[Current status of pubertal sexual characteristics development of 2 704 girls aged 6-18 years in Tongzhou District of Beijing]

Objective: To understand the current status of pubertal sexual characteristics development of girls aged 6-18 years in Tongzhou District of Beijing and to compare the differences in sexual characteristics development among girls characterized as thin, normal, overweight, and obese. Methods: A cross-sectional survey was conducted among 2 844 girls aged 6-18 years in Tongzhou District of Beijing from September 2022 to July 2023. The developmental stages of breast and pubic hair were assessed on site, and menarche status was inquired. Weight and height were measured. The girls were subsequently characterized into thin, normal, overweight and obese groups. Basic information (including family and personal history) was obtained through questionnaires. Probit probability unit regression was applied to calculate the age of each Tanner stage of sexual characteristics development and the age of menarche. The χ2 test was applied to compare the counting data between two or multiple groups. Results: A total of 2 844 girls were surveyed and 2 704 girls met the inclusion criteria, resulting in a valid response rate of 95.1%. Among these girls, 1 105 (40.9%) were aged 6-9 years, 1 053 (38.9%) were aged 10-13 years, and 546 (20.2%) were aged 14-18 years. The of height-for-age Z-score (HAZ), weight-for-age Z-score (WAZ), and body mass index-for-age Z-score (BAZ) were 0.46(-0.23,1.16), 0.69(-0.16,1.67), and 0.67(-0.27,1.73) respectively. The prevalences of thin, overweight, and obesity were respectively 1.7% (45/2 704), 17.3% (467/2 704), and 19.9% (538/2 704), respectively. There were 45 girls in the thin group, 1 654 girls in the normal weight group, 1 005 girls in the overweight and obesity group. The age of Tanner stage breast 2 (B2), Tanner stage pubic hair 2 (P2), and menarche was 9.0 (95%CI 8.9-9.1), 10.5 (95%CI 10.4-10.6), and 11.4 (95%CI 11.3-1.5) years, respectively. The current status of breast and pubic hair maturity in girls with pubertal development shows that 64.6% (1 211/1 874) of these girls had breast development preceding pubic hair development, 32.4% (607/1 874) had concurrent breast and pubic hair development, and 3.0% (56/1 874) had pubic hairs development preceding breast development. The interval age between B2 and B5 was 4.7 (95%CI 4.6-4.8) years, between P2 and P5 was 4.5 (95%CI 4.4-4.6) years, and between B2 and menarche was 2.4 (95%CI 2.3-2.5) years. The ages of sexual characteristics development in overweight and obese groups were earlier than that in normal and thin groups. The ages of B2 in thin, normal, overweight, and obese groups were 10.0 (95%CI 9.5-10.6), 9.3 (95%CI 9.2-9.4), and 8.6 (95%CI 8.4-8.7) years, respectively. The age of menarche in thin, normal, overweight, and obese groups were 13.1 (95%CI 12.4-13.7), 11.6 (95%CI 11.4-11.7), and 11.1 (95%CI 11.0-11.2) years, respectively. The interval ages between B2 and B5 and between P2 and P5 was 4.5 and 4.1 years, respectively in the overweight and obese groups, and those in normal group and thin group was 4.7 and 4.5 years, 4.6 and 4.7 years, respectively. Conclusions: The ages of sexual characteristics development and menarche tend in Tongzhou District of Beijing to be earlier than that being reported of Beijing's survey 20 years ago. Girls characterized as overweight and obese not only start puberty at an earlier age than girls of normal weight, but also have a shorter developmental process.

Comprehensive metabolome characterization and comparison between two sources of Dragon's blood by integrating liquid chromatography/mass spectrometry and chemometrics

Dragon's Blood (DB) serves as a precious Chinese medicine facilitating blood circulation and stasis dispersion. Daemonorops draco (D. draco; Qi-Lin-Jie) and Dracaena cochinchinensis (D. cochinchinenesis; Long-Xue-Jie) are two reputable plant sources for preparing DB. This work was designed to comprehensively characterize and compare the metabolome differences between D. draco and D. cochinchinenesis, by integrating liquid chromatography/mass spectrometry and untargeted metabolomics analysis. Offline two-dimensional liquid chromatography/ion mobility-quadrupole time-of-flight mass spectrometry (2D-LC/IM-QTOF-MS), by utilizing a powerful hybrid scan approach, was elaborated for multicomponent characterization. Configuration of an XBridge Amide column and an HSS T3 column in offline mode exhibited high orthogonality (A0 0.80) in separating the complex components in DB. Particularly, the hybrid high-definition MSE-high definition data-dependent acquisition (HDMSE-HDDDA) in both positive and negative ion modes was applied for data acquisition. Streamlined intelligent data processing facilitated by the UNIFI™ (Waters) bioinformatics platform and searching against an in-house chemical library (recording 223 known compounds) enabled efficient structural elucidation. We could characterize 285 components, including 143 from D. draco and 174 from D. cochinchinensis. Holistic comparison of the metabolomes among 21 batches of DB samples by the untargeted metabolomics workflows unveiled 43 significantly differential components. Separately, four and three components were considered as the marker compounds for identifying D. draco and D. cochinchinenesis, respectively. Conclusively, the chemical composition and metabolomic differences of two DB resources were investigated by a dimension-enhanced analytical approach, with the results being beneficial to quality control and the differentiated clinical application of DB.

Global Profiling of the Antioxidant Constituents in Chebulae Fructus Based on an Integrative Strategy of UHPLC/IM-QTOF-MS, MS/MS Molecular Networking, and Spectrum-Effect Correlation

An integrative strategy of UHPLC/IM-QTOF-MS analysis, MS/MS molecular networking (MN), in-house library search, and a collision cross-section (CCS) simulation and comparison was developed for the rapid characterization of the chemical constituents in Chebulae Fructus (CF). A total of 122 Constituents were identified, and most were phenolcarboxylic and tannic compounds. Subsequently, 1,3,6-tri-O-galloyl-β-d-glucose, terflavin A, 1,2,6-tri-O-galloyl-β-d-glucose, punicalagin B, chebulinic acid, chebulagic acid, 1,2,3,4,6-penta-O-galloyl-β-d-glucose, and chebulic acid, among the 23 common constituents of CF, were screened out by UPLC-PDA fingerprinting and multivariate statistical analyses (HCA, PCA, and OPLS-DA). Then, Pearson's correlation analysis and a grey relational analysis were performed for the spectrum-effect correlation between the UPLC fingerprints and the antioxidant capacity of CF, which was finally validated by an UPLC-DPPH• analysis for the main antioxidant constituents. Our study provides a global identification of CF constituents and contributes to the quality control and development of functional foods and preparations dedicated to CF.

[Updated growth standards for Chinese children under 7 years of age]

Objective: To construct growth standards for Chinese children under 7 years of age. Methods: Cross-sectional study design based on national representative data on children's growth and development in 2015 was used. Stratified cluster sampling method was used. A total of 83 628 healthy children aged 0-<7 years from 9 cities, including Beijing, Harbin, Xi'an, Shanghai, Nanjing, Wuhan, Guangzhou, Fuzhou, and Kunming, were investigated from June to November 2015, excluding those with adverse conditions that may impact the establishment of the growth standards. Weight, length (height) and head circumference were measured using unified measurement tools and measurement methods. The Lambda-Mu-Sigma method was employed to establish percentile and standard deviation score reference values of weight-for-age, length (height)-for-age, head circumference-for-age, weight-for-length (height) and body mass index (BMI)-for-age of the study population. The standard deviation score curves of the new-established growth standards were compared with the 2009 reference standards. Results: Reference values of percentile (P3, P10, P25, P50, P75, P90, P97) and standard deviation score (-3, -2, -1, 0,+1,+2,+3) of weight-for-age, length (height)-for-age, head circumference-for-age, weight-for-length (height) and BMI-for-age were obtained. Compared with the 2009 growth standards, the difference of weight at P50 was -0.1-0.4 kg, the difference of length (height) at P50 was 0.1-1.3 cm, the difference of head circumference at P50 was -0.2-0.2 cm, the difference of weight for length (height) at P50 was -0.2-0.5 kg, and the difference of BMI at P50 was -0.2-0.2 kg/m2. The main differences were as follows: weight for girls aged 5.0-<7.0 years was 0.4-0.6 kg higher at +2 s, height for boys and girls aged 2.0-<7.0 years was 0.4-1.4 cm higher at -2 s, and BMI for boys and girls aged 5.0-<7.0 years was 0.1-0.3 kg/m2 higher at +2 s than the 2009 reference standards. Conclusion: The newly established growth standards for Chinese children under 7 years of age that have achieved a minor revision to the 2009 reference standards, are recommended for nationwide use in growth monitoring and nutritional assessment.

Steroidal Saponins from Solanum lyratum Thunb

Four undescribed steroidal compounds along with twenty known compounds were isolated from n-butanol extracted fraction of the whole plants of Solanum lyratum Thunb (SLNF). Their structures were assigned based on analyses of the extensive spectroscopic data (including MS, 1D/2D NMR, and ECD) or comparisons of the NMR data with those reported. Among the knowns, three compounds were isolated from Solanum plants for the first time, while one compound was isolated from S. lyratum for the first time. In addition, the cytotoxicities of these isolates against human colon SW480 and hepatoma Hep3B cells were evaluated by a MTT assay. And, nine of them and SLNF exhibited significant activities against both SW480 and Hep3B cells, while twelve of them significantly inhibited the activities of SW480 cells. This study allows for the exploitation of chemical markers with potential significance in discrimination of Solanum plants, and uncovers the diverse steroidal constituents from S. lyratum dedicated for its future application in cancer treatment.

Carotenoid-derived norsesquiterpenoids and sesquiterpenoids from Tagetes erecta L

Tagetes erecta L. (marigold), a common landscaping flower widely cultivated in America, Africa, Asia and Europe, is the fundamental source of carotenoids (especially lutein) in food and pharmaceutical industry. Carotenoids are well-known to possess various healthy and beneficial biological activities such as eye protection, anti-aging, and anti-inflammatory. In our exploitation of carotenoid-derived products from T. erecta, nine previously undescribed compounds including seven megastigmane-type norsesquiterpenoids (1-7), one carotenoid-derived sesquiterpenoid (8), and one natural 3-hydroxyl-α-ionylideneacetic acid derivative (9), along with twelve known compounds (10-21), were afforded from the 95% ethanol extract of the petals of T. erecta. Their planar chemical structures and the absolute configurations were established by analysis of the extensive spectroscopic data including HRESI-MS, 1D/2D NMR and the simulation of ECD. Further, a plausible biosynthesis pathway for compounds 1-20 is proposed.

A rare tetrahydroimidazopyridine from the marine-derived fungus Paraconiothyrium sp. YK-03

A new tetrahydroimidazopyridine named butyl (5R,6R,7S,8S)-5,6,7,8-tetrahydro-6,7,8-trihydroxy-5-(hydroxymethyl)imidazo[1,2-a]pyridine-2-carboxylate(1), together with eight known compounds (2-9), were isolated from the fermentation broth of a marine-derived fungus Paraconiothyrium sp. YK-03. Their chemical structures were elucidated by extensive analysis of one-dimensional and two-dimensional NMR spectroscopy, HR-ESIMS and optical rotation. Among these compounds, compound 1 represented a rare tetrahydroimidazopyridine, and compounds 2-7 were isolated from the Paraconiothyrium species for the first time. A plausible biosynthetic pathway for compound 1 was proposed.

[Clinical characteristics of COVID-19 Omicron variant infection in children with allergic diseases]

Objective: To analyze the clinical characteristics of infection of COVID-19 Omicron variants in children with allergic diseases. Methods: This was a cross-sectional retrospective study. A total of 657 pediatric patients with allergic diseases aged between 0-17 years confirmed with COVID-19 infection were enrolled from the Children's Hospital affiliated to Capital Institute of Pediatrics from January to March 2023. The median age was 6.6(4.7,9.9) years, with 443 males (67.4%) and 214 females (32.6%). Demographic data, vaccination status, clinical manifestations, therapeutic drugs, and other data were collected. The patients were then divided into different groups according to the age, type of allergic diseases and vaccination status, and their clinical characteristics were compared. Results: A total of 657 children with allergic diseases were included in this study, among them 568 with asthma. Fever is the most common symptoms after COVID-19 infection (627/657, 95.4%), and 509 children (77.5%) with high fever. Cough was observed in 446 (67.9%) and fatigue in 167 (25.4%) cases.10 cases (1.5%) were diagnosed as pneumonia. The proportion of pharyngalgia(22%,84/382, χ2=19.847, P<0.01), fatigue (31.7%, 121/382,χ2=23.831, P<0.01), headache(34.6%, 132/382,χ2=57.598, P<0.01), muscle joint pain(16.0%, 61/382,χ2=22.289, P<0.01) and vomiting(11.0%, 42/382,χ2=12.756, P<0.01) were highest in the>6 years group. Children younger than 3 years had the lowest proportion of runny nose(8.8%, 5/57,χ2=8.411, P<0.01), cough(45.6%, 26/57,χ2=6.287, P<0.05) and expectoration(7.0%, 4/57,χ2=5.950, P<0.05). 62.8%(137/218) of the patients in 3-6 year group had the highest rate of cough(χ2=6.287, P<0.05), with a higher proportion of wheezing (10.1%, 22/218). Cough and/or wheezing symptoms were most quickly relieved in the 6 year old group, who had a highest proportion of 68.8%(260/382) in duration of respiratory symptoms within 1 week compared with 52.2% (114/218)of 3-6 years group and 41.2% (22/57)of<3 year group, respectively(χ2=23.166, P<0.01). The asthma group had a significant higher proportion of cough(59.7% vs 41.6%, χ2=10.310, P<0.01), wheezing (8.5% vs 0.0%, χ2=8.114, P<0.01) and expectoration (19.2% vs 7.9%, χ2=10.310, P<0.01) than that of non-asthma group. Besides, patients with cough and/or wheezing in the asthma group had more impact on exercise and sleep (16.1% vs 0, χ2=5.436, P<0.05) and a longer duration over 4 weeks (25.1% vs 3.7%, χ2=6.244, P<0.05). Conclusions: The most common symptoms in children with allergy infected with COVID-19 Omicron variant were fever and cough. Children under 3 years of age had relatively fewer respiratory symptoms while those with asthma or aged 3-6 years were more likely to have cough and wheezing and longer duration of symptoms. The data suggested that the prevention and management of COVID-19 should be strengthened in children with allergy.

Furfural Derivatives and Phenolic Constituents in Stemona tuberosa Lour

Chemical investigation on the water-soluble constituents of Stemona tuberosa Lour. resulted in the isolation of a previously undescribed furfural derivative namely (S)-5-((R)-hydroxy(5-(hydroxymethyl)furan-2-yl)methyl)-5-methylfuran-2(5H)-one and twenty-five known compounds from the water decoction of the dried root tubers. Their structures were determined by analysis of the extensive spectroscopic data, including 1D/2D NMR, HR-ESI-MS, and ORD, as well as the ECD simulation and comparison. Most of them were phenolic and among them, four compounds were isolated from Stemona plants for the first time. This study uncovers diverse constituents from water decoction of S. tuberosa dedicated for its quality control and allows for the exploitation of chemical markers with potential significance for discrimination of Stemona plants.

Steroidal constituents from Solanum nigrum

Three previously undescribed steroidal constituents including two sterols (1-2) and one pregnane-type steroidal glycoside (6), along with nineteen known ones (3-5, 7-22), were isolated from the 80% alcohol extraction of Solanum nigrum L. Their structures and the absolute configurations were established by analysis of the extensive spectroscopic data (1H/13 NMR, 1H1H COSY, HSQC, HMBC, and NOESY), and/or by comparisons of the experimental electronic circular dichroism (ECD) spectra with those calculated ones by TDDFT method. Further, a MTT assay was applied to demonstrate that compounds 1-4, 6-12, 18, and 22 exhibited significant cytotoxic activities against SW480 cells, and compounds 1-4, 6-14, and 16-22 showed significant cytotoxic activities against Hep3B cells.

Degradation Profiling of Nardosinone at High Temperature and in Simulated Gastric and Intestinal Fluids

Nardosinone, a predominant bioactive product from Nardostachys jatamansi DC, is well-known for its promising therapeutic applications, such as being used as a drug on anti-inflammatory, antidepressant, cardioprotective, anti-neuroinflammatory, anti-arrhythmic, anti-periodontitis, etc. However, its stability under varying environmental conditions and its degradation products remain unclear. In this study, four main degradation products, including two previously undescribed compounds [2-deoxokanshone M (64.23%) and 2-deoxokanshone L (1.10%)] and two known compounds [desoxo-narchinol A (2.17%) and isonardosinone (3.44%)], were firstly afforded from the refluxed products of nardosinone in boiling water; their structures were identified using an analysis of the extensive NMR and X-ray diffraction data and the simulation and comparison of electronic circular dichroism spectra. Compared with nardosinone, 2-deoxokanshone M exhibited potent vasodilatory activity without any of the significant anti-neuroinflammatory activity that nardosinone contains. Secondly, UPLC-PDA and UHPLC-DAD/Q-TOF MS analyses on the degradation patterns of nardosinone revealed that nardosinone degraded more easily under high temperatures and in simulated gastric fluid compared with the simulated intestinal fluid. A plausible degradation pathway of nardosinone was finally proposed using nardosinonediol as the initial intermediate and involved multiple chemical reactions, including peroxy ring-opening, keto-enol tautomerization, oxidation, isopropyl cleavage, and pinacol rearrangement. Our findings may supply certain guidance and scientific evidence for the quality control and reasonable application of nardosinone-related products.

[Alertness and task processing speed impairment status and influencing factors of young-middle aged men with obstructive sleep apnea hypopnea syndrome]

Objective: To investigate the alertness and task processing speed impairment status in young-mild aged men with obstructive sleep apnea hypopnea syndrome (OSAHS), and analyze its influencing factors. Methods: This prospective study recruited 251 snoring patients aged 18 to 59 (38.9±7.6) years in the Sleep Center of the Second Affiliated Hospital of Soochow University from July 2020 to September 2021 and all patients were diagnosed by polysomnography (PSG). Clinical information, Epworth Sleepiness Scale (ESS) and PSG date were collected. All patients were assessed with the Montreal Cognitive Assessment (MoCA) questionnaires, Mini-mental State Examination (MMSE) and Computerized Neurocognitive Assessment System which includes the reaction time of Motor Screening Task (MOT) for alertness, the reaction time of pattern recognition memory (PRM), spatial span (SSP) and spatial working memory (SWM) for task processing speed. Based on AHI tertiles, all patients were divided into Q1 group (AHI<15 times/h, n=79), Q2 group (15 times/h≤AHI<45 times/h, n=88), and Q3 group (AHI≥45 times/h, n=84). The characteristics of clinical information, ESS, PSG parameters and cognitive scores among three groups were compared. Multiple linear stepwise regression was conducted to analyze the influencing factors of cognitive impairment. Results: There were no statistically significant differences in age, years of education, history of smoking and drinking, and past disease history (except for the prevalence of hypertension) among the 3 groups (P>0.05). There were statistically significant among-group differences in the body mass index (BMI), ESS, prevalence of hypertension and complaints of daytime sleepiness (P<0.05). Compared with Q1 and Q2 group, the arousal index (ArI), oxygen desaturation index (ODI),the proportion of non-rapid eye movement phase 1 and 2 (N1+N2) and percentage of total sleep time with oxygen saturation level<90% (TS90) of Q3 group were higher (all P<0.05). In the cognitive assessment, there was no statistically significant difference in the MoCA total and individual scores and MMSE scores among the three groups (P>0.05). Compared with the Q1 group, the task processing speed and alertness were worse in Q3 group, as shown by slower PRM immediate and delayed reaction time, SSP reaction time and MOT reaction time (all P<0.05). The total time of SWM in Q2 group was slower than that in Q1 group (P<0.05). Multiple linear stepwise regression showed that years of education (β=-40.182, 95%CI:-69.847--10.517), ODI (β=3.539, 95%CI: 0.600-6.478) were the risk factors of PRM immediate reaction time. Age(β=13.303,95%CI: 2.487-24.119), years of education(β=-32.329, 95%CI:-63.162--1.497), ODI (β=4.515, 95%CI: 1.623-7.407) were the risk factors of PRM delayed reaction time. ODI was the risk factor of SSP reaction time (β=1.258, 95%CI: 0.379-2.137). TS90 was the risk factor of MOT reaction time (β=1.796, 95%CI: 0.664-2.928). Conclusions: The early cognitive impairment in young-mild aged OSAHS patients was manifested in decreased alertness and task processing speed, and intermittent nocturnal hypoxia was its influencing factor in addition to age and years of education.

Phytochemistry, data mining, pharmacology, toxicology and the analytical methods of Cyperus rotundus L. (Cyperaceae): a comprehensive review

Cyperus rotundus L. has been widely used in the treatment and prevention of numerous diseases in traditional systems of medicine around the world, such as nervous, gastrointestinal systems diseases and inflammation. In traditional Chinese medicine (TCM), its rhizomes are frequently used to treat liver disease, stomach pain, breast tenderness, dysmenorrheal and menstrual irregularities. The review is conducted to summarize comprehensively the plant's vernacular names, distribution, phytochemistry, pharmacology, toxicology and analytical methods, along with the data mining for TCM prescriptions containing C. rotundus. Herein, 552 compounds isolated or identified from C. rotundus were systematically collated and classified, concerning monoterpenoids, sesquiterpenoids, flavonoids, phenylpropanoids, phenolics and phenolic glycosides, triterpenoids and steroids, diterpenoids, quinonoids, alkaloids, saccharides and others. Their pharmacological effects on the digestive system, nervous system, gynecological diseases, and other bioactivities like antioxidant, anti-inflammatory, anti-cancer, insect repellent, anti-microbial activity, etc. were summarized accordingly. Moreover, except for the data mining on the compatibility of C. rotundus in TCM, the separation, identification and analytical methods of C. rotundus compositions were also systematically summarized, and constituents of the essential oils from different regions were re-analyzed using multivariate statistical analysis. In addition, the toxicological study progresses on C. rotundus revealed the safety property of this herb. This review is designed to serve as a scientific basis and theoretical reference for further exploration into the clinical use and scientific research of C. rotundus.

Graphical Abstract

Supplementary Information

The online version contains supplementary materials available at 10.1007/s11101-023-09870-3.

[Reference values and growth curves of length for weight and head circumference for weight among Chinese newborns]

Objective: To establish the reference values and growth curves of length for weight and head circumference for weight among Chinese newborns in order to provide a reference for the assessment of body proportionality at birth. Methods: A cross-sectional design was applied. A total of 24 375 singleton live birth newborns with gestational ages at birth of 24⁺⁰ to 42⁺⁶ weeks were recruited from June 2015 to November 2018 from 13 cities including Beijing, Harbin, Xi'an, Shanghai, Nanjing, Wuhan, Guangzhou, Fuzhou, Kunming, Tianjin, Shenyang, Changsha, and Shenzhen, excluding those with maternal or newborn conditions that may impact the establishment of the reference values. The generalized additive model for location, scale, and shape was employed to establish reference values in terms of percentile and growth curves of length for weight and head circumference for weight for male and female newborns. The random forest machine learning method was employed to analyze the importance of variables between the established reference values in this study and the previous published weight/length, body mass index (BMI), ponderal index (PI), weight/head circumference, length/head circumference in the assessment of symmetrical and asymmetrical small for gestational age (SGA) newborns. Results: A total of 24 375 newborns with 13 197 male infants (preterm birth 7 042 infants and term birth 6 155 infants) and 11 178 female infants (preterm birth 5 222 infants and term birth 5 956 infants) were included in this study. The reference values in terms of percentile (P₃, P₁₀, P₂₅, P₅₀, P₇₅, P₉₀, P₉₇) and growth curves of length for weight and head circumference for weight were obtained for male and female newborns with gestational ages of 24⁺⁰ to 42⁺⁶ weeks. The median birth lengths corresponding to the birth weights of 1 500, 2 500, 3 000, and 4 000 g were 40.4, 47.0, 49.3 and 52.1 cm for males and 40.4, 47.0, 49.2, and 51.8 cm for females, respectively; the median birth head circumferences were 28.4, 32.0, 33.2 and 35.2 cm for males and 28.4, 32.0, 33.1, and 35.1 cm for females, respectively. The differences of length for weight between males and females were minimum, with the difference range of -0.3 to 0.3 cm at P₅₀; the differences of head circumference for weight between males and females were minimum, with the difference range of 0 to 0.2 cm at P₅₀. Based on the match between birth length and birth weight for classifying symmetrical and asymmetrical SGA, length for weight and PI contributed the most, accounting for 0.32 and 0.25, respectively; based on the match between birth head circumference and birth weight, head circumference for weight and weight/head circumference contributed the most, accounting for 0.55 and 0.12, respectively; based on the match between birth length or head circumference with birth weight, head circumference for weight and length for weight contributed the most, accounting for 0.26 and 0.21, respectively. Conclusion: The establishment of the new standardized growth reference values and growth curves of length for weight and head circumference for weight among Chinese newborns are useful for clinical practice and scientific research.

Santalane-type sesquiterpenoids and isobenzofuranones from cultures of Paraconiothyrium sporulosum YK-03

Three undescribed santalane-type sesquiterpenoids (parasantalenoic acids A-C) and two undescribed epimeric isobenzofuranones (paraphthalides A and B) were isolated from cultures of the marine mud-associated fungus Paraconiothyrium sporulosum YK-03. Their structures were elucidated by analysis of the extensive spectroscopic and crystal X-ray diffraction data, combined with ECD calculations and comparison. Santalane-type sesquiterpenoids have been firstly found in the Paraconiothyrium species. Parasantalenoic acids A-C represent three rare polyhydroxylated santalane-type sesquiterpenoid carboxylic acids, and parasantalenoic acid A represents the first example of 2-chlorinated santalane-type sesquiterpenoid. A plausible biosynthetic pathway for parasantalenoic acids A-C was proposed. Additionally, the anti-neuroinflammatory activities of parasantalenoic acids A-C were investigated by evaluating their inhibitory effects on nitric oxide (NO) production in lipopolysaccharide (LPS)-stimulated BV-2 microglia cells. Among them, parasantalenoic acid C showed significant anti-neuroinflammatory activity with an inhibition of 86.45 ± 2.45% at 10 μM.

Sesquiterpenoids and monoterpenoids from the water decoction of Valeriana officinalis L

Nine previously undescribed compounds including three sesquiterpenoids, three iridoids, two monoterpenoids and a furan fatty acid, along with seventeen known ones, were isolated from the water decoction of roots and rhizomes of Valeriana officinalis L. Structure elucidation of the twenty-six compounds were accomplished by analysis of the extensive spectroscopic data, and the absolute configurations of the nine previously undescribed ones were established by NOESY experiment and the electronic circular dichroism (ECD) simulations. Among them, β-patchoulene-8-O-β-D-glucopyranoside, 11-methoxyl-viburtinal, and protocatechuic acid showed anti-neuroinflammatory potentials by significantly inhibiting the secretion of nitric oxide (NO) on BV-2 cells upon LPS stimulation (p < 0.001) without affecting the cell viability.

Phytochemical and pharmacological studies on Solanum lyratum: a review

Solanum lyratum is one of the temperate plants, broadly distributed in Korea, China, Japan, India, and South-East Asia and well-documented in those oriental ethnic medicine systems for curing cancers, jaundice, edema, gonorrhea, cholecystitis, phlogosis, rheumatoid arthritis, etc. This review systematically summarized the research progress on S. lyratum respecting the botany, traditional uses, phytochemistry, pharmacology, and toxicology to increase people's in-depth understanding of this plant, by data retrieval in a series of online or off-line electronic databases as far as we can reach. Steroidal saponins and alkaloids, terpenoids, nitrogenous compounds, and flavonoid compounds are the main chemical constituents in S. lyratum. Among them, steroidal alkaloids and saponins are the major active ingredients ever found in S. lyratum, exerting activities of anti-cancer, anti-inflammation, anti-microbial, anti-allergy, and anti-oxidation in vivo or in vitro. As a result, S. lyratum has been frequently prescribed for the abovementioned therapeutic purposes, and there are substantial traditional and modern shreds of evidence of its use.

Aristolone in Nardostachys jatamansi DC. induces mesenteric vasodilation and ameliorates hypertension via activation of the KATP channel and PDK1-Akt-eNOS pathway

BACKGROUND

Nardostachys jatamansi DC. is a common medicinal herb used to treat cardiovascular diseases, particularly hypertension. Previously, our lab characterized the chemical compounds of N. jatamansi. However, the bioactive compounds of N. jatamansi and their mechanisms of action on blood pressure and blood vessels are unknown.

PURPOSE

The vasorelaxant effects of the methanolic extract (MeOH ext.) of the roots and rhizomes of N. jatamansi, its main compounds, and their underlying mode of action, were investigated.

METHODS

The main compounds of N. jatamansi were isolated and identified using UHPLC-TOF MS. The antihypertensive effect of N. jatamansi extracts and (-)-aristolone were determined using spontaneously hypertensive rats. The extracts, fractions, and compounds were also evaluated for their vasorelaxant effects on U46619 contractile responses in isolated thoracic aortic and mesenteric arterial rings. The endothelial-dependent relaxation, as well as the regulatory pathways and targets of (-)-aristolone, were studied in-vitro and ex-vivo. Molecular docking and biophysical characterization (Surface plasmon resonance) studies were utilized to investigate the molecular interaction between (-)-aristolone and the target protein.

RESULTS

MeOH ext. (200 mg/kg) reduces the systolic and diastolic blood pressure in spontaneously hypertensive rats. MeOH ext. and its ethyl acetate fraction (EtOAc Fr.), but not the H₂O fraction, had a significant relaxing effect on the thoracic aorta. (-)-aristolone and kanshone H from EtOAc Fr. induced vasorelaxation of the thoracic aorta and mesenteric artery. In human umbilical vein endothelial cells, (-)-aristolone treatment upregulated phosphorylation of Akt (T308) and eNOS. Molecular docking and surface plasmon resonance experiments revealed an interaction between (-)-aristolone and phosphoinositide-dependent protein kinase 1 (PDK1), an upstream protein kinase that phosphorylates Akt at T308. Treatment with PDK1 inhibitor PHT-427 and eNOS inhibitor L-NAME consistently inhibited (-)-aristolone-induced vasorelaxation. In addition, K_ATP channel inhibitor glibenclamide dramatically inhibited the vasorelaxant effects of (-)-aristolone and kanshone H in the endothelium-denuded thoracic aorta. Finally, (-)-aristolone lowers hypertensive rats' systolic and diastolic blood pressure.

CONCLUSIONS

The extracts of N. jatamansi promote vasorelaxation and alleviate hypertension. The essential chemicals responsible for producing vasorelaxation effects are (-)-aristolone and kanshone H, which activate the PDK1-Akt-eNOS-NO relaxing pathway and stimulate the opening of the K_ATP channel. These findings point to N. jatamansi and aristolone as possible antihypertensive agents.

[Clinical characteristics of patients with obstructive sleep apnea hypopnea syndrome combined with alveolar hypoventilation]

Objective: To evaluate the clinical characteristics of patients with obstructive sleep apnea hypopnea syndrome (OSAHS) combined with alveolar hypoventilation. Methods: This retrospective study included patients who were diagnosed as OSAHS by polysomnography (PSG) and underwent daytime awake transcutaneous carbon dioxide (PtcCO₂) monitoring from November 2019 to February 2021 at the Sleep Center of the Second Affiliated Hospital of Soochow University. A total of 177 patients were enrolled in the analysis, including 167 males and 10 females, aged (40±8) years old. Patients with daytime awake PtcCO₂>45 mmHg (1 mmHg=0.133 kPa) were diagnosed as daytime alveolar hypoventilation, with which participants were divided into the daytime alveolar hypoventilation group and non-daytime alveolar hypoventilation group. Body mass index (BMI) cut-off value predicting daytime alveolar hypoventilation was calculated and the patients were divided into the high BMI group and low BMI group. The continuous nocturnal PtcCO₂ data was available for a subset of 128 patients, and the patients were divided into two groups according the daytime alveolar hypoventilation or not. Across-group differences were compared, respectively. Results: Compared with the non-daytime alveolar hypoventilation group (n=125), the BMI [27.57 (26.55, 30.33) vs 26.60 (25.06, 28.09) kg/m²], Epworth sleepiness score(ESS) score [9.50 (6.25, 12.00) vs 7.00 (4.00, 10.75)], higher oxygen desaturation index (ODI) [38.00 (15.23, 64.93) vs 26.80 (11.30, 44.30) events/h] and percentage of total time with oxygen saturation level<90% (TS90%) [11.24% (1.88%, 32.44%) vs 4.35% (0.72%, 9.87%)] of the daytime alveolar hypoventilation group(n=52) were significantly higher (P<0.05), and lowest arterial oxygen saturation (LSaO₂) [74.50% (60.25%, 82.00%) vs 79.00% (73.00%, 84.50%)], mean arterial oxygen saturation (MSaO₂) [94.00% (91.00%, 95.00%) vs 95.00% (94.00%, 96.00%)] were significantly lower (P<0.05). The BMI cut-off value for predicting daytime alveolar hypoventilation was 27.04 kg/m². Of the 177 enrolled patients, 90 were in the high BMI group and 87 were in low group. Compared with the low BMI group, the proportion of daytime sleepiness, the ESS score, the prevalence of hypertension, AHI and daytime awake PtcCO₂ in the high BMI group were significantly higher (P<0.05). Among the subset of 128 patients with nocturnal PtcCO₂ data available, the BMI, daytime PtcCO₂ level, the nocturnal CO₂ level and the prevalence of sleep related alveolar hypoventilation in the daytime alveolar hypoventilation group (n=40) were significantly higher than those in the non-daytime alveolar hypoventilation group (n=88) (P<0.05). Conclusions: The OSAHS patients with alveolar hypoventilation have higher BMI and more severe nocturnal hypoxia. OSAHS patients with BMI>27.04 kg/m² are more likely to develop sleep related alveolar hypoventilation disorder.

[Focus on the importance of classification of hyperglycemia in pregnancy and diagnostic criteria for gestational diabetes mellitus]

Hyperglycemia in pregnancy (HIP) is the most common pathological obstetric disease. However, there is no uniform standard in the world for classification of HIP and diagnosis of gestational diabetes mellitus(GDM). This article will analyze this issue and support the International association of diabetes and pregnancy study group(IADPSG) criteria as a global standard for diagnosing GDM,also support HIP should be divided into four categories: PGDM, ODM, GDM and prediabetes, so as to refine clinical management.

Polyhydroxylated bergamotane-type sesquiterpenoids from cultures of Paraconiothyrium sporulosum YK-03 and their absolute configurations

Eight undescribed polyhydroxylated bergamotane-type sesquiterpenoids with bicyclic, tricyclic and tetracyclic systems, namely sporulamides A-D, sporulosoic acids A-B and sporuloketals A-B, along with three known analogs were isolated from cultures of the marine mud-associated fungus Paraconiothyrium sporulosum YK-03. The chemical structures of these sesquiterpenoids were elucidated by the extensive spectroscopic techniques of NMR and HR-ESI-MS. Assisted by the X-ray crystallography analysis and electronic circular dichroism (ECD) spectroscopic calculation and comparison, their absolute configurations were established. Sporuloketals A-B represent two rare tetracyclic bergamotanes. It's the first time that ECD empirical rules have been successfully verified and applied for determining the absolute configurations of these bergamotane-type sesquiterpenoids.

Prunus cerasoides Extract and Its Component Compounds Upregulate Neuronal Neuroglobin Levels, Mediate Antioxidant Effects, and Ameliorate Functional Losses in the Mouse Model of Cerebral Ischemia

Prunus cerasoides (PC) has been reported to have antimicrobial and anti-inflammatory properties, but its potential as a neuroprotective agent in a mouse model of cerebral ischemia has not been explored. Considering neuroglobin (Ngb), an endogenous neuroprotective factor, as a novel approach to neuroprotection, in this study, Ngb promoter activity, Ngb expression changes, and antioxidant protection by PC extract (PCE) and PC component compounds (PCCs) were analyzed in oxygen–glucose deprivation (OGD)-treated neurons. In vivo analysis involved transient middle cerebral artery occlusion (tMCAO) in mice with pre- and post-treatment exposure to PCE. Following ischemic stroke induction, neurological behavior scores were obtained, and cellular function-related signals were evaluated in the ischemic infarct areas. In addition to PCE, certain component compounds from PCE also significantly increased Ngb levels and attenuated the intracellular ROS production and cytotoxicity seen with OGD in primary neurons. Administration of PCE reduced the infarct volume and improved neurological deficit scores in ischemic stroke mice compared with the vehicle treatment. Increased Ngb levels in infarct penumbra with PCE treatment were also accompanied by decreased markers of apoptosis (activated p38 and cleaved caspase-3). Our findings point to the benefits of Ngb-mediated neuroprotection via PCE and its antioxidant activity in an ischemic stroke model.

A review on traditional uses, phytochemistry, pharmacology, toxicology and the analytical methods of the genus Nardostachys

ETHNOPHARMACOLOGICAL RELEVANCE

The plants of the genus Nardostachys (Caprifoliaceae) have been used for a long history in different cultural systems of medicine, including Chinese, Ayurvedic, Korean folk medicine and Islamic, for treatments of disorders in nervous, digestive, cardiovascular and integumentary systems.

AIM OF THE REVIEW

This review aims to provide comprehensive information on Nardostachys plants including botany update, traditional uses, data mining of uses in traditional Chinese medicine (TCM) and current Chinese medicinal patents, chemical constituents, pharmacological effects, toxicity and analytical method studies.

MATERIALS AND METHODS

Studies of the genus Nardostachys were collected via Google Scholar and Baidu Scholar, ScienceDirect, SciFinder, Wiley Online Library, ACS Publications, NLM/NCBI, Web of Science, CNKI, WANFANG DATA, EMBASE, Huabeing database and Traditional Chinese Medicine Resource Network and libraries. Some local books, PhD or MS's dissertations were also included. The literatures cited in this review covered the period from 1962 to March 2021. The Plant List and Kew Herbarium Catalogue databases were used to authenticate the scientific name.

RESULTS

Botany description of Nardostachys genus is updated. Analysis of the literatures indicates that Nardostachys species are valuable herbs with therapeutic potentials for various disorders. Data mining on ancient TCM prescriptions and current Chinese medicinal patents containing Nardostachys revealed its common compatibility with other herbs in China. Phytochemical studies identified terpenoids and phenolic compounds as the main constituents in the genus Nardostachys and sesquiterpenoids as the major bioactive components. Experimental studies demonstrated that crude extracts, major fractions and the main constituents from Nardostachys species mainly exhibited pharmacological activities on nervous, digestive, cardiovascular and skin systems. Further, in vivo and in vitro toxicological studies demonstrated that Nardostachys plants showed either no or low toxicities, except at high doses. Finally, methods of qualitative and quantitative analyses on chemical constituents of genus Nardostachys were summarized, including TLC/HPTLC, GC and HPLC/UPLC methods, combined with common detectors including PDA, DAD and MS.

CONCLUSIONS

This review summarizes the progress on phytochemistry, pharmacology, toxicology and analytical methods of the genus Nardostachys. Studies demonstrate traditional uses of the genus Nardostachys, and reveal novel bioactive effects for clinical uses. These achievements expand our knowledge on the genus Nardostachys and its clinical value.

[Effects of daytime hypercapnia on logical memory and working memory in patients with obstructive sleep apnea hypopnea syndrome]

Objective: To investigate the effects of daytime hypercapnia on logical memory and working memory in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods: This prospective study recruited patients complaining of snoring and diagnosed with OSAHS at the Sleep Center of the Second Affiliated Hospital of Soochow University from January to November 2020. Patients were assessed clinically and scored for their memory function. All patients underwent daytime transcutaneous carbon dioxide (PtcCO₂) test, and overnight polysomnography (PSG). Logical memory was scored using the Logical Memory Test (LMT), while working memory was evaluated by Digit Span Test (DST) and Cambridge Neuropsychological Test Automated Battery (CANTAB) which included Pattern Recognition Memory (PRM), Spatial Span (SSP), and Spatial Working Memory (SWM). Patients were divided into the normocapnic group and the hypercapnic group using the daytime PtcCO₂ test. The clinical and PSG parameters and the memory test scores between the two groups were compared. Binary logistic stepwise regression was conducted to identify risk factors of memory impairment in OSAHS patients. Results: Among the 123 enrolled OSAHS patients, 79 were normocapnic and 44 were hypercapnic. There was no significant difference in the general clinical parameters between the two groups. The snoring history in years in the hypercapnic group was longer than that in the normocapnic group (P<0.05). Compared with the normocapnic group, the apnea-hyponea index (AHI), oxygen desaturation index (ODI) and percentage of total sleep time with oxygen saturation level<90% (TS90) of the hypercapnic group were higher (all P<0.05), while other PSG parameters exhibited no statistically significant differences. There was no statistically significant difference in the immediate logical memory and PRM immediate accuracy rate between the two groups, while the delayed logical memory, verbal and spatial working memory, and executive function were worse in the hypercapnic group, as shown by lower total LMT scores, lower DST, lower SSP scores (all P<0.05), and higher between errors and strategy scores (P<0.01) of SWM in the hypercapnic group. Binary logistic stepwise regression showed that PtcCO₂ ≥45 mmHg (1 mmHg=0.133 kPa, OR=3.055, 95%CI 1.359-6.868, P=0.007) and higher body mass index (BMI) (OR=1.132, 95%CI 1.005-1.275, P=0.041) were risk factors for poor performance in Digit Span Backwards Test. Therefore, PtcCO₂ ≥45 mmHg was an independent risk factors for poor performance in delayed LMT, SSP, and between errors and strategy scores in SWM (OR=3.109, 3.941, 3.238 and 2.785, respectively, all P<0.05). Conclusion: Hypercapnia had negative impacts on logical memory and working memory of OSAHS patients, especially on the delayed logical memory, verbal working memory and spatial working memory impairment.

[Relationship between emotional apathy and motor symptoms, sleep and cognitive function in patients with early Parkinson's disease]

Objective: To study the relationship between emotional apathy and motor symptoms, sleep, and cognitive function in patients with early Parkinson's disease (PD). Methods: One hundred and twenty-nine early PD patients who were treated in the Second Affiliated Hospital of Soochow University from June to October 2020 were included, including 82 male and 47 female patients. The emotional apathy was assessed by modified apathy rating scale (MAES). The above 129 patients were divided into 67 patients in the PD with emotional apathy group (MAES>14 points) and 62 patients in the PD without emotional apathy group (MAES≤ 14 points). Age, gender, course of disease and levodopa equivalent dose were also collected. Hoehn-Yahr stage and unified Parkinson's disease rating scale PartⅢ(UPDRS-Ⅲ), Pittsburgh Sleep Quality Index (PSQI), polysomnography, and Montreal Cognitive Assessment Scale (MoCA) were used to evaluate the motor symptoms, sleep and cognitive functions of patients with early PD, and the clinical characteristics of patients with early PD with apathywere determined. Results: Compared with PD patients without apathy, those with apathy had longer disease duration [M(Q₁,Q₃)][5.0 (3.0, 7.0) years vs 3.0 (2.0, 5.0) years, P=0.006] and severer motor symptoms [20.0 (10.0, 28.0) vs 14.0 (8.5, 23.0), P=0.047]. There was no significant difference in PSQI score between the two groups. Among the 33 patients who completed polysomnography, compared with PD patients without apathy (n=16), those with apathy (n=17) had a longer rapid eye movement (REM) sleep latency [150 (124, 184) min vs 87 (57, 133) min, P=0.035)] and more frequent periodic limb movements in the REM phase(P=0.042).The REM sleep ratio (r=0.373, P=0.042), apnea-hypopena index (AHI)(r=0.374, P=0.046) and oxygen deficit index (r=0.409, P=0.025) were positively correlated with the degree of apathy in PD patients. PD patients with apathy had relatively poorer performance in cognition assessment than those without apathy and total MoCA score was inversely correlated with the degree of apathy (r=-0.231, P=0.017). Conclusion: Early PD patients with apathy have objective sleep disorders dominated by REM sleep disorders, which can have a negative impact on cognitive function.

Antidepressant activities and regulative effects on serotonin transporter of Nardostachys jatamansi DC

ETHNOPHARMACOLOGICAL RELEVANCE

Nardostachys jatamansi (D.Don) DC. (family Caprifoliaceae, NJ) is well-documented and commonly used in the systems of traditional medicine in China, Tibet, Nepal, Bhutan, India and Japan for curing digestive and neuropsychiatric disorders with a long history of medication. However, the possible action mechanisms of antidepressant effects of NJ remain unraveled.

AIM OF THE STUDY

The aim of this study was to systematically investigate chemical substances of NJ and their effects on serotonin transporter (SERT) in antidepressant activity.

MATERIALS AND METHODS

Antidepressant effects of total methanol extract of NJ were evaluated by tail suspension test (TST) and open field test (OFT). Then the total extract was analyzed by ultra-high-performance liquid chromatography (UHPLC) method, and its effect on SERT activity was evaluated by high content assay (HCA) to determine half maximal effective concentration (EC₅₀). This total extract was subfractioned into twenty subfractions by preparative high-performance liquid chromatography (p-HPLC) method, and 'subfraction-SERT activity' relationship curve was fitted with medians of the retention time of those subfractions and their SERT activity values. Then, the fraction NJFr.01 enriched with SERT enhancers was optimized, prepared and analyzed by UHPLC method. Antidepressant effects of the fraction NJFr.01 were evaluated by TST and OFT. Further, major constituents of the total extract and fraction NJFr.01 were isolated by p-HPLC and identified by extensive nuclear magnetic resonance (NMR) analyses and comparisons with those reported data, and their SERT activities were also evaluated. Finally, antagonistic effects of chlorogenic acid and desoxo-narchinol A against fluoxetine on SERT were evaluated.

RESULTS

Results of TST and OFT demonstrated antidepressant effects of toatal extract of NJ. The EC₅₀ of total extract on SERT enhancement was 31.63 μg/mL. The fitted 'subfraction-SERT activity' relationship curve revealed that fraction NJFr.01 was enriched with SERT enhancing constituents. Both total extract and fraction NJFr.01 significantly enhanced SERT activity, while the rest fraction NJFr.02 didn't show any SERT activity. Then, antidepressant effects of fraction NJFr.01 were demonstrated by TST and OFT. Further, phytochemistry investigation and UHPLC analyses confirmed the identification of fourteen constituents in the total extract of NJ, including 7-oxonardinoperoxide (1), desoxo-narchinol A (2), kanshone B (3), narchinol B (4), nardosinonediol (5), kanshone A (6), 1-hydroxylaristolone (7), debilon (8), nardosinone (9), kanshone H (10), 1,8,9,10-tetradehydroaristolan-2-one (11), (-)-aristolone (12), 1(10)-aristolene-2-one (13) and jatamol A (14), and seven constituents in the fraction NJFr.01, including chlorogenic acid (15), 8α-dihydrogeniposide (16), 7-deoxy-8-epi-loganic acid (17), adoxosidic acid (18), 8-epi-loganic acid (19), 8α-6,7-dihydroapodantheroside acetate (20) and 6″-acetylpatrinalloside (21). Their structures were established by NMR analyses and comparisons with those reported data. HCA results of these constituents demonstrated the major components of fraction NJFr.01 enhanced SERT activity. Antagonistic results showed that chlorogenic acid and desoxo-narchinol A reversed inhibition effect of fluoxetine on SERT activity.

CONCLUSION

This study first systematically expatiated the roles of SERT activity in antidepressant effects of NJ, including total methanol extract and the water-soluble fraction NJFr.01 enriched with SERT enhancing constituents. This is the first report of natural SERT enhancing extract and fractions with antidepressant potential in NJ.

[Reference values and growth curves of weight/length, body mass index, and ponderal index of Chinese newborns of different gestational ages]

Objective: To establish the reference values and growth curves of weight/length, body mass index, and ponderal index for Chinese newborns with gestational ages of 24 to 42 weeks, in order to provide a reference for the assessment of body proportionality and nutritional status at birth. Methods: Cross-sectional study design was applied. From June 2015 to November 2018, a total of 24 375 singleton live birth newborns with gestational ages of 24 to 42 weeks from 13 cities including Beijing, Harbin, Xi'an, Shanghai, Nanjing, Wuhan, Guangzhou, Fuzhou, Kunming, Tianjin, Shenyang, Changsha, and Shenzhen were selected, excluding those impacting the establishment of the reference values. The generalized additive model for location, scale, and shape (GAMLSS) was employed to establish percentile (P₃, P₁₀, P₂₅, P₅₀, P₇₅, P₉₀, P₉₇) reference values and growth curves of weight/length, body mass index, and ponderal index for male and female newborns with gestational ages of 24 to 42 weeks. The established growth standards in this study were compared with the standards from the 1988 Chinese data, the INTERGROWTH project, and the USA reference values. Results: A total of 24 375 newborns with 12 264 preterm newborns (7 042 males and 5 222 females) and 12 111 full-term newborns (6 155 males and 5 956 females) were included in this study. The percentile reference values and growth curves of weight/length, body mass index, and ponderal index were obtained for male and female newborns with gestational ages of 24 to 42 weeks. Weight/length of males in all gestational ages at P₁₀, P₅₀ and P₉₀ was 0 to 0.2 kg/m higher than that of females, and body mass index of males in all gestational ages at the P₁₀, P₅₀ and P₉₀ was 0.1 to 0.3 kg/m² higher than that of females. The established growth curves of weight/length and body mass index at the upper percentile and ponderal index at both upper and lower percentiles were greatly different from those of the 1988 Chinese data, which, for example, reported the difference ranges at P₉₀ as -1.09 to 0.40 kg/m for weight/length, -1.19 to 0.92 kg/m² for body mass index, and -0.64 to 0.81 kg/m³ for ponderal index. The established weight/length curves were generally consistent with the reference values from the INTERGROWTH project with a difference of -0.17 to 0.20 kg/m at P₅₀, while being 0.02 to 0.40 kg/m lower at P₉₀ and 0.13 to 0.41 kg/m higher at P₁₀ than that of the INTERGROWTH reference values at gestational ages of ≤32 weeks. The established body mass index curves differed from that of the USA reference values with a difference of -0.47 to 0.17 kg/m² at P₅₀, while being 0.53 to 1.10 kg/m² lower at gestational ages of ≥37 weeks but 0.17 to 0.45 kg/m² higher at gestational ages of ≤28 weeks than that of the USA reference values at P₉₀. Conclusion: The establishment of the new standardized growth reference values of weight/length, body mass index, and ponderal index for Chinese newborns by different gestational ages are useful for clinical practice and scientific research.

[Timing of permanent tooth emergence and its association with physical growth among children aged from four to seven years in nine cities of China]

Objective: To investigate the timing of permanent tooth emergence and its association with physical growth among children aged 4-7 years in 9 cities of China, and to analyze the trend of permanent teeth development. Methods: According to a stratified cluster sampling design, a cross-sectional survey on the timing of permanent tooth emergence children aged 4-7 years was carried out in 9 cities (Beijing, Harbin and Xi'an in northern China; Shanghai, Nanjing and Wuhan in central China; Guangzhou, Fuzhou and Kunming in southern China) from June to October in 2015. A total of 37 973 children (19 035 boys and 18 938 girls) were recruited and were divided into different age groups (4.0-<4.5, 4.5-5.0, 5.0-5.5 and 6.0-<7.0 years of age). The situation of the exfoliation of primary teeth and the eruption of permanent teeth were investigated. Height and weight were measured using the standardized methods. Z-scores of physical growth indicators were calculated using the growth standards for Chinese children in 2009. Probit regression analysis was used to determine the median and percentile age of transition from deciduous to permanent teeth. Chi-square test was used for comparison of categorical data and t test was used for comparison of measurement data between boys and girls, urban and suburban as well as among different ages and regions. Meanwhile, the data from the national survey on physical growth and development of children under 7 years of age in 9 cities of China in 1995 were used to analyze the trends of the permanent teeth development. Results: The rate of transition from deciduous to permanent teeth in 37 973 children aged 4-7 years was higher with age, which was 0.6% (42/7 568) in 4.0-<4.5 years of age group, 30.3% (2 295/7 583) in 5.5-<6.0 years of age group, and 74.5% (5 680/7 627) in 6.0-<7.0 years of age group. The rates of transition from deciduous to permanent teeth in boys were all lower than those of girls except for children aged 4.0-<4.5 years (all P<0.01). The rate of transition from deciduous to permanent teeth in urban children was higher than that in suburban children for older than 5.5-6.0 years of age group in boys and older than 4.5-5.0 years of age group in girls, which was 74.2% (1 427/1 924) in urban boys aged 6.0-<7.0 years and 69.2% (1 305/1 885) in suburban boys aged 6.0-<7.0 years (χ(2)=11.446, P<0.01). The age of transition from deciduous to permanent teeth was 6.00 (95%CI: 5.98-6.01) years and the range of the 3-97 percentile was 4.88-7.11 years of age. The median permanent tooth emergence age of girls was lower than that of boys (5.94 vs. 6.06 years) and the median age of urban children was lower than that of suburban children (5.94 vs. 6.05 years). The median permanent tooth emergence age of southern Chinese children (6.05 years) was higher than that of northern (5.97 years) and central Chinese children (5.97 years). The weight for age Z-scores (WAZ), height for age Z-scores (HAZ) and body mass index for age Z-scores (BMIZ) of children with transition from deciduous to permanent teeth (0.35±1.17, 0.32±1.00, 0.23±1.16) were significantly higher than those of children without transition from deciduous to permanent teeth (0.03±1.13, 0.03±1.02, 0.04±1.13, t=20.81,21.67,12.09, all P<0.05). In comparison with the data in 1995, data in 2015 showed that the rate of transition from deciduous to permanent teeth was higher, for example, the rate of urban boys aged 6.0-<7.0 years group was 63.8% (1 146/1 796) in 1995, and increased to 74.2% (1 427/1 924) in 2015 (χ(2)=46.748, P<0.01). The median permanent tooth emergence age decreased by 0.24 years in 2015 as compared with that in 1995. Conclusions: The development of permanent teeth is earlier in girls than in boys, earlier in urban children than in suburban children and slightly delay in southern children than in central and northern Chinese children. In addition, the development of permanent teeth, which is related to the physical growth, slightly accelerate in China during the past 20 years.

[Survey on the stunting of children under seven years of age in nine cities of China]

Objective: To survey the children under 7 years of age in nine cities of China for a better understanding of the current situation of childhood stunting. Methods: According to a stratified cluster sampling design, a cross-sectional survey on children under 7 years of age was carried out in 9 cities (Beijing, Harbin and Xi'an in northern China; Shanghai, Nanjing and Wuhan in central China; and Guangzhou, Fuzhou and Kunming in southern China) from June to November in 2016. A total of 110 499 children were recruited. Height of children was evaluated using the growth standards for Chinese children (2009 edition) .Children with height less than the 3rd percentile of the growth standards were considered as stunting, and children with height between the 3rd and 10th percentiles of the growth standards were considered as relatively short stature. Chi-square test was used for comparison between data of boys and girls, urban and suburban, as well as among different ages and regions. Results: Totally 113 084 children under 7 years of age should be investigated and actually 110 499 children were investigated, with a rate of 97.7%. The prevalence of stunting was 1.9% (2 141/110 499) among all the children. The prevalence of stunting in urban children (1.6%, 904/55 524) was lower than that in suburban children (2.3%, 1 237/54 975, χ(2)=56.246, P<0.01). The gender difference in stunting prevalence was not statistically significant (1.9% (1 121/57 921) in boys and 1.9% (1 020/52 578) in girls, χ(2)=0.003, P=0.965). The prevalence of stunting decreased with age for children younger than 3 years, from 1.8% (312/17 080) in 0-<1 year of age group to 1.2% (168/13 740) in 2-<3 years of age group, but increased to 2.2% (240/11 073) at 6-<7 years group. Comparison among different regions showed that the stunting prevalence in southern region was higher than those in the central and northern regions (0.9% (193/20 374) in northern urban, 0.8% (154/18 486) in central urban, and 3.3% (557/16 664) in southern urban children), showing a statistical significance (χ(2)=437.736, P<0.01); 1.1% (241/21 924) in northern suburban, 1.4% (227/16 775) in central suburban and 4.7% (769/16 276) in southern suburban children, showing a statistical significance (χ(2)=646.533, P<0.01). In urban areas, the difference between the central and northern regions showed no statistical significance (χ(2)=1.429, P=0.232) and the stunting prevalence of central Chinese children was slightly higher than that of northern Chinese children in suburban areas (χ(2)=5.130, P=0.024). Among the nine cities, the stunting prevalence of Guangzhou (6.1%, 613/10 019) was higher than those of other cities (χ(2)=1 559.64, P<0.01). Among the stunting children, 78.4% (1 679/2 141) were classified as borderline or mild and only 7.2% (154/2 141) were classified as severe. The prevalence of relatively short stature was 5.2% (5 721/110 499). Conclusions: The prevalence of stunting among children under 7 years of age in nine cities of China is low and most of the stunting children were classified as mild; the prevalence of stunting in suburban children is higher than that in urban children; the gender difference show no statistical significance; and the prevalence of stunting in southern Chinese children is higher than those in central and northern Chinese children.

[Progress of interruption of schistosomiasis transmission in Jiangsu Province]

Schistosomiasis was once heavily endemic in Jiangsu Province. Following the control efforts for several decades, schistosomiasis was almost eradicated in all endemic counties in Jiangsu Province in 1980, and transmission control was achieved in the province in 2011. According to the principle of "implementing the control measures with adaptation to local circumstances and guiding the control programs with classified interventions", an integrated strategy with emphasis on the management of both infectious sources and snails has been recently employed for schitsosomiasis control in Jiangsu Province. In addition, a sensitive and highly effective surveillance system has been built and the application of novel techniques and information construction has been intensified to effectively interrupt the transmission of schistosomiasis in the Province. Transmission interruption of schistosomiasis was achieved in all endemic counties in Jiangsu Province. The paper summarizes the endemic situation of schistosomiasis, progress of schistosomiasis control, and major schistosomiasis control measures implemented during the stage of transmission interruption in Jiangsu Province.

Evaluation of the gestational diabetes mellitus diagnostic criteria recommended by the international association of diabetes and pregnancy study group for long-term maternal postpartum outcomes in mainland China

The gestational diabetes mellitus (GDM) diagnostic criteria recommended by the International Association of Diabetes and Pregnancy Study Group (IADPSG) were established based on the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study and have been the most commonly used criteria for determining GDM worldwide. Although individuals from mainland China were not included in the HAPO study, the IADPSG criteria have been used in China since 2011. However, the appropriateness of the criteria for evaluating maternal postpartum outcomes in mainland China are unknown. We conducted this study to determine whether the IADPSG criteria are appropriate for Chinese patients for evaluating long-term maternal postpartum outcomes.Eighty-four patients who were diagnosed with hyperglycemia during pregnancy and had delivery in Peking University First Hospital from February 2007 to December 2009 were enrolled in the study. For patients in Group A, GDM was diagnosed using both the National Diabetes Data Group (NDDG) and the IADPSG criteria, while patients in Group B, gestational impaired glucose tolerance (GIGT) was diagnosed using the NDDG criteria while GDM was diagnosed based on the IADPSG criteria. Anthropometric data, glucose metabolism, lipid profiles, β cell function, and insulin resistance index were evaluated and compared to baseline after 5- to 6-year postpartum period.Patients in group A had significantly higher oral glucose tolerance test (OGTT) fasting, 2-hour and 3-hour plasma glucose levels compared to patients in group B at 24 to 28 weeks of gestation (P < .05). No significant differences were observed between the groups for anthropometric data, postpartum abnormal glucose metabolism (50.91% vs 44.83%, P = .596), type 2 diabetes mellitus (T2DM) (16.36% vs 3.45%, P = .167), lipid profiles, β cell function (homeostasis model assessment β-cell function index (HOMA-β) 1.04 vs 0.99, P = .935) and insulin resistance (homeostasis model assessment insulin resistance index (HOMA-IR) 2.01 vs 1.69, P = .583).Patients diagnosed with GDM using either the NDDG or IADPSG criteria had abnormal glucose levels and lipid metabolism after delivery. Patients with mild hyperglycemia had similar postpartum β-cell functional impairment and insulin resistance to those with moderate hyperglycemia during pregnancy. Hence, with respect to maternal long-term postpartum outcomes, the IADPSG diagnostic criteria for GDM could be appropriate for patients in mainland China.

Estrogenic properties of Prunus cerasoides extract and its constituents in MCF-7 cell and evaluation in estrogen-deprived rodent models

Prunus cerasoides (PC) products contain relatively high levels of flavones and isoflavones and may be potential sources of phytoestrogens for postmenopausal symptom relief. We assessed the PC extract (PCE) and its representative constituents in vitro with assays for estrogen receptor alpha binding, estrogen response element transcriptional activity, cell proliferation, and gene expression changes for pS2 in MCF-7 cells. PCE and its compounds showed strong estrogen receptor binding affinities and estrogen response element induction. A previously undescribed compound (designated as compound 18), now identified as being gentisic acid, 5-O-β-D-(6'-O-trans-4-coumaroyl)-glucopyranoside, also showed potent estrogenic properties and induced proliferation of MCF-7 cells. PCE was evaluated for its in vivo uterotrophic effects in immature female rats as well as for its lipid lowering effects in estrogen-deprived animals. For ovariectomized rats and aged female mice, PCE-treated groups had lower plasma triglyceride levels compared with control and, for the same comparison, had reduced serum levels of liver stress/damage markers. Our results point to strong estrogenic activities and beneficial metabolic effects for PCE, with properties that put PC and its extracts as promising sources of phytoestrogens for symptom relief in menopausal and postmenopausal cases.

A magneto-microfluidic platform for fluorescence immunosensing using quantum dot nanoparticles

This study reports the online fluorescent detection of carcinoembryonic antigen (CEA) and α-fetoprotein (AFP) biomarker proteins in microfluidic channels using functional nanoparticles. Functional magnetic nanoparticles labeled with two antibodies were predeposited on separated microfluidic channels. Antigens were passed through each microfluidic channel to react with the respective antibodies. Two types of fluorescent nanoparticles labeled with antibodies were then used to detect and confirm antigens in the immunocomplex. Results indicate that online fluorescent detection of proteins can provide advantages for real-time monitoring and diagnostic applications. The running time was less than 20 min for each trial. The detection limits of CEA and AFP were found to be 0.6 and 0.2 pg ml^-1. These detection limits are lower than those of ELISA. The linear ranges of CEA and AFP detection were from 1.8 pg ml^-1 to 1.8 ng ml^-1 and from 0.68 pg ml^-1 to 0.68 ng ml^-1 for two deposition zones in a magnetic sandwich immunoassay. The linear ranges of this method are wider than those of ELISA and those of most other methods. The measurements of CEA and AFP in serum samples from this method differed from ELISA results by 11% and 9.4%, respectively. The detection limit of online detection has achieved the same range as those of previous offline detection. This method has a good potential for automation and multichannel analysis to increase the throughput with some modifications in the future. The proposed method can provide simple, fast, and sensitive online detection for biomarkers.

Bioactivities of serotonin transporter mediate antidepressant effects of Acorus tatarinowii Schott

ETHNOPHARMACOLOGICAL RELEVANCE

Acrorus tatarinowii Schott has been widely used in the treatments of neuropsychiatric and digestive disorders in clinical practices of traditional Chinese medicine for thousands of years. Both clinical and preclinical studies demonstrated antidepressant effects of A. tatarinowii. However, the possible action mechanisms of antidepressant effects of A. tatarinowii remain unraveled.

AIM OF THE STUDY

The present study aimed to investigate the roles of serotonin transporter (SERT) in antidepressant effects of A. tatarinowii.

MATERIALS AND METHODS

Antidepressant effects of water extract of A. tatarinowii were evaluated by forced swimming test (FST), tail suspension test (TST) and locomotor activity test. The water extract was analyzed by ultra high performance liquid chromatography (UPLC) method. Two major fractions of A. tatarinowii, petroleum ether extract and water extract after petroleum ether processed, were prepared and analyzed by UPLC method. Further, volatile oil extracted by ether extraction, solid phase micro-extraction (SPME) and hydro-distillation were compared and analyzed by gas chromatography-mass spectrometer (GC-MS) method. Finally, major constituents of water extract of A. tatarinowii were isolated by preparative high performance liquid chromatography (HPLC) and identified by extensive spectroscopic analyses. Effects of all of the above mentioned samples on SERT activity were tested by a high content assay (HCA).

RESULTS

Results of FST, TST and locomotor activity confirmed that water extract of A. tatarinowii significantly decreased mice immobility time but did not change mice locomotor activity. UPLC analysis results revealed that the water extract contained trace amount of β-asarone (0.0004206%) and α-asarone (0.0001918%). HCA results demonstrated that the water extract significantly enhanced SERT activity at 100 μg/mL. Further, GC-MS and UPLC analyses revealed that petroleum ether extract contained high content of β-asarone (45.63%) and α-asarone (12.50%). GC-MS analysis results demonstrated that the volatile oil extracted by ether extraction, SPME and hydro-distillation contained similar major components. HCA results verified that the petroleum ether extract significantly enhanced SERT activity at 1.56 μg/mL. Moreover, UPLC analysis of water extract after petroleum ether processed did not show any characteristic peaks. HCA results demonstrated that this extract significantly inhibited SERT activity at 50-100 μg/mL. Finally, phytochemistry investigation on the water extract of A. tatarinowii afforded seven constituents including veratric acid (9), anisic acid (7), 3,4,5-trimethoxybenzoic acid (3), trans-isoferulic acid (2), 2,4,5-trimethoxybenzoic acid (11), 4-hydroxybenzoic acid (6) and syringic acid (13). Their structures were established on the basis of nuclear magnetic resonance (NMR) and mass spectrometer (MS) data and comparative UPLC analyses. HCA results demonstrated the major components of the water extract of A. tatarinowii demonstrated SERT enhancement/inhibition activities.

CONCLUSIONS

This study first systematically demonstrated the roles of SERT activity in antidepressant effects of A. tatarinowii, including water extract, major fractions and main constituents. These results revealed that A. tatarinowii could regulate SERT activities in bidirectional ways.

[Development of primary teeth among infants and toddlers in nine cities of China in 2015]

Objective: To investigate the status of the development of primary teeth and to identify the development patterns among infants and toddlers in nine cities of China in 2015. Methods: Healthy children aged 1-<36 months were investigated by across-sectional survey and retrospective studies, which was carried out in 9 cities (Beijing, Harbin and Xi'an in northern China; Shanghai, Nanjing and Wuhan in central China; and Guangzhou, Fuzhou and Kunming in southern China) from June to October in 2015. Subjects (n=103 995) were divided into 14 age groups (1-<2, 2-<3, 3-<4, 4-<5, 5-<6, 6-<8, 8-<10, 10-<12, 12-<15, 15-<18, 18-<21, 21-<24, 24-<30, 30-<36 months). There were 150-200 boys and girls respectively in each group of urban and suburb areas in each city. The eruption status and the number of primary teeth were examined by the trained child health care physician or pediatrician on the spot. The timing of primary teeth eruption of children was retrospectively surveyed using a questionnaire. The prevalence of primary teeth was calculated and χ(2) test was used for comparison of categorical data. Probit regression analysis was used to determine the median and percentile age of eruption of primary teeth. Results: Totally 103 995 children aged 1-<36 months were investigated. There were 52 346 children in urban areas (boys 26 228, girls 26 118) and 51 649 children in suburb areas (boys 25 912, girls 25 737). The eruption rate of primary teeth in children under 2 years became higher with age and the difference among each age group was statistically significant (χ(2)=85 913.868, P<0.01), which was 0.3% (22/7 450) in 3-<4 months group, 43.0% (3 227/7 503) in 6-<8 months group and 99.9% (7 441/7 446) in 15-<18 months group. The eruption age of primary teeth was 6.6 months (95%CI: 6.5-6.7 months), and the range of the 3rd to 97th percentile was 4.1-10.6 months. The eruption ages of primary teeth in urban and suburb areas children were 6.6 months (95%CI: 6.5-6.7 months) and 6.6 months (95%CI: 6.5-6.7 months) respectively. The eruption age of primary teeth was earlier in boys (6.4 months, 95%CI: 6.3-6.5 months) than that in girls (6.7 months, 95%CI: 6.6-6.8 months). The median eruption age of primary teeth was earlier in northern China (6.2 months) than that in central (6.7 months) and southern China (6.9 months). The eruption rate of primary teeth became higher with age, showing that the median number of primary teeth was 2 in 8-<10 months group, 8 in 12-<15 months group and 20 in 30-<36 months group. Conclusions: The timing of eruption of primary teeth was similar between urban and suburb areas children and that of the boys was slightly earlier than that of the girls. There were slight differences among different regions in the eruption timing of primary teeth. The range of the 3rd to 97th percentile in the eruption age of primary teeth was 4.1-10.6 months and the number of primary teeth followed the regular development pattern with age.

Biomechanical study of injectable hollow pedicle screws for PMMA augmentation in severely osteoporotic lumbar vertebrae: effect of PMMA distribution and volume on screw stability

OBJECTIVEThe purpose of this study was to compare stability of injectable hollow pedicle screws with different numbers of holes using different volumes of polymethylmethacrylate (PMMA) in severely osteoporotic lumbar vertebrae and analyze the relationship between screw stability and distribution and volume of PMMA.METHODSForty-eight severely osteoporotic cadaveric lumbar vertebrae were randomly divided into 3 groups-groups A, B, and C (16 vertebrae per group). The screws used in group A had 4 holes (2 pairs of holes, with the second hole of each pair placed 180° further along the thread than the first). The screws used in group B had 6 holes (3 pairs of holes, placed with the same 180° difference in position). Unmodified conventional screws were used in group C. Each group was randomly divided into subgroups 0, 1, 2, and 3, with different volumes of PMMA used in each subgroup. Type A and B pedicle screws were directly inserted into the vertebrae in groups A and B, respectively, and then different volumes of PMMA were injected through the screws into the vertebrae in subgroups 0, 1, 2, and 3. The pilot hole was filled with different volumes of PMMA followed by insertion of screws in groups C0, C1, C2, and C3. Distributions of PMMA were evaluated radiographically, and axial pull-out tests were performed to measure the maximum axial pullout strength (Fmax).RESULTSRadiographic examination revealed that PMMA surrounded the anterior third of the screws in the vertebral bodies (VBs) in groups A1, A2, and A3; the middle third of screws in the junction area of the vertebral body (VB) and pedicle in groups B1, B2, and B3; and the full length of screws evenly in both VB and pedicle in groups C1, C2, and C3. In addition, in groups A3 and B3, PMMA from each of the screws (left and right) was in contact with PMMA from the other screw and the PMMA was closer to the posterior wall and pedicle than in groups A1, A2, B1, and B2. One instance of PMMA leakage was found (in group B3). Two-way analysis of variance revealed that 2 factors-distribution and volume of PMMA-significantly influenced Fmax (p < 0.05) but that they were not significantly correlated (p = 0.078). The Fmax values in groups in which screws were augmented with PMMA were significantly better than those in groups in which no PMMA was used (p < 0.05).CONCLUSIONSPMMA can significantly improve stability of different injectable pedicle screws in severely osteoporotic lumbar vertebrae, and screw stability is significantly correlated with distribution and volume of PMMA. The closer the PMMA is to the pedicle and the greater the quantity of injected PMMA used, the greater the pedicle screw stability is. Injection of 3.0 mL PMMA through screws with 4 holes (2 pair of holes, with the screws in each pair placed on opposite sides of the screw) produces optimal stability in severely osteoporotic lumbar vertebrae.

Performance of Arma chinensis reared on an artificial diet formulated using transcriptomic methods

An artificial diet formulated for continuous rearing of the predator Arma chinensis was inferior to natural prey when evaluated using life history parameters. A transcriptome analysis identified differentially expressed genes in diet-fed and prey-fed A. chinensis that were suggestive of molecular mechanisms underlying the nutritive impact of the artificial diet. Changes in the diet formulation were made based on the transcriptome analysis and tested using life history parameters. The quantity of pig liver, chicken egg, tuna fish, biotin, nicotinamide, vitamin B6, thiamine, riboflavin, vitamin C, L-glutamine, and sucrose was reduced, and wheat germ oil, calcium pantothenate and folic acid were increased. Ecuadorian shrimp was added as a partial substitute for tuna fish. Several parameters improved over six generations, including increased egg viability, and decreased egg and adult cannibalism. Additionally, several parameters declined, including longer developmental times for 2nd-5th instars, and decreased nymphal weights. The improvements in life history parameters support the use of transcriptome analyses to help direct formulation improvements. However, the decline in some parameters suggests that additional information, e.g., proteomic data, may be useful as well to maximize diet formulations.

Preventing arteriovenous shunt failure in hemodialysis patients: a population-based cohort study

Essentials Uncertainty remains about antiplatelets for vascular access patency in hemodialysis patients. 95 971 people under hemodialysis were followed in a claims database in Taiwan. Aspirin reduced vascular access failure rate and did not increase major bleeding rate. Clopidogrel, Aggrenox, and warfarin might increase major bleeding rate. SUMMARY: Background Dialysis adequacy is a major determinant of survival for patients with end-stage renal disease. Good vascular access is essential to achieve adequate dialysis. Objectives This study evaluated the impacts of different drugs on the vascular access failure rate of an arteriovenous fistula or an arteriovenous graft and the rate of major bleeding in hemodialysis patients. Patients and methods We studied patients with end-stage renal disease registered in the Taiwan National Health Insurance program from 1 January 1997 to 31 December 2012. A total of 95 971 patients were enrolled in our study. Vascular access dysfunction was defined as the need for thrombectomy or percutaneous angioplasty. Major bleeding was defined as emergency department visits or hospitalization with a primary diagnosis of gastrointestinal bleeding or intracerebral hemorrhage. The adjusted odds ratios between person-quarters with or without antiplatelet or oral anticoagulant use were calculated using a generalized estimating equation. Results The odds ratio of vascular access failure was 0.21 (0.11-0.39) for aspirin, 0.76 (0.74-0.79) for clopidogrel, 0.67 (0.59-0.77) for dipyridamole, 0.67 (0.53-0.86) for Aggrenox and 0.96 (0.90-1.03) for warfarin. The highest odds ratio for intracerebral hemorrhage was 5.33 (1.25-22.72) in younger patients using Aggrenox. The highest odds ratio for gastrointestinal bleeding was 1.34 (1.10-1.64) for clopidogrel. Conclusion Antiplatelet agents, but not warfarin, might reduce the vascular access thrombosis rate. The gastrointestinal bleeding rate was increased in the group using clopidogrel. Aggrenox should be used with caution in young individuals because it might increase the rate of intracerebral hemorrhage.

[Clinical characteristics of silent pheochromocytoma]

Objective: To summarize the clinical characteristics of silent paraganglioma. Methods: A total of 247 pheochromocytoma cases in Peking University First Hospital between January 1993 and December 2015 were analyzed retrospectively.The cases were divided into two groups according to whether they had hypertension: non-silent group (193 cases) and silent group (53 cases), then the clinical characteristics between the groups were compared, and the clinical features of silent pheochromocytoma were reviewed. Results: There were 53 silent pheochromocytoma cases in this study, which accounted for 21.5% (53/247), and imaging was the main way to find the tumor. Forty-one in 53 cases (77.4%) located in adrenal gland, in which 31 cases (75.6%) were benign and 2.3-8.0 cm in diameter, while 10 cases (24.4%) were malignant and 3.5-12.0 cm in diameter. Twelve in 53 cases (22.6%) located in extra-adrenal tissue, in which 4 cases were benign and 2.0-5.5 cm in diameter, while 8 cases were malignant and 5.0-10.5 cm in diameter. With the tumor diameter increased, the malignant rate increased: 1 in 8 cases in diameter<3 cm, 2 in 12 cases in diameter 3-5 cm, 15 in 33 cases in diameter>5 cm were malignant. There was no significant difference in age, sex, tumor location, benign or malignant rate between the two groups (all P>0.05). Compared with the non-silent group, the proportion of tumor size≥5 cm in silent group was significantly higher (62.3% vs 45.9%, P=0.034), and the incidence of hyperglycemia and the concentrations of norepinephrine and epinephrine were lower (all P<0.05) in silent group.Misdiagnosis was common in silent group, and up to 35.8% (19/53) had not been diagnosed correctly before operation. Twenty-one in 53 (39.6%) silent pheochromocytoma cases occured severe intra-operative blood pressure fluctuation. Conclusions: Silent pheochromocytoma was not uncommon and imaging was the main way to find it. The tumor size was always big and misdiagnosis was common, especially extra-adrenal tumors. Therefore, regardless of the adrenal or extra-adrenal tumors, especially in diameter>3.0 cm but with normal blood pressure, the possibility of silent pheochromocytoma should be considered. In order to reduce misdiagnosis and intra-operative blood pressure fluctuations, preoperative diagnosis and preparation, as well as intra-operative monitoring should be fully made.

Biomechanical comparative study of the stability of injectable pedicle screws with different lateral holes augmented with different volumes of polymethylmethacrylate in osteoporotic lumbar vertebrae

BACKGROUND CONTEXT

Polymethylmethacrylate (PMMA) is widely used for pedicle screw augmentation in osteoporosis. Until now, there had been no studies of the relationship between screw stability and the distribution and volume of PMMA.

PURPOSE

The objective of this study was to analyze the relationship between screw stability and the distribution pattern and injected volume of PMMA.

STUDY DESIGN

This is a biomechanical comparison of injectable pedicle screws with different lateral holes augmented with different volumes of PMMA in cadaveric osteoporotic lumbar vertebrae.

METHODS

Forty-eight osteoporotic lumbar vertebrae were randomly divided into Groups A, B, and C with different pedicle screws (16 vertebrae in each group), and then each group was randomly divided into Subgroups 0, 1, 2, and 3 with different volumes of PMMA (four vertebra with eight pedicles in each subgroup). A pilot hole was prepared in advance using the same method in all samples. Type A and type B pedicle screws were directly inserted into vertebrae in Groups A and B, respectively, and then different volumes of PMMA (0, 1.0, 1.5, and 2.0 mL) were injected through the screws and into vertebrae in Subgroups 0, 1, 2, and 3. The pilot holes were filled with different volumes of PMMA (0, 1.0, 1.5, and 2.0 mL), and then the screws were inserted in Groups C0, C1, C2, and C3. Screw position and distribution of PMMA were evaluated radiographically, and axial pullout tests were performed to measure maximum axial pullout strength (F_max).

RESULTS

Polymethylmethacrylate surrounded the anterior one-third of screws in the vertebral body in Groups A1, A2, and A3; the middle one-third of screws in the junction area of the vertebral body and the pedicle in Groups B1, B2, and B3; and the full length of screws evenly in both the vertebral body and the pedicle in Groups C1, C2, and C3. There was no malpositioning of screws or leakage of PMMA in any sample. Two-way analysis of variance revealed that two factors-distribution and volume of PMMA-significantly influenced F_max (p<.05) but that they were not significantly correlated (p=.088). F_max values in groups using augmentation with PMMA values significantly improved compared with those in groups without PMMA (p<.05).

CONCLUSIONS

Polymethylmethacrylate can significantly enhance the stability of different injectable pedicle screws in osteoporotic lumbar vertebrae, and screw stability is significantly correlated with the distribution pattern and the injected volume of PMMA. The closer the PMMA to the pedicle and the greater the quantity of injected PMMA, the greater is the pedicle screw stability. Injection of 2.0 mL of PMMA through screws with four lateral 180° holes or of 1.0 mL of PMMA through screws with six lateral 180° holes increases the stability of pedicle screws.

Dinardokanshones C-E, isonardoeudesmols A-D and nardoeudesmol D from Nardostachys jatamansi DC

Dinardokanshones C-E, three sesquiterpenoid dimers comprising an unusual nornardosinane-type sesquiterpenoid core and an aristolane-type sesquiterpenoid unit conjugated by an extra pyran or furan ring, together with monomeric sesquiterpenoids isonardoeudesmols A-D and nardoeudesmol D, were isolated from the underground parts of Nardostachys jatamansi DC. Structures of the eight compounds were elucidated by analysis of the extensive spectroscopic data, and their absolute configurations were established by analysis of NOESY and X-ray diffraction data, combined with computational electronic circular dichroism (ECD) calculations. The results of SERT activity assay revealed that isonardoeudesmol D and nardoeudesmol D significantly inhibited SERT activity, while dinardokanshones D-E and isonardoeudesmols B-C significantly enhanced SERT activity, among which dinardokanshone D exhibited the strongest effect.

A Simple and Rapid UPLC-PDA Method for Quality Control of Nardostachys jatamansi

Nardostachys jatamansi is a well-documented herbal agent used to treat digestive and neuropsychiatric disorders in oriental medicinal systems. However, few simple, rapid, and comprehensive methods were reported for quality assessment and control of N. jatamansi. Herein, a UPLC with photodiode array detection method was developed for both fingerprint investigation of N. jatamansi and simultaneous quantitative analysis of the six serotonin transporter modulatory constituents in N. jatamansi. For chromatographic fingerprinting, 24 common peaks were selected as characteristic peaks to assess the consistency of N. jatamansi samples from different retail sources. Six of the common peaks (5, 7, 12: , and 16:  - 18: ) were identified as desoxo-narchinol A, buddleoside, isonardosinone, nardosinone, kanshone H, and (-)-aristolone, respectively, by phytochemical investigation. Five of the six compounds significantly either enhanced or inhibited serotonin transporter activity, while (-)-aristolone (18: ) didn't show any serotonin transporter activity. In quantitative analysis, the six compounds showed good linearity (r > 0.999) within test ranges. The precision, expressed as relative standard deviation, was in the range of 0.25 - 2.77%, and the recovery of the method was in the range of 92 - 105%. The UPLC-photodiode array detection-based fingerprint analysis and quantitative methods reported here could be used for routine quality control of N. jatamansi.

Polarization rotation and the electrocaloric effect in barium titanate

We study the electrocaloric effect in the classic ferroelectric BaTiO₃ through a series of phase transitions driven by applied electric field and temperature. We find both negative and positive electrocaloric effects, with the negative electrocaloric effect, where temperature decreases with applied field, in monoclinic phases. Macroscopic polarization rotation is evident through the monoclinic and orthorhombic phases under applied field, and is responsible for the negative electrocaloric effect.

[Fast-onset antidepressant potentials of essential oil of herbs]

The existing antidepressants demonstrated delayed onset of clinical effects, so fast-onset antidepressants are required. Essential oil of herbs showed potentials fast-onset antidepressant potential. First, its aromatic odor can directly activate olfactory nerves; its high lipophilicity causes a high blood-brain barrier penetration rate; and its high volatility is suitable for nasal-brain targeting and inhalation delivery. Therefore, essential oils can rapidly regulate brain functions by multiple ways, suggesting a fast-onset antidepressant potential. Second, the advance of studies on chemistry and pharmacology of antidepressant essential oils demonstrated chemical substances, antidepressant effects and possible action mechanisms of antidepressant essential oils. Third, the effect of essential oils' antidepressant components on fast-onset antidepressant targets was investigated. It was found that chemical constituents of essential oils antagonized NMDA receptor activities, suggesting that essential oils have fast-onset antidepressant effect. Finally, characteristics of essential oils, fast-onset antidepressant targets and drug delivery methods are integrated to give full play to essential oils' fast-onset antidepressant advantage and provide a new direction for new drug discovery.

Chemical Constituents from the Flowers of Wild Gardenia jasminoides J.Ellis

Four new iridoids, 2'-O-(E)-coumaroylshanzhiside (1), 6'-O-(E)-coumaroylshanzhiside (2), 8α-butylgardenoside B (3), 6α-methoxygenipin (4), and one new phenylpropanoid glucoside, 5-(3-hydroxypropyl)-2-methoxyphenyl β-d-glucopyranoside (5), together with sixteen known compounds, were isolated from the edible flowers of wild Gardenia jasminoides J.Ellis. Their chemical structures were characterized by extensive spectroscopic techniques, including 1D- and 2D-NMR, HR-ESI-MS, and CD experiments. The absolute configurations of the new isolates' sugar moiety were assigned by HPLC analysis of the acid hydrolysates. Furthermore, the antioxidant activities of those isolates were preliminarily evaluated by DPPH scavenging experiment. And comparison of ¹ H-NMR spectra for the EtOH extract of G. jasminoides J.Ellis, gardenoside B and geniposide revealed that the flowers of this plant have a considerable content of gardenoside B instead of geniposide in the fruits, indicating different activities and applications in people's daily life.