Characterization of isoquinoline alkaloids from Neolitsea sericea var. aurata by HPLC-SPE-NMR

Application of the HPLC-SPE-NMR technique to identify the alkaloids in an EtOH extract of the leaves of Neolitsea sericea var. aurata led to the characterization of 14 alkaloids while consuming plant material equivalent to 1.1 g. Of these, seven are N-oxides, four of which are new, namely, 9S,17S-pallidine Nalpha-oxide (6), 1S,2S-reticuline Nalpha-oxide (8), 6R,6aS-boldine Nbeta-oxide (9), and 6S,6aS-N-methyllaurotetanine Nalpha-oxide (13). Their structures were also confirmed by partial synthesis.     

细辛类药材挥发油薄层层析比较

为给细辛类药材的鉴别提供依据,采用薄层层析法比较了细辛类药材挥发油的化学成分。发现正品细辛地上部分与对应地下部分挥发油的薄层层析图谱仅稍有差异;汉城细辛挥发油的薄层层析图谱与北细辛相似,与华细辛区别较大;细辛类药材挥发油的薄层层析图谱在种内有较好的稳定性,种间差别明显。表明正品细辛地上部分与相应地下部分挥发油的化学成分组成相似;该方法可用于细辛类药材的种间鉴别。     

中医药治疗多囊卵巢综合征研究进展

多囊卵巢综合征现已成为妇科疾病中之热点、难点。从病因病机、辨证论治、专方验方、中药周期治疗等方面，概括了近几年中医药对多囊卵巢综合征（pcos）的病因病机认识以及中医药治疗方面的研究进展。总结认为中医对本病治疗有肯定疗效，但对中药治疗机理、研究方法尚待进一步研究。     

Typhonium flagelliforme inhibits cancer cell growth in vitro and induces apoptosis: an evaluation by the bioactivity guided approach

AIM OF THE STUDY: Typhonium flagelliforme (Lodd.) Blume (Araceae) is a Malaysian plant used locally to combat cancer. In order to evaluate its antiproliferative activity in vitro and to possibly identify the active chemical constituents, a bioactivity guided study was conducted on the extracts of this plant. MATERIALS AND METHODS: The active extracts of Typhonium flagelliforme were fractionated by flash column chromatography and each fraction was evaluated for antiproliferative activity using MTT assay. The apoptotic effect of the active fraction was determined microscopically and by using TUNEL colorimetric assay. GC-MS and NMR were used to determine the chemical constituents of this active fraction. RESULTS: Several fractions of the hexane and dichloromethane extracts were found to inhibit the growth of NCI-H23 non-small cell lung carcinoma cell line significantly, with IC(50)<15 microg/ml. However, most of these active fractions were also found to inhibit the growth of non-tumorigenic BALB/c 3T3 mouse fibroblast cell line except for fraction 21 of the dichloromethane extract (D/F21). This particular fraction was not only less cytotoxic to the non-tumorigenic cells, where the IC(50) was 48.6 microg/ml compared to IC(50) 7.5 microg/ml for NCI-H23, but it was also found to induce apoptosis in the cancer cell line. GC-MS analysis revealed that D/F21 contains hexadecanoic acid, 1-hexadecene, phytol and a derivative of phytol. The presence of non-saturated fatty acids in this fraction was confirmed by nuclear magnetic resonance spectroscopy. CONCLUSIONS: D/F21 was found to be the active and cancer cell line specific fraction of Typhonium flagelliforme. Its major chemical constituents had been determined spectroscopically.     

耳部瘢痕疙瘩的个性化治疗

目的:探讨耳部瘢痕疙瘩多种外科手术方法结合辅助疗法的治疗效果,摸索一套以外科手术为主的个性化的综合治疗体系。方法:选择2002-01/2004-07中国协和医科大学整形外科医院瘢痕中心收治耳部瘢痕疙瘩患者40例56耳,男9例,女31例;年龄8～60岁,平均30.17岁;发病时间1～15年;单耳24例,双耳16例;发病原因:穿耳孔28例,创伤4例,耳部手术5例,局部破溃感染2例,无诱因1例;瘢痕疙瘩0.7cm×0.7cm×0.5cm～10cm×5cm×3cm;球形、哑铃状或葫芦状等形状不一,边界清楚,部分伴有疼痛、瘙痒。根据耳部瘢痕疙瘩的大小、位置、浸润范围、与耳郭及周围器官的关系,实施不同的手术方案,手术方法遵循无张力缝合,局部无继发畸形以及保持良好的耳郭形态的原则。①直径<1cm的瘢痕疙瘩,采用完全切除,直接拉拢缝合。②直径>1cm的瘢痕疙瘩,切除后直接缝合后张力较大,多采用局部旋转皮瓣或推进皮瓣修复。③巨大瘢痕疙瘩,采用瘢痕疙瘩部分切除或保留瘢痕表皮的瘢痕组织摘除法。④术后第1天开始进行电子线照射,连续3d,1次/d,5Gy/次,总剂量为15Gy。伤口拆线后2周局部外用瘢痕敌(施乐辉有限公司生产,批号:0538)持续贴敷,维持3～6个月,适度加压。⑤长期随访,加强患者自我管理意识,并对有复发倾向者及时治疗。局部注射激素类抗瘢痕药物,曲安奈德 透明质酸酶 20g/L利多卡因注射液瘢痕内注射,混合液具体配方及用法:曲安奈德40mg,透明质酸酶500U,20g/L利多卡因注射液1mL瘢痕内均匀注射,每次用量视瘢痕疙瘩体积适当调整,1次/周,4周后将混合液用利多卡因稀释1倍,1次/2周注射,以后视瘢痕疙瘩消退情况逐渐撤药。结果:纳入患者40例,均进入结果分析。术后随访1年以上,除1例复发,3例有复发倾向者(及时采用局部激素注射等非手术方法治疗后有效),其余均未见复发,且无明显的瘢痕增生,耳郭和耳垂的外形满意。结论:耳部瘢痕疙瘩采用个性化的综合治疗方法,不仅能够有效地治疗瘢痕疙瘩,降低复发率,而且能够最大限度地恢复患者的容貌。     

Recovery of uterine and ovarian function in patients with complete placenta previa after caesarean delivery: A retrospective study

This retrospective study was designed to explore the recovery of uterine and ovarian function in patients with complete placenta previa (PP) after caesarean delivery (CD). 136 complete placenta previa patients (group completed placenta previa) and 140 patients without complete PP (group non-PP, control group) were included in this study from Jan 2016 to Dec 2018. Subgroup analysis of patients with complete PP was made to determine the impact of different hemostatic methods used during CD on the recovery of uterine function. There were no statistically significant differences between the 2 groups in postpartum menstrual cycle changes, ovarian hormone, and uterine vascular supply as measured by pulsatility index and systolic/diastolic ratio (P > .05). However, the group with complete PP had a reduced endometrial thickness (0.47 ± 0.11 vs 0.50 ± 0.12, P < .001), a lower uterine resistance index at 42nd days (0.84 ± 0.03 vs 0.90 ± 0.03, P < .001), and a delayed resumption menstruation (7.07 ± 2.61 vs 5.31 ± 2.16, P < .001) when compared with control group. Subgroup analysis showed that RI index of all subgroups in completed PP group was lower, endometrial thickness was thinner and the time to menstrual recovery was longer than that of non-PP group. In conclusion, the endometrial thickness and blood supply at 42nd days, not ovarian function, maybe affected after CD in patients with complete PP.     

Resection margin in laparoscopic hepatectomy: a comparative study between wedge resection and anatomic left lateral sectionectomy

Background

Experience from open hepatectomy shows that anatomic liver resection achieves a better resection margin than wedge resection. In recent years, laparoscopic hepatectomy has increasingly been performed in patients with liver pathology including malignant lesions. Wedge resection (WR) and left lateral sectionectomy (LLS), which also represent non-anatomic and anatomic resection respectively, are the two most common types of laparoscopic hepatectomy performed. The aim of the present study was to compare the two types of laparoscopic hepatectomy with emphasis on resection margin.

Methods

Between November 2003 and July 2009, 44 consecutive patients who underwent laparoscopic hepatectomy were identified and retrospectively reviewed. The WR and LLS group of patients were compared in terms of operative outcomes, pathological findings, recurrence patterns and survival.

Results

Out of the 44 patients, 21 underwent LLS and 23 a WR. The two groups of patients were comparable in demographics. The two groups did not differ in conversion rate, blood loss, blood transfusion, mortality, morbidity and post-operative length of stay. The LLS group patients had significantly larger liver lesions, wider resection margin and less sub-centimetre margins. In patients with malignant liver lesions, there was no difference between the two groups in incidence of intra-hepatic recurrence and 3-year overall and disease-free survival.

Conclusion

Operative outcomes are similar between laparoscopic WR and LLS. However, WR is less reliable than LLS in achieving a resection margin of more than 1 cm. Larger studies involving more patients with longer follow-up are warranted to determine the impact of the resection margin on intra-hepatic recurrence and survival.     

The prevalence and characteristics of Streptococcus pneumoniae isolates expressing serotypes 6C and 6D in Hong Kong prior to the introduction of the 7-valent pneumococcal conjugate vaccine

A study was conducted to determine the prevalence of the 2 newly described types, 6C and 6D, among pneumococcal isolates collected in Hong Kong before availability of the 7-valent pneumococcal conjugate vaccine. A total of 154 serogroup 6 isolates obtained from nasopharynx (n = 106), blood (n = 22), respiratory (n = 24), and cerebrospinal fluid (CSF) (n = 2) during 1995 to 2001 were analyzed by polymerase chain reaction typing. Five nasopharyngeal and 2 sputum isolates were found to belong to 6C and 6D, respectively. The isolates were genetically diverse, but one 6C and two 6D isolates exhibited some clonal relationship. Phylogenetic analysis of the wchA-wciN(β)-wciO nucleotide sequences showed that the Hong Kong 6C/6D isolates had 2 allelic profiles, which were more closely related to 6C/6D isolates from Fijian and Korea than were those from Brazil and the United States. However, all of the wciP gene sequences for both Hong Kong and non-Hong Kong isolates clustered together: 6C isolates with the wciP-9 allele and 6D isolates with the wciP-5 allele. In conclusion, the prevalence of the 2 newly described serotypes was low before the era of the pneumococcal conjugate vaccine. Nonetheless, results from the molecular studies indicated that the evolution of the capsular genes have involved complex pathways.     

全髋关节置换治疗成人髋关节发育不良继发严重骨关节炎26例

回顾性分析2008-08/2007-02湘南学院附属医院骨科与岳阳职业技术学院附属医院骨科收治的成人髋关节发育不良继发骨性关节炎患者26例(29髋),男11例,女15例:年龄46～78岁,平均53岁;其中3例为双髋.按Crowe分型分类:Ⅰ型3髋,Ⅱ型11髋,Ⅲ型12髋,Ⅳ型3髋.置换前按Harris评分标准平均(47.1±4.6)分.全部患髋均行全髋关节置换,骨水泥型3例,混合型5例,生物型21例.所有患者置换顺利进行,置换后伤口均Ⅰ期愈合.置换后5个月,患者均能下地行走,生活自理且恢复日常工作.全部患者获得随访,末次随访时Harris评分平均(84.5±6.4)分,与置换前Harris评分平均(47.1±4.6)分相比,差异有显著性意义(t=16.732 4,P<0.05).26例患者置换后关节脱位1例,精神症状2例.随访X射线检查示假体位置良好,未见无菌性松动和假体下沉等征象.无肺栓塞、深静脉血栓形成、感染等并发症发生.提示全髋关节置换是治疗成人先天性髋关节脱位伴骨性关节炎的一种有效方法.