Antiviral activity of mangiferin from the rhizome of Anemarrhena asphodeloides against herpes simplex virus type 1

Objective:To evaluate the antiviral activity of pure compounds against herpes simplex virus type 1(HSV-1)from the rhizome of Anemarrhena asphodeloides.Methods:Bioassay-guided isolation was conducted to separate the active compound and its chemical structure was elucidated by spectral analysis.In vitro antiviral efficacy of active compound was detected by Cell Counting Kit-8 assay,plaque reduction assay,and fluorescence observation.RT-PCR was used to determine the viral load and the cytokine-related gene expression after HSV-1 infection.In vivo study was also conducted to further determine antiviral efficacy of an active compound against HSV-1.Results:An active compound was isolated and elucidated as mangiferin.Mangiferin significantly inhibited the replication of HSV-1 in Vero cells with a half maximal inhibitory concentration(IC_(50))of 64.0 mg/L.Time-of-addition and time-of-removal assays demonstrated that mangiferin could effectively inhibit the replication of HSV-1 in the early stage(8 h).UL12,UL42,and UL54 gene expression levels of HSV-1 in the 64 mg/L mangiferin-treated group were markedly reduced as compared with the HSV-1 group(P<0.01).Fluorescence observation showed that mangiferin attenuated the mitochondrial damage maintainingΔΨm induced by HSV-1 in Vero cells.The expression of inflammatory factors TNF-α,IL-1β,and IL-6 was remarkably increased in the virus-infected group as compared with that in the normal group(P<0.05),the levels of these inflammatory factors dropped after treatment with mangiferin.Mangiferin significantly decreased the viral load and attenuated the HSV-1-induced up-regulation of TNF-α,IL-1β,and IL-6.The relative protection rate of HSV-1-infected mice could reach up to55.5%when the concentration of mangiferin was 4 g/kg.Conclusions:Mangiferin exhibits promising antiviral activity against HSV-1 in vitro and in vivo and could be a potential antiviral agent for HSV-1.

A complicated case of innominate and right common arterial aneurysms due to Takayasu’s arteritis

BACKGROUND Innominate artery aneurysms (IAAs) are relatively rare. Endovascular therapy has been an alternative to open surgery in some IAA cases, but open repair is still necessary in complicated cases. CASE SUMMARY We report a 35-year-old female who suffered from Takayasu’s arteritis. The patient did not get regular treatment, and IAA and right common carotid artery aneurysm developed, which complicated with occlusion of the left carotid artery, subclavian artery, and the initial part of the left vertebral artery. The patient also had moderate aortic valve insufficiency. With inflammation being controlled well, the patient received the surgery for arterial aneurysms of innominate and right common carotid arteries and aortic valve insufficiency. The shunts for cerebral blood supply were designed to protect the brain and the surgery was conducted successfully under extracorporeal circulation. CONCLUSION The case illustrates that open surgery may be appropriate for some complicated IAAs, and brain protection is important.

Huge brown tumor of the rib in an unlocatable hyperparathyroidism patient with “self-recovered” serum calcium and parathyroid hormone: A case report

BACKGROUND The brown tumor is a kind of complication of hyperparathyroidism(HPT). The ultimate therapy usually is the resolution of HPT. We herein report an unlocatable HPT patient who received resection of a huge brown tumor of the rib, and experienced "self-recovery" of serum calcium and parathyroid hormone.CASE SUMMARY A 34-year-old female patient who suffered from a gradually increasing mass of the left chest wall since 2007 came to our hospital for treatment. The patient had a history of serum Ca and parathyroid hormone(PTH) increasing since June 2015 and received zoledronic acid treatment for 17 mo. When she came to our hospital in November 2017 after discontinuing medical treatment for 3 mo, the serum Ca and PTH levels were within normal ranges. The patient had no imaging abnormalities of parathyroid ultrasound or 99 m Tc-methoxyisobutyl isonitrile.Enhanced computed tomography revealed a local soft tissue mass of 96 mm × 113 mm with bone erosion of the left 8 th rib, and the mass presented irregular enhancement with an unclear boundary between the mass and spleen. The mass was thought to likely be caused by HPT, but a malignancy could not be ruled out.Resection of the mass was performed, and the pathology proved that the mass was a brown tumor. A diagnosis of unlocatable HPT was considered. Since the serum Ca and PTH levels were both normal pre-and post-operation, the patient did not receive exploratory surgery for HPT, and received regular follow-up.CONCLUSION The huge brown tumor of the rib and "self-recovered" serum PTH and Ca levels are relatively rare in HPT patients. An exploratory operation may be deferred for these patients, and long-term follow-up should be performed.

Prospective Randomized Study of Sarpogrelate Versus Clopidogrel-based Dual Antiplatelet Therapies in Patients Undergoing Femoropopliteal Arterial Endovascular Interventions： Preliminary Results

Background：Sarpogrelate is a selective 5-hydroxytryptamine （5-HT） receptor subtype 2A antagonist which blocks 5-HT induced platelet aggregation and proliferation of vascular smooth muscle cells.We compared the efficacy of sarpogrelate-based dual antiplatelet therapies for the prevention of restenosis and target lesion revascularization （TLR） rates comparing with that of clopidogrel after percutaneous endovascular interventions （EVIs） of femoropopliteal （FP） arterial lesions.Methods：This prospective,multicenter,randomized clinical trial recruited a total of 120 patients with successful EVI of FP lesions at seven centers across China between January 2011 and June 2012.Patients were randomized to receive either sarpogrelate （100 mg trice daily for 6 months,n =63） or clopidogrel （75 mg once daily for 6 months,n =57）.All patients also received oral aspirin （100 mg once daily for 12 months）.Clinical follow-up was conducted up to 12 months postprocedure.Results：There was no significant difference between the two groups in basic demographic data.The restenosis rate was higher in the clopidogrel group （22.80%） than in sarpogrelate group （17.50%）,but there was no significant difference between these two groups （P =0.465）.The TLR rate,ipsilateral amputation rate,mortality in all-cause and bleeding rate were also similar in the two groups （P 〉 0.05）.Conclusions：Aspirin plus sarpogrelate is a comparable antithrombotic regimen to aspirin plus clopidogrel after EVI of FP arterial lesions.Dual antiplatelet therapies might play an important role in preventing restenosis after successful EVI of FP lesions.