Three cases of lymphocytic thrombophilic arteritis presenting with an annular eruption

We describe three patients who presented with a striking erythematous non‐blanching annular eruption and features of lymphocytic thrombophilic arteritis (LTA), with a prominent lymphocytic vasculitis involving deep dermal vessels. Lymphocytic inflammation was also evident in the superficial vessels and one patient had small superficial ulcers over the ankle area resembling livedoid vasculopathy (LV). Multiple biopsies demonstrated a persistent absence of neutrophils in the infiltrate consistent with a lymphocytic process. In addition to highlighting the annular morphology as a novel presentation of LTA, these cases suggest a possible relationship between LV and LTA and support the notion that they are distinct from neutrophilic vasculitides such as cutaneous polyarteritis nodosa.     

Sneddon综合征2例分析

目的 研究Sneddon综合征（Sneddon syndrome,SS）的临床表现、诊断及治疗,以提高临床对该综合征 的认识,提高诊疗水平。 方法 收集2014年8月1日-2017年6月1日于首都医科大学附属北京天坛医院神经病学中心住院治疗的 Sneddon 综合征患者2例,回顾性分析患者临床资料,总结其临床表现、实验室检查、神经影像学检 查、认知功能评价、神经病理学特征及治疗。 结果 2例患者均出现皮肤广泛网状青斑合并多次缺血性卒中事件,均未发现特异性的血生化及脑 脊液异常。头颅磁共振成像（magnetic resonance imaging,MRI）均可见颅内多发的异常信号,颅内外血 管影像学评价均未发现明显的大血管狭窄。认知功能评价可见患者认知功能均存在下降。行皮肤病 理组织活检,病理结果均符合SS表现。治疗上均采取了抗血小板聚集治疗,对于认知功能下降,予以 改善认知疗法。 结论 S neddon 综合征的诊断要综合考虑患者的临床表现、实验室检查、影像学检查结果以及皮肤 病理组织活检结果。患者的特征性皮肤表现及多次卒中事件有助于该病的诊断,必要时可行皮肤活 检以明确诊断。     

水朝阳旋覆花的倍半萜内酯类化合物

目的:研究水朝阳旋覆花Inula helianthus-aquatica地上部分中的倍半萜内酯类化学成分。方法:应用硅胶柱色谱,Sephadex LH-20柱色谱,以及高效液相制备色谱等方法分离和纯化化合物,再通过运用光谱学方法,结合化合物的理化性质来鉴定结构。结果:从水朝阳旋覆花的地上部分分离得到7个倍半萜内酯类和4个其他类的化合物,并且依次鉴定为2-desoxy-4-epi-pulchellin(1),6-acetoxy-4-hydroxy-1,10H-pseudoguaia-11(13)-en-12,8-olide(2),4-acetoxy-6-hydroxy-1,10H-pseud-oguaia-11(13)-en-12,8-olide(3),8-epi-inuviscolide(4),2,3,11,13-tetrahydroaromaticin(5),11,13-dihydro-ergolide(6),4-epip-ulchellin-2-O-acetate(7),7-差向黑麦草内酯(8),黑麦草内酯(9),β-谷甾醇(10),胡萝卜苷(11)。结论:所有化合物均为首次从该植物中分离得到。     

Reticulate eruptions: Part 2. Historical perspectives, morphology, terminology and classification

Reticulate eruptions of vascular origin may represent an underlying arterial, venous, microvascular or combined pathology. In the presence of arterial pathology, individual rings are centred around ascending arterial vessels that supply the corresponding area of skin within an arterial hexagon that clinically presents with a blanched centre. Confluence of multiple arterial hexagons generates a stellate (star-like) pattern. In the presence of a primary venous pathology, individual rings correspond to the underlying reticular veins forming multiple venous rings. Focal involvement of a limited number of vessels presents with a branched (racemosa) configuration while a generalized involvement forms a reticulate (net-like) pattern. 'Livedo' refers to the colour and not the pattern of the eruption. Primary livedo reticularis (Syn. cutis marmorata) is a physiological response to cold and presents with a diffuse blanchable reticulate eruption due to vasospasm of the feeding arteries and sluggish flow and hyperviscosity in the draining veins. Livedo reticularis may be secondary to underlying conditions associated with hyperviscosity of blood. Livedo racemosa is an irregular, branched eruption that is only partially-blanchable or non-blanchable and always signifies a pathological process. Retiform purpura may be primarily inflammatory with secondary haemorrhage or thrombohaemorrhagic, as seen in disseminated intravascular coagulopathy.     

欧亚旋覆花总黄酮对糖基化终末产物诱导L929细胞衰老及RAGE表达的影响

目的探讨欧亚旋覆花总黄酮(IBFTF)对糖基化终末产物(AGEs)诱导小鼠皮肤成纤维细胞株L929衰老的保护作用,和AGEs特异性受体(RAGE)的表达机制。方法采用0.100 g/L AGEs培养液刺激离体培养的L929细胞48 h制备衰老模型,药物组分别给予不同质量浓度IBFTF(0.1、0.2、0.4 g/L)继续作用6 h,阳性对照组给予0.1 g/L氨基胍半硫酸盐(AG)继续作用6 h,对照组给予完全培养液。检测胞内β-半乳糖苷酶阳性染色细胞数量和细胞周期比例等衰老指标;检测胞内活性氧(ROS)、超氧化物歧化酶(SOD)和丙二醛(MDA)水平等氧化应激指标。采用细胞免疫荧光检测RAGE荧光强度,Western blotting和q RT-PCR分别检测RAGE蛋白和m RNA表达情况。结果 IBFTF可显著抑制AGEs诱导的L929细胞衰老并降低RAGE的蛋白和m RNA表达水平;不同质量浓度IBFTF作用于衰老的L929细胞后,可显著提高细胞内SOD活性,显著降低MDA和ROS水平,具有浓度依赖性。结论 IBFTF对AGEs诱导衰老的L929细胞有保护作用,其机制可能是通过抑制RAGE表达来实现的。     

Cimicifuga racemosa treatment and health related quality of life in post-menopausal Spanish women

Objective.?The effect of Cimicifuga racemosa (CR) treatment was evaluated in healthy symptomatic post-menopausal women using the Cervantes health-related quality of life (HR-QoL) scale.

Design.?A prospective observational study was carried out in 122 healthy symptomatic post-menopausal Spanish women with elevated body weight, aged between 45 and 59 years. Three groups were formed according to age intervals. Each patient completed the Cervantes HR-QoL scale before and after CR treatment (20 mg, twice a day for 3 months). Changes in Cervantes scale global quality of life scores as well as in their domains (menopause and health, psychic, sexuality and couple relationship) were analysed.

Results.?The CR treatment ameliorated global quality of life in both the whole group of patients and when women were analysed by age subgroups. There were significant positive changes in Z scores for the Cervantes HR-QoL scale ‘menopause and health’, and ‘psychic’ domains in both the entire population and by age groups. The ‘sexuality domain’ significantly improved when the entire population was assessed, but not when each age-group was separately analysed; while there were no changes in ‘couple relationship domain’ scores.

Conclusion.?CR treatment increased both global quality of life and the four domains of the Cervantes HR-QoL scale, being an effective treatment to reduce symptoms in post-menopausal woman with elevated body weight.     

早期子宫内膜癌患者术后应用黑升麻制剂治疗绝经相关症状

目的探讨黑升麻制剂(莉芙敏片)用于治疗早期子宫内膜癌患者术后绝经相关症状的安全性和有效性。方法60例因子宫内膜癌Ⅰ期术后出现绝经相关症状的患者,根据用药意愿分为莉芙敏研究组及不用药对照组,每组各30例。莉芙敏组口服莉芙敏片20 mg,每日2次,共24周;对照组不服药。随访12个月,比较2组的Kupperman绝经指数(KMI)总分、骨密度、肝肾功能、血常规等实验室检查项目及肿瘤复发率、死亡率。结果莉芙敏组治疗前KMI总分为26±7,治疗24周后为9±4,较治疗前明显降低(P＜0.05);对照组KMI总分治疗前、后分别为25±8和21±5,差异无统计学意义。莉芙敏组骨密度值在治疗前、后分别为(0.790±0.17)和(0.891±0.21) g/cm2,差异有统计学意义(P＜0.05);对照组骨密度值治疗前、后分别为(0.808±0.19)和(0.816±0.15) g/cm2,差异无统计学意义。莉芙敏组服药期间无不良事件发生。随访1年对照组有1例肿瘤复发,莉芙敏组和对照组各有1例死亡。 结论黑升麻制剂可用于改善早期子宫内膜癌患者术后的绝经相关症状,且不增加肿瘤的复发率。     

黑升麻的雌激素活性及其对人类乳腺癌MCF-7细胞雌激素受体水平的影响

为了检测黑升麻 (CR)的雌激素活性及其对人类乳腺癌 MCF- 7细胞雌激素受体 (ERs)水平的影响 ,未成年雌性小鼠按体重以 75、15 0和 30 0 m g/ kg的 CR灌胃 14d,观察处于动情期的时间 ,第 15天处死后取子宫和卵巢称重。以 MTT实验筛选 CR的最佳细胞作用剂量 ,观察对照组、CR组 (4.75μg/ L )和 17β-雌二醇组 (0 .3nmol/ L)的细胞生长曲线 ,并在流式细胞仪上用间接免疫荧光法测定各组 ERs水平。结果发现子宫重量随 CR剂量增加而增加 ,30 0 mg/ kg的 CR可显著增加动情天数 (P<0 .0 5 )。 4.75 μg/ L CR对 MCF- 7细胞的促增殖作用最强 ,达 6 4.7% ;CR组和 17β-雌二醇组的细胞群体倍增时间 (TD)分别为 32 .1h和31.7h,明显低于对照组 (TD=35 .3h) ;4.75 μg/ L 的 CR可显著增加细胞的 ERs水平 (P<0 .0 1)。结果表明CR具有雌激素活性 ,其升高 ERs水平的作用可能是该物质可治疗更年期综合征的机制之一。     

旋覆花药材HPLC指纹图谱研究

目的：研究旋覆花药材的指纹图谱的测定方法，确定旋覆花HPLC指纹图谱。方法：采用HPLC/UV测定旋覆花药材甲醇提取液的指纹图谱，并与同属其他植物花序进行比较。结果：建立了旋覆花药材的HPLC指纹图谱，发现13个色谱峰为共有峰，确定了其相对保留时间和峰面积比值的范围。结论：利用旋覆花指纹图谱可以对不同植物来源的旋覆花药材进行鉴别，并可在一定程度上进行质量控制。     

Cocktail探针药物法评价羊耳菊对大鼠CYP450酶活性的影响

目的:采用Cocktail探针药物法考察羊耳菊活性部位提取物(以下均简称为羊耳菊)对6种大鼠细胞色素P450(CYP450)主要亚型酶活性的影响。方法:羊耳菊高、低剂量组大鼠给药剂量分别为8. 127,2. 709 g·kg-1·d-1(以生药量计算),分别连续灌胃7,14 d后尾静脉注射Cocktail探针药物咖啡因、咪达唑仑、甲苯磺丁脲、奥美拉唑、美托洛尔和氯唑沙宗,不同时间点采集血样,建立超高效液相串联质谱法(UPLC-MS)测定大鼠血浆中6种探针药物的浓度,运用DAS 2. 0软件计算其药动学参数,以考察羊耳菊在大鼠体内对CYP1A2,CYP3A,CYP2C9,CYP2C19,CYP2D6,CYP2E1这6种亚型酶代谢活性的影响。结果:与空白组相比,奥美拉唑指标下,给药组的药时曲线下面积AUC0-t和AUC0-∞增大,14 d给药组的半衰期(T1/2)增大,清除率(CL)降低;甲苯磺丁脲指标下,14 d高剂量组的AUC0-t,AUC0-∞和T1/2增大;咖啡因指标下,给药组的T1/2明显增大,14 d给药组的AUC0-t和AUC0-∞增大而CL降低;但以上3个指标的表观分布容积(V)均无明显变化。与空白组相比,咪达唑仑指标下,除7 d低剂量组之外,其他给药组的AUC0-t,AUC0-∞和T1/2明显增大,CL明显降低,V增大;氯唑沙宗和美托洛尔的药动学参数与空白组相比差异没有显著性。结论:羊耳菊对大鼠肝药酶CYP3A,CYP1A2,CYP2C9和CYP2C19的活性具有不同程度的抑制作用,其中对CYP3A的抑制作用最强。