[Chemical constituents from Alangium chinense subsp. pauciflorum].

Chemical constituents of 70% ethanol extract of Alangium chinense subsp. pauciflorum were investigated. The 70% ethanol extract of A. chinense subsp. pauciflorum was isolated and purified by D-101 macroporous resins, silica gel, Sephadex LH-20 and other methods. As a result, nineteen compounds were isolated and identified as 4-cyclohexene-1α,2α,3α-triol-1-O-ß-D-glucoside(1), 1ß,4α,6α,13-tetrahydroxy-eudesm-11(12)-ene(2), sucrose(3), 1'-O-benzyl-α-L-rhamnopyranosyl-(1″→6')-ß-D-glucopyranoside(4), bis(2-ethylhexyl)benzene-1,2-dicarboxylate(5),(Z)-10-heneicosenoic acid(6), di-O-methylcrenati(7), methyl-α-D-fructofuranoside(8), ß-daucosterol(9), syringic acid(10), vanillicacid(11), octacosanol(12), isoarborinol(13), 2,7-dihydroxy-6-methyl-4-(1-methylethyl)-1-naphthalenecarboxylate(14),vanillin(15), coniferyl aldehyde(16), 9(11)-dehydroergosterolperoxide(17), 5α,8α-epidioxy-(22E,24R)-ergosta-6,22-dien-3ß-ol(18), ß-sitosterol(19), respectively. Compounds 1 and 2 were new compounds, compounds 5-11, 13, 15-18 were isolated from Alangium for the first time.The anti-inflammatory activity of compourd 1 was determinded by the LPS-induced RAW264.7 macrophage inflammation model. The results showed that the new compound 1 has a certain inhibitory effect on LPS-induced NO production of RAW264.7 cells, and the inhibitory rate was 54.57%.

[Three-dimensional Ultrasound of the Pelvic Floor in Early Postpartum after First Delivery].

OBJECTIVE: To dynamically observe the shape of levator hiatus and the mobility of bladder neck with three dimensional transperineal ultrasound, and then to evaluate female pelvic floor in early postpartum after delivery. METHODS: 170 primiparae (the vaginal delivery group and the cesarean section group) and 35 nulliparous women were recruited, and three dimensional transperineal ultrasound were performed with standardized gynecological pelvic settings. Ultrasonic dynamic imaging information was obtained in the condition of resting, Valsalva maneuver and anal sphincter contraction, including two-dimensional midsagittal view and the three-dimensional axial plane in which some biometric measurements were determined. RESULTS: The anteroposterior diameters of levator hiatus were significantly greater on sphincter contraction in the vaginal delivery group than that in nulliparous group after the 6-8 weeks delivery, but the measurements of the levator hiatus within cesarean delivery group and nulliparous group did not show statistically significant differences (P > 0.05). The mobility of bladder neck was significantly greater on Valsalva maneuver in the vaginal delivery group than those in the other groups, while the backward motion of bladder neck was greater on Valsalva maneuver in the cesarean section group than that in nulliparous group. The incidence of postpartum stress urinary incontinence was greater in the vaginal delivery group (10/104) than that in the cesarean section group (4.5%, 3/66), but no statistically significant differences were observed (P > 0.05). CONCLUSION: The large difference of pelvic floor exists between vaginal delivery and cesarean delivery. The bladder neck decent and levator hiatus anteroposterior diameter may be relatively sensitive indicators in ultrasonic evaluation of pelvic floor muscle contraction, especially the latter may be adopted as an observation index to evaluate pelvic floor muscle recovery after delivery.

Concurrent chemoradiotherapy with paclitaxel and nedaplatin followed by consolidation chemotherapy in locally advanced squamous cell carcinoma of the uterine cervix: preliminary results of a phase II study.

PURPOSE: To evaluate the efficacy and toxicities of concurrent chemoradiotherapy (CCRT) and consolidation chemotherapy in patients with locally advanced squamous cell cervical carcinoma. METHODS AND MATERIALS: Patients with LASCC (FIGO Stage IIB-IIIB) were treated with pelvic external beam radiotherapy (45 Gy for Stage IIB and 50 Gy for Stage III) and high-dose-rate intracavitary brachytherapy (50 Gy for Stage IIB and 35 Gy for Stage III). The cumulative dose at point A was 50 Gy for Stage IIB and 65 Gy for Stage III. Concurrent chemotherapy with paclitaxel (35 mg/m(2)) and nedaplatin (20 mg/m(2)) was given every week for 6 weeks. Consolidation chemotherapy with paclitaxel (135 mg/m(2)) and nedaplatin (60 mg/m(2)) was administered every 3 weeks for 4 cycles. RESULTS: All patients completed CCRT, and 28 of 34 patients completed consolidation chemotherapy. The complete response rate was 88% (95% CI, 73-96%). The most common Grade 3 or higher toxicities were leukopenia/neutropenia (10.9% of the cycles). During a median follow up of 23 months (range, 14-30 months), 5 patients had locoregional failure and 1 patient had distant metastasis. The estimated 2-year progression-free survival and overall survival were 82% (95% CI, 68-95%) and 93% (95% CI, 83-100%), respectively. Grade 3 late complications occurred in 3 patients (9%). CONCLUSIONS: CCRT with paclitaxel and nedaplatin followed by consolidation chemotherapy is well tolerated and effective in patients with locally advanced squamous cell cervical carcinoma. Further randomized trials of comparing this regimen with the standard treatment are worth while.

[Analysis of 174 cases with cervical cancer in women under 35 years old].

OBJECTIVE: To analyse the prevalence, etiology, presentation, preserving ovary and prognosis of cervical cancer in women under 35 years old. METHODS: The clinical information of 174 patients were retrospectively analysed. RESULTS: The percentage of new cervical cancer cases from 1991 to 2001 was 1.2%, 1.2%, 4.3%, 4.2%, 4.6%, 4.5%, 7.3%, 9.0%, 10.7%, 9.4%, 10.8%, respectively (P < 0.01). Contact bleeding was the main symptom that occurred in 101 cases (101/174, 58.0%). Cervicitis was incorrectly diagnosed in 45 cases (45/174, 25.9%). Sex irregularities occurred in 51 cases (51/174, 29.3%). The number of cases with carcinoma in situ, stage I, stage II, stage III was 22, 40, 94, 18, respectively. There are 29 cases with lymph vascular involvement, 60 with 1/2 or more penetration of the cervical stroma. The incidence of HPV16/18 infection was 34%. The ovarian metastasis was 0.8%. The 5 year survival rate of stage I - III was 71.6%, 60.4% and 13.3%, respectively (P < 0.01). COX regression analysis indicated that stage, lymph-vascular involvement and the depth of tumor infiltration were independently prognostic factors. For patients with one risk factor after radical surgery, the survival of patients with adjuvant radiation therapy and chemotherapy or not was 100%, 88%, respectively (P > 0.05). For patients with two or more risk factors, it was 68%, 1/7, respectively (P < 0.05). CONCLUSIONS: There is an increasing prevalence of cervical cancer in women under 35 years old, which is possibly related to the sexual transition. The preserving ovary in young cervical cancer patients is safe and effective. Patients with late stage, lymph-vascular involvement and deep infiltration of cervical stroma have poor prognosis. Adjuvant treatment may be helpful for patients with 2 or more risk factors after radical surgery.