Five cadinane-type sesquiterpenoids were isolated from the n-hexane extract of Commiphora myrrha by using various chromatographic techniques, including silica gel, ODS and semi-preparative HPLC. Their structures were identified by physicochemical properties and spectroscopic data. These compounds were defined as (3S,4R)-3,9-dimethoxymyrrhone (1), 9-methoxymyrrhone (2), myrrhone (3), commiterpene B (4) and comosone Ⅱ (5). Compound 1 is a new compound, of which the absolute configuration was established by single crystal X-ray crystallographic analysis. Compound 5 is firstly isolated from the Commiphora genus.

OBJECTIVETo improve the diagnosis and treatment of primitive neuroectodermal tumors (PNET) of the pancreas.

METHODSOne patient with PNET of the pancreas was reported in this article. The corresponding literatures on the diagnosis and treatment was reviewed.

RESULTSThe patient was diagnosed as pancreatic PNET by her clinical, microscopic, and immunohistochemical features as well as cytogenetic analysis after the resection of the tumor located in the uncinate process in PUMC Hospital. Radiochemotherapy was given after the operation for 8 months and no recurrence was observed. Since PNET of pancreas have no specific clinical symptoms and most patients have jaundice and/or abdominal pain, the diagnosis depended on the immunohistochemical features of positive P30/32(MIC2) and at least two of the neural markers. The cytogenetic analysis showed translocation mainly harbored the characteristic t (11; 22) (q24; q12). Since pancreatic PNET were highly aggressive, early chemotherapy, close follow-up, and immediate surgical interventions were required as early as possible.

CONCLUSIONPNET can occur in pancreas, and diagnosis and treatment should be made as early as possible to improve the outcome.

Child ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Humans ; Neuroectodermal Tumors, Primitive ; diagnosis ; therapy ; Pancreatic Neoplasms ; diagnosis ; therapy

Thymic carcinoid is a rare neoplasm with unclear risk factors and controversial classifications .Clinical manifestations vary from asymptomatic to many nonspecific symptoms , among which endocrinopathy seems to be as-sociated with poor prognosis .Image studies show no specificity both in CT and PET/CT, but are of great value in clinical staging .Ki67 index has been found to be a powerful tool for grading neuroendocrine tumors and further studies should be made .The diagnosis of thymic carcinoid mainly depends on pathology and immunohistochemistry plays a role in differential diagnosis .Radical resection is the first choice in treatment , and target therapy becomes possible with the development in molecular pathology .

OBJECTIVETo evaluate the efficacy and safety of olmesartan medoxomil compared with losartan potassium in patients with mild to moderate essential hypertension.

METHODThis is a randomized, double-blind, double-dummy, active-controlled, parallel, multi-center study. After a 2-week placebo run-in period, a total of 287 eligible subjects were randomized at 1:1 ratio to receive olmesartan medoxomil 20 mg or losartan potassium 50 mg, once daily for 8 weeks. The blood pressure was assessed after 4 weeks treatment. If the subject's seating diastolic blood pressure (SeDBP) was still >or=90 mm Hg, the dosage was doubled for another 4 weeks; for those subjects whose SeDBP was <90 mm Hg after 4-week treatment, the initial dosage remained unchanged and the treatment continued until completion of the study.

RESULTS(1) The mean trough reduction in SeDBP from baseline in olmesartan group was significantly greater than that in losartan group after 4 weeks (11.72 mm Hg vs 9.23 mm Hg, P=0.004) and 8 weeks treatment (12.94 mm Hg vs 11.01 mm Hg, P=0.035). (2) The number and percentage of responders in olmesartan group (81, 65.3%) were statistically higher than those (68, 52.7%) in losartan group (P=0.028) after 4 weeks treatment and were similar between the two groups after 8 weeks treatment (P>0.05). (3) Individual and overall trough/peak ratios of DBP and SBP in 24-hour ambulatory blood pressure monitoring were higher in olmesartan group than losartan group. The hypotensive effect of olmesartan was more durable than losartan at 24 hour interval. (4) The incidence of study drug-related adverse events (AEs) in olmesartan group (10.5%) was similar as that in losartan group (13.9%, P>0.05). Most of these AEs were mild and transient.

CONCLUSIONThis study shows that olmesartan medoxomil, at oral dose of 20 mg-40 mg once daily was effective and safe for hypertension treatment and the hypotensive effect was superior to losartan potassium (50 mg-100 mg once daily).

Adolescent ; Adult ; Aged ; Antihypertensive Agents ; administration & dosage ; China ; Double-Blind Method ; Female ; Humans ; Hypertension ; drug therapy ; physiopathology ; Imidazoles ; adverse effects ; therapeutic use ; Losartan ; adverse effects ; therapeutic use ; Male ; Middle Aged ; Olmesartan Medoxomil ; Tetrazoles ; adverse effects ; therapeutic use

OBJECTIVETo study the clinicopathologic features of peripheral T-cell lymphoma, unspecified (PTL-U) with follicular pattern.

METHODSThe clinical data, hematoxylin and eosin-stained sections of lymph node biopsies and follow-up data of 18 cases of PTL-U associated with follicular growth pattern were reviewed and studied. Eight cases of reactive lymphoid hyperplasia were used as controls. Semi-quantitative observation by retiform micrometer rule was carried out. Immunohistochemical study was also performed in all cases. T-cell receptor and immunoglobulin heavy chain gene rearrangement studies were conducted by polymerase chain reaction-based method.

RESULTSThe median age of the patients was 53 years. The male-to-female ratio was 1.57:1 in lymphoma group. All of the lymphoma patients presented with superficial lymphadenopathy, with (8/18) or without B symptoms. Histologically, the lymphoma was characterized by follicles of various sizes and shapes. The T zones were expanded by medium-sized lymphoma cells which contained clear cytoplasm and irregular nuclei. Mitotic figures were commonly identified. Immunohistochemical study confirmed that the lymphoma cells were of T-lineage. The proliferative index, as highlighted by Ki-67, was higher [average = (38.24 +/- 13.42)%/mm2] than that in the control group. T-cell receptor gene rearrangement was demonstrated in 71.4% (10/14) of the lymphoma cases.

CONCLUSIONSA definitive diagnosis of PTL-U with follicular pattern can be made on the basis of morphologic examination, immunohistochemical assessment and clinical features. Cases with atypical features can further be delineated by molecular analysis. Long-term follow up of these patients is prudent.

Adolescent ; Adult ; Aged ; CD3 Complex ; metabolism ; Child ; Child, Preschool ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Gene Rearrangement, T-Lymphocyte ; Humans ; Ki-67 Antigen ; metabolism ; Lymphatic Diseases ; pathology ; Lymphoma, B-Cell, Marginal Zone ; pathology ; Lymphoma, Follicular ; drug therapy ; metabolism ; pathology ; Lymphoma, T-Cell, Peripheral ; drug therapy ; metabolism ; pathology ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Remission Induction ; Young Adult

Interfascial plane block is a quick,safe and simple technique that offers effective analgesia for video-assisted thoracotomy.However,the currently described methods still have certain limitations.We explored the application of a novel interfascial plane block method-iliocostal plane block in video-assisted thoracotomy,along with the use of stained cadaveric anatomy,with an attempt to shed new light on the analgesia for video-assisted thoracotomy.
Analgesia ; Humans ; Thoracotomy

OBJECTIVETo analyze the clinical features, diagnosis and treatment of lung cancer associated paraneoplastic limbic encephalitis (PLE).

METHODSThe clinical data of 7 cases of patients with lung cancer associated PLE out of 8927 patients of lung cancer from January 2000 to May 2010 was analyzed retrospectively. All the patients were male, aging from 41 to 54 years with a mean of 48 years. The data including history, physical examination, laboratory tests, diagnosis, treatment and follow-up were collected and analyzed.

RESULTSAll the 7 patients had smoking history. All 7 patients had varying short-term memory loss, 6 had epilepsy, 4 had different degrees of mental disorders, and 2 had syndrome of inappropriate secretion of antidiuretic hormone. Malignancies were screened and detected by chest X-ray or CT scan, while the pathological diagnoses were obtained through biopsy or transbronchial needle aspiration through electronic bronchoscope (5/7), biopsy of supraclavicular lymph nodes (1/7) and open pulmonary lobectomy (1/7). The pathological diagnosis included small cell lung cancer in 6 cases, adenocarcinoma of lung in 1 case. During the follow-up, 1 patient was lost, and the mean time of follow-up of the remaining 6 patients was about 11.5 months (ranged from 4 to 21 months). Four patients received early immunosuppressive treatment in terms of corticosteroids, only slight relief of neurological symptoms was seen in 2 patients. However, after chemotherapy (6/6), radiation (3/6), or surgical removal of the tumor (1/6), complete remission (3/6, with negative anti-Hu antibody) or partial remission (3/6, 2 of whom with positive anti-Hu antibody) of neurological symptoms were observed. Till October 2010, 3 patients with poorer tumor stag died ( survival were 4, 10, and 14 months respectively), while the other 3 patients with negative anti-Hu antibody and relative better tumor stag were still in the follow-up (the period were 5, 15, and 21 months).

CONCLUSIONSPLE is a rare disease. In comparison with immunosuppressive therapy, chemotherapy, radiation or surgical removal of the tumor could provide better remission of the neurological symptoms. Positive serum anti-Hu antibody, poorer tumor stag, and together with poorer response to treatments seem to indicate a poorer prognosis.

Adult ; Carcinoma, Small Cell ; complications ; Humans ; Limbic Encephalitis ; etiology ; therapy ; Lung Neoplasms ; complications ; Male ; Middle Aged ; Retrospective Studies

There is an increasing interest in phytoestrogens due to their potential medical usage in hormone replacement therapy (HRT). The present study was designed to investigate the in vitro effects of estrogen-like activities of two widespread coumarins, osthole and imperatorin, using the MCF-7 cell proliferation assay and their alkaline phosphatase (ALP) activities in osteoblasts Saos-2 cells. The two compounds were found to strongly stimulate the proliferation of MCF-7 cells. The estrogen receptor-regulated ERα, progesterone receptor (PR) and PS2 mRNA levels were increased by treatment with osthole and imperatorin. All these effects were significantly inhibited by the specific estrogen receptor antagonist ICI182, 780. Cell cycle analysis revealed that their proliferation stimulatory effect was associated with a marked increase in the number of MCF-7 cells in S phase, which was similar to that observed with estradiol. It was also observed that they significantly increased ALP activity, which was reversed by ICI182,780. These results suggested that osthole and imperatorin could stimulate osteoblastic activity by displaying estrogenic properties or through the ER pathway. In conclusion, osthole and imperatorin may represent new pharmacological tools for the treatment of osteoporosis.
Alkaline Phosphatase ; genetics ; metabolism ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Cnidium ; chemistry ; Coumarins ; pharmacology ; Drugs, Chinese Herbal ; pharmacology ; Furocoumarins ; pharmacology ; Humans ; MCF-7 Cells ; Osteoblasts ; cytology ; drug effects ; enzymology ; Phytoestrogens ; pharmacology ; Receptors, Estrogen ; genetics ; metabolism

Cultivated ginseng in the farmland would become the mainly planting mode of Panax ginseng. However,there are relatively few cultivation ginseng varieties for farmland in China. Correlative analysis of qualitity and agronomic traits of P. ginseng cultivation in the farmland could provide a reference for the selection of excellent germplasm and new variety breeding of P. ginseng. In this study,the main index of saponin and agronomic traits of 4-6 years' samples were analyzed by UPLC and measured. The results show that there was significant difference in agronomic indexes of Damaya. The coefficient of variation of the root length( CV = 41. 97%) and fresh weight( CV = 31. 81%) were maximum,and the coefficient of variation of the stems thickness( 16. 72%) and root thickness were minimum. There was a significant correlation between yield and root thickness( P<0. 05). There was significant difference in drug yield of different harvest years( P<0. 05),and the yield of 6-years was 31. 52%-39. 69% higher than 4-years. However,there wasn't significant difference in total ginsenosides between 4 and 6 years old P. ginseng,but there was significant difference in ginseng Rg2,Rc and Rb2( P<0. 05),and the ginsenoside contents of different harvesting years were accorded with the criterion standards of 2015 Chinese Pharmacopoeia. There was no significant correlation between the saponin and the agronomic trait,while there was positive correlation with root thickness( P < 0. 05). Therefore,the stem diameter was positive correlation with yield of P. ginseng. Selection of the stem thickness of seedlings is beneficial to the increase of the yield and breeding of P. ginseng.
China ; Crop Production ; Ginsenosides/analysis* ; Panax/chemistry* ; Plant Breeding ; Plant Roots/growth & development* ; Plant Stems/growth & development*

This study aims to study the chemical components from the gum resin of Boswellia carterii. Five cembranoid diterpenes were isolated from the gum resin of B. carterii by various of column chromatographies including silica gel, Sephadex LH-20, and semi-preparative HPLC. Their structures were identified on the basis of physicochemical properties, mass spectrometry(MS), nuclear magnetic resonance(NMR), Ultraviolet(UV) and infrared(IR) spectroscopic data. These compounds were identified as(1S,2E,4R,5S,7E,11E)-4-methoxy-5-hydroxycembrane(1),(1R~*,4R~*,5E,8E,12E,15E)-4-hydroxycembra-5,8,12,15-tetraene(2), cembrene A(3),(3S,4S,7R)-4-hydroxycembrane(4), and pavidolide D(5). Compound 1 was a new compound. Compounds 2, 4, and 5 were obtained from the gum resin of B. carterii for the first time. Compound 2 showed weak inhibition on the human liver cancer cell line HepG2.
Boswellia ; Cell Line ; Diterpenes ; Humans ; Molecular Structure ; Resins, Plant