[Clinical characteristics and efficacy analysis of various treatments for spontaneous carotid artery dissection].

Objective: To investigate the clinical features of spontaneous carotid artery dissection (SCAD) and the efficacy of different treatment methods. Methods: The clinical data of 164 patients with SCAD who were treated at the First Affiliated Hospital of Zhengzhou University from June 2018 to January 2023 were retrospectively analyzed. There were 127 males and 37 females, with a mean age of (49.5±11.1) years. They were divided into conservative treatment group (n=100) and surgical treatment group (n=64) according to whether they received surgical treatment. Patients were followed at 3, 6, and 12 months after discharge and annually thereafter through outpatient or inpatient visits. The incidence of cerebral ischemic events, cerebral hemorrhage events, and mortality rates during hospitalization and follow-up periods were analyzed in the two patient groups. To examine correlates of revascularization in SCAD, multifactorial logistic regression analysis was used. Results: Of the 164 patients, 18 patients had bilateral SCAD and a total of 182 carotid arteries were included in the study. Ischemic stroke (85 cases, 51.8%) and transient ischemic attack (31 cases, 18.9%) were the main clinical manifestations in SCAD patients. Hypertension (81 cases, 49.4%) and hyperlipidemia (39 cases, 23.8%) were the main comorbidities in SCAD patients. During hospitalization, 100 patients in the conservative treatment group received medication in 113 carotid arteries, no new cerebral ischemic events or symptomatic intracranial hemorrhage events occurred, and no death occurred. A total of 69 carotid arteries were surgically treated in 64 patients in the surgical treatment group. The success rate was 97.1% (67/69). In the surgical treatment group, the proportion of carotid stenosis degree≥90% was 47.8% (33/69), the proportion of type Ⅱ SCAD was 60.9% (42/69), and the proportion discharged from the hospital to receive antiplatelet therapy was 92.8% (64/69), which were higher than those in the conservative treatment group, which were 25.7% (29/113), 45.1% (51/113), and 73.5% (83/113), respectively (all P<0.05). The follow-up time [M(Q1, Q3)] in the conservative treatment group was 24 (13, 34) months, with an 8% (9/113) rate of ischemic events and a 7.1% (8/113) rate of readmission; in the surgical treatment group, the follow-up time was 24 (11, 38) months, and there were no new ischemic events or deaths. The results of multifactorial logistic regression analysis showed that the degree of true luminal stenosis<90% (OR=2.738, 95%CI: 1.067-7.026, P=0.036) and type Ⅰ dissections (OR=2.656, 95%CI: 1.189-5.935, P=0.017) were the correlates of complete revascularization. Conclusions: Ischemic stroke and transient ischemic attack are the main clinical manifestations in patients with SCAD. Pharmacological antithrombotic therapy remains the method of choice, and endovascular treatment after failure of conservative therapy reduces the risk of recurrent long-term cerebral ischemic events and the re-admission rate of patients.

[Research status of glucagon-like peptide-1 receptor agonists on obstructive sleep apnea].

Obstructive sleep apnea (OSA) is the most common sleep-disordered breathing disease. Continuous positive airway pressure (CPAP) is the gold standard for treatment, but compliance is suboptimal. Therefore, new therapeutic strategies need to be explored. OSA is often associated with multiple comorbidities, particularly type 2 diabetes and obesity. Effective weight loss is known to be crucial in reversing OSA and its associated comorbidities. However, sustained weight loss is difficult to achieve with lifestyle changes alone. Medications that have both hypoglycemic and weight-loss effects are one way to achieve this goal. This article discussed the therapeutic effect of glucagon-like peptide-1 receptor agonists on this disease.

The first naturally occurring Tie2 kinase inhibitor.

[structure: see text] Bioassay-guided fractionation of the plant Acacia aulacocarpa, guided by a bioassay for Tie2 tyrosine kinase activity, yielded the novel triterpene 3,21-dioxo-olean-18-en-oic acid (1) as the first naturally occurring non-protein inhibitor of Tie2 kinase. The structure of 1 was assigned by analysis of spectral data. In addition to its activity as an inhibitor of Tie2 kinase, compound 1 also shows modest activity against a variety of cultured mammalian cells.

Phenolic and triterpenoid glycosides from Aster batangensis.

A new phenolic glycoside, asterbatanoside A [p-hydroxyacetophenone-4-O-beta-D-xylopyranosyl-(1-->6)-beta-D- glucopyranoside], and two new triterpenoid saponins, asterbatanoside B [2 alpha,3 beta,23-trihydroxyolean-12-en-28-oic acid-28-O-beta-D-glucopyranosyl-(1-->6)-beta-D-glucopyranoside] and asterbatanoside C [3-O-beta-D-glucopyranosyl-2 beta,3 beta,23-trihydroxyolean- 12-en-28-oic acid-28-O-beta-D-glucopyranoside] were isolated from the roots of Aster batangensis. Their structures were determined by spectroscopic methods and chemical evidence. The total synthesis of asterbatanoside A is also reported.

Triterpene saponins from Aster yunnanensis.

Four new triterpene saponins, asteryunnanosides A, B, C and D, have been isolated from Aster yunnanensis and their structures deduced as 2 alpha,3 beta,23-trihydroxyolean-12-en-28-oic acid-28-O-alpha-L-rhamnopyranosyl-(1-->2)-beta-D-glucopyranoside, 2 alpha,3 beta,23-trihydroxyolean-12-en-28-oic acid-28-O-beta-D-glucopyranosyl-(1-->2)-beta-D-glucopyranoside, 2 alpha,3 beta-dihydroxyolean-12-en-28-oic acid-28-O-alpha-L-rhamnopyranosyl-(1-->2)-beta-D-glucopyranoside and 2 alpha,3 beta-dihydroxyolean-12-en-28-oic acid-28-O-beta-D-glucopyranosyl-(1-->2)-beta-D-glucopyranoside, respectively, by means of spectral and chemical data.

Triterpenoid saponins from Aster batangensis.

Four novel triterpenoid saponins named asterbatanoside F, G, H and I were isolated from the roots of Aster batangensis and their structures elucidated as 3-O-beta-D-glucopyranosyl-23-O-acetyl-bayogenin-28-O-beta-D-glu cop yranosyl- (1-->6)-[alpha-L-rhamnopyranosyl-(1-->2)]-beta-D-glucopyranoside, 3-O-beta-D-glucopyranosyl-bayogenin-28-O-beta-D-glucopyranosyl-(1- ->6)-[alpha-f1p4amnopyranosyl-(1-->2)]-beta-D-glucopyranoside, 3-O-beta-D-glucopyranosyl- (1-->3)-beta-D-glucopyranosyl-bayogenin-28-O-beta-D-glucopyranosyl -(1-->6)-beta-D-glucopyranoside, and 3-O-beta-D-glucopyranosyl-(1-->3)-beta-D- glucopyranosyl-23-O-acetyl-bayogenin-28-O-beta-D-glucopyranosyl-(1 -->6)-beta-D- glucopyranoside by means of spectral data, especially NMR including COSY, HETCOR, COLOC, HOHAHA, ROESY and selective INEPT techniques, and chemical evidence.

Glycosides from Aster yunnanensis.

A new oleanane-type triterpene saponin named asteryunnanoside E and a new acetylene glycoside named asteryunnanoside I have been isolated from the roots of Aster yunnanensis, and their structures elucidated as 3-O-beta-D-glucopyranosyl-bayogenin-28-O-beta-D- glucopyranosyl-(1-->2)-beta-D-glucopyranoside and 2Z,8E-decadiene-4,6-diyn-1-O-beta-D-glucopyranos yl-(1-->2)-beta-D- glucopyranoside by means of 1D and 2D NMR techniques (COSY, HETCOR, COLOC, HOHAHA and ROESY) and chemical transformations.

The pregnane glycoside marsdekoiside A from Marsdenia koi.

A new pregnane glycoside, marsdekoiside A was isolated from the stems of Marsdenia koi (Asclepiadaceae) and its structure was elucidated from chemical and spectral data as 12-cinnamoyl-dihydrosarcostin-3-O-methyl-6-deoxy-beta-D-allopyr ano syl-(1----4)-O-beta-D-oleandropyranosyl-(1----4)-O-beta-D-++ +cymar opyranoside.

Yuanhuacin A is a selective antagonist of phorbol ester receptor in protein kinase C.

Protein kinase C with a molecular weight of 82 kD has been purified to electrophoresis homogeneous from rat brain through a series of chromatography columns including DE-52, Sepharose G-200 and phenyl-Sepharose. The enzyme possessed autophosphorylation activity. Yuanhuacin A inhibited the 3H-phorbol-12, 13-dibutyrate (3H-PdBu) binding of PKC with an IC50 value of 1.48 +/- 0.28 x 10(-8) mol/L when the concentration of 3H-PdBu was 1.5 x 10(-9) mol/L (Ki = 1.2 x 10(-8) mol/L). Yuanhuacin A inhibited the PdBu-stimulated PKC activity in the catalysis of the phosphorylation of Histone III-S with an IC50 of 2.82 +/- 0.37 x 10(-9) mol/L (PdBu = 10(-6) mol/L), while it had no effect on the basal and Ca(2+)-stimulated PKC activity in the same assay system. This result suggests that Yuanhuacin A is a selective antagonist of the phorbol ester receptor in protein kinase C.

Noni as an anxiolytic and sedative: a mechanism involving its gamma-aminobutyric acidergic effects.

Noni (Morinda citrifolia) is increasing in worldwide popularity as a food or dietary supplement with versatile health benefits. The aim of this study was to investigate the effects of Noni fruit on anxiety symptoms in vitro. To this end, a competitive GABAa receptor-binding assay was developed. Our preliminary study indicates that the methanol crude extract of Noni fruit showed significant affinity to the gamma-aminobutyric acid A (GABAa) inhibitory neurotransmitter receptors, and displayed 75% binding inhibition of the agonist radioligand [3H] muscimol at a concentration of 100 microg/ml. Further experiments demonstrated that the MeOH extract, and its BuOH and H2O partitions, exhibited IC50 values of 22.8, 27.2, and 17.1 microg/ml, respectively, in the GABAa-binding assay. Experimental results with Noni fruit indicate the presence of competitive ligand(s), which may bind to the GABAa receptor as an agonist, and thus induce its anxiolytic and sedative effects. The study provides an in vitro rationale for one of Noni's versatile and traditional uses. In addition, an HPLC fingerprint profile of the methanolic extract of Noni fruit has been established for quality control purpose.

Some progress on the chemistry of natural bioactive terpenoids from Chinese medicinal plants.

(1) Pseudolaric acids--Novel diterpenes, Pseudolaric acid A, B, C and D were isolated from Pseudolarix kaempferi Gorden (pinaceae). Their structures were assigned by spectroscopic data and chemical correlations. In the continuous studies, the absolute configurations, the conformations in the solutions, the fragmentation mechanisms of MS and assignments of all NMR spectral signals were also reported. They showed the antifungal and cytotoxic activities. (2)--Daphnane diterpenes--In the further studies on the plants of Thymelaeaceae, besides 10 known diterpenes, 16 new daphnane diterpenes were isolated from Daphne genkwa, D. tangutica, D. giraldii, Wikstroemie chamaedaphne. They showed the antifertilities activities. (3) Tripterygium diterpenes--14 new diterpenes were isolated from Triperygium wilfordii, T. regeli and T. hypoglaucum. Some of them showed the antitumour activities. The CD spectra showed that A/B ring of all compounds have trans configuration as same as tripdiolide and triptolide determined by X-ray diffraction. (4) Pregnane glycosides from Marsdenia koi--Two new pregnane glycosides marsdenikoiside A and marddenikoiside B which can terminate the early pregnancy were isolated from Marsdeia koi. Their structures were elucidated by hydrolysis and spectroscopic methods.

PIP: Bioactive terpenes were isolated from the following plant species: 1) Pseudolaric acids: The active compounds of novel diterpenes, Pseudolaric acid A, B, C, and D, were isolated from Pseudolarix kaempferi Gordon (pinaceae). Their structures were determined by spectroscopic data and chemical correlations. In continuous studies, absolute configurations, confirmation in solutions, fragmentation mechanisms of MS, and assignments of all nuclear magnetic resonance (NMR) spectral signals were also reported. They showed antifungal and cytotoxic activities. Pseudolaric acid A 1 and B 2 showed antifungal activities. Recently, pseudolaric acid B was established as a general cytotoxic agent against P-388 lymphocytic leukemia, KB carcinoma of the nasopharynx, HT-1080 fibrosarcoma, H00 578T breast cancer, human melanoma, human lung cancer, and human colon cancer cell lines. 2) Daphnane diterpenes: In further studies on the plants of Thymelaeaceae, besides 10 known diterpenes, 16 new daphnane diterpenes were isolated from Daphne genkwa, D. tangutica, D. giraldii, Wikstroemie chamaedaphne that showed antifertility activities. In continuous studies, besides 6 known compounds, 17 new daphnane diterpenes were isolated. 3) Tripterygium diterpenes: 14 new diterpenes were isolated from Tripterygium wilfordii, T. regeli and T. hypoglaucum. Tripterygium wilfordii has been used as an anticancer drug, male contraceptive, and immunedepressant in Chinese folk medicine for a long time. Some of them showed antitumor activities. The CD spectra showed that A/B ring of all diterpenes had the same transconfiguration as tripdiolide and triptolide as determined by X-ray diffraction. In 1972 triptolide, tripdiolide and triptonide were isolated with significant anti-tumor activities. Celastrol demonstrated immunodepressive activities. In addition to 10 known triterpenes, 15 new diterpenes were isolated from the plants of Tripterygium by silica gel chromatography. 4) Pregnane glycosides from Marsdenia koi: Two new pregnane glycosides, marsdenikoiside A and marsdenikoiside B, which can terminate early pregnancy were isolated from Marsdenia koi. Their structures were elucidated by hydrolysis and spectroscopic methods.

Asteryunnanosides F and G: two new triterpenoid saponins from Aster yunnanensis.

Two new triterpenoid saponins, aster-yunnanosides F and G, were isolated from the roots of Aster-yunnanensis. Their structures were determined as oleanolic acid-28-O-beta-D-glucopyranosyl-(1-->6)-beta-D-glucopyranoside and 3-O-beta-glucopyranosyloleanolic acid-28-O-beta-D-glucopyranosyl-(1-->6)-[alpha-L-rhamnopyranosyl-(1-->2) ]- beta-D-glucopyranoside by spectral data, especially 2D NMR analysis including COSY, HETCOR, HOHAHA, and ROESY techniques, and chemical transformation.

New triterpenoid saponins, asterbatanoside D and E, from Aster batangensis.

Two new triterpenoid saponins named asterbatanoside D and E have been isolated from Aster batangensis and their structures elucidated as 3-O-beta- D-glucopyranosyl-bayogenin-28-O-beta-D-glucopyranosyl-(1-->6)-beta -D- glucopyranoside and 3-O-6'-acetyl-beta-D-glucopyranosyl-bayogenin-28-O-beta-D- glucopyranosyl-(1-->6)-beta-D-glucopyranoside by means of MS, 1D and 2D NMR techniques (COSY, TOCSY, ROESY, HMQC, and HMBC), and chemical reactions.

Studies on New Components and Stereochemistry of Diterpenoids from Trypterygium wilfordii.

An extensive investigation of the petroleum ether extract of TRIPTERYGIUM WILFORDII plants have revealed the presence of four new compounds, triptonoterpene, neotriptonoterpene, triptonodiol, and neotriptonolide, in addition to the diterpenes isolated and characterized earlier. The structures of these novel natural products have been elucidated.