Transient bone marrow oedema: A variant pattern of sacral insufficiency fractures

A 71-year-old woman presenting with severe low back pain was found to have a large oval area of increased sacral uptake on Tc-99m MDP scan, with corresponding T1-hypointense and T2-hyperintense areas on magnetic resonance (MR) images, highly suggestive of malignancy. Open biopsies showed only callus formation. The patient responded clinically to conservative measures, with twice-repeated follow-up Tc-99m MDP and MR scans documenting resolution of transient bone marrow oedema. We suggest that this form of marrow oedema represents a variant pattern of sacral insufficiency fractures.     

4-烷硫基-4-脱氧-4′-去甲表鬼臼毒素的合成和抗肿瘤活性

对4’-去甲表鬼臼毒素的C₄位进行化学修饰,合成和筛选了10个4-烷硫基-4-脱氧-4’-去甲表鬼臼毒素衍生物以进一步研究C₄位不同的原子和取代基与活性之间的关系及寻找结构简单、活性更强的抗肿瘤新药。4’-去甲表鬼臼毒素与硫醇在三氟化硼·乙醚或三氟乙酸存在下生成相应的硫醚,也可用硫醇与4β-溴-4-脱氧-4’-去甲表鬼臼毒素反应生成相应的硫醚。在体外筛选中,化合物10和12抑制L1210白血病细胞的活性与依托泊甙相当或更强,化合物9,10,12和15抑制KB细胞的活性与依托泊甙相当或更强。     

取代苄基/萘甲基异喹啉类及有关季铵衍生物的合成与生物活性

以具心血管活性的异喹啉类生物碱为先导物,结合某些钾通道阻滞剂的结构特征,设计合成了28个3,4-二氢(I_1～4)和1,2,3,4-四氢苄基/萘甲基异喹啉化合物(II_1～18)及有关季铵衍生物(I_5,6和II_19～22)。药理试验表明:除化合物I₄有一定升压作用外,大多化合物有不同程度的降压和减慢心率活性,其中化合物II1的降压活性最强。分析定量构效关系发现:化合物母核氮原子电荷愈大(即其绝对值愈小),降压作用愈强;反之,减慢心率作用愈强。异喹啉母核氮原子电荷可能为影响作用于血管或心脏组织的重要因素之一。     

用二维核磁共振技术研究野菊花三醇的结构

从野菊花(Chrysanthemum indicum L.)亲脂性极性较大的部分,分离得到一个新的倍半萜成分,命名为野菊花三醇。通过¹H-¹H COSY,¹H-¹³C COSY及远程¹H-¹³C COSY二维核磁共振谱研究,确定其属于(牛龙)牛儿烷衍生物,并确定其结构和相对立体构型。     

四氢异喹啉类化合物的合成和抗血小板聚集活性

某些异喹啉化合物有抗血小板聚集活性,如喘速宁的纯光学异构体R-(+)体有较明显的抗血小板聚集作用。本文重点对四氢异喹啉母核(I₁～I₄)的2位进行取代基修饰,共合成了14个化合物。体外药理筛选结果初步表明,大部分化合物有一定的抗血小板聚集活性,其中II₃,II₅,II₇,II₈和II₁₀活性较强。     

Cavernous sinus thrombophlebitis masquerading as ischaemic stroke: a catastrophic pitfall in any emergency department

Cavernous sinus thrombophlebitis is a clinically rare but fatal disease that progresses rapidly. Its initial presentation is always neglected by emergency physicians, until typical symptoms and signs are noted or thin-slice brain CT results obtained, by which time it is already too late. A case of cavernous sinus thrombophlebitis caused by sinusitis, which initially masqueraded as ischaemic stroke, is reported. Blindness of the left eye was the outcome. High suspicion, accurate diagnosis and aggressive antibiotic treatment are emphasised.