[Treatment of 100 children with infantile nephrotic syndrome by integrated traditional Chinese medicine and Western medicine]

For ten years (1979-1989), 150 cases of infantile nephrotic syndrome were treated by integrated TCM and Western medicine (WM). The WM group (50 cases) was treated by conventional WM drugs (prednisone, CLB, etc) and the TCM-WM group (100 cases) was treated by the above-mentioned WM plus treatment according to Syndrome Differentiation with decoction of Chinese medicinal herbs. Wulin San, Zhenwu Tang and Zhibai Dihuang Tang were selected in treating Spleen-Qi Deficiency distressed by Dampness, both Spleen-Kidney Yang Deficiency and both Liver-Kidney Yin Deficiency Syndrome respectively. The total effective rate was 100%, and the efficacy of TCM-WM group was higher than that of WM group (P < 0.005). The efficacy of TCM-WM treatment of nephritic nephropathy was far better than that of simple nephropathy (P < 0.05). Also the efficacy of TCM-WM was superior in raising plasma albumin and reducing blood cholesterol than that of WM (P < 0.001). The cellular immunity function and plasma cortisol of TCM-WM group were significantly improved than that of WM, P < 0.01 and 0.001 respectively. The result showed that the curative effect of the TCM-WM group in treating nephrotic syndrome was much better than that of WM alone.

[Chemical constituents of Actinidia kolomikta (Rupr. et Maxim.) Planch]

Two crystalline components I and II were isolated from the roots of Actinidia kolomikta. I was identified as delta 7-stigmasterol and II was named alpha-kolomiktriose and elucidated as 2, 3-di-0-beta-D-galactopyranosyl-alpha-D-galactopyranose on the basis of spectral data (13C NMR, 1H NMR, IR and EI-MS).

Changes of brain response induced by simulated weightlessness

The characteristics change of brain response was studied during 15 degrees head-down tilt (HDT) comparing with 45 degrees head-up tilt (HUT). The brain responses evaluated included the EEG power spectra change at rest and during mental arithmetic, and the event-related potentials (ERPs) of somatosensory, selective attention and mental arithmetic activities. The prominent feature of brain response change during HDT revealed that the brain function was inhibited to some extent. Such inhibition included that the significant increment of "40Hz" activity during HUT arithmetic almost disappeared during HDT arithmetic, and that the positive-potential effect induced by HDT presented in all kinds of ERPs measured, but the slow negative wave reflecting mental arithmetic and memory process was elongated. These data suggest that the brain function be affected profoundly by the simulated weightlessness, therefore, the brain function change during space flight should be studied systematically.

Isolation and identification of hepatitis E virus in Xinjiang, China

This paper describes isolation and identification of a virus (termed strain 87A) which has the cytopathic effect and haemagglutination properties of hepatitis E virus (HEV). This virus was isolated by tissue culture from the faeces of a patient with acute non-A, non-B enteric hepatitis in Xinjiang, China. The isolated virus was neutralized by acute phase sera obtained from other patients with acute non-A, non-B enteric hepatitis. The virus particles also could be specifically aggregated with acute phase sera from patients with known HEV hepatitis in China, Burma, India and the U.S.S.R., and with acute and convalescent sera from an HEV-infected chimpanzee. Crystalline arrangements of virus particles in the cytoplasm were observed by electron microscopy in ultrathin sections of infected cells. The sedimentation coefficient of the strain 87A virus particles in sucrose gradients was 176S. Purified virus particles revealed a protein band of about 76K on SDS-PAGE and Western blotting. The evidence indicates that the strain 87A virus is an HEV. Our ability to propagate HEV in cell culture should facilitate research on this hepatotropic virus.

[Isolation and identification of Leclercia adecarboxylate in clinical isolates in China]

1987, 3 strains of gram-negative straight rods were examined from 3 cases of patients with diarrhea. It's producing yellow pigment, fermentative metabolism of carbohydrates, oxidase test negative and motility with the help of peritrichous flagella. Through systematic biochemical identification, calculation of G+C mol% and homology of DNA/DNA, the species of Leclercia adecarboxylate are identified. While the susceptibility to certain antibiotics and the pathogenicity for white mice are tested, and relation of these microorganisms to clinical diarrhea is discussed.

The pairing of the separated A and B chains of insulin and its derivatives, FTIR studies

From the amide I bands of their deconvolved FTIR spectra, the S-thiomethyl derivatives of the insulin A, B, despentapeptide(26-30) B and desoctapeptide(23-30) B chains all contain significant amounts of ordered secondary structure. The intact B chain is considerably more ordered than either the A or the truncated B chains. Comparison of the spectra of the separated and mixed intact chains of insulin suggests further folding upon mixing of the chains leading to significant increases in ordered secondary structures, presumably because of stabilization by interaction of the chains. The interactions of the A chain with the DPI B chain appear to be weaker as compared to that with the intact B chain. The above results suggest that only the intact A and B chains contain sufficient structural information to recognize each other and interact to form a native-like structure which make the correct formation of the disulfide linkages possible.

[Saponins in fruits pedicels of Panax notoginseng (Burk.). F.H. Chen]

Six saponins were isolated from the fruit pedicels of Panax notoginseng for the first time. They were identified as ginsenoside-Rc, -Rb3, -Re, notoginsenoside-Fe, -R1 and gypenoside IX by chemical and spectroscopic analysis.

Increase of plasma IL-6 concentration with age in healthy subjects

The present study demonstrated that plasma IL-6 concentration was higher in older subjects than in younger ones and significantly in the male group (P = 0.02); Spearman rank correlation showed that plasma IL-6 concentration was positively correlated with age (r = 0.28, N = 55, P < 0.05); there was a highly significant correlation between the concentrations in plasma IL-6 and IL-1 alpha (r = 0.51, N = 52, P < 0.001). These findings suggest the possibility that age-related changes of plasma IL-6 and IL-1 alpha may provide a pathological basis for the susceptibility to such illness as commonly occurs in elderly people, especially Alzheimer's disease as the two interleukins can induce the production of alpha 1-antichymotrypsin and beta-amyloid protein precursor.

Traumatic sinus of Valsalva fistula

Two rare cases of nonpenetrating trauma-induced fistula from the right sinus of Valsalva to the right heart chambers are reported. Both were diagnosed preoperatively and operated on successfully. A transverse tear was found in the right sinus of Valsalva, just below the right coronary ostium, in both patients. The ragged inlet and a rough fistula tract were noted during operation. The tears were closed with direct sutures or with a Dacron patch. Coronary artery bypass grafting was needed in 1 patient. The results of operation were excellent.

Perfusion scan in pulmonary tumor microembolism: report of a case

A 76-year-old male patient was admitted to our hospital with the chief complaint of dyspnea. A chest CT scan showed pericardial effusion, mediastinal lymphadenopathy and a tumor in the right ventricle with invasion to the main trunk of the pulmonary artery. A 99mTc MAA perfusion lung scan revealed multiple small subsegmental peripheral defects and a "fissure sign", while the 133Xe ventilation scan was normal. After the chest CT scan and scans of both lungs, tumor microembolism was highly suspected. Open chest surgery was performed. A huge tumor in the right ventricle involving the main trunk of the pulmonary artery was found. In addition, multiple tumor thrombi in the pulmonary arteries and veins were also noted. The pathology was metastatic squamous cell carcinoma. Thereafter, the primary lesion was found by bronchoscopy. The final diagnosis was squamous cell carcinoma of the right lower lobe bronchus with metastases to the right ventricle and pulmonary vessels, and in association with pulmonary tumor microembolism. We present this uncommon case and describe the pulmonary perfusion pattern of the tumor microembolism.

The effect of the acetylcholine transport blocker vesamicol on central cholinergic pressor neurons

Vesamicol (AH5183) inhibits the uptake of acetylcholine into cholinergic neuronal storage vesicles. Earlier in vitro studies have demonstrated that such inhibition can lead to a failure of transmission, particularly in peripheral cholinergic tissues. The present study was designed to determine whether vesamicol could inhibit central cholinergic transmission in conscious freely moving rats. Central (lateral cerebroventricular) injection of 20 micrograms of vesamicol significantly reduced the hypertensive and bradycardic response to subsequent central injection of physostigmine in spontaneously hypertensive rats. Inhibition of the pressor response was greatest when physostigmine was administered 1 hr after vesamicol. Acetylcholine and choline levels were determined in three brain regions derived from rats treated one hr earlier with either vehicle or vesamicol. Acetylcholine levels were found to be unaltered after vesamicol treatment, although choline levels were significantly higher in two brain regions. These results are consistent with the ability of vesamicol to inhibit the function of central cholinergic cardiovascular regulatory neurons. The mechanism for this inhibition is not related to depletion of total brain acetylcholine content but may be due to depletion of a small critical pool of transmitter.

Electropharmacological effects of sandostatin in human atrial fibers

We studied the actions of sandostatin (0.1-1000 nM), an analogue of somatostatin, on human atrial tissues obtained from hearts of 20 patients undergoing corrective cardiac surgery. In 3 preparations showing fast response action potential in normal [K]0 Tyrode solution, sandostatin induced little effect, even at the highest concentration (1 microM). In 10 preparations showing a slow rate of phase-0 depolarization when atrial fibers were depolarized (maximum diastolic potential near -40 mV) in high [K]0 (27 mM), sandostatin at concentrations as low as 1 nM decreased significantly the velocity of the upstroke, and the amplitude of slow response of the action potential as well as the force of contraction. In 6 experiments on spontaneously active atrial fibers (maximum diastolic potential = -53.8 +/- 2.7 mV), sandostatin increased the spontaneous cycle length in a fashion dependent upon concentration. The decrease in spontaneous rate of firing was associated with an inhibition of the late diastolic slope, a change also induced by somatostatin. A longer period of washout, however, (30 min or longer) was required for complete recovery from the depressant effects. Sandostatin (0.1-100 nM) also depressed triggered activity induced by cardiotonic agents. The present findings indicate that sandostatin induces a prolonged action in human atrial cells. Sandostatin may depress abnormal automatic rhythms through an inhibition of transmembrane influx of calcium.

Unusual cardiac malformations in Holt-Oram syndrome: report of two cases

The Holt-Oram syndrome is a hereditary disease which associated with upper limbs anomalies and cardiac defects such as secundum type atrial septal defect. Two cases of this syndrome with unusual cardiac findings are reported: One has an unroofing coronary sinus type atrial septal defect and preexcitation syndrome, the other has pentalogy of Fallot.

Depressant effect of adenosine in isolated human and canine atrial fibres

STUDY OBJECTIVE0--he aim was to explore the cellular mechanisms responsible for the depressant effects of adenosine in human atrial tissues.

DESIGN

Conventional microelectrode technique was used to record transmembrane action potential of human atrial tissues obtained at cardiac surgery. Effects of adenosine (0.1-100 microM) on action potential characteristics and contractile force of human atrial fibres in the absence and presence of an adenosine receptor antagonist (DPSPX) were evaluated. Results were then compared with those obtained from the canine atrial tissues.

EXPERIMENTAL MATERIAL

Atrial tissues obtained from hearts of 25 patients undergoing corrective cardiac surgery were used. Seven mongrel dogs were anaesthetised and strands of atrial muscle were removed and used for comparison.

MEASUREMENTS AND MAIN RESULTS

In human atrial fibres showing fast response action potential (mean dV/dtmax around 100 V.s-1) in normal [K]o (4 mM) Tyrode solution, adenosine (1 nM-10 microM) did not induce consistent effects on the action potential characteristics. When the fibres were depolarised in high [K]o (27 mM) or in atrial fibres showing slow response action potential (dV/dtmax less than 50 V.s-1), however, 10 microM adenosine reduced the upstroke velocity and the amplitude of action potential significantly and markedly depressed the contractile force. In atrial fibres spontaneously active in normal Tyrode solution (maximum diastolic potential around -50 mV), adenosine inhibited rate of spontaneous discharge in a concentration dependent manner. Delayed afterdepolarisation and aftercontraction induced by adrenaline or/and high [Ca]o were also suppressed. The depressant effects of adenosine were blocked after pretreatment with 50 microM DPSPX, a specific antagonist for adenosine receptor.

CONCLUSIONS

These findings show that adenosine may abolish abnormal automatic rhythms and triggered activity in human atria.

[Gluco, lipometabolic and trace elements alteration in bile with acute purulent cholangitis]

Analysis was made of the gluco, lipometabolic materials and trace elements in bile from patients. The specimens were collected in 11 cases with acute purulent cholangitis and 13 cases of selective biliary surgery at both inter-operational time, at which the bile were got by needling from the common bile duct, and post-operational time, at which the bile was obtained from T tube drainage bile before the extraction of the T tube or discharge from hospital. It was found that lactic acid and glucose markedly decreased and LDH activity increased in the cholangitis group at inter-operational time. Lifted hepatic glyconeogenesis and gluco-consumption and hepatic cellular damage were indicated. At the same time, most of the lipo-materials and lipase activity increased, as compared with the selective group, which showed that lipolysis was encouraged and that lipo-materials had flowed into the bile because of hepatic cellular damage. At the time of acute cholangitis, the Zn and Fe in bile markedly increased but the Cr in bile decreased, and the mechanism was not clear.

[The role of hemorheologic changes in the pathogenesis of acute hemorrhagic necrotizing pancreatitis]

The hemorheologic alterations were studied in experimental acute hemorrhagic necrotizing pancreatitis (AHNP) which was induced by injection of 5% sodium taurocholate into the main pancreatic duct. The results showed that during the early stage of AHNP, all of hemorheologic parameters were significantly elevated, and continually increased at the rest intervals. The authors suggested that the blood viscosity and hematocrit increase, red blood cells tend to aggregate, and erythrocyte deformation decrease are the causation of pancreatic microcirculatory disturbances and promoting pancreatic progressive necrosis. After using low molecular dextran and Salvia miltiorrhizae, the hemorheologic alterations in AHNP were recovered, and the histologic observation improved. Our data indicate the hemorheologic disturbances is one of the key factors in the pathogenesis of AHNP.

Reconstruction of superior vena cava in invasive thymoma

Aggressive en-bloc resection of the superior vena cava was performed in a 50-year-old man who had superior vena caval syndrome caused by invasive thymoma. After the superior vena cava was resected, a Gore-Tex vascular graft was used to reconstruct the lower end of the right innominate vein and lower end of the superior vena cava. The patient was treated with postoperative radiotherapy to the mediastinum and has been asymptomatic for 14 months following surgery.

Electromechanical effects of protamine in isolated human atrial and canine ventricular tissues

Effects of protamine sulfate (1-100 mg%) on the electrical and mechanical activities of isolated dog ventricular tissues and human atrial fibers were studied. In dog Purkinje fibers, 10 mg% protamine reduced markedly the maximum diastolic potential and the rate of phase 0 depolarization. Eventually, slow response action potential developed at a depolarized level and the twitch force declined abruptly. The depolarization and the negative inotropy were reversed by increasing [Ca])o or [K]o but not by tetrodotoxin. When Purkinje fibers were depolarized in 27 mM [K]o Tyrode solution plus 0.5 microM epinephrine, higher concentrations of protamine (30 mg% or above) were required to depress the slow response action potentials and twitch, in contrast to the action of verapamil and diltiazem (1-30 microM). Dog ventricular and human atrial muscle fibers were more resistant to the depressant effects of protamine. In human atrial fibers, however, 10 mg% protamine was able to depress significantly the oscillatory afterpotentials and aftercontractions induced by epinephrine and theophylline. The present findings suggest that the depolarization and decline in force of cardiac tissues induced by protamine, at a concentration about twice of the maximum clinically relevant dose, may be explained by the development of slow response action potentials as a result of decrease in membrane K+ and Na+ conductances.

Depressant effects of isoflurane and halothane on isolated human atrial fibers

The present experiments were designed to study the cellular mechanism responsible for the depressant effects of halothane and isoflurane on human atrial tissues obtained at cardiac surgery. The fibers were superfused in Tyrode's solution, and transmembrane potentials were recorded with a microelectrode technique. In atrial fibers showing fast response action potential (maximum velocity of depolarization [Vmax] greater than 100 V/s), halothane (0.75 vol%, 0.44 mM) and isoflurane (1.25 vol%, 0.53 mM) decreased slightly the upstroke velocity but depressed the plateau and twitch force significantly. In atrial fibers showing slow rate of phase-0 depolarization or when atrial fibers were depolarized in high [K]0, both halothane and isoflurane decreased the upstroke of slow response and the force. The depressant effects of anesthetics partially mimicked the actions of 1 microM tetrodotoxin and diltiazem and could be reversed by epinephrine or high [Ca]0. The delayed afterdepolarizations or aftercontractions and contracture induced by epinephrine or strophanthidin were also inhibited by both anesthetics. Halothane and isoflurane may depress normal electromechanical activity and arrhythmogenic triggered activity through a reduction of cation fluxes across the cell membrane.

Controlled reperfusion following regional ischemia

The ability to reverse acute coronary occlusion with fibrinolytic agents and percutaneous transluminal angioplasty has increased interest in the revascularization of ischemic myocardium. This study defines changes in global ventricular function, mass, and compliance during acute coronary occlusion and following reperfusion with blood in the beating and arrested heart. In 17 dogs on cardiopulmonary bypass, the proximal left anterior descending coronary artery was occluded for 45 minutes. In 12 dogs, flow was reestablished by releasing the coronary snare in the beating heart. In the other 5 dogs, the snare was released during a continuous 10-minute infusion of blood potassium cardioplegia in the arrested heart. Coronary occlusion resulted in significant decreases in stroke work index and left ventricular (LV) mass, but compliance was unchanged. Reperfusion in the beating heart increased LV mass compared with the values measured before ischemia (104 +/- 5 versus 95 +/- 5 gm; p less than 0.05) and decreased LV compliance (39 +/- 4 versus 53 +/- 4 ml at LV end-diastolic pressure of 8 mm Hg; p less than 0.05). In contrast, with blood cardioplegia-based reperfusion in the arrested heart, LV mass and LV compliance remained unchanged from control values. We conclude that revascularization of acutely ischemic myocardium in the beating heart further impairs LV function by increasing LV mass and decreasing compliance. This damage can be avoided by reperfusion with blood cardioplegia in the arrested heart.

The effects on fetal brain development in the rat of a severely iodine deficient diet derived from an endemic area: observations on the first generation

Rats were fed on a severely iodine deficient diet (iodine content 4.5 micrograms/100 g) similar to that being consumed by people living in a village with a high rate of endemic cretinism. After a period of 4 months, the thyroid and brain were studied in the adult and their fetuses at 16, 17, 18, 19 and 20 days of gestation, and in postnatal animals at 1, 5, 10, 20, 30 and 60 days of age. By comparison with a control group (diet with iodine content 54.7 micrograms/100 g) the experimental group showed marked goitres, a higher uptake of 125I by the thyroid, reduced serum T4, and reduction in brain weight. The cerebral and cerebellar histological findings showed that the density of brain cells had increased, and the mean neuron size was reduced. Furthermore, disappearance of the cerebellar EGL was delayed. These findings indicate that this animal model is likely to be suitable for the studies of endemic cretinism in man.

A giant congenital aneurysm of the right coronary artery

A young woman with shortness of breath was diagnosed preoperatively as having a coronary artery aneurysm. The aneurysm originated from the right coronary artery and was extraordinarily large. The aneurysm was excised successfully under extracorporeal circulation.

A comparison of results of type I and type II radical operations for carcinoma of the gastric cardia

During 1954-1981, 527 patients with cancer of the gastric cardia underwent resection. Of these, 146 underwent type I radical operation (transthoracic resection) with eight (5.5%) operative deaths; 344 underwent type II radical operation (abdominothoracic resection) with 42(12.2%) operative deaths; and 37 with Stage IV lesions underwent extended operation or palliative operation with 4(10.8%) operative deaths. Of 440 cases of Stage I-III cases that survived the operation, the 5-year survival rate was 18.5%, and the 10-year survival rate was 10.7%. For stage I cancer, the end results of type I and type II radical operations were similar. In Stage II, whether the lymph nodes were positive or negative, the end result of the type II operation was better, but without statistical significance. In Stage III cancer without lymph node metastases, the end result of the type II operation was better, but without statistical significance; in those with lymph node metastases, the type II operation was definitely better than the type I operation (P less than 0.05).

Fertile mule in China and her unusual foal

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Two-dimensional echocardiography in dogs. Variation of left ventricular mass, geometry, volume, and ejection fraction on cardiopulmonary bypass

Quantitative two-dimensional echocardiography was evaluated in 39 open-chest dogs placed on cardiopulmonary bypass. The correlation coefficient of left ventricular end-diastolic volume against postmortem pressure-volume curves was r = 0.89 to 0.93 (347 measurements in 15 dogs, 0 to 24 mm Hg). Ejection fraction was validated against roller pump flow and echo left ventricular end-diastolic volume (r = 0.83, n = 13). Left ventricular mass in vivo was compared with postmortem left ventricular mass (r = 0.81 in 21 early studies, r = 0.91 in 10 later studies with updated equipment) and was found to increase with ischemic injury as well as cardiopulmonary bypass with hemodilution. Left ventricular mass increased (p less than 0.001) from 119 +/- 5 (standard error of the mean) to 138 +/- 6 gm (n = 23) after 2 1/2 hours on cardiopulmonary bypass and moderate hemodilution. With the addition of ischemic arrest, left ventricular mass increased from 119 +/- 7 to 148 +/- 11 gm (p less than 0.01, n = 8), and myocardial water content increased by 2.0% +/- 0.4%, which accounted for at least 65% of the observed mass change. Mean left ventricular wall thickness increased from 13.8 to 15.5 mm (p = 0.02) after ischemia. Ventricular shape became more spherical with increasing left ventricular end-diastolic pressure. We conclude that two-dimensional echocardiography can be reliably used for accurate, serial measurements in physiological studies. The demonstrated variability in left ventricular mass is important, yet frequently ignored. Recognizing left ventricular mass changes may facilitate the detection of myocardial injury reflected as edema.

Pharmacologic antagonism of propranolol in dogs. III. Effects of dopamine-isoproterenol and glucagon on hemodynamics and myocardial oxygen consumption in ischemic hearts during chronic propranolol administration

In 31 dogs chronically beta blocked with oral propranolol (12 to 14 mg/kg/day), glucagon (20 micrograms/kg) and combined dopamine (10 micrograms/kg/min) and isoproterenol (0.2 micrograms/kg/min) were given intravenously and tested for hemodynamic efficacy. Dogs were divided into four groups. Basal hemodynamics were obtained In Group I (n = 8) without cardiopulmonary bypass. In Group II (n = 8), hemodynamics were studied after 15 minutes of global ischemia during cardiopulmonary bypass. In Group III (n = 8), hemodynamics were studied after regional ischemia produced by ligation of the proximal left anterior descending coronary artery. In Group IV (n = 7), myocardial oxygen consumption and left ventricular mechanics were studied before and after 1 hour of cardiopulmonary bypass. Our results indicate the following: (1) Dopamine-isoproterenol improves hemodynamics in basal, post-global ischemic, and post-regional ischemic states. Glucagon improves hemodynamics either insignificantly or to a lesser extent than dopamine-isoproterenol. Furthermore, glucagon produces a larger increase in heart rate, which is not desirable. (2) Both dopamine-isoproterenol and glucagon increase myocardial oxygen consumption in comparison with control.

Heart-rate effects on canine left-ventricular end-diastolic compliance measured by two-dimensional ultrasound

Despite recent interest in left ventricular (LV) compliance during open-heart surgery, the effect of heart rate (HR) remains unclear due to technical limitations of previous studies. In the presence of Formalin-induced complete atrioventricular (AV) block, AV sequentially paced heart rate was varied between 100, 125, and 150 beats/min in eight dogs on cardiopulmonary bypass. The heart was cradled in an open pericardial well filled with ultrasound-conducting gel. LV end-diastolic pressure (LVEDP) was varied over 0-20 mm Hg by flow regulation in the bypass circuit. Left ventricular end-diastolic volume (LVEDV) was calculated from three orthogonal two-dimensional (2-D) echocardiographic sections using Simpson's rule. Exponential curves derived from the relation LVEDP = ke(bxLVEDV) demonstrated a small, but significant increase in the mean exponential constants (b = 0.034, 0.037, and 0.049 at HR 100, 125, and 150, respectively) reflecting progressive stiffening with increasing heart rate. However, mean overall pressure-volume relations were not significantly altered when analyzed in four separate intervals of LVEDP. It is concluded that although LV volume determinations with 2-D echocardiography demonstrate a steady trend toward decreased end-diastolic LV compliance with increasing rate, this change is so small as to make heart rate a minor determinant of observed intraoperative compliance changes.