鲜卑花酯的分离和结构

A new ferulic acid ester, C₁₆H₂₂O₉, mp 141～143℃ (EtOAc), named sibirate (Ⅰ), was isolated from the aerial part of Sibiraea angustata (Rchd.) Hand.-Mazz. in addition to a known compound ferulic acid. By means of IR, EI-MS, FAB-MS, ¹H NMR, ¹³C NMR and chemical evidences the structure of sibirate was established as glucityl ferulate.     

Incidence of bacteraemia or fever during transoesophageal echocardiography: a prospective study of 82 patients

The incidence of bacteraemia during transoesophageal echocardiography(TEE) was evaluated in a prospective study of 82 consecutivepatients. Three series of blood cultures were carried out foreach patient: from group 1 (n=44), prior to the examination,at the end of the examination and 15min afterwards. For group2 (n=38), blood cultures were performed prior to the examination,10 min after the start and immediately after the end. A singlepositive blood culture was detected in two patients. For thefirst patient, blood culture at the end of the examination demonstratedCorynebacteria, and for the second, Staphylococcus epidermidiswas identified on cultures taken during the examination. Duringthe first 24 h, a transient subfebrile temperature was recordedin 15% of the patients, including the patient with the Corynebacteriapositiveblood culture. By mid-term (6 months) no patient had developedendocarditis.Ourfindings suggest that antibiotic prophylaxis during TEE isnot warranted.     

Mitral flow propagation velocity assessed with M-mode color Doppler in patients with dilated cardiomyopathy]

BACKGROUND: The role of diastolic disfunction in the setting of severe left ventricular (LV) disfunction is usually forgotten due to difficulties in quantification and interpretation. The propagation velocity (PV) of mitral inflow into the left ventricle has been proposed as a load independent indicator of LV diastolic function. Our aim was to correlate PV with age, body surface, chambers dimensions, wall thickness and with classic parameters of systolic and diastolic function. We had in mind the validation of this index in the quantification of LV filling and in risk stratification of patients with dilated cardiomyopathy (DC). MATERIAL AND METHODS: We prospectively studied 32 consecutive patients, mean age 56.1 +/- 15.7 years, 22 (68.75%) male, mean ejection fraction 28.1 +/- 7.5%. All of them were in NYHA class < or = II and on ACE inhibitors. Eight (25%) were on beta-blockers. Patients without sinus rhythm, paced or with significant hypertensive, congenital or valvular heart disease were previously excluded. The following parameters of LV systolic function were assessed by echocardiography: fractional shortening, ejection fraction and cardiac output. LV filling was assessed by transmitral flow pulsed Doppler analysis: isovolumic relaxation time (IVRT), peak E and A wave velocities, E wave deceleration time (DT). We also evaluated a new Doppler index of combined systolic and diastolic myocardial performance (Tei index). PV (cm/s) was calculated by Color M-mode. Univariate regression analysis was performed (PV as dependent variable). RESULTS: We detected a high prevalence of diastolic function disturbances: 25 (78.1%) patients with a delayed relaxation pattern and only 3 (9.4%) with a restrictive pattern. PV did not correlate with age, body surface and LV geometry. There was a significant correlation between PV and E/A ratio (r = 0.61; p < 0.0001), IVRT (r = -0.50; p = 0.006), DT (r = -0.41; p = 0.01) and Tei index (r = -0.36; p = 0.04). CONCLUSIONS: Our results indicate that, in patients with a predominance of delayed relaxation, there is a strong relationship between PV and the classic parameters of LV filling. For similar levels of systolic impairment, PV could be an easy, fast and reproducible quantitative indicator of severity on DC.     

New hepatitis B virus mutant form in a blood donor that is undetectable in several hepatitis B surface antigen screening assays

BACKGROUND: Envelope mutant forms of hepatitis B virus (HBV), impairing HBV antibody recognition, have been reported with mutations in single or multiple sites of the hepatitis B surface antigen (HBsAg) group- specific "a" determinant. Blood donors infected with such an HBsAg mutant form of HBV may escape detection by HBsAg screening assays and therefore may affect the safety of the blood supply. CASE REPORT: A repeat blood donor became HBsAg-reactive in an enzyme immunoassay. Confirmatory testing yielded negative results for HBsAg in a radioimmunoassay and in four enzyme immunoassays used in blood donor screening. The specificity of the HBsAg reactivity in the first enzyme immunoassay was confirmed by HBsAg neutralization with antibody to HBsAg. Additional HBV confirmatory test results were positive for antibody to hepatitis B core antigen and antibody to hepatitis B e antigen; negative for antibody to HBsAg and for hepatitis B e antigen; and positive for HBV DNA. DNA sequence analysis of the "a" determinant region of HBsAg revealed amino acid substitutions from Q (Gln) to R (Arg) at codon 129 and from M (Met) to T (Thr) at codon 133. CONCLUSION: This case illustrates the presence of HBsAg mutant forms of HBV in a West European blood donor population that were undetected by several HBsAg screening assays. Adaptation of HBsAg screening is indicated to overcome deficiencies in sensitivity in detecting HBsAg mutant forms of HBV. Screening for antibody to hepatitis B core antigen or HBV DNA may also detect blood donors infected with HBsAg mutant forms of HBV     

刺果甘草化学成分的研究

刺果甘草(Glycyrrhiza pallidiflora Maxim)根及根茎的甲醇提取物经盐酸甲醇反应,柱层析分离,得到五个单体。经理化常数和光谱分析,确定化合物Ⅰ为β-谷甾醇,Ⅲ为macedonic acid methylester,Ⅳ为21-dehydro-macedonic acid methyl ester,命名为刺果酸甲酯(pallidifloric acid methyl ester),Ⅴ为5-羟基-4-甲氧基异黄酮,命名为刺果甘草素(pallidiflorin)。化合物Ⅱ初步确定为具有11,13(18)异环双烯的五环三萜衍生物。其中Ⅳ是首次从植物中分得,Ⅴ为新化合物。     

Substance abuse. The silent saboteur in rehabilitation

Clearly, substance abuse among traumatically disabled persons can potentially sabotage rehabilitation outcomes for this population. There is evidence that substance abusers will comprise a growing percentage of patients within rehabilitation programs. Rehabilitation professionals must examine their own attitudinal barriers toward making a substance-abuse program an integral part of comprehensive rehabilitation care. Rehabilitation nurses are in a unique position to assist the rehabilitation team to identify the need for development of a substance-abuse program.     

Central nervous system lesions in pediatric patients: Gd-DTPA-enhanced MR imaging

Twenty pediatric patients, aged 2-18 years, with known or suspected masses in the brain and/or spinal cord were studied with magnetic resonance imaging at 0.6T with and without use of 0.1 mmol/kg gadolinium diethylenetriaminepentaacetic acid (Gd-DTPA). The multisection, multiecho imaging mode was utilized. Surgically proved mass lesions included astrocytoma (n = 6), medulloblastoma (n = 2), ependymoma (n = 1), craniopharyngioma (n = 1), oligodendroglioma (n = 1), germinoma (n = 1) and fibrosarcoma (n = 1). Presumptive diagnoses included astrocytoma (n = 3), arachnoid cyst (n = 1), tuberous sclerosis (n = 1), cryptic vascular malformation (n = 1), and normal (n = 1). There was dramatic enhancement in 11 of 20 patients, with improved definition of the presence and extent of lesions in six patients. No adverse effects were noted in any of the 20 patients. It is concluded that Gd-DTPA is useful in delineating the presence, extent, and number of certain lesions of the central nervous system in children.