Parity has been shown to inversely associate with cardiovascular disease (CVD) mortality, but the evidence of epidemiological studies is still controversial. Therefore, we quantitatively assessed the relationship between parity and CVD mortality by summarizing the evidence from prospective studies. We searched MEDLINE (PubMed), EMBASE and ISI Web of Science databases for relevant prospective studies of parity and CVD mortality through the end of March 2015. Fixed- or random-effects models were used to estimate summary relative risks (RRs) and 95% confidence intervals (CIs). Heterogeneity among studies was assessed using the I2 statistics. All statistical tests were two-sided. Ten prospective studies were included with a total of 994,810 participants and 16,601 CVD events. A borderline significant inverse association was observed while comparing parity with nulliparous, with summarized RR = 0.79 (95% CI: 0.60–1.06; I2 = 90.9%, P < 0.001). In dose-response analysis, we observed a significant nonlinear association between parity number and CVD mortality. The greatest risk reduction appeared when the parity number reached four. The findings of this meta-analysis suggests that ever parity is inversely related to CVD mortality. Furthermore, there is a statistically significant nonlinear inverse association between parity number and CVD mortality.

547.972The Chinese plant Rosa rugosa Thunb. is known to be an antioxidant and a good natural source of antioxidants [1]. Therefore, we investigated the chemical composition of flowers of R. rugosa Thunb. collected in Xinjiang Autonomous region (PRC).Dry raw material (5 kg) was extracted with ethanol (70%). The alcohol extract was concentrated in vacuo and fractionated over a column packed with large-pore ion-exchange resin with elution by water and aqueous alcohol (25 and 50%). The alcohol fractions were rechromatographed over polyamide, silica gel, and Sephadex LH-20 to afford 1-9, of which four were kaempferol flavonoids, four were quercetin flavonoids, and one was a phenylethylglycoside. The aqueous fraction was extracted with ethylacetate and chromatographed over silica gel to isolate two acidic phenolic compounds 10 and 11.Kaempferol (1), yellow powder (acetone), mp 278-279°C. UV spectrum (λ max , MeOH, nm): 266, 322sh, 366; +AlCl 3 : 270, 305sh, 350sh, 424; +AlCl 3 /HCl: 270, 305sh, 347sh, 424. PMR spectrum (400 MHz, acetone-d 6 , δ, ppm, J/Hz): 8.16 (2H, d, J = 8.8, H-2′,6′), 7.03 (2H, d, J = 8.8, H-3′,5′), 6.54 (1H, d, J = 2.0, H-8), 6.27 (1H, d, J = 2.0, H-6).

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Six new labdane diterpenoids, preleosibirone A (1), 13-epi-preleosibirone A (2), isopreleosibirone A (3), leosibirone A (4), leosibirone B (5), and 15-epi-leosibirone B (6), were isolated from the leaves of Leonurus sibiricus. The absolute configurations of 1, 2, 5, and 6 were established by X-ray crystallographic analyses, and leosibirone A (4) was shown to be an artifact of the isolation process.

Although the medicinal plant Artemisia rupestris L. has been widely researched for several decades, its alkaloids have never been isolated before. To our surprise, the alkaloids in the plant were not detected in the stems but detected in the flowers. Herein, a novel and strange guaipyridine sesquiterpene alkaloid with a carboxyl group named rupestine was purified successfully from the total alkaloids extracted from the flowers by high-speed counter-current chromatography (HSCCC). The two-phase solvent system used was composed of ethyl acetate-methanol-water (8:1:7, v/v/v). Fifty six milligrams of rupestine was obtained at over 97% purity and 95% recovery from 200 mg of the total alkaloids in one-step separation. Its structure was elucidated by spectroscopic methods including high resolution ESI-MS, (1)H NMR, (13)C NMR, Heteronuclear Multiple Bond Correlation (HMBC), Heteronuclear Single Quantum Coherence (HSQC), and Nuclear Overhauser Enhancement Spectroscopy (NOESY).

Phytochemical study of the leaves and stems of Calea zacatechichi Schl. (Asteraceae) led to the isolation of a series of six germacranolides (1-6) with significant antileishmanial activity. The structure of a new compound named by us as calealactone D (1) was determined by NMR and MS, and its absolute configuration by X-ray crystallography. In addition, calealactone E (5) was discovered as a new naturally occurring compound, and the absolute configuration of calealactone C (2) was also determined by X-ray crystallography. All compounds were biologically evaluated in antimicrobial and antiprotozoal assays.

Dual antiplatelet therapy (DAT) with aspirin and clopidogrel is the standard regimen to achieve rapid platelet inhibition and prevent thrombotic events. Currently, little information is available regarding alternative antiplatelet therapy in patients with an allergy or intolerance to aspirin. Although cilostazol is already a common alternative to aspirin in clinical practice in China, its efficacy and safety remain to be determined. We retrospectively analyzed 613 Chinese patients who had undergone primary percutaneous coronary intervention (PCI). Among them, 405 patients received standard DAT (aspirin plus clopidogrel) and 205 patients were identified with intolerance to aspirin and received alternative DAT (cilostazol plus clopidogrel). There were no significant differences between the two groups in their baseline clinical characteristics. The main outcomes of the study included major adverse cardiac events (MACEs) and bleeding events during 12 months of follow-up. The MACEs endpoint was reached in 10 of 205 patients treated with cilostazol (4.9%) and in 34 of 408 patients treated with aspirin (8.3%). No statistically significant difference was observed in MACEs between the two groups. However, patients in the cilostazol group had less restenosis than did patients in the aspirin group (1.5% vs 4.9%, P=0.035). The occurrence of bleeding events tended to be lower in the cilostazol group (0.49% vs 2.7%, P=0.063). These clinical observations were further analyzed using network system pharmacology analysis, and the outcomes were consistent with clinical observations and preclinical data reports. We conclude that in Chinese patients with aspirin intolerance undergoing coronary stent implantation, the combination of clopidogrel with cilostazol may be an efficacious and safe alternative to the standard DAT regimen.

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