大孔吸附树脂纯化淫羊藿总黄酮的研究

目的考察AB-8大孔吸附树脂对淫羊藿总黄酮的分离纯化方法,方法采用静态吸附,考察AB-8大孔吸附树脂的吸附性能,并采用紫外-可见分光光度法对淫羊藿总黄酮含量进行了定量分析。结果 AB-8大孔吸附树脂对淫羊藿总黄酮具有较好的选择性。结论 AB-8大孔吸附树脂用于淫羊藿总黄酮的分离纯化效果良好。     

Prospective Analysis on Survival Outcomes of Nonsmall Cell Lung Cancer Stages over Ⅲb Treated with HangAm-Dan

Background and objective Non-small cell lung cancer (NSCLC) stages over Ⅲb still remain as an intractable disease. Survivalrate of NSCLC stages over Ⅲb could be increased through chemotherapy and radiation, but results are not satisfactory. Oriental medicine herbal formula, Hang, Am-Dan (HAD) has been developed for anti-tumor purpose and several previous studies havealready reported its effects. The aim of this study is to assess HAD's efficacy on prolonging the survival rate of NSCLC stages over Ⅲb.Methods We have administered 3 000 mg of HAD daily to patients. The study included 74 first visit patients of East-West Cancer Center (EWCC) from November 2007 to April 2008, diagnosed with inoperable NSCLC stages over Ⅲb. Among them, 30 patients were in HAD group and 44 patients were in combined group with conventional therapy and HAD. We have observed and analyzed their overall survivaLResults Of total 74 patients, overall 1 year, 2 year survival rates and the median survival time were 62.1%, 34.9% and 17.0 months (95%Ch 12.9-21.1). NSCLC stage LIFO patients showed higher survival rates than NSCLC stage IV patients (P=0.408). The 1 year, 2 year survival rates and the median survival time of the combined group were 70.5%, 37.9% and 20.0 months (95%CI: 16.4-24.6). In HAD group, the I year, 2 year survival rates and the median survival time were 50.0%, 25.7% and 12.0 months (95%Ch 6.6-17.4). The combined therapy group showed higher survival rates than the HAD group (P=0.034). Each groups treated with HAD for more than 4 weeks showed higher survival rates than those treated for less than 4 weeks, but there was no significant difference (P=0.278). In hazard ratio, the combined therapy group showed lower mortality rate than the HAD group with statistical significance (P=0.040).Conclusion HAD could prolong the survival rate ofinoperable NSCLC stages over IIIb. HAD is more effective when combined with conventional therapy. In the future, more controlled clinical trials with larger sample in multi-centers are needed to re-evaluate the efficacy and safety of HAD.     

Comparative performance of gene‐based warfarin dosing algorithms in a multiethnic population

Summary. Background: Gene‐based warfarin dosing algorithms have largely been developed in homogeneous populations, and their generalizability has not been established. Objectives: We sought to assess the performance of published algorithms in a racially diverse and multiethnic sample, and determine if additional clinical variables or genetic variants associated with dose could enhance algorithm performance. Patients and methods: In 145 compliant patients on warfarin with a goal international normalized ratio (INR) of 2–3, stable, therapeutic doses were compared with predicted doses using 12 reported algorithms that incorporated CYP2C9 and VKORC1 variants. Additional covariates tested with each model included race, concurrent medications, medications known to interact with warfarin and previously described CYP4F2, CALU and GGCX variants. Results: The mean patient age was 67 ± 14 years; 90 (62%) were male. Eighty‐two (57%) were Caucasian, 28 (19%) African‐American, 20 (14%) Hispanic and 15 (10%) Asian. The median warfarin dose was 35 mg per week (interquartile range 23–53 mg per week). Gene‐based dosing algorithms explained 37–55% of the variation in warfarin dose requirements. Neither the addition of race, number of concurrent medications nor the number of concurrent medications interacting with warfarin enhanced algorithm performance. Similarly, consideration of CYP4F2, CALU or GGCX variant genotypes did not improve algorithms. Conclusions: Existing gene‐based dosing algorithms explained between approximately one‐third and one‐half of the variability in warfarin dose requirements in this racially and ethnically diverse cohort. Additional clinical and recently described genetic variants associated with warfarin dose did not enhance prediction in our patient population.     

Effects of Left Atrial Dilatation on the Endocardial Atrial Defibrillation Threshold: A Study in an Ovine Model of Pacing Induced Dilated Cardiomyopathy

Left atrial (LA) dilatation is a common finding in patients with chronic atrial fibrillation (AF). Progressive dilatation may alter the atrial defibrillation threshold (ADFT). In our study, epicardial electrodes were implanted on the LA free wall and right ventricular apex of eight adult sheep. Large surface area, coiled endocardial electrodes were positioned in the coronary sinus and right atrium (RA). LA dilatation was induced by rapid ventricular pacing (190 beats/min) for 6 weeks and echocardiographically assessed weekly along with the ADFT (under propofol anesthesia). LA effective refractory period (ERP) was measured every 2–3 days using a standard extra stimulus technique and 400 ms drive. The AF cycle length (AFCL) was assessed from LA electrograms. During the 6 weeks of pacing the mean LA area increased from 6.1 ± 1.5 to 21.3 ± 2.4 cm². There were no significant changes in the mean ADFT (122 ± 15 V), circuit impedance (46 ± 5 Ω), or LA AFCL (136 ± 23 ms). There was a significant increase in the mean LA ERP (106 ± 10 ms at day 0, and 120 ± 13 ms at day 42 of pacing). In this study, using chronically implanted defibrillation leads, the minimal energy requirements for successful AF were not significantly altered by ongoing left atrial dilatation. This finding is a further endorsement of the efficiency of the coronary sinus/RA shock vector. Furthermore, the apparent stability of the AF present may be a further indication of a link between the type of AF and the ADFT.     

Acquired cutaneous lymphangiectasia

Summary We report a case of acquired cutaneous lymphangiectasia associated with underlying malignancy, and following an arthrotomy. Clinical and histological features were identical with those of acquired lymphangioma. Lymphangiography showed signs of acquired lymphatic obstruction. Both the underlying tumour and the arthrotomy were thought to be contributory factors.     

Significance of hepatitis B core antigen in the liver in patients with chronic hepatitis B and its relation to hepatitis B virus DNA

Liver biopsies from 52 patients with chronic hepatitis B were investigated for the presence and distribution of HBcAg and the results were compared with the status of hepatitis B virus deoxyribonucleic acid (HBV-DNA). The patients consisted of 37 men and 15 women, aged 16-55 years (mean = 34 years). Serum alanine aminotransferase (ALT) was elevated in 50 patients (range: 18-969 U/L; mean = 290 U/L). Serological testing showed HBsAg in all, HBeAg in 45 (87%), and HBV-DNA in 28 (54%). Liver biopsies demonstrated HBcAg in 35 (67%) patients. HBcAg was not only present in 31 of 45 (69%) patients who were seropositive for HBeAg, but also in four of seven (57%) with antibody to HBeAg (anti-HBe). In 28 of 35 (80%) patients with HBcAg in the liver, serum HBV-DNA was detected. However, no serum HBV-DNA was detected in 17 patients who had no detectable HBcAg in the liver. The distribution of HBcAg in the liver was rather cytoplasmic and nuclear than nuclear alone. Among 33 patients with cytoplasmic HBcAg in the liver, 15 (45%) had an evidence of acute exacerbation of hepatitis with marked ALT elevation (range: 168-894 U/L; mean = 385 U/L) and nine patients showed severe chronic active hepatitis and confluent necrosis, histologically. These results indicate that the presence of HBcAg in the liver correlates with the amount of circulating hepatitis B virus as quantified by serum level of HBV-DNA. The predominant cytoplasmic HBcAg in the liver may suggest the possibility of multiple episodes of acute exacerbation and more severe ongoing hepatitis during the clinical course.