Antidermatophytic triterpenoids from Syzygium jambos (L.) Alston (Myrtaceae)

Chemical investigation of the EtOAc extract of the stem bark of Syzygium jambos (L.) Alston (Myrtaceae) afforded a number of known triterpenes such as friedelin, beta-amyrin acetate, betulinic acid and lupeol. Friedelin was submitted to a Baeyer-Villiger oxidation, and was also reduced with LiAlH(4) to give the known friedelolactone and friedelanol, respectively. These compounds were identified by comparison of NMR spectral data with those from the literature. The EtOAc extract and the isolated compounds were tested for their antidermatophytic activity against three dermatophyte species: Microsporum audouinii, Trichophyton mentagrophytes and Trichophyton soudanense, commonly found in Cameroon. Betulinic acid and friedelolactone were the most active compounds, and the most sensitive fungi were Trichophyton soudanense and Trichophyton mentagrophytes.     

Simultaneous perineal ultrasound and vaginal pressure measurement prove the action of electrical pudendal nerve stimulation in treating female stress incontinence

Study Type – Diagnostic (case series) Level of Evidence 4 What's known on the subject? and What does the study add? Pelvic floor muscle training (PFMT) and transvaginal electrical stimulation (TES) are two commonly used forms of conservative treatment for stress urinary incontinence (SUI). PFMT may build up the structural support of the pelvis, but many SUI patients are unable to perform PFMT effectively and its primary disadvantage is lack of long‐term patient compliance. TES is a passive treatment that produces PFM contraction and patient compliance with it is good; however, its effect is not as good as that of PFMT when performed correctly. Electrical pudendal nerve stimulation (EPNS) combines the advantages of PFMT and TES and incorporates the technique of deep insertion of long needles. In this study, simultaneous perineal ultrasound and vaginal pressure measurement prove that EPNS can contract the PFM and simulate PFMT. It is shown that EPNS is an alternative therapy for female SUI patients who fail PFMT and TES and the therapy can also be used for severe SUI.

OBJECTIVES

• ? To prove that electrical pudendal nerve stimulation (EPNS) can contract the pelvic floor muscles (PFM) and simulate pelvic floor muscle training (PFMT).
• ? To show that EPNS is an alternative therapy for female stress urinary incontinence (SUI) that does not respond effectively to PFMT and transvaginal electrical stimulation (TES).

PATIENTS AND METHODS

• ? Thirty‐five female patients with SUI who did not respond effectively to PFMT and TES (group I) were enrolled and 60 other female patients with SUI were allocated to group II (30 patients) and group III (30 patients).
• ? Long needles were deeply inserted into four sacral points and electrified to stimulate the pudendal nerves. Group I and group II were treated by a doctor skilled in performing EPNS and group III, by a doctor unskilled in performing EPNS.
• ? When EPNS was performed in group I, perineal ultrasonographic PFM movements, vaginal pressure (VP) and PFM electromyography were recorded simultaneously.
• ? The therapeutic effects were evaluated according to objective and subjective criteria

RESULTS

• ? When EPNS was performed correctly, the patient felt strong PFM contractions. Simultaneous recordings in group I showed: B‐mode cranio‐caudal PFM movements; M‐mode PFM movement curves (amplitude: about 1 mm, n= 31); a sawtooth curve of VP changes (2.61 ± 1.29 cmH₂O, n= 34); and PFM myoelectric waves (amplitude: 23.9 ± 25.3 µV).
• ? If during the EPNS process the electric current was stopped or its intensity was reduced to about 7–12 mA or the two lower needles were drawn back, then the above ultrasonographic PFM movements and VP changes disappeared.
• ? In group I, the incontinence severity and quality of life score was 16.5 ± 4.0 before treatment and decreased to 4.2 ± 4.0 after 27.5 ± 11.9 sessions of treatment (P < 0.01). At the end of treatment, 100% improvement occurred in 16 cases (45.7%). A 2‐year follow‐up showed that 100% improvement occurred in 14 of cases (40.0%).
• ? In group II, the incontinence severity and quality of life score was 17.1 ± 6.3 before treatment and decreased to 3.5 ± 3.7 after 10 sessions of treatment (P < 0.01) and 100% improvement occurred in 12 cases (40.0%). In group III, the incontinence severity and quality of life score was 17.6 ± 6.3 before treatment and decreased to 10.8 ± 8.2 after 10 sessions of treatment (P < 0.01) and 100% improvement occurred in one case (3.3%).
• ? The post‐treatment score was lower and the therapeutic effect was better in group II than in group III (both P < 0.01).

CONCLUSIONS

• ? EPNS can contract the PFM and simulate PFMT.
• ? EPNS is an alternative therapy for female SUI patients who fail PFMT and TES.

     

针灸治疗原发性失眠的随机对照试验

目的：评价调督安神法针灸治疗原发性失眠的临床疗效及安全性。方法：本研究采用患者随机对照试验设计,将72例原发性失眠患者按1∶1比例分为治疗组和对照组。治疗组以调督安神法为治疗原则进行针灸治疗,要求得气,取穴百会、神庭、印堂、神门、安眠、三阴交;对照组为假针灸治疗,假针灸针不刺破皮肤,取穴同治疗组。两组每次均治疗30 min,每周3次,连续治疗4周。分别在治疗前、治疗2周、治疗4周以及治疗结束后2周、4周随访时对患者进行失眠严重程度指数(ISI)、焦虑自评量表（SAS）以及抑郁自评量表（SDS）的评估,观察并记录针灸的不良反应。结果：治疗组完成32例,脱落4例;对照组完成30例,脱落6例。与治疗前相比,两组的ISI评分在治疗后及随访时有显著性差异（P＜0.01）;与对照组相比,治疗组在治疗4周、治疗结束后2周、4周随访时评分差异有统计学意义（P＜0.05）,但在治疗2周时差异无统计学意义（P＞0.05）。与对照组相比,治疗组的SAS及SDS评分在治疗4周、治疗结束后2周、4周随访时有显著性差异（P＜0.01,P＜0.05）,但在治疗2周时差异无统计学意义（P＞0.05)。两组针灸疗法不良事件发生率比较,差异无统计学意义（P＞0.05）。结论：调督安神法针灸方案治疗原发性失眠临床疗效显著,安全性高。     

Altered functional brain networks in Prader–Willi syndrome

Prader–Willi syndrome (PWS) is a genetic imprinting disorder characterized mainly by hyperphagia and early childhood obesity. Previous functional neuroimaging studies used visual stimuli to examine abnormal activities in the eating‐related neural circuitry of patients with PWS. It was found that patients with PWS exhibited both excessive hunger and hyperphagia consistently, even in situations without any food stimulation. In the present study, we employed resting‐state functional MRI techniques to investigate abnormal brain networks related to eating disorders in children with PWS. First, we applied amplitude of low‐frequency fluctuation analysis to define the regions of interest that showed significant alterations in resting‐state brain activity levels in patients compared with their sibling control group. We then applied a functional connectivity (FC) analysis to these regions of interest in order to characterize interactions among the brain regions. Our results demonstrated that patients with PWS showed decreased FC strength in the medial prefrontal cortex (MPFC)/inferior parietal lobe (IPL), MPFC/precuneus, IPL/precuneus and IPL/hippocampus in the default mode network; decreased FC strength in the pre‐/postcentral gyri and dorsolateral prefrontal cortex (DLPFC)/orbitofrontal cortex (OFC) in the motor sensory network and prefrontal cortex network, respectively; and increased FC strength in the anterior cingulate cortex/insula, ventrolateral prefrontal cortex (VLPFC)/OFC and DLPFC/VLPFC in the core network and prefrontal cortex network, respectively. These findings indicate that there are FC alterations among the brain regions implicated in eating as well as rewarding, even during the resting state, which may provide further evidence supporting the use of PWS as a model to study obesity and to provide information on potential neural targets for the medical treatment of overeating. Copyright © 2013 John Wiley & Sons, Ltd.     

T细胞介导的1型糖尿病小鼠模型的建立及机制研究

目的:建立T细胞介导的1型糖尿病(IDDM)小鼠模型。方法:BALB／c小鼠小剂量连续多次ip链脲佐菌素(STZ)制备1型糖尿病模型,4周后处死取脾制备脾细胞悬液建立T淋巴细胞系,并将不同数量T淋巴细胞过继转移到经不同方式预处理的BALB／c小鼠体内。符合高血糖诊断标准后处死动物,观察胰腺病理变化,检测脾淋巴细胞增殖反应。结果:2次ip小剂量STZ联合3×106T细胞过继转移,或采用2次ip环磷酰胺联合2次ip STZ和1．5×106T细胞过继转移,均可建立1型糖尿病动物模型。血糖分别于T细胞过继转移后第20和第13天显著升高(P<0．05),脾淋巴细胞增殖能力明显增强(P< 0．05),胰腺见大量淋巴细胞浸润和严重胰岛β细胞破坏。结论:BALB／c小鼠一次性过继转移IDDM发病T淋巴细胞可成功复制1型糖尿病模型。     

CO_2气腹下子宫恶性肿瘤腹腔镜手术对腹膜微环境的改变和意义

目的:探讨CO_2气腹下子宫恶性肿瘤腹腔镜手术对腹膜间皮细胞的细胞间粘附分子-1(ICAM-1)、整合素β1和透明质酸(HA)表达的影响,了解腹膜微环境变化对肿瘤细胞种植和转移的可能影响。方法:选择2005年9月至2006年9月行腹腔镜手术的宫颈癌和子宫内膜癌各20例,与同期行开腹手术的宫颈癌和内膜癌各10例进行对比。DAKO Envision二步法检测患者手术开始时和手术结束前腹膜间皮细胞ICAM-1和整合素β1蛋白的表达。放射免疫法测定不同手术时间的腹膜(开始时,手术1、2、3h和结束前)HA的浓度。结果:随腹腔镜和开腹手术时间的延长,宫颈癌和内膜癌患者腹膜间皮细胞ICAM-1和整合素β1蛋白阳性和强阳性表达均有增加趋势,但各自在不同手术组间及手术开始和结束时比较均无统计学差异;不同手术时间的HA浓度在腹腔镜组和开腹组阎无统计学差异,但两组手术2h HA均明显升高(P＜0．05)。结论:CO_2气腹下子宫恶性肿瘤的腹腔镜手术导致腹膜微环境中间皮细胞ICAM-1和整合素β1蛋白轻度增高, HA分泌明显增多的变化可能有利于肿瘤细胞与间皮细胞之间粘附,这种改变也存在于开腹手术中,是否对肿瘤转移有促进作用有待进一步研究。     

Neonatal mortality in a referral hospital in Cameroon over a seven year period: trends,associated factors and causes

Background

The fourth Millennium Development Goals targets reduction by 2/3 the mortality rate of under-fives by 2015. This reduction starts with that of neonatal mortality representing 40% of childhood mortality. In Cameroon neonatal mortality was 31‰ in 2011.

Objectives

We assessed the trends, associated factors and causes of neonatal deaths at the Yaounde Gynaeco-Obstetric and Pediatric Hospital.

Methods

The study was a retrospective chart review. Data was collected from the hospital records, and included both maternal and neonatal variables from 1st January 2004 to 31st December 2010.

Results

The neonatal mortality was 10%. Out-borns represented 49.3% of the deceased neonates with 11.3% born at home. The neonatal mortality rate followed a downward trend dropping from 12.4% in 2004 to 7.2% in 2010. The major causes of deaths were: neonatal sepsis (37.85%), prematurity (31.26%), birth asphyxia (16%), and congenital malformations (10.54%). Most (74.2%) of the deaths occurred within the first week with 35% occurring within 24hours of life. Mortality was higher in neonates with birth weight less than 2500g and a gestational age of less than 37 weeks. In the mothers, it was high in single parenthood , primiparous and in housewives and students.

Conclusion

There has been a steady decline of neonatal mortality since 2004.Neonatal sepsis, prematurity, birth asphyxia and congenital malformations were the major causes of neonatal deaths. Neonatal sepsis remained constant although at lower rates over the study period.     

蝉花肾损伤保护作用的药理及临床研究进展

蝉花是寄生在蝉上的一种虫草真菌,也是我国传统名贵中药材。现代研究表明蝉花具有免疫调节、改善肾功能、抗疲劳、抗肿瘤、降血糖等广泛的药理作用,临床上用于治疗慢性肾脏病取得良好的疗效。综述天然蝉花或人工培养蝉花延缓糖尿病肾病、抗肾间质纤维化、抗肾小球硬化、保护残肾等对肾损伤保护作用的药理研究进展,以及对慢性肾功能衰竭和慢性间质性肾炎的临床研究进展,以期为开发具有肾损伤保护作用的新药与大健康产品提供依据。     

蝉花及其成分增强免疫、抗肿瘤药理作用研究进展

蝉花是寄生在蝉上的真菌,也是我国传统名贵中药材。现代研究表明蝉花及其有效成分具有免疫调节、抗疲劳、抗肿瘤、降血糖及改善肾功能等广泛的药理作用,尤其以增强免疫力作用的研究报道为多。近年来蝉花的抗肿瘤活性也逐渐受到关注,因此主要对蝉花的增强免疫力和抗肿瘤活性研究进行综述,并对其后续研究及应用前景进行展望。