A multidisciplinary approach to providing care to adolescents with spinal cord trauma resulting from all-terrain vehicle accidents.

All-terrain vehicle accidents that affect the spine can lead to complex injuries in adolescents. This requires that many subspecialties work together on a multidisciplinary team to improve patient outcomes. Our case presentation will examine the multidisciplinary approach to care required for an 11-year-old adolescent involved in an all-terrain vehicle accident that resulted in traumatic spinal cord injury.

Risk factors associated with hospital readmission in pediatric asthma.

Asthma is a leading cause of hospitalization among children, and about 15-50% of pediatric patients are readmitted after an index admission. The purpose of this integrative review is to explore contemporary scientific findings on the association between pediatric asthma readmission and various demographic, environmental, psychosocial and clinical risk factors. An electronic database search resulted in a sample of 29 studies. African American, public or no insurers, previous admission and complex chronic comorbidity were identified as risk factors associated with pediatric asthma readmission. However, more interdisciplinary and well-designed investigations are warranted to further explicate the spectrum of environmental and psychosocial correlates.

Simultaneous quantification of 12 bioactive components of Ligusticum chuanxiong Hort. by high-performance liquid chromatography.

A sensitive and specific HPLC-UV method has been developed, for the first time, to simultaneously quantify 12 bioactive ingredients in Ligusticum chuanxiong Hort. (Rhizoma Chuanxiong). This assay was fully validated in respect to precision, accuracy and sensitivity. This method was successfully applied to quantify twelve ingredients in six different Chuanxiong samples. The results demonstrated significant variations in the total content and quantity of each of the main bioactive compounds in different herbs, indicating that quality control of bioactive ingredients in Chuanxiong is critical to ensure its clinical benefits. This assay can be readily utilized as quality control method for Chuanxiong.

[Study on fingerprint of rhizoma chuanxiong by HPLC-DAD-MS].

AIM: To establish a high performance liquid chromatographic fingerprint for the quality control of rhizoma Chuanxiong, a traditional Chinese medicine derived from the root of Ligusticum chuanxiong Hort.. METHODS: An on-line optimized HPLC-DAD-MS technique was employed. The HPLC analysis was performed on a Waters Symmetry C18 column (150 mm x4. 6 mm ID, 5 microm) with a Waters Spherisorb S5 ODS2 (10 mm x 4.6 mm) guard column. The mobile phase consisted of A (methanol) and B (0.25% acetic acid). Components were separated using the following gradient profile: 32% B at 0-3 min, 32%-85% B at 3-33 min, 85%-100% B at 33-52 min; flow rate was 0.7 mL x min(-1). DAD was set from 190 to 400 nm, the fingerprint was monitored at 294 nm. All mass spectra were acquired in the positive ion mode with electrospray ionization; the full scan mass spectrum was recorded over the range of m/z 100-800. Nine samples from three companies were analyzed; the main characteristic peaks were identified based on the comparison of UV and MS spectra of each analyte with that of authentic compounds and literature data. RESULTS: The HPLC fingerprint was established based on the analysis of nine rhizoma Chuanxiong herbal samples supplied by three companies. Twenty-one characteristic peaks were found in all nine samples. These peaks were classified into four groups: group I at 0-12 min, three peaks were found, and the marker peak 3 was confirmed as ferulic acid; group II at 12-24 min, four peaks were found, and the marker peaks 4 and 5 were identified as senkyunolide I and senkyunolide H; group III at 24-32 min, there were seven peaks, and the marker peaks 9, 11, 13 and 14 were elucidated as senkyunolide A, coniferylferulate, ligustilide and 3-butylidenephthalide, respectively; group IV at 32-50 min, seven peaks were observed, and the marker peaks 15 and 17 were identified as riligustilide and levistolide A. The peak areas of 13 main peaks with normalized peak area (1% were determined. Using the most abundant peak 13 as the reference peak, the calculated relative retention times (tR of the characteristic peak/tR of the reference peak) among nine samples were consistent (RSD < or = 1%), while the calculated relative peak areas (peak area of the characteristic peak/peak area of the reference peak) among nine samples were significantly different (P < 0.001), indicating that all nine samples tested contain similar 13 main components with different quantities. CONCLUSION: The established HPLC fingerprint is very specific, and can be used to evaluate the quality consistency of different rhizoma Chuanxiong herbs.

Antitussive activity of Stemona alkaloids from Stemona tuberosa.

Bioactivity-directed fractionation of the crude extract of Stemona tuberosa led to the isolation and characterization of four new stenine-type Stemona alkaloids, namely tuberostemonine J ( 2), tuberostemonine H ( 3), epi-bisdehydrotuberostemonine J ( 4) and neostenine ( 5), together with the known neotuberostemonine ( 1). These five isolated alkaloids were examined for antitussive activity in guinea pig after cough induction by citric acid aerosol stimulation. In this report, we demonstrated, for the first time, that compounds 1 and 5 showed significant antitussive activities. Further study of the structure-activity relationship on these isolated alkaloids and two synthetic analogues revealed that the saturated tricyclic pyrrolo[3,2,1- jk] benzazepine nucleus is the primary key structure contributing to the antitussive activity and all cis configurations at the three ring junctions are the optimal structure for the antitussive activity of stenine-type Stemona alkaloids.

Simultaneous analysis of seventeen chemical ingredients of Ligusticum chuanxiong by on-line high performance liquid chromatography-diode array detector-mass spectrometry.

An on-line high performance liquid chromatography (HPLC)-diode array detector (DAD)-mass spectrometry (MS) analytical method has been developed to simultaneously separate and identify seventeen main constituents of Chuanxiong ( Ligusticum chuanxiong Hort.), a traditional Chinese medicinal herb. In three Chuanxiong samples, nine compounds were unequivocally determined as vanillin (1), ferulic acid (2), senkyunolide I (4), senkyunolide H (5), senkyunolide A (6), coniferyl ferulate (7), Z-ligustilide (8), neocnidilide (9) and 3-butylidenephthalide (10) by comparing their t R, UV, and MS data with those obtained for the authentic compounds. Furthermore, additional eight compounds were tentatively identified as senkyunolide J (11), senkyunolide F (12), 3-butylphthalide (13), cnidilide (14), riligustilide (15) or Z,Z'-6,8',7,3'-diligustilide (16), tokinolide B (17), levistolide A (18) and senkyunolide P (19), based on their MS data and the comparison of their UV spectra with the published references. This is the first report to describe the development of an on-line HPLC-DAD-MS method to simultaneously analyse seventeen main constituents present in Chuanxiong and to construct the chemical profiles of various Chuanxiong samples.