Aconicumines A-D, an advanced class of norditerpenoid alkaloids with an unprecedented N,O-diacetal motif from Aconitum taipeicum Hand.-Mazz., exhibit anti-inflammatory properties in vitro.

Aconicumines A-D, an advanced class of norditerpenoid alkaloids, and seven known alkaloids, were isolated from Aconitum taipaicum Hand.-Mazz. (Ranunculaceae). The structures of the previously undescribed compounds, including their absolute configurations, were fully elucidated based on spectroscopic and single-crystal X-ray diffraction data analysis. Aconicumines A-D exhibit interesting cage-like structure, characterised by an unprecedented N,O-diacetal moiety (C6-O-C19-N-C17-O-C7) that has not been previously observed in diterpenoid alkaloids. Possible biosynthetic pathways for aconicumines A-D were proposed. Aconitine, hypaconitine, and aconicumine A showed significant inhibition of nitric oxide production in RAW 264.7 macrophages induced by lipopolysaccharide with IC50 values ranging from 4.1 to 19.7 µM compared to positive control (dexamethasone, IC50 = 12.5 µM). Furthermore, the primary structure-activity relationships for aconicumines A-D were also represented.

Risk factors for intracranial infection after craniotomy: A case-control study.

BACKGROUND: Intracranial infection, serving as a severe postoperative infection after craniotomy, poses significant problems for patients' outcomes. OBJECTIVE: To explore risk factors for intracranial infection after craniotomy. METHODS: A total of 2,174 patients who underwent craniotomy from 1 May 2018 to 30 June 2019 were retrospectively studied. Finally, 196 patients with intracranial infections were classified as case group, and 392 patients randomly selected from patients without intracranial infection were classified as control group. Demographic, clinical, laboratory, microbiological, and antimicrobial data were systemically recorded. The characteristics, pre- and postoperative variables, and other variables were evaluated as risk factors for intracranial infection by univariate analysis and binary logistic regression model. RESULTS: There was no significant difference in terms of demographics between two groups, except for gender, hypertension, length of stay (LOS), intraoperative blood loss, tumor, and trauma surgery. The independent risk factors were male, age ≤45, hypertension, tumor surgery, surgery in autumn (compared with spring), surgical duration ≥4 hr, intraoperative blood loss ≥400 ml, and postoperative oral infection, coma, and serum RBC > normal value. Trauma surgery (p < .001, OR = 0.05, 95% CI: 0.017-0.144) was an independent protective factor (p < .05, OR < 1) for intracranial infection. All 196 patients in the case group submitted specimens for cerebrospinal fluid (CSF) cultures, and 70 (35.71%) patients had positive results. Gram-positive pathogens predominated (59 cases, 84.28%). Staphylococcus were the most common causative pathogens, and fully resistant to aztreonam, cefazolin, and benzylpenicillin, but not resistant to linezolid and minocycline. CONCLUSION: Identifying the risk factors, pathogens, and pathogens' antibiotic resistance for intracranial infection after craniotomy plays an important role in the prognosis of patients.

[Combined use of bare stent and coils in the treatment of aortic dissection with distal tear at celiac trunk].

OBJECTIVE: To evaluate a novel method of combining use of bare stent and coils in the treatment of aortic dissection with distal tear at celiac trunk. METHODS: From April 2007 to August 2010, two cases of Stanford type B dissections underwent initially endovascular stent-grafting to seal proximal tears while distal tears at celiac trunks failed to seal spontaneously. Bare stents were then implanted into celiac trunks crossing tears. And an appropriate amount of coils were pushed into false lumen via a catheter passing through the holes of stents for maintaining the patency of celiac trunk and sealing tears. RESULTS: Both procedures succeeded. False lumen was indistinct on angiography while celiac trunks were patent. No complication occurred. After the follow-up periods of 5 and 2 years respectively, false lumen disappeared and celiac arteries became patent. CONCLUSION: The novel method of combining use of bare stent and coils is technically simple. It required a simple puncture. Major traumas of open and hybrid operations are avoided. It is also indicated for cases of tears at renal or superior mesenteric arteries. As a supplemental method for conventional TEVAR, radical cure may be achieved for some complicated Stanford B dissections.