中药菟丝子的高效毛细管电泳法鉴别

提取菟丝子种子植物蛋白用高效毛细管电泳法进行生药鉴定。实验表明,同属不同种菟丝子的碱溶性或酸溶性蛋白在成分和含量上均存在显著差异。根据其种子植物蛋白的电泳谱图,可有效地鉴别菟丝子的来源。运用此法对13个生药样品进行了鉴定,结果与扫描电镜和显微鉴别的结果一致。     

HIV detection in amniotic fluid samples. Amniocentesis can be performed in HIV pregnant women?

OBJECTIVES: To assess amniotic fluid (AF) HIV contamination as a marker of intrauterine HIV infection and to evaluate amniocentesis as a risk factor for vertical HIV transmission when the mother was under antiretroviral treatment. STUDY DESIGN: Three hundred and sixty-six HIV pregnant women were included in the study. AF was obtained from three groups of patients: (a) genetic amniocentesis before 1997 (n=11); (b) amniocentesis a few days before the delivery day (n=18); and (c) AF collected on delivery (n=38). An univariate study was conducted to analyze amniocentesis as a risk factor of HIV transmission (groups a and b). Groups b and c were recruited after 1997; these patients were under combined antiretroviral treatment, they were studied to relate AF HIV contamination with fetal infection and maternal blood viral load at delivery (n=56). RESULTS: From 1984 to 1996, before antiretroviral therapy use in HIV pregnant women, transmission rate was 17%. In the group of patients who underwent genetic amniocentesis (group a) it was 30% (3/10) versus 16.2% (40/247) for patients without amniocentesis. Between 1997 and 2000 transmission rate was 3%. In group b it was 0% (0/18) when amniocentesis was done versus 3.7% (3/81) if no amniocentesis was done (no statistical differences). AF virus was undetectable in all samples (n=56) and no newborn infection was observed after the follow up. CONCLUSIONS: Amniotic fluid virus load was undetectable when maternal antiretroviral therapy was used, even if the virus was detectable in maternal blood samples. This finding raises the possibility to perform amniocentesis, when it is indicated, to provide the mother with an adequate antiretroviral treatment.     

九种龙胆中五种裂环烯醚萜甙类苦味成分的高效液相色谱定量分析

本文建立了龙胆类生药中五种苦甙类成分,即:龙胆苦甙(gentiopicroside),当药苦甙(swertiamarin)、当药甙(sweroside)、苦龙胆酯甙(amarogentin)和苦当药酯甙(amaroswerin)的高效液相色谱(HPLC)定量分析方法,并对国产九种龙胆中这五种成分的含量进行了测定和比较。     

Lymphoblastic lymphoma in adults: results of a pilot protocol

Thirteen adult patients with histologically confirmed lymphoblastic lymphoma were treated with an intensive chemotherapy program consisting of induction with cyclophosphamide, adriamycin, vincristine, and prednisone (modified CHOP); consolidation and central nervous system (CNS) prophylaxis with methotrexate intrathecally and by high-dose intravenous injection, citrovorum factor and L-asparaginase; reinforcement with CHOP; and maintenance with 6-mercaptopurine and methotrexate. Treatment duration was 1 yr. A 14th patient with T-cell acute lymphoblastic leukemia was also treated at presentation by the same regimen. Thirteen patients had at least a mediastinal mass or abnormal cells in the bone marrow; one presented with CNS disease. The median age was 22 yr (range 16--50), and male--female ratio was 2.5:1. All patients had a rapid complete clinical response. Of the 13 patients without initial CNS disease, 4 have relapsed, 3 with primary CNS relapse and 1 with a recurrent abdominal mass. Five patients have died, 2 from drug toxicity, 2 from CNS relapse, and 1 from chronic myelogenous leukemia, which was diagnosed simultaneously with the lymphoblastic lymphoma. The median follow-up is 19 mo, and all patients have completed their planned therapy. At 3 yr, the actuarial survival is 61% and relapse-free survival is 56%.     

Risk factors for developing pneumonia within 48 hours of intubation.

Two hundred fifty intubated patients were followed during the first 48 h after intubation in order to identify potential risk factors for developing pneumonia within this period. Thirty-two developed pneumonia during this time. Univariate analysis established that large volume aspiration, presence of sedation, intubation caused by respiratory/cardiac arrest or decrease in the level of consciousness, emergency procedure, cardiopulmonary resuscitation (CPR), and Glasgow coma score < 9 were significantly associated with pneumonia. In contrast, prior infection and prior antimicrobial use were associated with a protective effect. Presence of subglottic secretion drainage and 15 other variables had no significant effect. Multivariate analysis selected CPR (odds ratio [OR] = 5.13, 95% confidence intervals [CI] = 2.14, 12.26) and continuous sedation (OR = 4.40, 95% CI = 1.83, 10.59) as significant risk factors for pneumonia, while antibiotic use (OR = 0.29, 95% CI = 0.12, 0.69) showed a protective effect. Our findings emphasize that risk factors for pneumonia change during the intubation period, and preventing pneumonia requires a combined approach.     

Intracardiac fungal masses in high-risk neonates: clinical observations

Four cases of intracardiac fungal masses occurred over 2 y amongst 7 cases of systemic candidiasis in a neonatal referral unit. The gestations and birthweights were 25, 23, 24 and 30 wk and 805, 605, 640 and 1395 g, respectively. The pedunculated, solitary right atrial masses were detected 2-17 d after diagnosing candidemia in 3 cases, whereas it was the presenting feature in the 4th. All had indwelling right atrial catheters and received multiple courses of broad-spectrum antibiotics. The masses were removed successfully in two cases fit for surgery. None survived despite antifungal therapy, including liposomal amphotericin B at 6 mg/kg/d. Early introduction of enteral feeds, minimization of prolonged exposure to broad-spectrum antibiotics and judicious use of central catheters may reduce the incidence of systemic candidiasis in high-risk neonates. Surveillance echocardiography and timely surgical intervention may reduce the mortality and/or morbidity related to intracardiac fungal masses.     

Alkaloids from Porcelia macrocarpa.

Three new azaanthracene alkaloids, 6,7-dimethoxycleistopholine (3), 5-hydroxy-6-methoxycleistopholine (4), and 5-hydroxy-6,7-dimethoxycleistopholine (5), along with 14 known alkaloids, including the new natural product 6-methoxycleistopholine (2), were isolated from a CH2Cl2 extract of the branches of Porcelia macrocarpa.