Proximal femoral nail anti rotation under local anesthesia for femoral intertrochanteric fractures in high-risk patients / 中国骨伤

OBJECTIVE@#To compare the clinical efficacy under local anesthesia and general anesthesia proximal femoral nail anti-rotation(PFNA) fixation for intertrochanteric fracture of femur in high risk patients.@*METHODS@#From February 2018 to February 2019, 32 patients underwent PFNA operation due to intertrochanteric fracture of femur, including 16 patients undergoing PFNA operation under local anesthesia, 9 males and 7 females, aged 54 to 98 (82.43±9.30) years and hospitalized for (10.94±5.30) days;16 patients undergoing PFNA operation under general anesthesia, 6 males and 10 females, aged 51 to 83 (72.69±9.48) years and hospitalized for (12.88±4.12) days. The patients' gender, age, fracture AO classification, preoperative VAS (visual analogue score), preoperative ASA condition grade, postoperative 1st day resting state VAS, hospitalization cost and length of stay were recorded.@*RESULTS@#All patients recovered well, the wound healed well, and the ability of lower limb activity was restored. The average follow-up time was 4.6 months. There was significant difference in age between two groups (0.05). There was no significant difference on ASA between two groups (>0.05), but there was significant difference on ASA≥grade Ⅲ between two groups (0.05).@*CONCLUSION@#Under the multi-disciplinary diagnosisand treatment mode, the method of PFNA operation is safe and feasible, the patients with local anesthesia are older, and the proportion of patients with ASA≥grade Ⅲ is higher, which is better for some elderly high-risk patients than general anesthesia.

S1PR1 predicts patient survival and promotes chemotherapy drug resistance in gastric cancer cells through STAT3 constitutive activation.

BACKGROUND: S1PR1-STAT3 inter-regulatory loop was initially suggested to be oncogenic in several cancer cells. However, the clinical relevance of this mechanism in tumor progression, disease prognosis and drug response was not established. METHODS: The correlations between S1PR1 transcription, overall survival and chemotherapy response of GC patients were tested using a large clinical database. The relevance of S1PR1 expression and STAT3 activation in both tumor tissues and cancer cell lines was also tested. The effect of S1PR1 high expression achieved by persistent STAT3 activation on tumor cell drug resistance was investigated in vitro and in vivo. FINDINGS: An enhanced S1PR1 expression was highly related with a reduced overall survival time and a worse response to chemotherapy drug and closer correlation to STAT3 in gastric cancer patients. The issue chip analysis showed that the expressions of S1PR1 and STAT3 activation were increased in higher graded gastric cancer (GC) tissues. Cellular studies supported the notion that the high S1PR1 expression was responsible for drug resistance in GC cells through a molecular pattern derived by constitutive activation of STAT3. The disruption of S1PR1-STAT3 signaling significantly re-sensitized drug resistance in GC cells in vitro and in vivo. INTERPRETATION: S1PR1-STAT3 signaling may participate drug resistance in GC, thus could serve as a drug target to increase the efficacy of GC treatment. FUND: This work was supported by the National Natural Science Foundation of China (No. 81570775, 81471095), the grant from the research projects in traditional Chinese medicine industry of China (No. 201507004-2).

Effect of puerarin in promoting fatty acid oxidation by increasing mitochondrial oxidative capacity and biogenesis in skeletal muscle in diabetic rats.

BACKGROUND: Type 2 diabetes is characterized by dyslipidemia and the accumulation of lipids in non-adipose tissue, including skeletal muscle. Puerarin, which is a natural isoflavonoid isolated from the root of the plant Pueraria lobata, has been shown to have antidiabetic activity. However, the lipid-reducing effect of puerarin, in particular in skeletal muscle, has not yet been addressed. METHODS: We examined the effect of puerarin on mitochondrial function and the oxidation of fatty acids in the skeletal muscle of high-fat diet/streptozotocin-induced diabetic rats. RESULTS: Puerarin effectively alleviated dyslipidemia and decreased the accumulation of intramyocellular lipids by upregulating the expression of a range of genes involved in mitochondrial biogenesis, oxidative phosphorylation, the detoxification of reactive oxygen species, and the oxidation of fatty acids in the muscle of diabetic rats. Also, the effect of puerarin on mitochondrial biogenesis might partially involve the function of the µ-opioid receptor. In addition, puerarin decreased the trafficking of fatty acid translocase/CD36 to the plasma membrane to reduce the uptake of fatty acids by myocytes. In vitro studies confirmed that puerarin acted directly on muscle cells to promote the oxidation of fatty acids in insulin-resistant myotubes treated with palmitate. CONCLUSIONS: Puerarin improved the performance of mitochondria in muscle and promoted the oxidation of fatty acids, which thus prevented the accumulation of intramyocellular lipids in diabetic rats. Our findings will be beneficial both for elucidating the mechanism of the antidiabetic activity of puerarin and for promoting the therapeutic potential of puerarin in the treatment of diabetes.

New isocoumarin and stilbenoid derivatives from the tubers of Sparganium stoloniferum (Buch.-Ham.).

A new isocoumarin derivative 8,5'-dihydroxy-6'-methoxy-4-phenyl-5,2'-oxidoisocoumarin (1) and a new stilbenoid derivative methyl 5-hydroxy-2-(2-hydroxyphenyl)benzofuran-4-carboxylate (2) together with nine known compounds (3-11) were isolated from the tubers of Sparganium stoloniferum Buch.-Ham.. Another stilbenoid derivative (3) and a xanthone (4) were identified as new natural products and compounds 5-10 were obtained for the first time from the genus Sparganium. All their structures were elucidated by comprehensive spectroscopic analysis and comparison with available literature information.

Chemical constituents from the tubers of Scirpus yagara and their anti-inflammatory activities.

A new natural compound, dehydrophyllodulcin (1) was isolated from the tubers of Scirpus yagara, together with 11 known compounds. Among them, compounds 2, 5-8, and 10-12 were isolated from this plant for the first time. (1)H NMR, (13)C NMR, and 2D NMR data of compound 1 are first reported in this article, though it was synthesized in 1996. The structures of all compounds were determined by comprehensive analyses of their spectroscopic data and compared with literature information. Moreover, the anti-inflammatory effects of compounds 1, 3, 4, 6, and 9 against inflammatory cytokines production in Lipopolysaccharide - or Pam3csk4-stimulated macrophage RAW264.7 cells were evaluated by Enzyme-linked immunosorbent assay. And these compounds significantly inhibited the tumor necrosis factor (TNF)-α, interleukin (IL)-6 productions in RAW264.7 cells, with IC50 values less than 20 µM.

Protective effects of the active fraction from the tuber of Scirpus yagara in mouse endotoxin shock model.

ETHNOPHARMACOLOGICAL RELEVANCE: Scirpus yagara Ohwi is a perennial, aquatic plant, whose dry tubers have long been used as Traditional Chinese Medicine (TCM) "Sanleng" for the treatment of postpartum abdominal pain, hyperemesis gravidarum, amenorrhea, dyspepsia and several inflammatory related diseases. Although it is known to have anti-inflammatory activities, its mechanism of action on lipopolysaccharide (LPS)-induced inflammation has not yet been identified in detail.This study was designed to investigate the anti-inflammatory activity of the active fraction (AF) from the tuber of Scirpusyagara both in vitro and in vivo. MATERIALS AND METHODS: RAW264.7 macrophage was incubated for 16h with 1µg/ml of LPS in absence or presence of AF (0, 10, 50 and 100µg/ml) and the secretions of tumor necrosis-alpha (TNF-α) and interleukin-6 (IL-6) in the medium were determined by using an enzyme-linked immunosorbent assay (ELISA). In the in vivo study, mice were orally administrated with AF (50 and 300mg/kg) for three days consecutively. 1h after the last AF administration, the mice were intraperitoneally injected with LPS (15mg/kg), and the life span of LPS-challenged mice were determined. Furthermore, the levels of pro-inflammatory cytokines TNF-α and IL-6 in the serum, lung and liver were measured using ELISA kit, and histological change in lungs was examined by light microscopy. Additionally, the components of AF were analyzed by high performance liquid chromatography (HPLC) using a C18 column. RESULTS: AF significantly decreased TNF-α and IL-6 production induced by LPS in RAW264.7 macrophage. In LPS-induced mouse endotoxin shock model, AF pre-treatment significantly improved the survival rate of mice. And LPS-induced increases of pro-inflammatory cytokines TNF-α and IL-6 in the serum, lung and liver were markedly suppressed by AF. Moreover, the histopathological examination indicated that AF could significantly attenuate lung tissues injury in endotoxemic mice. In addition, eight compounds (protocatechuic acid, vanillic acid, p-coumaric acid, ferulic acid, methyl-3,6-dihydroxy-2-[2-(2-hydroxyphenyl)-ethynyl] benzoate, sciryagarol I, sparstolonin B, SanLeng diphenyllactone) of AF were quantified by HPLC analysis. CONCLUSIONS: These results suggested that AF protected mice against LPS-induced lethality by inhibiting the production of multiple cytokines and organ dysfunction. Thus AF may prove beneficial in the prevention and treatment of endotoxin shock.

Bioactive cis-stilbenoids from the tubers of Scirpus yagara.

Two new cis-stilbenoids, sciryagarol I (1) and II (2) were isolated from the EtOAc extract of the tubers of Scirpus yagara, together with four known compounds. The structures of all compounds were determined by comprehensive analyses of their spectroscopic data and comparison with literature information. The compounds 3, 4 and 6 were isolated for the first time from this genus. Some compounds were tested for their cytotoxicity against human tumor cell lines and antimicrobial activity. Compounds 1-4 showed significant cytotoxicity against the Hela cell lines with IC(50) values ranging from 7.21 to 61.21µM. 1 and 2 exhibited some antimicrobial activity against Staphylococcus aureus and Candida albicans with uniform MICs of 79.3µl/ml for 2, and 152µl/ml for 1, respectively.

[Study on quality evaluation of Sparganii rhizoma by biopotency determination method].

OBJECTIVE: To establish a method for determining anticoagulation potency of Sparganii Rhizoma, and evaluate the effect of Sparganii Rhizoma herbs from different producing areas on promoting blood circulation and removing blood stasis; and study the material basis of Sparganii Rhizoma through the correlation analysis on its anticoagulation potency, ferulic acid and total flavonoid content. METHOD: The anticoagulation time of Sparganii Rhizoma from different producing areas with activeated partial thromboplastin time for their active extracts. Their biopotency was calculated by using the method of "parallel lines of dose effect" (3, 3). The degree of correlation between their anticoagulation potency and chemical constituents were calculated by using Pearson correlational analysis method. RESULT: Sparganii Rhizoma and is control drugs had a good linear relationship between dose and effect (Y = 172.76X - 193.39, R2 = 0.9955). The method had better accuracy (RSD 4.7%), repeatability (RSD 2.3%) and intermediate precision (RSD 5.4%), finding that the biopotency of Sparganii Rhizoma from different producing areas ranged between 52.33-238.58 U x g(-1), and all of them passed the test on reliability. The results of correlation analysis showed no remarkable relationship between the anticoagulation potency of Sparganii Rhizoma and the contents of the two chemical constituents. CONCLUSION: This biopotency determination method established in the experiment can be used as one of approaches for qulaity evaluation on Sparganii Rhizoma.

Surgical treatment for musicogenic epilepsy.

We report a patient with medically intractable musicogenic epilepsy (ME) who was treated with surgery. Using the non-invasive methods of ictal and interictal electroencephalography (EEG), MRI, interictal single photon emission computed tomography and clinical manifestations, we first localized the musicogenic seizures (MS). The ictal onset zone was then further localized using intracranial EEG to the middle part of the left superior temporal gyrus. Surgical resection of the epileptogenic zone was then performed. The patient had two seizures within 2 weeks post-operatively, but has then had no seizures during the following year (Engel class II). The results suggest that patients who have medically intractable ME combined with unilateral ictal onset zones should be considered for the surgical treatment of epilepsy.

A new cytotoxic casbane diterpene from Euphorbia pekinensis.

A new cytotoxic casbane diterpene, named pekinenal, was isolated from the roots of Euphorbia pekinensis. Its structure was elucidated as 5alpha-hydroxy-1betaH,2alphaH-casba-3Z,7E,11E-triene-18-al by a combination of 1D- and 2D-NMR techniques and confirmed by X-ray crystallography. Pekinenal showed cytotoxic activity against all four human cancer cell lines tested.

A new elemanolide sesquiterpene lactone from Elephantopus scaber.

A new elemanolide sesquiterpene lactone, named elescaberin (1), together with two known compounds, namely, isodeoxyelephantopin (2) and deoxyelephantopin (3), was isolated from the whole plant of Elephantopus scaber. The structure of 1 was elucidated on the basis of spectroscopic analysis. All three compounds exhibited significant inhibitory activities against human SMMC-7721 liver cancer cells in vitro (IC(50) 8.18-14.08 micromol/l).

[Structure modification on sesquiterpene lactones from Elephantopus scaber].

In order to look for lower toxic and strongly active compounds, the structure of sesquiterpene lactones from Elephantopus scaber was modified. Deoxyelephantopin and scabertopin were isolated from the whole plant of Elephantopus scaber and hydrogenated and epoxidated. Five sesquiterpenoide derivatives were prepared and their structures were identified by IR, NMR and MS spectra analysis. Four sesquiterpenoides are new compounds. Part of the compounds show definite antitumor activity.

Enhancing the efficacy of photodynamic therapy by a chinese herbal medicine for hepatocellular carcinoma.

Hepatocellular carcinoma (HCC) ranks the sixth among the most common malignancies, with chronic HBV infection being the most common cause. HCC is more common in Africa, China and south-east Asia, but its incidence in the USA, Canada and Australia is rising. Current treatment modalities for HCC are not effective, and only a small percentage of patients are suitable for surgical resection and liver transplantation. Thus other treatment options and improvement of available modalities are badly in need. Photodynamic therapy (PDT) may have some therapeutic benefit for patients with HCC. The study by Tang et al. has implicated that coupled with Pheophorbide a (Pa), PDT may offer therapeutic benefit for patients with HCC. Inhibition of cell proliferation and induction of apoptosis by Pa may be mechanistically responsible for Pa-PDT. As Pa is an extract from a Chinese herbal medicine Scutellaria Barbata, which is widely available, less toxic and less expensive, such a combination may find a better clinical usage in the treatment of HCC patients. More studies are mandatory to fully elucidate the efficacy and mechanisms of Pa-mediated PDT.

[Studies on the constituents from the herb of Vernonia patula].

OBJECTIVE: To isolate and elucidate the chemical constituents of the whole plant of Vernonia patula, and to provide samples for biological activity screening. METHOD: The chromatography on silica gel was used and the structures were determined by IR, NMR and MS spectra analysis and physicochemical property comparion. RESULT: Four triterpenoids were isolated and identified as bauerenyl acetate(I), friedelin(II), epifriedelanol(III), 20(30)-taraxastene-3 beta, 21 alpha-diol(IV). CONCLUSION: Compounds I and IV were isolated from genus Vernonia for the first time and compounds II and III were isolated from the whole plant of V. patula for the first time. The four compounds show no inhibitory effect on the growing of PC-12 cells.

Studies on chemical constituents of Cuscuta chinensis / 中国中药杂志

<p><b>OBJECTIVE</b>To study the chemical constituents of the seeds of Cuscuta chinensis.</p><p><b>METHOD</b>The separation was carried out by polyamide and silica gel chromatography, and the compounds were identified by means of physico-chemical and spectroscopic methods.</p><p><b>RESULTS</b>Eight compounds were isolated from the plant and identified as quercetin 3-O-beta-D-galactoside-7-O-beta-D-glucoside (I), quercetin 3-O-beta-D-apiofuranosyl-(1-->2)-beta-D-galactoside (II), hyperoside (III), isorhamnetin (IV), kaempferol (V), quercetin (VI), d-sesamin (VII) and 9(R)-hydroxy-d-sesamin (VIII).</p><p><b>CONCLUSION</b>Compounds IV and VII were isolated from Cuscuta for the first time, and I, II and VIII were characteristic constituents for this vegetable drug.</p>

Studies on water-soluble constituents of Echinacea prupurea / 药学学报

<p><b>AIM</b>To study the water-soluble constituents of Echinacea purpurea.</p><p><b>METHODS</b>The compounds were isolated by chromatography method and their structures were identified on the basis of spectral analyses.</p><p><b>RESULTS</b>Five compounds were identified as 2-(4-hydroxylphenyl)-ethyl-O-alpha-L-rhamnopy-ranoasyl-(1-->6)-beta-D- glucopyranoside, named echipuroside A 1); (6S, 9R)-6-hydroxy-3-one-alpha-inonol-9-O-beta-D-glucopyranoside 2), ampelopsisionoside 3); phenylmethyl-6-O-beta-D-xylopyranosyl(1-->6)-beta-D-glucopyranoside 4) and phyenylmethyl-beta-D-glucopyranoside 5).</p><p><b>CONCLUSION</b>Compound 1 is a new compound, the others were isolated from this plant for the first time.</p>