Liver transplantation for hepatic cirrhosis in cystic fibrosis

Five children with cystic fibrosis complicated by hepatic cirrhosis received liver grafts. They all had portal hypertension with varices and three had variceal bleeding; respiratory function was only moderately impaired, but four were colonised with pseudomonas and one with aspergillus. Liver transplantation was well tolerated and there was no increase in respiratory or other early postoperative complications. Four of the children were fully well from 14 to 35 months after transplantation; the most recently transplanted had problems from a biliary stricture. In spite of the need for immunosuppression there was no increase in infection and respiratory function improved or remained stable. Once the children were stabilised after transplantation their nutrition and general health were greatly improved.     

Effects of sleep position on infant motor development

BACKGROUND: As a result of the American Academy of Pediatrics' recommendation that healthy infants be placed on their side or back for sleep, the percentage of infants sleeping prone has decreased dramatically. With the increase in supine sleeping, pediatricians have questioned if there are differences in the rate of acquisition of early motor milestones between prone and supine sleeping infants. METHODS: To examine this question, we performed a prospective, practice-based study of healthy term infants. Infants were recruited before the age of 2 months. Parents were asked to record infant sleep position and awake time spent prone until 6 months of age. A developmental log was used to track milestones from birth until the infant was walking. Age of acquisition of eight motor milestones was determined, and the mean ages of milestone attainment of prone and supine sleepers were compared. RESULTS: Three hundred fifty-one infants completed the study. Prone sleepers acquired motor milestones at an earlier age than supine sleepers. There was a significant difference in the age of attainment of rolling prone to supine, tripod sitting, creeping, crawling, and pulling to stand. There was no significant difference in age when infants walked. CONCLUSIONS: The pattern of early motor development is affected by sleep position. Prone sleepers attain several motor milestones earlier than supine sleepers. However, all infants achieved all milestones within the accepted normal age range. Pediatricians can use this information to reassure parents. This difference in milestone attainment is not a reason to abandon the American Academy of Pediatrics' sleep position recommendations.     

Inactivation of free and cell-associated human immunodeficiency virus in platelet suspensions by aminomethyltrimethylpsoralen and ultraviolet light

BACKGROUND: It has previously been reported that 40 micrograms per mL of aminomethyltrimethylpsoralen (AMT) plus 2.4 to 7.2 J per cm2 of ultraviolet A (UVA) light inactivated 4 to 6 log10 of several model viruses in platelet suspensions. This inactivation was achieved while satisfactory levels of platelet count, pH, morphology, aggregation, and hemostatic effectiveness were maintained. STUDY DESIGN AND METHODS: The efficacy of this procedure for inactivating free and intracellular human immunodeficiency virus (HIV), including integrated proviral sequences, was studied. RESULTS: The kinetics of inactivation for free HIV (4-5 log10 kill with 1.2-4.8 J/cm2) were similar to those obtained for the previously studied viruses. For studies on cell-associated virus, H9 cells productively infected with HIV were added to platelet suspensions and treated with the above regimen of AMT and UVA. The phototreated cells were then cocultivated with uninfected H9 cells for 4 weeks and supernatants were assayed by enzyme-linked immunosorbent assay for HIV p24. No evidence of HIV replication was detectable for cells receiving as little as 2.4 J per cm2 of UVA irradiation in the presence of AMT. Further, it has been demonstrated that stably integrated sequences from the HIV proviral env gene can no longer be amplified by polymerase chain reaction after 1.2 J per cm2 of UVA (with 40 micrograms/mL AMT) exposure. CONCLUSION: These data suggest that AMT and UVA is an effective antiviral treatment for free and cell- associated HIV in platelet suspensions.     

胀果甘草中2个新的二氢黄酮甙

从胀果甘草(Glycyrhizia inflata Bat.)根茎的95%醇提取部分经HPLC分得两个新的二氢黄酮二糖链甙,经化学和波谱分析,将其结构分别确定为甘草素-7-O-β-D-呋喃芹糖-4′-O-β-D-吡喃葡萄糖甙(liquiritigenin-7-O-β-D-apiofuranosyl)-4′-O-β-D-glucopyranoside(I)和甘草素-7-O-β-D-(3-O-乙酰基)呋喃芹糖-4′-O-β-D-吡喃葡萄糖-甙[liquiritigenin-7-O-β-D-(3-O-acetyl)-apiofuranosyl-4′-O-β-D-glucopyra-noside](I)。     

云南甘草中新三萜皂甙元的结构鉴定

从云南甘草(Glycyrrhiza yunnanensis)根中分离出10个化合物。本文报道其中二个新三萜皂甙元,云南甘草皂甙元A和B(glyyunnansapogenin A and B),以及已知化合物β-谷甾醇的鉴定。云南甘草皂甙元A和B的结构经衍生物制备,红外,核磁共振氢谱、碳谱和质谱等光谱测定和解析、分别推定为3β,24-dihydroxy-16-oxo-olean-12-en-29-oic acid和3β,21α,24-trihydroxy-olean-12-en-30-oic acid。     

用二维核磁共振技术研究赤芝孢子内酯A和B的结构

通过¹H-¹H,¹H-¹³C相关谱(COSY),¹H-¹³C远程偶合相关谱(OOLOC)及NOE二维谱(NOESY)等新的二维核磁共振技术确定了两个新化合物赤芝孢子内酯A和B的结构。     

HIV蛋白酶抑制剂依地那韦药效学、药动学及治疗艾滋病的临床应用

目的:介绍蛋白酶抑制剂依地那韦治疗艾滋病.方法:采用国际多中心、随机、双盲等方法,三联疗法:一个蛋白酶抑制剂加二个核苷类逆转录酶抑制剂与二联疗法,单一蛋白酶抑制剂作疗效比较.结果:采用包括依地那韦在内的三联疗法在提高CD_4细胞计数,降低HIV病毒负荷疗效最好.三联疗法组比二联疗法组死亡几乎减少一半.结论:以蛋白酶抑制剂如依地那韦为主的三联疗法可提高CD_4细胞计数,HIV病毒负荷降到检测水平以下,从而提高了存活率,降低了死亡率.