Factores de riesgo para infección en cavidad residual post cirugía de hidatidosis hepática en pacientes de la serranía peruana / Risk factors for infection in the residual cavity after liver hydatidosis surgery in patients from the Peruvian highlands

Resumen Objetivo: Determinar los factores de riesgo a la infección en cavidad residual post quistectomía hepática en los pacientes del hospital Ramiro Prialé Prialé - EsSalud -Huancayo. Materiales y Métodos: Se realizó una cohorte retrospectiva, entre enero del 2014 y enero del 2018. Se utilizó una ficha de recolección de datos. Se obtuvieron los riesgos relativos (RR) crudos y ajustados, con intervalos de confianza al 95%. Resultados: Participaron 83 pacientes. El 41,2% de las mujeres presentaron infección en la cavidad postquistectomía y la mediana de edad de los pacientes infecta dos fue de 33 años. Los antecedentes patológicos que se relacionaron con la infección fueron obesidad o sobrepeso (62,5%), neoplasia previa (100%) y enferme dad inmunológica previa (31%). La infección en cavidad residual postquistectomía estuvo relacionada a la presencia de obesidad o sobrepeso, diabetes mellitus, neoplasia previa , cirugía previa y al uso de antibióticos posteriores a la cirugía. Conclusiones: La obesidad o sobrepeso, diabetes mellitus, haber padecido alguna neoplasia o cirugía previa y el uso de antibióticos luego de la cirugía; son factores de riesgo para la infección en cavidad residual postquistectomía hepática en los pacientes del Hospital Nacional Ramiro Prialé Prialé EsSalud de Huancayo, Perú.

Abstract Objective: To determine the risk factors with the infection in the residual cavity after hepatic cystectomy in the patients of the Ramiro Prialé Prialé hospital - EsSalud -Huancayo. Materials and Methods: A retrospective cohort was conducted, between January 2014 and January 2018. A data collection sheet was used. Crude and adjusted relative risks (RR) were obtained, with 95% confidence intervals. Results: 83 patients participated. 41.2% of women infected in the post-cystectomy cavity and the median age of infected patients was 33 years. The pathological antecedents that were related to the infection were obesity or overweight (62.5%), previous neoplasia (100%) and previous immune disease (31%). Post-cystectomy residual cavity infection was affected by the presence of obesity or overweight (aRR: 1.56; 95% CI: 1.15-2.13; p value = 0.005), diabetes mellitus (aRR: 2.67; 95% CI : 2.09-3.41; p value <0.001), previous neoplasia (aRR: 2.49; 95% CI: 1.94-3.20; p value <0.001), previous surgery (aRR: 1.49; 95% CI: 1.36-1.64; p value <0.001) and the use of post-surgery antibiotics (aRR: 2.14; 95% CI: 1.30-3.51; p value = 0.003) Conclusions: Obesity or overweight, diabetes mellitus, having suffered some neoplasia or previous surgery and the use of antibiotics after surgery; they are factors associated with infection in the residual post-cystectomy liver cavity in patients of the Ramiro Prialé Prialé EsSalud National Hospital in Huancayo, Peru.

Central cellular signaling pathways involved with the regulation of lipid metabolism in the liver: a review

The liver is primarilyresponsible for energy homeostasis and the regulation of lipid, carbohydrate and protein metabolism. Lipid metabolism consists of distributing lipids to peripheral tissues or ensuring their return to the liver to be reprocessed. Additionally, cellular metabolism isregulated by several molecules in different signaling pathways. Lipid homeostasis in the liver is mainly regulated by AKT, AMPK, SREBP, PPAR, and JNK. The PI3K/AKT/mTOR signaling pathway results in the biosynthesis of macromolecules and regulates lipogenesis and the expression of lipogenic genes. AMPK is an energy sensor that regulates metabolism and is activated when stored ATP is depleted, and it is responsible for the suppression of several key lipogenic factors in the liver related to cholesterol and fatty acid synthesis. SREBPs control lipogenic geneexpressionandcholesterol metabolism and actin the nutritional regulation of fatty acids and triglycerides. The continued activation of SREBPs is associated with cellular stress, inflammation and ultimately steatosis. PPARs are intrinsically important regulators of lipid metabolism. These genes are essential tovarious metabolic processes, especially lipid and glucose homeostasis, and can play a role in cell differentiation. JNK signaling is related to insulin resistance and its activation results in decreased mitochondrial activity and fat accumulation. Therefore, the study of cell signaling pathways related to lipid metabolism and liver function may help to identify abnormalities and develop strategies to manage and regulate metabolic disorders and resulting complications.

New records of medicinal plants in Tibet / 中国中药杂志

By the fourth survey of Chinese medicinal resources, new medicinal plants records of 2 genera and 5 species were reported in Tibet. They are two genera Rhynchoglossum and Asteropyrum, and five species including Rh. obliquum, A. peltatum, Urena repanda, Schefflera khasiana and Mimulus tenellus. All the voucher specimens are preserved in Herbarium of Tibet Agriculture and Animal Husbandry University.

Study on Ranunculaceae herbal decoction pieces using X-ray diffraction / 中国中药杂志

The powder X-ray diffraction(PXRD) technique was used to investigate fourteen kinds of Ranunculaceae herbal decoction pieces(RHDP) recorded in Chinese Pharmacopoeia and to explore a novel PXRD quality control method for RHDP. The results indicated that only three RHDP-Paeoniae Radix Alba, Paeoniae Radix Rubra, and Moutan Cortex, contained calcium oxalate monodydrate(COM), whereas no COM existed in other eleven kinds of RHDP. The difference in PXRD for Paeoniae Radix Alba and Paeoniae Radix Rubra from different growing areas were investigated. The quantitative analysis method for COM was discussed by considering the water-boiling manufacturing process of herbal decoction pieces. The water-boiling experiments revealed that the PXRD peaks from COM crystals in RHDP were enhanced significantly after boiling. Paeoniae Radix Alba, Paeoniae Radix Rubra, Moutan Cortex, Aconiti Lateralis Radix Praeparata, Aconiti Radix, Aconiti Kusnezoffii Radix, and Anemone Raddeanae Rhizoma exhibited a similar series of broader peaks in the 2θ region of 15° to 35°, whose origins were discussed on the basis of chemical constituents RHDP reported by other researchers. These diffraction broader peaks most likely originated from periodic orientation of benzene ring in organic molecular crystals of aconitine-and paeonolum-based alkaloids and glycosides chemical constituents, subsequently, possibly from some other organic constituents. The PXRD technique can be used to rapidly identify Cimicifuga heracleifolia with an amorphous dispersion peak and C. dahurica with a sharp-peak feature. Climatidis Radix et Rhizoma exhibited a series of sharp PXRD peaks. The PXRD method can provide a valuable quality control method for RHDP.

Composición y distribución de hepáticas (Marchantiophyta) en un intervalo altitudinal en la Cordillera Oriental de Colombia / Composition and distribution of liverworts (Marchantiophyta) in a continuous altitudinal range on the Cordillera Oriental of Colombia

Resumen La composición de especies de hepáticas sobre los Andes del Norte varía con la altitud en relación con diferentes factores bióticos (vegetación) y abióticos (temperatura, humedad y luminosidad). Para probar esta afirmación se determinó la diversidad y distribución de las Marchantiophytas en un rango altitudinal entre los 2 400 y 3 400 m sobre la Cordillera Oriental colombiana, estableciendo cómo éstas varían entre altitudes y zonas de vida con respecto a los factores abióticos. Se realizaron muestreos cada 200 m y se registraron datos ambientales durante un año. Se encontraron 162 especies, la composición de hepáticas varió a lo largo del gradiente altitudinal con un gran número de especies únicas en cada altitud. Se encontró la máxima diversidad en los 3 000 m, con una dominancia del hábito folioso y de especies epifitas, mientras que la mayor riqueza de familias y géneros se presentó entre los 3 200 y 3 400 m. Anoplolejeunea conferta presentó la mayor cobertura en la zona así como el mayor valor del índice de valor de importancia (IVI) y distribución altitudinal más amplia, ubicándose desde los 2 400 hasta 3 000 m en cuatro diferentes sustratos. Las hepáticas se distribuyeron altitudinalmente de manera diferencial, con una diversidad beta alta (0.864) debido al recambio altitudinal de especies, con más del 30 % de disimilaría en la composición de especies cada 200 m altitudinales, dependiendo principalmente de cambios en la luminosidad. Consecuentemente, la temperatura, humedad y luminosidad y su relación con la vegetación son determinantes en la diversidad y distribución de las hepáticas en la Cordillera Oriental de los Andes colombianos.

Abstract The species composition of liverworts varies with altitude in the Northern part of the Andes due to the relationship of biotic (vegetation) and abiotic factors (temperature, humidity, and sunlight brightness). In order to test this affirmation we determined the diversity, species composition, abundance, and distribution of species of Marchantiophyta in an altitudinal range from 2 400 to 3 400 m on the Colombian Cordillera Oriental, and established how these vary with altitude and life-zones, regarding abiotic factors. Samples, taken every 200 m in the altitudinal range, and environmental data were registered during a year. We found 162 species, the composition of liverworts varied throughout the altitudinal gradient with a high number of unique species in each altitude. The maximum diversity was found at 3 000 m, along with a dominance of leafy habit and epiphytic species, while the higher richness of families and genera was found between 3 200 and 3 400 m. Anoplolejeunea conferta had the largest value of coverage in the zone, the highest value of importance value index (IVI), and the widest altitudinal distribution, from 2 400 to 3 000 m in four different substrates. The liverworts were distributed differently with altitude, we found a high beta diversity (0.864) due to the replacement of species, with more that 30 % of dissimilarity in species composition every 200 altitudinal meters, mainly depending on sunlight brightness variation. Accordingly, we found that abiotic factors like temperature, humidity, and sunlight brightness and its relationship vegetation are determinant in the diversity and altitudinal distribution of liverworts in the study area. Rev. Biol. Trop. 66(2): 559-570. Epub 2018 June 01.

Flavor and meridian tropism classification analysis of Callianthemum taipaicum / 中国中药杂志

To explore the flavor and meridian tropism classification of Callianthemum taipaicum by principal components analysis(PCA) and partial least square analysis(PLS). Meanwhile,to establish a high performance liquid chromatography-tandem mass spectrometry(HPLC-ESI-MS) method for the simultaneous determination of 55 active components from 13 kinds of Ranunculaceae of Chinese traditional herbs. Samples were separated on HPLC system by Agilent 5 TC-C₁₈（2）（4.6 mm×250 mm，5 μm）column and eluted with acetonitrile and 0.1% formic acid at the flow rate of 0.6 mL·min⁻¹. The data were performed by HPLC-ESI-MS with multiple reaction monitoring（MRM）scanning mode under positive and negative ion modes and quantified by external standards. The data from 13 Ranunculaceae herbs were analyzed by the PLS-tree and cooman's prediction of PCA and PLS to evaluate the similarities and differences of C. taipaicum in flavor and meridian tropism. The results showed that calibration curves of 55 components all showed good linearity, >0.99,with good precision, repeatability and stability. After compared to other 12 herbs,PCA and PLS results revealed that the C. taipaicum belonged to lung and bladder meridians while its flavor attributive to pungent,warm in nature. In conclusion,the analysis approach of chemometric calculation combined with multi-components quantification is suitable for the classification of meridian tropism and flavor of Chinese traditional medicine,which can be used for alternative research of rare herbs.

Distribution Status of Hybrid Types in Large Liver Flukes, Fasciola Species (Digenea: Fasciolidae), from Ruminants and Humans in Vietnam

The aim of this study is to delineate ‘admixed hybrid’ and ‘introgressive’ Fasciola genotypes present in the Fasciola population in Vietnam. Adult liver flukes collected from ruminants in 18 Provinces were morphologically sorted out by naked eyes for small (S), medium (M) and large (L) body shapes; and human samples (n=14) from patients. Nuclear ribosomal (rDNA) ITS1 and ITS2, and mitochondrial (mtDNA) nad1 markers were used for determination of their genetic status. Total 4,725 worm samples of ruminants were tentatively classified by their size: 6% (n=284) small (S)-, 13% (n=614) medium (M)-, and 81% (n=3,827) large (L)-forms. All the representative (n=120, as 40 each group) and 14 human specimens, possessed maternal mtDNA of only F. gigantica and none of F. hepatica. Paternally, all (100%) of the L-(n=40) and 77.5% (n=31) of the M-flukes had single F. gigantica rDNA indicating ‘pure’ F. gigantica. A majority (90%, n=36) of the S- and 15% (n=6) of the M-worms had single F. hepatica rDNA, indicating their introgressive; the rest (10%, n=4) of the S- and 7.5% (n=3) of the M-flukes had mixture of both F. gigantica and F. hepatica rDNAs, confirming their admixed hybrid genetic status. Fourteen human samples revealed 9 (64%) of pure F. gigantica, 3 (22%) of introgressive and 2 (14%) of admixed hybrid Fasciola spp. By the present study, it was confirmed that the small worms, which are morphologically identical with F. hepatica, are admixed and/or introgressive hybrids of Fasciola spp., and able to be the pathogens of human fascioliasis.

Chemicals from Cimicifuga dahurica and Their Inhibitory Effects on Pro-inflammatory Cytokine Production by LPS-stimulated Bone Marrow-derived Dendritic Cells

Inflammation is a biological response caused by overactivation of the immune system and is controlled by immune cells via a variety of cytokines. The overproduction of pro-inflammatory cytokines enhances abnormal host immunity, resulting in diseases such as rheumatoid arthritis, cardiovascular disease, Alzheimer's disease, and cancer. Inhibiting the production of pro-inflammatory cytokines such as interleukin (IL)-12p40, IL-6, and tumor necrosis factor (TNF)-α might be one way to treat these conditions. Here, we investigated the anti-inflammatory activity of compounds isolated from Cimicifuga dahurica (Turcz.) Maxim., which is traditionally used as an antipyretic and analgesic in Korea. In primary cell culture assays, 12 compounds were found to inhibit the production of pro-inflammatory cytokines (IL-12p40, IL-6, and TNF-α) in vitro in bone marrow-derived dendritic cells stimulated with LPS.

Asociación entre los niveles de déficit de base y la aparición de disfunción orgánica múltiple en pacientes con preeclampsia severa admitidas en la clínica gestión salud SAS (Cartagena) entre el 1 de enero de 2014 hasta 31 diciembre 2016 / Association between the levels of base deficit and the appearance of multiple organic dysfunction in patients with severe preeclampsia admitted in the clinic management health s.a.s (Cartagena) between January 1, 2014 to December 31, 2016

Objetivo: Evaluar la asociación entre el déficit de base y Disfunción Orgánica Múltiple Metodología: Estudio transversal analítico realizado en pacientes con preeclampsia severa de la Clínica Gestión Salud S.A.S (Colombia), entre el 1ero de enero 2014 y el 31 de Dic 2016. Los datos fueron obtenidos de fuente secundaria; el déficit de base (DB), se obtuvo desde los reportes de gases arteriales o venosos; el diagnóstico de Disfunción Orgánica Múltiple (DOM), se hizo conforme a los criterios del Ministerio de Protección Social (MPS) de Colombia para Morbilidad Materna Extrema. Se utilizó estadística paramétrica y no paramétrica; el nivel de significancia fue p<0,05. Resultados: Resultados: Un total de 72 pacientes fueron incluidas; la edad promedio fue de 25,55 años ± 7,66. El 72,22% desarrolló DOM. Las disfunciones más frecuentes fueron vasculares (73,61%) y hepáticas (70,83%). El 16,67% presentó eclampsia y el 47,22% desarrolló síndrome de HELLP. No hubo desenlaces fatales. El promedio del déficit de base fue de -5,26 ± 3,99. Las pacientes con déficit de base ≤ -5, tuvieron mayor frecuencia de DOM (84,21%; p = 0,008175), de disfunción hepática (92,11%; p = 0,0000269), de disfunción de la coagulación (65,79%; p = 0,002048) y de síndrome de HELLP (73,68%; p = 0,000001985). Un análisis de regresión logística mostró asociación estadísticamente significativa entre desarrollo de DOM y déficit de base ≤ -5. En general estos resultados son concordantes con la literatura. Conclusión: El DB mayor se asocia con mayor probabilidad de desarrollar DOM

Objective: To evaluate the association between the base deficit and Multiple Organic Dysfunction Methodology: Analytical cross-sectional study carried out in patients with severe preeclampsia of the Clínica Gestión Salud S.A.S (Colombia), between January 1ero, 2014 and December 31, 2016. Data were obtained from a secondary source; the base deficit (DB) was obtained from the reports of arterial or venous gases; The diagnosis of Multiple Organic Dysfunction (DOM) was made in accordance with the criteria of the Ministry of Social Protection (MPS) of Colombia for Extreme Maternal Morbidity. Parametric and non-parametric statistics were used; the level of significance was p <0,05.Results: A total of 72 patients were included; the average age was 25.55 years ± 7.66. 72.22% developed DOM. The most frequent dysfunctions were vascular (73.61%) and hepatic (70.83%). 16.67% presented eclampsia and 47.22% developed HELLP syndrome. There were no fatal outcomes. The average base deficit was -5.26 ± 3.99. Patients with a base deficit ≤ -5 had a higher frequency of DOM (84.21%, p = 0.008175), liver dysfunction (92.11%, p = 0.0000269), coagulation dysfunction ( 65.79%, p =0.002048) and HELLP syndrome (73.68%, p = 0.000001985). A logistic regression analysis showed statistically significant association between DOM development and baseline deficit ≤ -5. In general, these results are concordant with the literature. Conclusion: The greater DB is associated with greater probability of developing DOM. Conclusion: DB values lower than -5, that is, having a higher DB is associated with an increase in the probability of having DOM. Hepatic dysfunction, coagulation dysfunction and HELLP syndrome are also more frequent in this group of patients

Seroprevalence and Risk Factors of Fascioliasis in Yaks, Bos grunniens, from Three Counties of Gansu Province, China

The aim of this study was to determine the seroprevalence and risk factors of fascioliasis in yaks, Bos grunniens, from 3 counties of Gansu Province in China. A total of 1,584 serum samples, including 974 samples from white yaks from Tianzhu, 464 from black yaks from Maqu, and 146 from black yaks from Luqu County, were collected and analyzed using ELISA to detect IgG antibodies against Fasciola hepatica. The overall F. hepatica seroprevalence was 28.7% (454/1,584), with 29.2% in white yaks (284/974) and 27.9% in black yaks (170/610). The seroprevalence of F. hepatica in yaks from Tianzhu, Luqu, and Maqu was 29.2%, 22.6%, and 29.5%, respectively. Female yaks (30.9%) had higher F. hepatica seroprevalence than male yaks (23.4%). Also, F. hepatica seroprevalence varied by different age group from 24.1% to 33.8%. Further, the seroprevalence ranged from 21.8% to 39.1% over different seasons. Interestingly, the season and age of yaks were associated with F. hepatica infection in yaks in the investigated areas. These findings provided a basis for further studies on this disease in yaks from 3 counties of Gansu Province in northwestern China, which may ultimately support the development of effective control strategies of fascioliasis in these areas.

Fasciola hepatica: Infection Status of Freshwater Snails Collected from Gangwon-do (Province), Korea

Fasciola hepatica is a trematode that causes zoonosis, mainly in cattle and sheep, and occasionally in humans. Few recent studies have determined the infection status of this fluke in Korea. In August 2015, we collected 402 samples of freshwater snails at Hoenggye-ri (upper stream) and Suha-ri (lower stream) of Song-cheon (stream) in Daegwalnyeong-myeon, Pyeongchang-gun in Gangwon-do (Province) near many large cattle or sheep farms. F. hepatica infection was determined using PCR on the nuclear ribosomal internal transcribed spacer 2 (ITS-2). Among the 402 samples, F. hepatica 1TS-2 marker was detected in 6 freshwater snails; thus, the overall prevalence in freshwater snails was 1.5%. The prevalence varied between collection areas, ranging from 0.0% at Hoenggye-ri to 2.9% at Suha-ri. However, F. gigantica ITS-2 was not detected in the 6 F. hepatica-positive samples by PCR. The nucleotide sequences of the 6 F. hepatica ITS-2 PCR-positive samples were 99.4% identical to the F. hepatica ITS-2 sequences in GenBank, whereas they were 98.4% similar to F. gigantica ITS-2 sequences. These results indicated that the prevalence of F. hepatica in snail intermediate hosts was 1.5% in Gangwon-do, Korea; however the prevalence varied between collection areas. These results may help us to understand F. hepatica infection status in natural environments.

A Case of Aconite Poisoning Successfully Recovered after Intravenous Fat Emulsion Therapy

Aconitum is a genus of various species of flowering plants that belongs to the Family Ranunculaceae. Most Aconitum sp. have extremely toxic alkaloid substances such as aconitine, mesaconitine and hypaconitine. Among these substances, aconitine can cause fatal cardiotoxicity by activating sodium channels followed by calcium channels in myocardial cells. Even though there have been various therapeutic plans suggested comprising antidotes based on diverse case reports and studies, there is no confirmatory treatment protocol for aconite poisoning. Here, we report an aconite poisoning patient who had refractory ventricular tachyarrhythmia that did not respond to intravenous amiodarone therapies even though they were sustained for over 2 hours, but showed successful recovery following intravenous fat emulsions (IFE) therapy.

A Case of Aconite Poisoning Successfully Recovered after Intravenous Fat Emulsion Therapy

Aconitum is a genus of various species of flowering plants that belongs to the Family Ranunculaceae. Most Aconitum sp. have extremely toxic alkaloid substances such as aconitine, mesaconitine and hypaconitine. Among these substances, aconitine can cause fatal cardiotoxicity by activating sodium channels followed by calcium channels in myocardial cells. Even though there have been various therapeutic plans suggested comprising antidotes based on diverse case reports and studies, there is no confirmatory treatment protocol for aconite poisoning. Here, we report an aconite poisoning patient who had refractory ventricular tachyarrhythmia that did not respond to intravenous amiodarone therapies even though they were sustained for over 2 hours, but showed successful recovery following intravenous fat emulsions (IFE) therapy.

Mining chemodiversity from biodiversity: pharmacophylogeny of medicinal plants of Ranunculaceae / 中国天然药物

This paper reports a pharmacophylogenetic study of a medicinal plant family, Ranunculaceae, investigating the correlations between their phylogeny, chemical constituents, and pharmaceutical properties. Phytochemical, ethnopharmacological, and pharmacological data were integrated in the context of the systematics and molecular phylogeny of the Ranunculaceae. The chemical components of this family included several representative metabolic groups: benzylisoquinoline alkaloids, ranunculin, triterpenoid saponin, and diterpene alkaloids, among others. Ranunculin and magnoflorine were found to coexist in some genera. The pharmacophylogenetic analysis, integrated with therapeutic information, agreed with the taxonomy proposed previously, in which the family Ranunculaceae was divided into five sub-families: Ranunculoideae, Thalictroideae, Coptidoideae, Hydrastidoideae, and Glaucidioideae. It was plausible to organize the sub-family Ranunculoideae into ten tribes. The chemical constituents and therapeutic efficacy of each taxonomic group were reviewed, revealing the underlying connections between phylogeny, chemical diversity, and clinical use, which should facilitate the conservation and sustainable utilization of the pharmaceutical resources derived from the Ranunculaceae.

Pharmacokinetics and tissue distributions of veratric acid after intravenous administration in rats / 中国天然药物

The present study was designed to investigate the pharmacokinetics and tissue distributions of veratric acid following intravenous administration in rats. The concentrations of veratric acid in rat plasma at various times after administrated at doses of 2.5, 5, and 10 mg·kg(-1) were quantified by HPLC. The tissue distributions of veratric acid at various times after a single intravenous dose of 2.5 mg·kg(-1) were also analyzed. The plasma pharmacokinetic parameters at the three doses were as follows: t(1/2), (86.23 ± 6.83), (72.66 ± 4.10) and (71.20 ± 2.90) min; C0, (11.10 ± 1.47), (23.67 ± 1.24) and (39.17 ± 3.90) μg·mL(-1); and AUC(0→∞), (1 240.90 ± 129.14), (2 273.84 ± 132.47) and (3 516.4 ± 403.37) min·μg·mL(-1), respectively. The compound was distributed into tissues rapidly and extensively after intravenous administration and was mainly distributed into the liver, heart and kidneys.

Advance in modern studies on compatibility of Coptidis Rhizoma and Evodiae Fructus / 中国中药杂志

In traditional clinical application, Coptidis Rhizome and Evodiae Fructus have been combined to treat various stomach heat and cold syndromes, gastritis, gastric ulcer and the like. With the application of modem instruments and the development of molecular pharmacologic theory, their chemical constituents and pharmacological effects have been sufficiently studied. In this paper, literatures from Pubmed were adopted, with particular emphasis on findings of international counterparts and studies on compatibility of main chemical components in Coptidis Rhizoma and Evodiae Fructus, in order to elaborate on the scientific comparability of Coptidis Rhizoma and Evodiae Fructus through chemical analysis, and pharmacological and biopharmaceutics studies and introduce the future development trend of the studies.

Endoscopic Extraction of Biliary Fascioliasis Diagnosed Using Intraductal Ultrasonography in a Patient with Acute Cholangitis

Fasciola hepatica infection may result in biliary obstruction with or without cholangitis in the chronic biliary phase. Because clinical symptoms and signs of F. hepatica are similar to other biliary diseases that cause bile duct obstruction, such as stones or bile duct malignancies, that are, in fact, more common, this condition may not be suspected and diagnosis may be overlooked and delayed. Patients undergoing endoscopic retrograde cholangiopancreatography or endoscopic ultrasonography for the evaluation of bile duct obstruction may be incidentally detected with the worm, and diagnosis can be confirmed by extraction of the leaf-like trematode from the bile duct. Intraductal ultrasonography (IDUS) can provide high-resolution cross-sectional images of the bile duct, and is useful in evaluating indeterminate biliary diseases. We present a case of biliary fascioliasis that was diagnosed using IDUS and managed endoscopically in a patient with acute cholangitis.

Caracterización epidemiológica de pacientes con cirrosis en una consulta de gastroenterologia en Pereira, Colombia, 2009-2012 / Epidemiologic characterization of the patients with cirrhosis treated in an outpatient clinic of gastroenterology in Pereira, Colombia, 2009-2012

Este estudio soporta sus bases en la necesidad de obtener datos claros que correspondan a la realidad de la población de la zona centro occidental de nuestro país, con el fin de aclarar el panorama con respecto a la cirrosis, condición asociada a múltiples factores que influyen, tanto en su origen y evolución, como en su pronóstico. Para ello realizamos un estudio descriptivo de cien pacientes con diagnóstico de cirrosis que consultaron al servicio de gastroenterología durante el período comprendido entre enero de 2009 hasta julio de 2012. Para un mejor análisis, el estudio se desarrolló conformando categorías epidemiológicas, etiológicas, de descompensación, de pronóstico y de muerte. La información se recolectó directamente de las historias clínicas de los pacientes y se completó con entrevistas, diligenciando un instrumento en el cual se reunían las variables necesarias para el análisis. A los pacientes que carecían de algunos datos imagenológicos se les realizaron estudios de extensión como ecografía hepática y doppler portal. Luego de la recolección de los datos, se realizó una descripción detallada de las variables propuestas encontrando algunas con mayor significancia estadística, las cuales se llevaron a análisis bivariado y multivariado. Se encontró una gran diversidad en esta población; la mayoría de los pacientes procedían de áreas urbanas; la relación de género fue 1:1. El alcohol fue el principal factor etiológico para el desarrollo de esta patología, lo cual concuerda con otros países Latinoamericanos. La causa autoinmune viene en incremento, acá ocupó un segundo puesto, seguida de la etiología viral.

The following research supports its bases in the necessity of dependable epidemiological data corresponding to population reality in the western center region of our country, in order to clarify the public health outlook for cirrhosis, understanding it as an associated condition with multiple influencing factors, both in its origin and its development, as well as in its prognosis. For this research we carry out a descriptive study with one hundred patients diagnosed with cirrhosis who consulted for a gastroenterology service in a period from January 2009 to July 2012. For a better analysis, the research was developed by creating the following categories: Epidemiological, etiological, by decompensation, by prognosis, and by death. The information was directly gathered from patient’s medical records and completed with interviews, in that way we earn an instrument which gathered the needed variables for analysis. Extension studies like hepatic ultrasound and portal Doppler were realized to patients without some imagenological information. After data garner, a detailed description of previously variables was performed, finding some of them with higher statistical significance, which were analyzed by a bivariate and multivariate system. A great variety was found in this population; most of patients came from urban areas; the relation in gender was 1:1. Consumption of alcohol was the main etiological factor to develop this pathology. Previous information matched with described data from other Latin-American countries. Autoimmune cause should be taken into account because is increasing and occupied a second place in the research, followed by infectious viral etiology.

Antibacterial activity of alcoholic extracts of two Clematis L. [Ranunculaceae] species from Iran

Despite the discovery of numerous antibiotics, drug resistance still remains as a major problem. Therefore, it is important to introduce and replace new sources of drug such as medicinal plants with antimicrobial properties. The genus Clematis [Ranunculaceae family] has six species in Iran. Aerial parts of Clematis have been used to cure fever and chronic diseases such as Rheumatism in traditional medicine. In this research, antibacterial activity of ethanolic and methanolic extracts of aerial part in two major species of the genus in Iran [contains C. orientalis and C. ispahanica] were studied. Aerial plant parts were dried in shade, powderized and then ethanolic and methanolic extracts were prepared. Antibacterial activity of the two extracts was measured against six laboratory standard strains including gram positive and gram negative bacteria by disc diffusion. Minimum inhibitory concentrations were also determined using broth microdilution. Results showed that antibacterial activity of methanolic extracts is stronger than the ethanolic one. Also, C. ispahanica has stronger antibacterial activity in comparison to C. orientalis. Gram positive test bacteria showed the most susceptibility to both extracts compared to gram negative organisms. According to antibacterial effects of alcoholic extracts, it seems necessary to diagnose effective antibacterial components to compare results with existed finding and introduce a new trapeutic source