The genus Chloranthus has 13 species and 5 varieties in China, which can be found in the southwest and northeast regions. Phytochemical studies on Chloranthus plants have reported a large amount of terpenoids, such as diterpenoids, sesquiterpenoids, and sesquiterpenoid dimers. Their anti-inflammation, anti-tumor, antifungal, antivirus, and neuroprotection activities have been confirmed by previous pharmacological research. Herein, research on the chemical constituents from Chloranthus plants and their biological activities over the five years was summarized to provide scientific basis for the further development and utilization of Chloranthus plants.
Diterpenes ; Phytochemicals/pharmacology* ; Plants ; Sesquiterpenes/pharmacology* ; Terpenes

OBJECTIVE: To evaluate the efficacy and safety of topical delivery of modified Da-Cheng- Qi Decoction (, MDCQD) by low-frequency ultrasound sonophoresis (LFUS) in patients with refractory metastatic malignant bowel obstruction (MBO) using an objective performance criteria (OPC) design. METHODS: Fifty patients with refractory metastatic MBO were enrolled in this open-label single-arm clinical trial. Alongside fasting, gastrointestinal decompression, glycerol enema, intravenous nutrition and antisecretory therapy, a 50 g dose of MDCQD (prepared as a hydrogel) was applied through topical delivery at the site of abodminal pain or Tianshu (S 25) using LFUS for 30 min, twice daily for 5 consecutive days. The overall outcome was the remission of intestinal obstruction, and improvement on abdominal pain, abdominal distention, nausea and vomiting scores. Indicators of safety evaluation included liver and renal function as well as blood coagulation indicators. RESULTS: Among 50 patients, 5 patients (10%) showed complete remission of intestinal obstruction and 21 patients (42%) showed improvement of intestinal obstruction. The overall remission rate of bowel obstruction was 52%. The results of the symptom score, based on the severity and frequency of the episode, are as follows: 26 patients (52%) showed improvment on symptom scores, 20 patients (40%) did not respond to treatment, and 4 patients (8%) discontinued treatment due to intolerance. No serious adverse effects or abnormal changes on liver and renal function or blood coagulation were observed. CONCLUSION Topical delivery of MDCQD at 100 g/day using LFUS can improve the treatment response in patients with refractory metastatic MBO.
Administration, Cutaneous ; Adult ; Aged ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Intestinal Neoplasms ; complications ; secondary ; Intestinal Obstruction ; drug therapy ; etiology ; Male ; Middle Aged ; Ultrasonic Therapy ; methods

OBJECTIVETo study the difference of spino-pelvic sagittal alignment between lumbar disc herniation(LDH) and lumbar canal stenosis(LCS) in adults.

METHODSThe integrated imaging data of 88 patients with lumbar disc herniation (42 cases) or lumbar canal stenosis(46 cases) were searched from January 1, 2015 to September 10, 2016 in our hospital.Twenty-two cases were excluded because of age factor, 36 cases of LDH (LDH group) and 30 cases of LCS (LCS group) were internalized in the study. The spino-pelvic parameters were measured including pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), lumbar lordosis (LL), thoracic kyphosis (TK), thoracolumbar junction (TLJ), sagittal vertical axis (SVA), sagittal vertical axis location (SVA-Location), T₁-spinopelvic inclination (T₁-SPI), T9-spinopelvic inclination (T₉-SPI). Independent sampletest was used in order to analyze the above data.

RESULTSThoracic kyphosis (TK) in LDH group was smaller than that of LCS group (difference was about 6 degree), there was significant difference between two groups (=0.031). And there were no significant differences in other parameters between two groups (>0.05).

CONCLUSIONSThe patients with lumbar disc herniation, the kyphosis of the thoracic spine is smaller, the truncus prones to the straight. The lumbar kyphosis is greater in patients with lumbar spinal stenosis, and the sagittal curvature of the lumbar spine is more obvious.

OBJECTIVETo evaluate the efficacy and safety of Chinese medicine (CM) decoction Chang'an I Recipe ( I ) in the treatment of irritable bowel syndrome with diarrhea (IBS-D).

METHODA multicenter, randomized, double-blind, placebo-controlled clinical trial was designed. Based on the order of inclusion, the IBS-D patients were randomly assigned to the treatment group or the placebo control group, administrated with Chang'an I Recipe or placebo, 150 mL/bag, 3 times daily, for 8 weeks. The primary indices of efficacy included the effective rates of IBS symptom severity score (IBS-SSS) and the differences in adequate relief (AR) responder; the secondary indexes of efficacy included the changes in scores of the IBS Quality of Life (IBS-QOL) and Hospital Anxiety and Depression (HAD) scales. The safety indices included adverse events and related laboratory tests.

RESULTSA total of 216 patients were included, with 109 in the treatment group and 107 in the control group, and finally 206 were included in the full analysis set (FAS), 191 were included in the per protocol set (PPS). In FAS, the total effective rate was 67.6% and 40.2% for the treatment and control groups, respectively, with 95% confidence interval (CI) for difference in the effective rates between the two groups of 14.4%-40.2%; while in PPS, the total effective rate was 71.3% and 41.2% for the treatment and control groups, respectively (95% CI 16.6%-43.4%). The consistent conclusions of FAS and PPS showed a better efficacy in the treatment group. Both FAS and PPS showed higher AR responder in the treatment group (FAS: 59.6% vs. 35.5%; PPS: 62.8% vs. 38.1%). As for IBS-QOL, the total score and scores in various dimensions of IBS-QOL were not significantly different between the two groups (P>0.05). Both anxiety and depression scales of HAD were not significantly different between the two groups (P>0.05). No adverse events or laboratory abnormalities were found to be obviously related to the tested drugs or clinically significant.

CONCLUSIONChang'an I Recipe was more effective than placebo in the treatment of IBS-D, with no obvious adverse reactions. (No.ChiCTR-TRC-09000328).

Objective To investigate the effect of optimizing protocol activity on the cardiac function in patients with hypertension.Methods One hundred and one patients with mild and moderate hypertension in Navy General Hospital were enrolled in the study.The patients took regular exercise(6 min walking activity and treadmill test),Echocardiogram was performed 24 h after 6 min walking activity and treadmill test.The cardiac function related parameters were obtained through M-mode,2DE,pulse Doppler and DTI detection to compare the effect of 6 min walking activity and treadmill test on cardiac function.Results The results showed that in the male hypertensive patients,EF and E/E' after treadmill test were superior to those after 6 min walking activity (EF:(59.33±4.46)% vs.(56.05±4.57)%;E/E':(4.12±1.66)vs.(4.95±1.79)),the differences were statistically significant(P=0.02,0.01),while among the female hypertensive patients,there were no significant differences in cardiac function(P>0.05).Conclusion Appropriate activity can improve the cardiac function in male hypertensive patients.EF and E/E' after the treadmill test performed better than those after the 6 min walking activity,while its influence on female hypertensive patients was not significant.

OBJECTIVETo evaluate the feasibility and efficiency of embolization of spinal dural arteriovenous fistula (SDAVF).

METHODSFrom December 2010 to May 2012, there were 104 cases of SDAVF were treated, and 26 cases were selected to be treated with embolization. The inclusion criteria was as follows: (1) No anterior or posterior spinal artery originated from the fistula segment; (2) The segmental artery can be catheterized with guiding or micro catheter; (3) High flow in fistula; (4) Patient's situation was not suitable for surgery or general anesthesia. Among 26 cases, there were 22 male and 4 female patients, the average age was 55.9 years (ranged from 34 to 81 years). The locations of SDAVF were 10 cases in thoracic, 9 in lumbar and 7 in sacral segment. The main symptoms were progressive numbness and weakness in both lower extremities, most cases accompanied with difficulties in urination and defecation. The average history was 17.1 months (from 1 to 156 months). ONYX-18 liquid embolic agent or Glubran-2 surgical glue were used as embolic material. The patients not cured with embolization were treated with surgery in the following 1 - 2 weeks. Follow-up evaluation was done with MRI after 3 months and DSA after 6 months, besides physical examination.

RESULTSFifteen from 26 cases achieved immediate angiographic cure results: 14 in 20 cases which embolized with ONYX-18; only 1 in 6 cases with Glubran-2. Three in 10 cases of thoracic SDAVF and 12 in 16 cases of lumbar/sacral SDAVF were cured with embolization. Partially embolized cases were treated with surgical obliteration of drainage veins within 2 weeks. Cured patients experienced immediate improvement after embolization and kept getting better in the follow-up. All the patients had MRI follow-up after 3 months and DSA follow-up after 6 months. In 6 month's follow-up, MRI showed the edema and flow void signal in the spinal cord disappeared. DSA showed no fistula recurrence or remnant. There was no deterioration case in all of the embolized cases.

CONCLUSIONSParticular SDAVF is suitable for embolization with ONYX-18. Most lesions located in lumbar and sacral segment are good indications for embolization.

Adult ; Aged ; Aged, 80 and over ; Central Nervous System Vascular Malformations ; therapy ; Embolization, Therapeutic ; methods ; Feasibility Studies ; Female ; Humans ; Male ; Middle Aged ; Treatment Outcome

China ; epidemiology ; Humans ; Occupational Diseases ; epidemiology

OBJECTIVETo evaluate the clinical efficacy of low molecular weight heparin (Fraxiparine) in rescuing venous crisis of island skin flap.

METHODSOf the 73 patients with venous crisis of island skin flap, 47 received subcutaneous injection of low-molecular-weight heparin (group I) and 26 were treated with phlebotomy, local compression and topical application of unfractionated heparin solution gauze (group II).

RESULTSThe flap survival ratio was (88.46∓8.64)% in group I and (38.37∓6.53)% in group II (P<0.001). At 0, 2, and 4 h after injection of low-molecular-weight heparin, the activated partial thromboplastin time (APTT) was obviously delayed (24.28∓6.71, 41.35∓7.64 and 32.34∓6.35, respectively, P<0.01), FXa:C level was significantly decreased (152.4∓30.7, 65.8∓24.4 and 83.4∓18.4, respectively, P<0.01), while FIIa:C level underwent no obvious alterations (155.70∓31.61, 143.20∓24.75, and 143.4∓23.35, respectively, P=NS).

CONCLUSIONFraxiparine has good antithrombotic efficacy in rescuing venous crisis of island skin flap without adverse effect on systemic coagulation.

Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Nadroparin ; therapeutic use ; Surgical Flaps ; adverse effects ; Treatment Outcome ; Young Adult

OBJECTIVEBenzodiazepines (BDZ) have many effects on various kinds of epilepsies, but long-term treatment with BDZ often leads to drug tolerance. This study aimed to seek drugs which can reverse the tolerance of flurazepam (FZP), and to explore the role of neuropeptide Y (NPY) in the reversal effect.

METHODSA rat model of anticonvulsant tolerance to FZP was prepared. The rats with FZP tolerance were randomly assigned to seven groups: FZP-tolerance, and nifedipine, levetiracetam, topiramate, flumazenil, L-NAME and pyridoxamine treatment groups. The tolerance to FZP was evaluated through pentylenetetrazol (PTZ) infusion into a tail vein. The latency to onset of clonic seizure and the PTZ threshold were recorded. The mRNA of NPY receptor Y2 in the hippocampus was determined by RT-PCR, and the distribution of NPY in the hippocampus was examined by immunohistochemistry.

RESULTSIn comparison with the blank control group, the average latency to the onset of clonic seizure was shortened, the average PTZ threshold decreased and the expression of NYT and NPY receptor Y2 mRNA decreased significantly in the FZP-tolerance group (p<0.01). In comparison with the FZP-tolerance group, the average latency to onset of clonic seizure was prolonged by 2 times and the average PTZ threshold doubled in the topiramate treatment group. The average latency to onset of clonic seizure was prolonged by 1 time and the average PTZ threshold increased 1 time in the nifedipine, the levetiracetam and the flumazenil treatment groups. The mRNA expression of NPY receptor Y2 increased by 1 or 2 times in the flumazenil, the nifedipine and the topiramate treatment groups when compared with the FZP-tolerance group.

CONCLUSIONSNifedipine, levetiracetam, topiramate and flumazenil can reverse the anticonvulsant tolerance to flurazepam. NPY may play a role in mediating the reversal effect.

Animals ; Anticonvulsants ; pharmacology ; Drug Tolerance ; Flurazepam ; pharmacology ; Hippocampus ; chemistry ; drug effects ; Male ; Neuropeptide Y ; analysis ; physiology ; Pentylenetetrazole ; RNA, Messenger ; analysis ; Rats ; Rats, Sprague-Dawley ; Reaction Time ; Receptors, Neuropeptide Y ; genetics ; Seizures ; chemically induced ; drug therapy

OBJECTIVETo investigate the clinicopathological characteristics, diagnostic methods and prognosis of small pancreatic cancer.

METHODSFrom May 2000 to January 2007, 89 patients with pancreatic cancer underwent surgery in our hospital. Of those, 14 had a tumor < or = 2 cm in diameter (small tumor group), and the other 75 had a tumor >2 cm in diameter (controlled group). The clinicopathological data of all the cases were retrospectively reviewed and analyzed.

RESULTSIn the small pancreatic cancer group, CT and MRI detected 66.7% (8/12) and 77.8% (7/9) of the tumors, respectively. Serosal infiltration was found in 2 cases, lymph node involvement in 3 cases, and retroperitoneal infiltration in 3 cases. The follow-up duration of this group was 4-86 months. The overall 3- and 5-year survival rates were 42.8% and 31.7%, while in the control group, the overall 3- and 5-year survival rates were 29.7% and 22.5%, respectively. The multivariate analysis showed that the lymph node involvement, serosal infiltration and retroperitoneal infiltration were independent risk factors (P<0.05). However, the tumor size was not shown to be an independent risk factor (OR value = 1.45, P = 0.971).

CONCLUSIONCT and MRI are valuable in detecting small pancreatic cancer. Small pancreatic cancers are likely to have a better prognosis when compared with larger ones. Lymph node metastasis and local infiltration are independent predictors of prognosis but not tumor size.

Aged ; Female ; Follow-Up Studies ; Humans ; Lymphatic Metastasis ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Staging ; Pancreatic Neoplasms ; diagnosis ; pathology ; surgery ; Proportional Hazards Models ; Retroperitoneal Space ; pathology ; Retrospective Studies ; Serous Membrane ; pathology ; Survival Rate ; Tomography, X-Ray Computed ; Tumor Burden