HEPATITIS C VIRUS AND ESSENTIAL MIXED CRYOGLOBULINAEMIA

Clinical and laboratory evidence of liver involvement are frequentlyfound in essential mixed cryoglobulinaemia (EMC). We lookedfor evidence of hepatitis C virus (HCV) infection in 37 patientswith EMC. Anti-HCV antibodies (Ab) were found in 16/37 (43%)patients with EMC using the ELISA 2 test and the RIBA 2 test.The 16 anti-HCV-Ab positive patients (group 1) were comparedto the 21 anti-HCV-Ab negative patients (group 2). Group 1 patientshad more frequent cutaneous involvement (P = 0.02), clinical,biological and histologic hepatic involvement (P<0.01), higherserum cryoglobulin and lower CH50 levels (P<0.001). Serumhepatitis B virus markers were infrequent in both groups andno patient from either group had detectable serum HBV DNA. Thesepreliminary results suggest that HCV may be another cause ofmixed cryoglobulinaemia. KEY WORDS: Hepatitis C virus, Cryoglobulinaemia     

Endobronchial foreign bodies in Vietnamese adults are related to eating habits

Background and objective: A high percentage of bronchoscopically extracted foreign bodies in Ho Chi Minh City were pits of the sapote fruit, a finding previously unreported. This paper presents a review of foreign body extractions, which identifies the substances found, documents the diagnostic pathway and draws attention to the specific aspiration risk of the sapote pit. Methods: The records of 100 consecutive adults who were found to have a bronchial foreign body during flexible bronchoscopy were reviewed. Results: In 83% of patients, the foreign body extraction was performed more than 2 weeks after the aspiration had occurred. In only 34% of patients was the diagnosis of an aspirated foreign body considered early in the patient's clinical course. The most frequent foreign bodies found were sapote pits (41%), followed by small bones (38%). Foreign bodies were lodged more frequently in the right bronchial tree (64%). In 98% of patients, the foreign bodies were successfully removed with the flexible scope. There was one postoperative death, which was not ascribed to the procedure. Conclusions: Physicians need to consider foreign body aspirations when evaluating patients with recurrent pneumonia, unexplained cough or atelectasis. Awareness of this problem might lead to public health measures that could reduce the incidence of these aspirations.     

Synthesis of side-chain to side-chain cyclized peptide analogs on solid supports

Cyclic peptide structures of the type -Lys-R₁—R_n-Glu- can be synthesized on the Merrifield resin by assembling the peptide chain using Nα-Fmoc-amino acids and Boc and tert.-butyl protection for the side-chains of Lys and Glu, respectively. If residues R₁ to R_n contain side-chain functional groups, TFA-resistant protection is required. After TFA treatment cyclization on the resin can be performed with appropriate coupling reagents. The formation of such cyclic structures may be preceded or followed by peptide chain assembly using Nα-Boc-amino acids and the entire peptide chain containing the cyclic portion is finally cleaved by HF treatment. Using this principle we synthesized the following opioid peptide related cyclic analogs: H-Tyr-d -Lys-Gly-Phe-Glu-NH₂ (I), H-Tyr-Lys-Gly-Phe-Glu-NH₂ (II), H-Tyr-d -Lys-Phe-Glu-NH₂ (III), H-Tyr-d -Glu-Gly-Phe-Lys-NH₂ (IV), H-Tyr-d -Glu-Phe-Lys-NH₂ (V), H-Tyr-d -Orn-Gly-Glu-NH₂ (VI) and H-Tyr-d -Ala-Lys-Phe-Glu-NH₂ (VII). Cyclic monomers were obtained in all cases, as demonstrated by mass spectrometry. Analysis of side-products revealed a slow-down of the HF deprotection of O-benzylated tyrosine as a consequence of hydrophobic interactions as well as the formation of a side-chain-linked antiparallel cyclic dimer in the case of compound VI. In conclusion, the described method permits the convenient preparation of peptide analogs cyclized via amide bond formation between side-chain amino and carboxyl groups in reasonable yield.     

Week-Long High-Maintenance Dose Clopidogrel Regimen Achieves Better Platelet Aggregation Inhibition than a Standard Loading Dose before Percutaneous Coronary Intervention: Results of a Double-Blind, Randomized Clinical Trial

Background: Adequate platelet inhibition before percutaneous coronary intervention (PCI) reduces periprocedural and long-term ischemic complications. Reduced response to clopidogrel has been associated with subsequent major adverse cardiovascular events. Strategies to optimize platelet inhibition pre-PCI are under investigation. This study evaluated the effect on platelet aggregation of four different dosing regimens of clopidogrel given before elective PCI in a randomized, prospective, double-blind, and placebo-controlled design.
Methods: One hundred twenty participants were randomized to one of four groups of clopidogrel: (a) 300 mg on the day prior to angiography; (b) 600 mg on the day prior to angiography; (c) 300 mg followed by 75 mg daily started 1 week prior to angiography; and (d) 300 mg followed by 150 mg daily started 1 week prior to angiography. Platelet aggregation was assessed by light transmission aggregometry (LTA) after stimulation with adenosine diphosphate 20 μM at baseline and at the time of diagnostic coronary angiography. The absolute change in platelet aggregation between these two time points was considered the main outcome measure.
Results: At the time of diagnostic coronary angiography, the 300-mg/150-mg daily regimen achieved the greatest decrease in platelet aggregation (37 ± 19%), while the 300 mg regimen provided the smallest (20 ± 22%), an absolute difference between the two groups of 17.2 ± 5.1% (P = 0.005).
Conclusions: A 300-mg loading dose of clopidogrel followed by 150 mg daily for 1 week prior to coronary angiography provides more effective platelet inhibition, as defined by LTA, compared to the standard 300-mg loading dose regimen at the time of coronary intervention.     

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??OBJECTIVE To investigate the liposoluble constituents of Urticae Rhizoma. METHODS The compounds were isolated and purified by silica gel, Sephadex LH-20, ODS gel column chromatographies, and semi-preparative HPLC. The structures were elucidated on the basis of spectral data and physiochemical properties. RESULTS Twenty-one compounds were isolated from the ethyl acetate fraction of Urticae Rhizoma, and identified as(-)-urticol(1),(-)-secoisolariciresinol(2), 23-hydroxybetulinic acid(3), 2??,3??, 24-trihydroxy-12-oleanen-28-oic acid(4), cleomiscosin A (5), dihydro-4-hydroxy-5-hydroxymethyl-2(3H)-furanone(6), methyl chlorogenate(7), kaempferol(8), pinoresinol monomethyether-4??-O-??-D-glucopyranoside(9), martairesinol-4??-O-??-D-glucopyranoside(10), cycloolivil-6-O-??-D-glucopyranoside(11), stigmasterol-3-O-??-D-glucopyranoside(12), nicotinamide(13), trans-caffeic acid-4-O-??-D-glucopyranoside(14), esculin(15), 5-hydroxyl-7-methoxycoumarin-8-O-??-D-glucopyranoside(16), 6-oxymethyluteolin-7-O-??-D-glucopyranoside(17), luteolin-7-O-??-D-glucopyranoside(18), quercetin-3-O-(4??-methoxy)-??-L-rhamnopyranoside(19), 2??-deoxy uridine(20), and apigenin-6, 8-di-C-??-D-glycoside(21), respectively. CONCLUSION All the compounds, except 8 and 12, are isolated from U. fissa for the first time. Meanwhile, compounds 5, 6, 9, 10, 11, 14, 16, 17, and 19 are all found in Urticaeae plants for the first time.     

针灸推拿治疗椎-基底动脉供血不足的临床研究进展

综述了近几年来针灸推拿治疗椎-基底动脉供血不足的现状,从针刺、针灸结合、电针、推拿、针刺结合推拿、综合治疗等疗法进行了总结和归纳,阐述了针灸推拿治疗本病的优势与不足,为临床更好的应用针灸推拿治疗该病提供参考.     

丹皮酚自微乳处方设计研究

目的 研究丹皮酚自微乳的处方设计.方法 采用测定溶解度,绘制伪三元相图和星点设计法筛选及优化处方.结果 以油酸乙酯(EO)为油相、聚氧乙烯辛基苯基醚(OP-10)为乳化剂、二乙二醇单乙基醚(HP)为助乳化剂,比例为24.47％∶50.35％∶25.18％时能形成稳定的丹皮酚自微乳.结论 丹皮酚自微乳处方设计方法简单,结果可靠,性质稳定.