A phytochemical study on Dichocarpum auriculatum, an endangered medicinal plant peculiar to China / 中草药·英文版

Objective: Dichocarpum auriculatum, an endangered perennial herb, is endemic to China and has been used as folk medicines for the treatment of cough, hepatitis, scrofula, and epilepsy. However, there is no phytochemical report on this herbal so far. For the resource development and protective importance of this endangered medicinal plant, a phytochemical study was undertaken. Methods: The chemical constituents were purified by silica gel column, Sephadex LH-20 column, and semi-preparative reversed phase HPLC. NMR and MS spectra were used for structural identification. Results: Thirteen compounds were isolated from D. auriculatum. Their structures were characterized as jatrorrhizine (1), berberine (2), steponine (3), magnoflorine (4), coclauril (5), menisdaurin (6), menisdaurilide (7), aquilegiolide (8), (6R, 9S)-3-oxo-α-ionol-β-D-glucopyranoside (9), blumenol C glucoside (10), palmitic acid (11), dibutylphthalate (12), and auriculatum A (13). Conclusion: Compound 13 is a new diester terephthalate derivative. All the compounds are obtained from the genus Dichocarpum for the first time, and compounds 9 and 10 have potential chemotaxonomic significance to the genus Dichocarpum.

Cyanide toxicity during cardiopulmonary bypass with small dose of nitroprusside: a case report / 대한마취과학회지

Sodium nitroprusside (SNP) is an anti-hypertensive drug, commonly used to decrease the systemic vascular resistance and lower the blood pressure. When the amount of cyanide generated by the SNP exceeds the metabolic capacity for detoxification, cyanide toxicity occurs. Under general anesthesia and cardiopulmonary bypass (CPB), it may be difficult to detect the development of cyanide toxicity. In cardiac surgical patients, hemolysis, hypothermia and decreased organ perfusion, which emphasize the risk of cyanide toxicity, may develop as a consequence of CPB. In particular, hemolysis during CPB may cause an unexpected overproduction of cyanide due to free hemoglobin release. We experienced a patient who demonstrated SNP tachyphylaxis and cyanide toxicity during CPB, even though the total amount of SNP administered was much lower than the recommended dose. We therefore report this case with a review of the relevant literature.

Management of Cyanide Intoxication with Extracorporeal Membrane Oxygenation and Continuous Renal Replacement Therapy / 대한중환자의학회지

Cyanide intoxication results in severe metabolic acidosis and catastrophic prognosis with conventional treatment. Indications of extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT) are expanding to poisoning cases. A 50-year-old male patient arrived in the emergency room due to mental change after ingestion of cyanide as a suicide attempt 30 minutes prior. He was comatose, and brain stem reflexes were absent. Initial laboratory analysis demonstrated severe metabolic acidosis with increased lactic acid of 25 mM/L. Shock and acidosis were not corrected despite a large amount of fluid resuscitation with highdose norepinephrine and continuous renal replacement therapy. We decided to apply ECMO and CRRT to allow time for stabilization of hemodynamic status. After administration of antidote infusion, although the patient had the potential to progress to brain death status, vital signs were improved with correction of acidosis. We considered the evaluation for organ donation. We report a male patient who showed typical cyanide intoxication as lethal metabolic acidosis and cardiac impairment, and the patient recovered after antidote administration during vital organ support through ECMO and CRRT.

Management of Cyanide Intoxication with Extracorporeal Membrane Oxygenation and Continuous Renal Replacement Therapy / 대한구급학회지

Cyanide intoxication results in severe metabolic acidosis and catastrophic prognosis with conventional treatment. Indications of extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT) are expanding to poisoning cases. A 50-year-old male patient arrived in the emergency room due to mental change after ingestion of cyanide as a suicide attempt 30 minutes prior. He was comatose, and brain stem reflexes were absent. Initial laboratory analysis demonstrated severe metabolic acidosis with increased lactic acid of 25 mM/L. Shock and acidosis were not corrected despite a large amount of fluid resuscitation with highdose norepinephrine and continuous renal replacement therapy. We decided to apply ECMO and CRRT to allow time for stabilization of hemodynamic status. After administration of antidote infusion, although the patient had the potential to progress to brain death status, vital signs were improved with correction of acidosis. We considered the evaluation for organ donation. We report a male patient who showed typical cyanide intoxication as lethal metabolic acidosis and cardiac impairment, and the patient recovered after antidote administration during vital organ support through ECMO and CRRT.

Smoke inhalation injury during enclosed-space fires: an update / Lesao por inalacao de fumaca em ambientes fechados: uma atualizacao

In view of the tragic fire at a nightclub in the city of Santa Maria, Brazil, which culminated in the sudden death of 232 young people, we decided to review the literature regarding smoke inhalation injury caused by enclosed-space fires, which can be divided into direct thermal damage, carbon monoxide poisoning, and cyanide poisoning. Such injuries often call for immediate orotracheal intubation, either due to acute airway obstruction or due to a reduced level of consciousness. The diagnosis and the severity of the thermal injury can be determined by fiberoptic bronchoscopy. The levels of gases and gas by-products in the bloodstream should be assessed as rapidly as possible, even while still at the scene of the incident. First responders can also treat carbon monoxide poisoning, with immediate administration of oxygen at 100%, as well as cyanide poisoning, with oxygen therapy and hydroxocobalamin injection.

Aproveita-se o trágico incêndio ocorrido em uma boate na cidade de Santa Maria, RS, que culminou na morte imediata de 232 jovens, para revisarmos a literatura com relação à lesão por inalação de fumaça em ambientes fechados, que pode ser dividida em dano térmico direito, intoxicação por monóxido de carbono e intoxicação por cianeto. Essas condições frequentemente levam à necessidade de intubação orotraqueal imediata, seja por obstrução aguda de vias aéreas, seja por depressão do nível de consciência. O diagnóstico e a gravidade da injúria térmica podem ser determinados pela fibrobroncoscopia. Quanto aos envenenamentos, a dosagem dos gases ou de seus subprodutos na corrente sanguínea é possível e deve ser realizada ainda na cena do incidente. Da mesma maneira, o tratamento da intoxicação por monóxido de carbono consiste na administração imediata de oxigênio a 100%, enquanto o da intoxicação por cianeto consiste em oxigenoterapia e hidroxicobalamina injetável como antídoto. .

Successful treatment by exchange transfusion of a young infant with sodium nitroprusside poisoning / 소아과

Although sodium nitroprusside (SNP) is often used in pediatric intensive care units, cyanide toxicity can occur after SNP treatment. To treat SNP-induced cyanide poisoning, antidotes such as amyl nitrite, sodium nitrite, sodium thiosulfate, and hydroxycobalamin should be administered immediately after diagnosis. Here, we report the first case of a very young infant whose SNP-induced cyanide poisoning was successfully treated by exchange transfusion. The success of this alternative method may be related to the fact that exchange transfusion not only removes the cyanide from the blood but also activates detoxification systems by supplying sulfur-rich plasma. Moreover, exchange transfusion replaces cyanide-contaminated erythrocytes with fresh erythrocytes, thereby improving the blood's oxygen carrying capacity more rapidly than antidote therapy. Therefore, we believe that exchange transfusion might be an effective therapeutic modality for critical cases of cyanide poisoning.

Transarterial embolization of dural carotid cavernous fistulas with low concentration of n-butyl-cyanoacrylate / 中华放射学杂志

Objective To investigate the technique of transarterial embolization of dural carotidcavernous fistulas(DCCFs)with low concentration(14%-25%)of n-butyl-cyanoacrylate(NBCA)and determine its value.Methods Eight patients with DCCFs were treated by transarterial embolization with low concentration of NBCA using a wedged microcatheter.Of the 8 patients,5 had unsuccessful transvenous embolization and 3 could not be treated with transvenous embolization.Results Transarterial embolization with low concentration of NBCA using a wedged microcatheter resulted in complete obliteration of the affected cavernous sinus and related shunts in 5 patients,no residual arteriovenous shunt was demonstrated on postembolization angiography.On clinical and angiographic follow-up 6-12 months later,complete resolution of clinical symptoms was observed in all 5 patients and there were no recurrent or residual DCCFs found.Partial obliteration of the involved cavernous sinus and the related shunt was achieved in the remaining 3 patients on immediate post-procedure angiography,but the volume of shunt diminished significantly.On clinical and angiographic follow-up 3 months later,in 2 patients,clinical symptoms were improved and the arteriovenous shunts were diminished;in the third patient,clinical symptom resolved and the shunt was obliterated.There were no major complications except for the transient worsening of ocular symptoms due to Ⅵ cranial nerve palsy in 1 patient.Conclusions Transarterial embolization of DCCFs with low concentration of NBCA using a wedged microcatheter was a safe and effective treatment method.It is an optimal alternative for the patients with DCCFs in which transvenous route was unsuccessful,or impossible.

Cyanide Poisoning after Consuming a Large Amount of Gingko Nuts

Traditionally, the gingko nut is used for enhancing liver function, skin immunity, pulmonary function, and antitussive action in chronic asthma. However, when overused, it can induce central nervous system dysfunction, and the following symptoms can manifest themselves: vomiting, dizziness, convulsion, insomnia, and confusion. We experienced a case of suspected cyanide intoxication that was manifested by convulsion and metabolic dysfunction after consuming a large number of ginko nuts. We report that case, together with a review of the literature.

Determination of Cyanide in Drinking Water by Continuous Flow-Injection-Photometry / 环境与健康杂志

Objective To establish a simple,accurate and sensitive method for determination of cyanide in drinking water. Methods By means of using flow injection analysis instrument, the cyanide in drinking water was determined on-line. Results The data obtained by this assay accorded with Beer's Law, the range was 2.0-50.0 ?g/L, r≥0.999, the detection limit, relative standard deviation and recovery rate were 0.23 ?g/L, 2.5%-3.8% and 94.9%-98.7% respectively. The sampling frequency was 20 samples per hour. Conclusion The method for determination of cyanide in drinking water employed in the present paper is simple, accurate, sensitive and suitable for the analysis of large number of water samples.

Effects of repeated exposure to hypoxia on hypoxia tolerance in mice / 中国病理生理杂志

The hypoxia tolerance of mice was significantly increased by repetitive action of auto-hypoxia. The tolerance duration of the 2nd, 3rd, 4th and 5th run was 1.8 2.5 3.0 and 3.6 times longer than that of the Ist one. The survival time of mice that had been exposed to hypoxia repeatedly for four runs was 10 times longer than that of the control animals when both of them were placed in the same low pressure chamber and was 4 times longer while KCN was administrated. The survival time under low oxygen pressure in mice injected with brain extract of resistant mice was 1.8 and 2.1 times longer than that of the saline-injected or normal mice's brain extract-injected animals respectively. These results indicate that some plastic or adaptic changes might occur in the tissue cells particularly in the brain cells during acute and repeated hypoxia. They lead the animals' hypoxia tolerance to a very high level. Water soluble antihypoxic or hypoxia-resistant elements might exist in the brain of hypoxia resistant animals, which were extractable, transferable, and permeable to the blood brain barrier.

Effects of Acute Hemorrhage Complicated with Cyanide Poisoning on the Hemodynamics in the Dog / 第三军医大学学报

The effects of acute hemorrhage complicated with cyanide posisoning on the hemodynamics were studied and compared with those simple cyanide poisoning in 24 dogs.Cyanide poisoning was induced by intravenous injection a lethal dose of NaCN of 2.5mg/kg,Acute hemorrhage was created by bleeding the dogs to an arterial pressure of 9.33 kPa(70mm Hg)within 2 minutes through a cannulated femoral artery.HR,CO,MAP,LVP,LVP (?)dp/bt max,and ECG were recorded.It was found that the excitatory response of cardiovascular functions was observed within 1 minute after cyanide poisoning,then a significant failure of the cardiavascular functions resulted in the rapid death of the animal 7~10 minutes after cyanide administration.In case when cyanide poisoning was complicated with acute hemorrhage,no excitatory response of the cardiovascular functions could be observed.An early cardiovascular collapse occurred which was characterized by a rapid fall of CO,MAP,LVP,LVP(?)dp/dt max as well as arrhythmia.All the dogs in this group died of acute failure of cardiovascular functions 4- 6 minutes after cyanide poisoning.The results of this study suggest that the failure of the cardiovascular functions is the main cause of death in case of acute hemorrhage complicated with cyanide poisoning.

Preparation of Stroma-free Methemoglobin Solution (SFMS) and the Effect of SFMS in the Treatment of Cyanide Poisoning: A Preliminary Study / 第三军医大学学报

Stroma-free methemoglobin solutions were prepared from dog and pig red blood cells. The procedure is based on oxidizing the ferrous iron in hemoglobin solution to the ferric state. Then all the cell membrane components (i.e.stroma) were removed through crystallization of the hemoglobin molecule in high ionic phosphate buffer, dialysis and repeated washing of crystals prior to solubilization. This method is feasible and reproducible. The methemoglobin solution obtained had similar potassium, sodium, chloride ion concentration and pH value as normol serum. Spectral maxima and minima were characteristic for methemoglobin.SFMS proved to be an effective antidote for cyanide intoxication. Its protection ratio was calculated to be 2.25 while the rats were treated with SFMS equal to 7 % of their total body hemoglobin. The potential advantages of SFMS over current antidotes include its immediate action with cyanide and doesn't compromise any of the patient's oxygen carrying capacity. In preliminary work, SFMS was given at levels of 4-10% total hemoglobin with little adverse effects.

ANTI-APOPTOSIS EFFECT OF NADH ON NORMAL LIVER CELL LINES TREATED WITH CYANIDE / 解放军医学杂志

This study was to observe the anti apoptosis effect of NADH on a normal liver cell line inflicted with chemical hypoxia. L02 liver cells were treated with 3mmol/L KCN in the presence of different concentrations of NADH (0～600?g/ml) for 0.5, 2, 4 hours. The percentage of apoptotic cells was assayed with flow cytometry(FCM). Another three groups of experiment were done as following. Group Ⅰ was control. Groups Ⅱ and Ⅲ were treated with 3mmol/L KCN in the presence or absence of NADH (400?g/ml) for 2h. The expression of proteins of Bcl XL, Bcl 2 and Bax in the L02 cells were determined with FCM analysis. The results showed that NADH could obviously prevent L02 cells from apoptotic damage at the concentration of 400?g/ml. it could also significantly upregulate the expression of Bcl 2 and Bcl XL proteins and downregulate the expression of Bax proteins after cyanide challenge( P