[Prevention and management of severe hemorrhage during gynecological operations]

OBJECTIVE

To investigate the prevention and management of severe bleeding during gynecological operations.

METHODS

A retrospective study of 85,505 gynecological operations from 21 hospitals in China during the period of 1990-1999 was analyzed.

RESULTS

There were 683 cases with bleeding more than 1,000 ml during surgery, an incidence of 0.80% (range 0.07%-6.98%). Operation for removal of malignant ovarian tumor was the commonest cause of severe bleeding (42.31%); followed by cervical carcinoma (28.71%); endometrial carcinoma (16.11%). Only 6 transvaginal surgeries (0.88%) had severe bleeding. The most common site of bleeding was massive oozing from the raw wound surface, then the paracervical area (15.7%), around sacral ligament (12.14%).

CONCLUSIONS

Advanced malignant tumors, tumors located at retroperitoneal or with extensive adhesion were the main causes of profuse bleeding during operation. Good surgical skill and well understanding of the pelvic anatomy are the basic key points for surgeons, and a supportive anesthesia is also important in reducing hemorrhage during operations. Once bleeding occurs, to stop the bleeding accurately and promptly by pressing, clamping, and suturing, and internal iliac artery ligation may be needed occasionally. Special attention should be paid to the hemostasis of the venous plexus of pelvic floor.

[Symbiotic effect of cultivating fish in rice field in north China]

Experiment on rice-fish symbiosis in north China showed that the rice production in rice-fish field was a bit higher than control, and the output-input ratio of energy, utilization efficiency of solar energy and soil organic matter content increased 0.08, 0.1 and 0.24%, respectively. The banded sclerotic blight incidence decreased 3.8% and the net economic income increased 900 RMB yuan per hectare. All the resul;ts showed that rice-fish symbiotic system had a good symbiotic effect.

Vascular expression of angiotensin type 2 receptor in the adult rat: influence of angiotensin II infusion

OBJECTIVE

The aim of this study was to investigate the relative role of the angiotensin type 1 (AT1) and type 2 (AT2) receptors in mediating angiotensin II-induced regulation of AT2 receptor in mesenteric artery.

DESIGN

Sprague-Dawley rats were infused with either angiotensin II or vehicle for 14 days at a dose of 58.3 ng/min. Ang II-infused rats were allocated to receive either an AT1 antagonist, valsartan at a dose of 30 mg/kg per day or the AT2 receptor antagonist PD123319 at a dose of 830 ng/min.

METHODS

Gene and protein expression of the AT2 receptor in the mesenteric vasculature was assessed by quantitative reverse transcriptase polymerase chain reaction, immunohistochemistry and by in vitro autoradiography with a specific radioligand, 1251-CGP 42112B.

RESULTS

The AT2 receptor mRNA and protein were detected in the mesenteric artery from adult rats. Both nuclear emulsion and immunohistochemical staining showed expression of the AT2 receptor in the adventitial and medial layers. Compared to control rats, angiotensin II infusion was associated with a significant increase in the AT2 receptor expression. Valsartan treatment significantly reduced AT2 receptor gene expression, with no significant effect of PD123319 on this parameter.

CONCLUSIONS

This study confirms that the presence of the AT2 receptor in mesenteric arteries in adult rats, shows an up-regulation of the AT2 receptor following angiotensin II infusion and suggests a role for the AT1 receptor in this regulation. In view of the recently demonstrated effects of the AT2 receptor, these findings may be relevant to the role of the AT2 receptor in the pathophysiology of vascular remodeling.

[A study of prognostic factors of stage IV epithelial ovarian cancer]

OBJECTIVE

To determine the effects of treatments for stage IV epidermal ovarian cancer and detect the prognostic factors.

METHODS

31 cases primarily treated in our hospital from 1990 to 1998 were analyzed retrospectively.

RESULTS

Univariate analysis showed that the number of courses of chemotherapy, the size of residual disease, the histologic cell type, and the metastatic site were the significant prognostic factors(P < 0.05). Cox proportional hazard model confirmed that two factors (the size of residual lesion < or = 2 cm and the cycles of chemotherapy > or = 8 decreased the death odds ratio by 0.28 and 0.72 respectively. Three factors (lack of operation, presence of supraclavicular lymph node involvement and liver involvement) increased the death odds ratio by 14.25 times, 11.44 times and 1.85 times respectively (P < 0.05).

CONCLUSION

Surgical debulking, aggressive and appropriate chemotherapy are important measures to improve survival rate for patients with stage IV epithelial ovarian cancer.

Transforming growth factor-beta receptor-associated protein 1 is a Smad4 chaperone

Members of the transforming growth factor-beta (TGF-beta) superfamily signal through unique cell membrane receptor serine-threonine kinases to activate downstream targets. TRAP1 is a previously described 96-kDa cytoplasmic protein shown to bind to TGF-beta receptors and suggested to play a role in TGF-beta signaling. We now fully characterize the binding properties of TRAP1, and show that it associates strongly with inactive heteromeric TGF-beta and activin receptor complexes and is released upon activation of signaling. Moreover, we demonstrate that TRAP1 plays a role in the Smad-mediated signal transduction pathway, interacting with the common mediator, Smad4, in a ligand-dependent fashion. While TRAP1 has only a small stimulatory effect on TGF-beta signaling in functional assays, deletion constructs of TRAP1 inhibit TGF-beta signaling and diminish the interaction of Smad4 with Smad2. These are the first data to identify a specific molecular chaperone for Smad4, suggesting a model in which TRAP1 brings Smad4 into the vicinity of the receptor complex and facilitates its transfer to the receptor-activated Smad proteins.

Theoretical characterization of photoisomerization channels of dimethylpyridines on the singlet and triplet potential energy surfaces

Photoexcitations and photoisomerizations due to low-lying n pi* and pi pi* excited states of dimethylpyridines are investigated by density functional theory, CASSCF, CASPT2 and MRCI methodologies. Mechanistic details for the formation of Dewar dimethylpyridines and the interconversions of dimethylpyridines are rationalized through the characterization of minima and transition states on the singlet and triplet potential energy surfaces of relevant intermediates. Our present theoretical schemes suggest that Mobius dimethylpyridine intermediate 14 and azabenzvalene intermediate 10 can serve as possible precursors to Dewar dimethylpyridines and singlet phototransposition products, respectively. The calculations suggest that an S1(pi pi*)/S0 conical intersection in dimethylpyridines 2 is involved in the formation of 14. An azabenzvalene 10 might be formed through S2(pi pi*)/S1(n pi*) interaction followed by an S1/S0 decay in dimethylpyridine 6. Calculated barriers of isomerizations from 14 to Dewar dimethylpyridine 7 and from 10 to 4 are 8.4 and 28.5 kcal mol(-1) at the B3LYP/6-311 G** level, respectively. In the suggested triplet multistage transposition mechanism, an out-of-plane distorted geometry 19 due to vibrational relaxation of the T1(3B1) excited state of 3,5-dimethylpyridine 6 is a precursor of the interconversion of 6 to 2.4-dimethylpyridine 4. The formation of a triplet azaprefulvene 21 with a barrier of 20.7 kcal mol(-1) is a key step during the triplet migration process leading to another out-of-plane distorted structure 27. Subsequent rearomatization of 27 completes the interconversion of 6 with 4. Present calculations provide some insight into the photochemistry of dimethylpyridines at 254 nm.

Genomic organization of BmTXKbeta and BmTXKS2, two scorpion venom peptides from Buthus martensii Karsch

To elucidate genomic organization of BmTXKbeta and BmTXKS2, two scorpion venom peptides from Chinese scorpion Buthus martensii Karsch(BmK) were first isolated and their genomic regions characterized using the PCR method. Analysis of nucleotide sequence shows that there exists different intron location in the venom genes. The region encoding mature peptide of BmTXKbeta is disrupted by an intron with 886 bp, whereas the intron of BmTXKS2 is located within its propeptide coding region, which is different from other scorpion toxin genes with their introns within the signal peptide coding region.

Modeling the active sites in metalloenzymes. 3. Density functional calculations on models for [Fe]-hydrogenase: structures and vibrational frequencies of the observed redox forms and the reaction mechanism at the Diiron Active Center

Optimized structures for the redox species of the diiron active site in [Fe]-hydrogenase as observed by FTIR and for species in the catalytic cycle for the reversible H(2) oxidation have been determined by density-functional calculations on the active site model, [(L)(CO)(CN)Fe(mu-PDT)(mu-CO)Fe(CO)(CN)(L')](q)(L = H(2)O, CO, H(2), H(-); PDT = SCH(2)CH(2)CH(2)S, L' = CH(3)S(-), CH(3)SH; q = 0, 1-, 2-, 3-). Analytical DFT frequencies on model complexes (mu-PDT)Fe(2)(CO)(6) and [(mu-PDT)Fe(2)(CO)(4)(CN)(2)](2)(-) are used to calibrate the calculated CN(-) and CO frequencies against the measured FTIR bands in these model compounds. By comparing the predicted CN(-) and CO frequencies from DFT frequency calculations on the active site model with the observed bands of D. vulgaris [Fe]-hydrogenase under various conditions, the oxidation states and structures for the diiron active site are proposed. The fully oxidized, EPR-silent form is an Fe(II)-Fe(II) species. Coordination of H(2)O to the empty site in the enzyme's diiron active center results in an oxidized inactive form (H(2)O)Fe(II)-Fe(II). The calculations show that reduction of this inactive form releases the H(2)O to provide an open coordination site for H(2). The partially oxidized active state, which has an S = (1)/(2) EPR signal, is an Fe(I)-Fe(II) species. Fe(I)-Fe(I) species with and without bridging CO account for the fully reduced, EPR-silent state. For this fully reduced state, the species without the bridging CO is slightly more stable than the structure with the bridging CO. The correlation coefficient between the predicted CN(-) and CO frequencies for the proposed model species and the measured CN(-) and CO frequencies in the enzyme is 0.964. The proposed species are also consistent with the EPR, ENDOR, and Mössbauer spectroscopies for the enzyme states. Our results preclude the presence of Fe(III)-Fe(II) or Fe(III)-Fe(III) states among those observed by FTIR. A proposed reaction mechanism (catalytic cycle) based on the DFT calculations shows that heterolytic cleavage of H(2) can occur from (eta(2)-H(2))Fe(II)-Fe(II) via a proton transfer to "spectator" ligands. Proton transfer to a CN(-) ligand is thermodynamically favored but kinetically unfavorable over proton transfer to the bridging S of the PDT. Proton migration from a metal hydride to a base (S, CN, or basic protein site) results in a two-electron reduction at the metals and explains in part the active site's dimetal requirement and ligand framework which supports low-oxidation-state metals. The calculations also suggest that species with a protonated Fe-Fe bond could be involved if the protein could accommodate such species.

Exchangeability of N termini in the ligand-gated porins of Escherichia coli

The ferric siderophore transporters of the Gram-negative bacterial outer membrane manifest a unique architecture: Their N termini fold into a globular domain that lodges within, and physically obstructs, a transmembrane porin beta-barrel formed by their C termini. We exchanged and deleted the N termini of two such siderophore receptors, FepA and FhuA, which recognize and transport ferric enterobactin and ferrichrome, respectively. The resultant chimeric proteins and empty beta-barrels avidly bound appropriate ligands, including iron complexes, protein toxins, and viruses. Thus, the ability to recognize and discriminate these molecules fully originates in the transmembrane beta-barrel domain. Both the hybrid and the deletion proteins also transported the ferric siderophore that they bound. The FepA constructs showed less transport activity than wild type receptor protein, but the FhuA constructs functioned with turnover numbers that were equivalent to wild type. The mutant proteins displayed the full range of transport functionalities, despite their aberrant or missing N termini, confirming (Braun, M., Killmann, H., and Braun, V. (1999) Mol. Microbiol. 33, 1037-1049) that the globular domain within the pore is dispensable to the siderophore internalization reaction, and when present, acts without specificity during solute uptake. These and other data suggest a transport process in which siderophore receptors undergo multiple conformational states that ultimately expel the N terminus from the channel concomitant with solute internalization.

Structure-activity relationship of alkyl camptothecin esters

The cytotoxicity of camptothecin (CPT) esters 1-6 was measured. Like parental camptothecin, esters 2 and 3, but not 1, 4, 5, and 6, inhibited proliferation of human leukemia cells in culture and induced programmed cell death as assessed by flow cytometry studies. Exhibition of similar levels of antiproliferative activities of CPT 2 and 3 required different incubation time periods in cell cultures, with CPT and 3 requiring the shortest and longest periods, respectively. Both 2 and 3 were inactive against cells resistant to the semisynthetic CPT derivative 9-nitrocamptothecin and unable to stabilize DNA-topoisomerase I (Topo I) "cleavable complexes" in a cell-free system, suggesting that Topo I activity was required but insufficient for the mechanism of action of 2 and 3. Mouse liver homogenate converted esters to parental CPT, but the conversion rates were different with different esters. Of four tested esters in this experiment, ester 2 had the fastest conversion rate. In vivo studies showed that ester 2 had an exceptional lack of toxicity in nude mice, even at enormous doses, and demonstrated extensive activity against human breast and colon tumors grown as xenografts in immunodeficient nude mice, whereas no antitumor activity was observed for the other esters. In conclusion, ester 2 is a prodrug of the antitumor compound CPT, and it can be administered at very high doses in mice with no appearance of toxicity. This study provides a basis for further evaluation of CPT ester 2 as an investigational anticancer agent.

Dependence of anticancer activity of camptothecins on maintaining their lactone function

Camptothecins contain a lactone ring that exists in the closed form below ph 7. Above 7, the open (CPT+) and the closed (CPT) form coexist in a 50-50 ratio in mouse plasma and in a 90-10 ratio in human plasma due to the high affinity of human serum albumin (HSA) for CPT+. CPT+ is much less toxic than CPT and it is excreted much faster. In complete RPMI 1640 culture medium, the equilibrium CPT(+)-CPT is 50-50. If 4% HSA is added, it moves to 90-10 modeling for the human physiological situation.

The quantitative distribution of a putative PKC epsilon mRNA in Limulus central nervous system by modified competitive RT-PCR

Recently, a full length cDNA for the epsilon (epsilon) isoform of protein kinase C (PKC) was cloned and sequenced from a cDNA library for the horseshoe crab, Limulus polyphemus. This multifunctional enzyme has been implicated in the modulation of the choline cotransporter in Limulus and the epsilon isoform has been identified in homogenates from its central nervous system (CNS). RT-PCR has proven to be a very useful method for quantifying even a few molecules of mRNA in tissue samples. A modified competitive RT-PCR was used here to quantify a putative PKC epsilon mRNA in Limulus CNS preparations. First, we replaced normally used oligo dT and random primers generated from mRNA with a PKC epsilon specific (3' end) primer P4. Then we used modified nucleotides to extend sample life in storage and finally, we used only annealing and denaturing temperatures during PCR to reduce background. The modified method was used for the first time to quantify PKC epsilon mRNA from three distinct areas of the CNS in Limulus. Results revealed high levels of PKC epsilon mRNA in the corpora pedunculata, in the abdominal ganglia and in the brain ring. These results indicate that PKC epsilon mRNA is broadly distributed throughout the Limulus CNS. Importantly, this modified competitive RT-PCR technique was successfully applied to the quantitation of specific mRNA from Limulus nervous tissue for which no internal standard is available commercially.

Interferon-inducible protein 10 induction and inhibition of angiogenesis in vivo by the antitumor agent 5,6-dimethylxanthenone-4-acetic acid (DMXAA)

5,6-Dimethylxanthenone-4-acetic acid (DMXAA), a drug synthesized in this laboratory that halts tumor blood flow and induces tumor hemorrhagic necrosis in transplantable murine tumors, is known to induce the synthesis of antiangiogenic cytokines in vitro. We have measured the induction of mRNA for modulators of angiogenesis in vivo and investigated whether DMXAA may also have an additional antiangiogenic action through the production of these cytokines. The genes for IFN-alpha and for interferon-inducible protein 10 (IP-10) were strongly induced in both spleen and Colon 38 tumor tissue after DMXAA treatment, whereas that for IFN-gamma was induced in spleen but not in tumor. Expression of mRNA for IFN-beta and for the p35 or the p40 subunits of interleukin 12 was not observed in either tissue. Splenic IP-10 mRNA induction was not a result of IFN-gamma production induced with DMXAA because spleen tissue from DMXAA-treated mice that lacked functional IFN-gamma receptors expressed similar amounts of IP-10 mRNA as those from wild-type mice. A single i.p. injection of DMXAA (20 mg/kg) was sufficient to reduce fibroblast growth factor-induced endothelial cell invasion of Matrigel implants in athymic nude mice by nearly 100%. The inactive analogue 8-methylxanthenone-4-acetic acid did not up-regulate the genes for IP-10 or IFNs and did not inhibit endothelial cell invasion. Antibodies to IP-10 reversed the inhibition of DMXAA of endothelial cell invasion by 58%; antibodies to tumor necrosis factor-alpha, IFN-gamma, and IFN-alpha reversed inhibition by 7%, 5%, and 0%, respectively. The data support the hypothesis that DMXAA, in addition to antivascular effects mediated by tumor necrosis factor-alpha, may have an antiangiogenic effect mediated largely by the induction of IP-10.

Mitochondrial DNA deletion mutations colocalize with segmental electron transport system abnormalities, muscle fiber atrophy, fiber splitting, and oxidative damage in sarcopenia

The in vivo cellular impact of age-associated mitochondrial DNA mutations is unknown. We hypothesized that mitochondrial DNA deletion mutations contribute to the fiber atrophy and loss that cause sarcopenia, the age-related decline of muscle mass and function. We examined 82,713 rectus femoris muscle fibers from Fischer 344 x Brown Norway F1 hybrid rats of ages 5, 18, and 38 months through 1000 microns by serial cryosectioning and histochemical staining for cytochrome c oxidase and succinate dehydrogenase. Between 5 and 38 months of age, the rectus femoris muscle in the hybrid rat demonstrated a 33% decrease in mass concomitant with a 30% decrease in total fibers at the muscle mid-belly. We observed significant increases in the number of mitochondrial abnormalities with age from 289 +/- 8 ETS abnormal fibers in the entire 5-month-old rectus femoris to 1094 +/- 126 in the 38-month-old as calculated from the volume density of these abnormalities. Segmental mitochondrial abnormalities contained mitochondrial DNA deletion mutations as revealed by laser capture microdissection and whole mitochondrial genome amplification. Muscle fibers harboring mitochondrial deletions often displayed atrophy, splitting and increased steady-state levels of oxidative nucleic damage. These data suggest a causal role for age-associated mitochondrial DNA deletion mutations in sarcopenia.

[Immunorelated pancytopenia]

OBJECTIVE

A report of a group of patients with pancytopenia which might be related to abnormal immunity.

METHODS

The clinical and laboratory features of 29 patients with positive bone marrow mononuclear cell (BMMNC) Coombs tests were analyzed.

RESULTS

Most of these cases were pancytopenia with normal or decreased bone marrow cellularities and increased normoblasts. They were all found to have negative results of conventional hemolysis tests and hematopoietic nutrient determination and had no evidence of malignant clonal hematopoiesis. However, all of them showed positive BMMNC-Coombs test and good response to corticosteroids.

CONCLUSION

Immunorelated pancytopenia might be caused by abnormal immunity (especially autoantibody) mediated destruction or abnormal function of blood cells. It is beneficial to differentiate immunorelated pancytopenia from aplastic anemia or myelodysplastic syndromes.

Study of iron metabolism abnormality in the hepatocyte damage of hepatitis B

OBJECTIVE

To study the effect of iron metabolism on patients with hepatitis B.

METHODS

Hemoglobin (Hb), serum ferritin (SF), transferritin (TRF), serum iron (SI), and total iron binding capacity (TIBC) were detected in 103 patients with hepatitis B and 20 healthy adults.

RESULTS

The severer the hepatocyte damage was, the higher the SF, SI and the lower the Hb, TRF, and TIBC were. Furthermore, it seems more obvious among fulminant hepatitis and liver cirrhosis.

CONCLUSIONS

The overload of iron may enhance the hepatocyte damage induced by HBV. Therefore, to detect serum markers of iron metabolism is helpful to evaluate curative effect and prognosis of hepatitis B.

[Study on the cytochrome P450 activity in alkane converting process of Candida tropicalis]

A method of reduced CO-difference spectrum was established to study the cytochrome P450 activity of the whole cell of Candida tropicalis during the alkane converting process. Using this method, the cytochrome P450 activities of the whole cells that were cultured in the different concentrations of alkane were studied. The results showed that the 5% alkane could induce the cytochrome P450 activity obviously but not inhibit the growth of cells, so it was determined preliminarily that the alkane concentration of the seed medium was 5%. The cytochrome P450 activities of dicarboxylic acid (DCA) fermentation processing were further studied. During the exponential phase of growth, the cytochrome P450 activity increased smoothly. However, during the phase of production of dicarboxylic acid, the cytochrome P450 activities increased rapidly after a sort decrease. The results still showed that the rate of production of dicarboxylic acid increased with the cytochrome P450 activity.

[Basement membrane in squamous cell carcinomas of the larynx: an immunohistochemical study]

OBJECTIVE

The study was to assess the distribution of basement membrane(BM) in laryngeal squamous cell carcinomas(LSCC). Correlation of BM and clinical parameters (TNM stage, histological grading, invasion mode, lymph node metastasis) was also examined.

METHODS

The expression of BM around tumor cell was determined in 40 cases of LSCC by using monoclonal antibody against human type IV collagen. An intact continuous BM was found in 17 cases (42.5%), while partial or widespread loss of the BM was detected in the other 23 cases (57.5%).

RESULTS

In cases with poor histological differentiation, the defect of BM was more severe than that in cases with high or middle histological differentiation (P < 0.05). Moreover, diffuse invasion carcinomas revealed lower type IV collagen expression comparing with cases with better tumor-host border (P < 0.05). There was a higher risk of regional lymph node metastasis among cases with poor BM expression (P < 0.01), but there was no association of clinical stage with BM defect (P > 0.05).

CONCLUSION

These observations indicated that testing the distribution of BM seems to be useful to evaluate the histological grading of malignancy of laryngeal carcinoma and be helpful to prognosticate the frequency of regional lymph node metastasis.

[A quantum chemical study of pi-back-donation bond and Raman intensity of 1 sigma + electronic state of Pt-CO molecule]

The Raman spectroscopic properties of Pt-CO molecule have been investigated based on the electronic state 1 sigma + determined by the HF and B3LYP methods. The result shows that the calculated stretching vibrational frequencies of the Pt-C and C-O bonds depend on the method and the basis sets used. It indicates that it is important to adopt an appropriate method to describe pi-donation and pi-back-donation bond. The result of the differential Raman scattering cross section for the stretching vibrations of the Pt-C and C-O bond shows that the latter is significantly larger value compared to the former.

Angiotensin type 2 receptor is expressed in the adult rat kidney and promotes cellular proliferation and apoptosis

BACKGROUND

Angiotensin II (Ang II) is associated with cell proliferation and apoptosis. The role of the angiotensin type 2 receptor (AT2R) in these processes remains controversial. Conventional radioligand binding of 125I-Sar1, Ile8 Ang II in adult kidney has failed to demonstrate the binding for the AT2R.

METHODS

The presence of the AT2R was explored in adult rat kidney by in vitro and in vivo autoradiography using the selective AT2R radioligand 125I-CGP 42112B. The roles of the angiotensin type 1 receptor (AT1R) and the AT2R in mediating cellular proliferation and apoptosis were assessed using selective AT1R or AT2R antagonists in Ang II-infused Sprague-Dawley (SD) rats.

RESULTS

125I-CGP 42112B binding was demonstrated by in vitro and in vivo autoradiography techniques in the glomeruli and proximal tubules of SD rats. This binding could be displaced by Ang II and the AT2R antagonist PD123319 but not by the AT1R antagonist valsartan. Subcutaneous infusion of Ang II for 14 days in eight-week-old SD rats induced proliferation of proximal tubular epithelial cells, as assessed by a twofold increase in proliferating cell nuclear antigen (PCNA)-positive cells and apoptosis, as assessed by a threefold increase in terminal dUTP nick end labeling (TUNEL)-positive cells. The administration of the AT2R antagonist PD123319 or the AT1R antagonist valsartan was associated with attenuation of the increases in both PCNA- and TUNEL-positive cells following Ang II infusion. Ang II infusion was associated with increased osteopontin gene and protein expression, which could be reduced by treatment with either valsartan or PD123319.

CONCLUSION

These findings indicate that there is significant expression of the AT2R in the adult kidney, and that the AT2R has a role in mediating Ang II-induced proliferation and apoptosis in proximal tubular epithelial cells and expression of osteopontin.

[Effects of electromagnetic radiation from cellular telephone handsets on symptoms of neurasthenia]

In order to study the effects of electromagnetic radiation from cellular telephone handsets on symptoms of neurasthenia, 115 and 101 persons with or without handsets were selected. The subjects were investigated by questionnaire on their general health, lifestyle, habit, mental stress, the frequency of using the handsets, living and working environment, the cases of suffered from diseases and symptoms of neurasthenia. The data were analyzed by Chi-square test and Logistic regression statistics. The results showed that the time of using handset was positively associated with depression (P < 0.05), nausea (P < 0.01) and loss of appetite(P < 0.05). The results showed that long time use of cellular telephone handset could induce the symptoms of neurasthenia.

Blockade of the renin-angiotensin and endothelin systems on progressive renal injury

The renin-angiotensin system (RAS) and endothelin system may both play a role in the pathogenesis of progressive renal injury. The aims of the present study were 3-fold: first, to explore the possible benefits of dual blockade of the RAS with an ACE inhibitor and an angiotensin type 1(AT1) receptor antagonist; second, to examine the relative efficacy of endothelin A receptor antagonism (ETA-RA) compared with combined endothelin A/B receptor antagonism (ETA/B-RA); and third, to assess whether interruption of both RAS and endothelin system had any advantages over single-system blockade. Subtotally nephrectomized rats were studied as a model of progressive renal injury and randomly assigned to one of the following treatments for 12 weeks: perindopril (ACE inhibitor), irbesartan (AT1 receptor antagonist), BMS193884 (ETA-RA), bosentan (ETA/B-RA), and a combination of irbesartan with either perindopril or BMS193884. Treatment with irbesartan or perindopril was associated with an improved glomerular filtration rate and reductions in blood pressure, urinary protein excretion, glomerulosclerosis, and tubular injury in association with reduced gene expression of transforming growth factor-beta(1) and matrix protein type IV collagen. The combination of irbesartan with perindopril was associated with further reductions in blood pressure and urinary protein excretion. No beneficial effects of either BMS193884 or bosentan were noted. Furthermore, the addition of BMS193884 to irbesartan did not confer any additional benefits. These findings suggest that the RAS but not the endothelin system is a major mediator of progressive renal injury after renal mass reduction and that the combination of an AT1 receptor antagonist with an ACE inhibitor may have advantages over the single agent of RAS blocker treatment.

[Long-term follow-up result of partial laryngectomy]

OBJECTIVE

To study the long-term follow-up result of partial laryngectomy and reservation of laryngeal function.

METHODS

Three hundred and seventy-nine patients who underwent partial laryngectomy from 1986 to 1995 were summarized (male 290 cases, female 89 cases). Among them, 184 cases were supraglottic carcinomas (T1 8 cases, T2 115, T3 48, T4 13, according to UICC in 1992), 192 cases were glottic carcinomas (T1 115, T2 63, T3 13, T4 1), 3 cases were transglottic carcinomas (T2 1, T3 2). In common 8 kinds of operations were performed: 26 cases underwent cordectomy, 138 vertical laryngectomy, 7 frontolateral laryngectomy, 12 horizontal glottic laryngectomy (middle part of the larynx), 58 supraglottic laryngectomy, 95 horizontovertical (3/4) laryngectomy, 24 subtotal laryngectomy with cricoglossoepiglottic anastomosis, 19 near-total laryngectomy with cricoglossal anastomosis (with reservation of unilateral arytenoid cartilage). 193 cases underwent concurrent neck dissection(121 unilateral, 72 bilateral).

RESULTS

All cases restored their phonation and overcame aspiration with removing nasal feeding from 7 to 23 days after operations. 362 cases were decannulated from 9 days to 3 months after operations. Another 8 cases were decannulated after a secondary plastic operation. Decannulation rate was 97.6%. The three, five and ten year survival rates were 86.8% (329/379), 81.3% (266/327) and 69.4% (120/173) respectively.

CONCLUSION

Partial laryngectomy is a kind of radical operation with reservation of laryngeal function. Mastering indications strictly, correct operation choices, excellent surgical skills and perfect repairing technique are bases of improving life qualities and curative effect.