evaluate the clinical values of DTI and three-dimensional brain fiber tracking for the diagnosis of MS.Methods Conventional MRI and DTI were performed in 32 patients with MS and 32 age-matched control subjects.Fractional anisotropy(FA)and apparent diffusion coefficient(ADC)maps were generated and coregistered with T_2-weighted MR images,FA and ADC values were calculated in regions of interest in plaques,periplaque white matter regions,NAWM regions and white matter regions in control subjects.And three-dimensional brain fiber tracking maps were generated by using the DTI.Results TheADCwas(1.233?0.119)?10~(-3)mm~2/s in MS plaques,(0.973?0.098)?10~(-3) mm~2/s in periplaque white matter regions,(0.748?0.089)?10~(-3)mm~2/s in NAWM,and(0.620? 0.094)?10~(-3)mm~2/s in control subjects.The FA was 0.225?0.052 in MS plaques,0.311?0.050 in perip]aque white matter regions,0.421?0.070 in NAWM,and 0.476?0.069 in control subjects. Significant differences in FA and ADC values were observed among all white matter regions(P

Objective To evaluate the efficacy of anesthesia with etomidate administered by TCI in combination with continuous iv remifentanil infusion titrated to maintain BIS values at 40-60 for non-cardiac surgery in a prospective randomized single-blinded multicenter controlled clinical study.Methods Two hundred and forty-four ASA Ⅰ or Ⅱ patients of both sexes aged 20-60 yr undergoing non-cardiac surgery lasting less than 3 h were randomly allocated into 2 groups:etomidate group (group E,n =123) and propofol group (group P,n =121 ).The patients were unpremedicated.A bolus of midazolam 0.03 mg/kg was injected iv immediately before induction of anesthesia.Anesthesia was induced with sufentanil 0.3-0.4 μg/kg and TCI of etomidate (effect-site concentration (Ce) =0.5-1.0 μg/ml) or propofol (Ce =3-4 μg/ml).Tracheal intubation was facilitated with rocuronium 0.9 mg/kg.The patients were mechanically ventilated (VT 8-10 ml/kg,RR 10-12 bpm,FiO2 =1 ).PETCO2 was maintained at 35-40 mm Hg.Anesthesia was maintained with TCI of etomidate ( Ce =0.3-0.8 μg/ml ) or propofol ( Ce =3-4 μg/ml) in combination with continuous iv infusion of remifentanil at 0.1-1.0 μg· kg-1 ·min-1 and intermittent iv boluses of rocuronium.BIS values were maintained at 40-60 during operation.Sufentanil 0.1 μg/kg was administered iv before skin closure.Ce at loss of consciousness,during maintenance of anesthesia and at emergence,the consumption of remifentanil and vasoactive agents,the emergence time and extubation time were recorded.The incidences of injecton pain,post-operative nausea and vomiting (PONV) and emergence agitation were measured.Results Ce of etomidate at loss of consciousness,at emergence and during maintenance of anesthesia was (0.50 ± 0.22),(0.16 ± 0.09) and 0.22-0.39 μg/ml respectively.The incidence of injection pain and the consumption of vasoactive agents were significantly lower but more remifentanil was needed in group E than in group P (P ＜0.05 or 0.01).There was no significant difference in emergence time and extubation time between the 2 groups (P ＞ 0.05).The incidence of PONV and emergence agitation were significantly higher during recovery in group E than in group P ( P ＜ 0.05 ).Conclusion The hemodynamics is stabler during operation,but the incidence of PONV and emergence agitation are significantly higher during recovery in group E than in group P.Etomidate induces little injection pain.

BACKGROUNDIn this prospective randomized study, we compared the predicted blood and effect-site C 50 for propofol and remifentanil target-controlled infusion (TCI) and the bispectral index (BIS) values at loss of consciousness (LOC) and response to a standard noxious painful stimulus (LOS) in elderly and young patients, respectively. We hypothesized that the elderly patients will require lower target concentration of both propofol and remifentanil at above two clinical end-points.

METHODSThere were 80 American Society of Anesthesiologists (ASA) physical status I-II unpremedicated patients enrolled in this study, they were divided into elderly group (age ≥65 years, n = 40) and young group (aged 18-64 years, n = 40). Propofol was initially given to a predicted blood concentration of 1.2 μg/ml and thereafter increased by 0.3 μg/ml every 30 s until Observer's Assessment of Alertness and Sedation score was 1. The propofol level was kept constant, and remifentanil was given to provide a predict blood concentration of 2.0 ng/ml, and then increased by 0.3 ng/ml every 30 s until loss of response to a tetanic stimulus. BIS (version 3.22, BIS Quattro sensor) was also recorded.

RESULTSIn elderly group, the propofol effect-site C 50 at LOC of was 1.5 (1.4-1.6) μg/ml, was significantly lower than that of young group, which was 2.2 (2.1-2.3) μg/ml, the remifentanil effect-site C 50 at LOS was 3.5 (3.3-3.7) ng/ml in elderly patients, was similar with 3.7 (3.6-3.8) ng/ml in young patients. Fifty percent of patients lost consciousness at a BIS value of 57.3 (56.4-58.1), was similar with that of young group, which was 55.2 (54.0-56.3).

CONCLUSIONIn elderly patients, the predicted blood and effect-site concentrations of propofol at LOC were lower than that of young patients. At same sedation status, predicted blood and effect-site concentrations of remifentanil required at LOS were similar in elderly and young patients. BIS were not affected by age. Low-propofol/high-opioid may be optional TCI strategy for elderly patients.

Adolescent ; Adult ; Age Factors ; Aged ; Anesthetics, Intravenous ; administration & dosage ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Piperidines ; administration & dosage ; therapeutic use ; Propofol ; administration & dosage ; therapeutic use ; Prospective Studies ; Unconsciousness ; chemically induced ; Young Adult

OBJECTIVETo compare the antibacterial effects of Huangqin-Tang with its metabolites produced by intestinal flora.

METHODThe antibacterial tests in vitro and in vivo were performed by agar dilution method and lethal protection of animal respectively.

RESULTHuangqin-Tang and its metabolites had antibacterial action on bacteria in vitro, however the antibacterial activity of metabolites of Huangqin-Tang on Salmomella, Dysentery bacillus and Proteus in vitro was stronger than Huangqin-Tang. The metabolites of Huangqin-Tang had protective effect on the animals infected by Staphylococcus aureus and Escherichia coli respectively from death, but Huangqin-Tang had no lethal protection action.

CONCLUSIONThe antibacterial effects of metabolites of Huangqin-Tang in vitro and in vivo are stronger than that of Huangqin-Tang, which shows that intestinal flora play a very important role in antibacterial effects of Huangqin-Tang.

Animals ; Anti-Bacterial Agents ; pharmacology ; therapeutic use ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Escherichia coli Infections ; drug therapy ; Feces ; microbiology ; Intestines ; microbiology ; Male ; Mice ; Phytotherapy ; Plants, Medicinal ; chemistry ; Proteus ; drug effects ; Salmonella ; drug effects ; Shigella dysenteriae ; drug effects ; Staphylococcal Infections ; drug therapy

OBJECTIVETo study causes of ineffectiveness of microvascular decompression (MVD) in treatment of hemifacial spasm (HFS).

METHODSReoperative MVD was performed in 23 HFS patients with previous ineffective MVD. In the patients, the main causes of ineffectiveness included misjudgment of compressing vessels (7 patients), improper insertion of decompressing grafts (9), improper selection of grafts (5) and small grafts (2).

RESULTSSymptoms of HFS disappeared immediately after the second MVD in 21 patients and delayed in 2 patients (after 2 weeks, 6 weeks). No recurrence of HFS was noted during the follow-up period of 1.0 - 6.0 years (mean 3.4 years).

CONCLUSIONSMVD is an effective microsurgical method for treating HFS. Accurate judgement of compressing vessels and proper decompression are the key to surgical effectiveness.

Adult ; Decompression, Surgical ; methods ; Female ; Follow-Up Studies ; Hemifacial Spasm ; surgery ; Humans ; Male ; Medical Futility ; Microsurgery ; methods ; Middle Aged ; Reoperation ; Treatment Outcome ; Vascular Surgical Procedures ; methods ; Young Adult

BACKGROUNDBispectral index (BIS) is considered very useful to guide anesthesia care in elderly patients, but its use is controversial for the evaluation of the adequacy of analgesia. This study compared the BIS changes in response to loss of consciousness (LOC) and loss of somatic response (LOS) to nociceptive stimuli between elderly and young patients receiving intravenous target-controlled infusion (TCI) of propofol and remifentanil.

METHODSThis study was performed on 52 elderly patients (aged 65-78 years) and 52 young patients (aged 25-58 years), American Society of Anesthesiologists physical status I or II. Anesthesia was induced with propofol administered by TCI. A standardized noxious electrical stimulus (transcutaneous electrical nerve stimulation, [TENS]) was applied (50 Hz, 80 mA, 0.25 ms pulses for 4 s) to the ulnar nerve at increasing remifentanil predicted effective-site concentration (Ce) until patients lost somatic response to TENS. Changes in awake, prestimulus, poststimulus BIS, heart rate, mean arterial pressure, pulse oxygen saturation, predicted plasma concentration, Ce of propofol, and remifentanil at both LOC and LOS clinical points were investigated.

RESULTSBISLOCin elderly group was higher than that in young patient group (65.4 ± 9.7 vs. 57.6 ± 12.3) (t = 21.58, P < 0.0001) after TCI propofol, and the propofol Ce at LOC was 1.6 ± 0.3 μg/ml in elderly patients, which was significantly lower than that in young patients (2.3 ± 0.5 μg/ml) (t = 7.474, P < 0.0001). As nociceptive stimulation induced BIS to increase, the mean of BIS maximum values after TENS was significantly higher than that before TENS in both age groups (t = 8.902 and t = 8.019, P < 0.0001). With increasing Ce of remifentanil until patients lost somatic response to TENS, BISLOSwas the same as the BISLOCin elderly patients (65.6 ± 10.7 vs. 65.4 ± 9.7), and there were no marked differences between elderly and young patient groups in BISawake, BISLOS, and Ce of remifentanil required for LOS.

CONCLUSIONIn elderly patients, BIS can be used as an indicator for hypnotic-analgesic balance and be helpful to guide the optimal administration of propofol and remifentanil individually.

TRIAL REGISTRATIONCTRI Reg. No: ChiCTR-OOC-14005629; http://www.chictr.org.cn/showproj.aspx?proj=9875.

Adult ; Aged ; Electroencephalography ; drug effects ; Female ; Humans ; Male ; Middle Aged ; Movement Disorders ; physiopathology ; Pain ; physiopathology ; Piperidines ; pharmacology ; Propofol ; pharmacology ; Transcutaneous Electric Nerve Stimulation ; Unconsciousness ; physiopathology

OBJECTIVETo evaluate the effectiveness of free graft transplantation two-stage urethroplasty for hypospadias repair.

METHODSFifty-eight cases with different types of hypospadias including 10 subcoronal, 36 penile shaft, 9 scrotal, and 3 perineal were treated with free full-thickness skin graft or (and) buccal mucosal graft transplantation two-stage urethroplasty. Of 58 cases, 45 were new cases, 13 had history of previous failed surgeries. Operative procedure included two stages: the first stage is to correct penile curvature (chordee), prepare transplanting bed, harvest and prepare full-thickness skin graft, buccal mucosal graft, and perform graft transplantation. The second stage is to complete urethroplasty and glanuloplasty.

RESULTSAfter the first stage operation, 56 of 58 cases (96.6%) were successful with grafts healing well, another 2 foreskin grafts got gangrened. After the second stage operation on 56 cases, 5 cases failed with newly formed urethras opened due to infection, 8 cases had fistulas, 43 (76.8%) cases healed well.

CONCLUSIONSFree graft transplantation two-stage urethroplasty for hypospadias repair is a kind of effective treatment with broad indication, comparatively high success rate, less complications and good cosmatic results, indicative of various types of hypospadias repair.

Adolescent ; Adult ; Child ; Child, Preschool ; Humans ; Hypospadias ; surgery ; Male ; Mouth Mucosa ; transplantation ; Penis ; abnormalities ; surgery ; Retrospective Studies ; Scrotum ; abnormalities ; surgery ; Skin Transplantation ; Treatment Outcome ; Urethra ; surgery ; Urologic Surgical Procedures, Male ; methods

OBJECTIVETo investigate the effects of long-term low dose hormone replacement therapy (HRT) on postmenopausal women in hormone level, cognition score, hippocampus volume, and magnetic resonance spectroscopy (MRS) parameters.

METHODSA total of 182 postmenopausal women aged 50-87 years were chosen at Peking Union Medical College Hospital and assigned to HRT group and control group. The volunteers of HRT group had taken low dose hormone [estradiol (E2) 0.5-1.0 mg and progesterone 0.5-2.0 mg, once a day] for 4-33 years. The concentrations of E2, progesterone, and testosterone were measured using enzyme-linked immunosorbent assay (ELISA). The gene types of apolipoprotein E (ApoE) were measured by polymerase chain reaction, and the subjects with susceptible genes (ApoE epsilon3/epsilon4) of Alzheimer's disease (AD) were screened. Their hippocampus volumes and MRS parameters were obtained through magnetic resonance imaging (MRI), and results in two groups were analyzed by statistical method.

RESULTSCompared with control group, the concentrations of E2 at each age stage in HRT group were significantly higher (P < 0.05) except the 80-89 years old subgroup; yet, there were no statistical differences in the concentrations of progesterone and testosterone between the two groups. There was no obvious difference in ApoE subtypes distribution between the two groups. The results of hippocampus MRI for the subjects with susceptible genes ApoE epsilon3/epsilon4 (HRT group 14 cases, control group 11 cases) showed that the ratio of bilateral hippocampus volume to whole brain volume in HRT group (0.406 +/- 0.028) was significantly higher than control group (0.369 +/- 0.031, P < 0.05). The results of 1H MRS for the subjects with susceptible genes ApoE epsilon3/epsilon4 (HRT group 12 cases, control group 11 cases) showed that the N-acetylaspartate/total creatine at the area of hippocampus in HRT group (1.54 +/- 0.08) were significantly higher than control group (1.45 +/- 0.13, P < 0.05).

CONCLUSIONSFor postmenopausal women, long-term low dose HRT can maintain the physiological concentration of E2 in plasma. Furthermore, the hippocampus MRI performed on those with ApoE epsilon3/epsilon4 genes shows that long-term low dose HRT can prevent hippocampus atrophy, which is beneficial to maintain the brain function and prevent AD.

Aged ; Aged, 80 and over ; Alzheimer Disease ; prevention & control ; Apolipoprotein E3 ; genetics ; Aspartic Acid ; analogs & derivatives ; metabolism ; Creatine ; metabolism ; Dose-Response Relationship, Drug ; Estradiol ; administration & dosage ; metabolism ; Estrogen Replacement Therapy ; Female ; Hippocampus ; metabolism ; Humans ; Magnetic Resonance Spectroscopy ; instrumentation ; methods ; Middle Aged ; Postmenopause ; metabolism ; Progesterone ; administration & dosage ; metabolism ; Testosterone ; metabolism

OBJECTIVETo compare the protective activity of liver injury induced by D-galactosamine (GalN) between Huangqin-Tang and their metabolites by human intestinal bacteria(HIB).

METHODThe liver injuries in conventional and pseudo-germfree mice were induced by GalN. After oral administration of Huangqin-Tang and their metabolites mixtures by HIB, the serum transaminase (ALT and AST) activities were detected.

RESULTIn conventional mice, large and medium doses (20 and 10 g.kg-1) of Huangqin-Tang decoction significantly reduced the increase of serum ALT activity after 18 h GalN treatment. In pseudo-germfree mice, metabolites significantly reduced the ALT levels. However, Huangqing-Tang didn't affect the ALT levels in this kind of mice. To all of the animals, AST levels remained the same after oral Huangqin-tang or their metabolites.

CONCLUSIONThe metabolism by intestinal bacteria plays a role in pharmacological effects of constituents of Chinese herbal medicine. The metabolites of the constituents by intestinal bacteria were the real active components in vivo.

Administration, Oral ; Alanine Transaminase ; blood ; Animals ; Aspartate Aminotransferases ; blood ; Bacteria ; metabolism ; Chemical and Drug Induced Liver Injury ; Drugs, Chinese Herbal ; isolation & purification ; metabolism ; pharmacology ; Galactosamine ; Intestines ; microbiology ; Liver Diseases ; metabolism ; Male ; Mice ; Plants, Medicinal ; chemistry ; Protective Agents ; metabolism ; pharmacology