[Clinical study of yi shen ning for treatment of kidney-yang deficiency after hormone withdrawal of primary nephrotic syndrome--clinical analysis of 100 cases]

This paper reports that Yi Shen Ning (YSN) which acts as warming and tonifying Kidney-Yang was administrated on 100 cases of primary nephrotic syndrome (PNS) while adrenocortical hormone (ACTH) was diminished to half dosage. The results showed that to apply the integrated TCM and WM according to the different stage of PNS was quite effective to treat deficient syndrome of Kidney-Yang appeared after withdrawal of ACTH. This recipe not only could improve the symptoms, but also pick plasma cortisol up earlier than expected, which was inhibited by exogenous hormone. The total remission rate of YSN group was 68.75%, higher than that of ACTH group (P < 0.05), especially for the cases dependent on exogenous hormone, the re-acquired remission rate reached to 58.3%.

Prevalence of anti-HCV among Chinese patients with acute and chronic liver disease

To assess whether the hepatitis C virus plays an important role in Chinese patients with acute and chronic liver disease, antibodies to HCV (anti-HCV) were measured by enzyme immunoassay in 67 patients with type A and B acute viral hepatitis, 165 patients with non-A, non-B (NANB) hepatitis, 438 patients with chronic hepatitis, 200 patients with postnecrotic liver cirrhosis, 72 patients with alcoholic liver disease, 55 patients with non-alcoholic fatty liver, 24 patients with toxic and drug-induced hepatitis, and 20 patients with other chronic liver diseases. Anti-HCV was not detected in sera from patients with type A and B acute viral hepatitis, toxic and drug-induced hepatitis, primary biliary cirrhosis, Wilson's disease, or lupoid hepatitis. The anti-HCV prevalence was found to be highest in patients with NANB hepatitis (59% in sporadic and 73.2% in transfusion-associated), 16.4% in non-alcoholic fatty liver, 5.6% in alcoholic liver disease, 6.8% in chronic hepatitis, and 16% in postnecrotic liver cirrhosis. In patients with chronic hepatitis, the anti-HCV prevalence was significantly higher in HBsAg-negative (15/34, 44.1%) than in HBsAg-positive cases (15/404, 3.7%; P less than 0.0001). The results indicate that HCV is a major agent of NANB hepatitis and plays an important role in HBsAg-negative chronic liver disease in Taiwan.

Sequence and structure of the catalytic RNA of hepatitis delta virus genomic RNA

Human hepatitis delta virus (HDV) RNA has been shown to contain a self-catalyzed cleavage activity. The sequence requirement for its catalytic activity appears to be different from that of other known ribozymes. In this paper, we define the minimum contiguous sequence and secondary structure of the HDV genomic RNA required for the catalytic activity. By using nested-set deletion mutants, we have determined that the essential sequence for the catalytic activity is contained within no more than 85 nucleotides of HDV RNA. These results are in close agreement with the previous determinations and confirmed the relative insignificance of the sequence at the 5' side of the cleavage site. The smallest catalytic RNA, representing HDV genomic RNA nucleotide positions 683 to 770, was used as the basis for studying the secondary structure requirements for catalytic activity. Analysis of the RNA structure, using RNase V1, nuclease S1 and diethylpyrocarbonate treatments showed that this RNA contains at least two stem-and-loop structures. Other larger HDV RNA subfragments containing the catalytic activity also have a very similar secondary structure. By performing site-specific mutagenesis studies, it was shown that one of the stem-and-loop structures could be deleted to half of its original size without affecting the catalytic activity. In addition, the other stem-and-loop contained a six base-pair helix, and the structure, rather than the sequence, of this helix was required for the catalytic activity. However, the structure of a portion of the stem-and-loop remains uncertain. We also report that this RNA can be divided into two separate molecules, which alone did not have cleavage activity but, when mixed, one of the RNAs could be cleaved in trans. This study thus reveals some features of the secondary structure of the HDV genomic RNA involved in self-catalyzed cleavage. A model of this RNA structure is presented.

Gonadal dysfunction and changes in sex hormones in postnecrotic cirrhotic men: a matched study with alcoholic cirrhotic men

To investigate the gonadal dysfunction and changes in sex hormones in male patients with postnecrotic cirrhosis, and to compare them with those in alcoholic cirrhotic men, three age-matched groups of men (hepatitis B virus-related postnecrotic cirrhosis 27, alcoholic cirrhosis 21, normal controls 30) were studied. Twelve of the 21 (57%) alcoholic cirrhotics and 16 of the 27 (59%) postnecrotic cirrhotics had a history of impotence. Both alcoholic and postnecrotic cirrhotic patients had significantly lower basal testosterone, but higher estradiol and prolactin levels than the control group (p less than 0.05). However, no differences were noted between the two cirrhotic groups. The degree of reduced testosterone and increased prolactin levels correlated with the severity of the cirrhosis. Despite the low testosterone concentration, basal levels of follicle stimulating hormone (FSH) and luteinizing hormone (LH) were not increased in the cirrhotic patients. All the three groups studied had normal FSH and LH responses to the stimulation of exogenous gonadotropin releasing hormone. On the basis of these results, we conclude that: (1) impotence and low testosterone level are not infrequent findings in men with hepatitis B virus-related postnecrotic cirrhosis, especially in those with decompensated liver function. (2) The liver disease per se is important for the development of male sexual dysfunction. (3) The derangement of hypothalamic-pituitary function may play a role in the sexual dysfunction and changes in sex hormones in male patients with cirrhosis.

Acute hepatitis B viral infection in a patient with anti-HBs

We report a patient with antibody to hepatitis B surface antigen (anti-HBs) but no antibodies to other hepatitis B virus components, who developed acute symptomatic type B hepatitis. The possible explanations for this unusual serological pattern are 1) the antibody-positive status, which developed against only a subdeterminant of hepatitis B surface antigen (HBsAg), arose naturally or as the result of cross-reaction with a variety of antigens; and 2) seroconversion to anti-HBs occurred in response to surface antigen of a mutant strain of hepatitis B virus (HBV). This anti-HBs positivity, in the absence of antibody to hepatitis B core antigen, does not provide natural immunization against HBV infection, and so is not protective. Individuals who are positive to anti-HBs antibody alone which is not elicited by HBV vaccine, should be vaccinated against possible HBV infection.

Intranasal bioavailability of insulin powder formulations: effect of permeation enhancer-to-protein ratio

The intranasal administration of powder formulations containing insulin and the permeation enhancer sodium tauro-24,25-dihydrofusidate (STDHF) were investigated in the sheep model. Both the hypoglycemic response and the serum insulin levels increased as the mole ratio of STDHF to insulin was increased from 0 to 16.8. In vitro dissolution rates of the powders and the rapid tmax (approximately 5 min) observed after intranasal administration suggest that the absorption of insulin is not dissolution limited. The bioavailabilities (F) of the powder formulations ranged from 2.9 to 37.8%. In comparison, the F values for a solution formulation with a STDHF:insulin ratio of 8.4 administered as either drops or spray were 15.7 and 37.4%, respectively. The permeation enhancer STDHF increases mucosal permeability and reduces the average molecular weight of the insulin species.

Biomechanical evaluation of cervical spine instability after multiple level laminectomy

Four fresh human cervical spine specimens (C2-T1) were tested both intact and with C5-C6 laminectomies to evaluate the biomechanical effects of multiple level laminectomy. The loads applied to the specimens were physiological and clinically relevant motion patterns were simulated. The results showed that C5 vertical displacements increased by 83.33% in axial compression, 168.75% in flexion, 106.09% in extension, and 35.14% in left bending after C5-C6 laminectomies compared with intact specimens. The increased rates of C6 vertical displacements after laminectomy were slightly lower than C5. The anterior horizontal bulging of C5-6 discs increased by 29.69% in axial compression, 13.86% in flexion, 61.79% in extension, and 13.40% in left bending after laminectomy. The rotational angles of whole specimens had an increase of 15% after laminectomy. The strains in the anterior vertebral bodies and posterior laminae near the articular processes of C5 and C6 were increased significantly after laminectomy. The data indicated that multiple level laminectomy can lead to biomechanical instability of the cervical spine.

High-yield extraction and purification of glutathione reductase from baker's yeast

Glutathione reductase was extracted from toluene-treated baker's yeast cells by a two-stage buffer autolysis method. The yeast cells were treated with toluene for 1 h at 40 degrees C. After removal of the toluene, the cells were then allowed to autolysis in buffer for 72 h at 4 degrees C. The cells were collected and resuspended in buffer. A second stage autolysis was carried out for another 96 h at 4 degrees C. The enzyme was purified to 786-fold from the second stage cell autolysate by using two steps of affinity chromatography with triazine dyes (Yellow H-E4G and Yellow H-E6G) coupled to Sepharose CL-4B. By using this simplified method, 1.44 mg (165 units/mg) of glutathione reductase was obtained from 65 g (wet weight) of yeast cells, equivalent to 80% enzyme recovery.

Seroepidemiology of hepatitis C virus infection in Taiwan

The prevalence of antibody to hepatitis C virus among Chinese subjects in Taiwan was evaluated using a commercially available enzyme immunoassay. The overall prevalence of antibody to hepatitis C virus was 0.28% among 1,419 healthy subjects, 0.8% among 500 unselected paid blood donors and 0.4% among 793 pregnant women. The three offspring of the mothers positive for antibody to hepatitis C virus were all found to be positive for antibody to hepatitis C virus at birth but all became negative by the age of 6 mo. Among healthy subjects, none of 1,000 school children and young adolescents had antibody to hepatitis C virus. Among patients in selected "high-risk" groups, antibody to hepatitis C virus was detected in 100% of 9 hemophiliac patients who were positive for antibody to human immunodeficiency virus, in 53% of 115 intravenous drug abusers, in 34.4% of 96 hemodialysis patient and in 15.8% of 19 homosexual men who were positive for antibody to human immunodeficiency virus. Only 7.1% of 196 prostitutes, 5.9% of 34 spouses of patients positive for antibody to hepatitis C virus and 0.5% of 201 brothelgoers had antibody to hepatitis C virus. These findings suggest that hepatitis C virus is transmitted mainly by the parenteral route in Taiwan. Transmission from mother to infant is not an important mode of spread of hepatitis C virus.

Purification and Characterization of d -Aminoacylase from Alcaligenes faecalis DA1

A d -aminoacylase from Alcaligenes faecalis DA1 has been purified to homogeneity by a simple purification procedure with two columns, Fractogel DEAE-650 and HW-50. The specific activity of the purified enzyme was found to be 580 U/mg of protein with N -acetyl- dl -methionine as the reaction substrate. The apparent molecular weight and isoelectric point of this enzyme were determined to be 55,000 and 5.4, respectively.

Superinfection with hepatitis C virus in patients with symptomatic chronic hepatitis B

11/323 patients (3.4%) with symptomatic chronic hepatitis B were positive for antibody to hepatitis C virus (anti-HCV). The positive rate of anti-HCV in patients with serum alanine aminotransferase (ALT) levels greater than 200 U/l (n = 219) did not exceed that of the patients with ALT less than or equal to 200 U/l (n = 104) (2.7% vs. 4.8%). Of the 219 patients who were positive for hepatitis B e antigen (HBeAg) and/or hepatitis B virus-DNA (HBV-DNA), 5 (2.3%) had anti-HCV, while 6/104 patients (5.8%) who were positive for antibody to HBeAg (anti-HBe) had anti-HCV (p greater than 0.1). In contrast to the anti-HCV-negative patients, the patients with anti-HCV had a higher percentage of cirrhosis in their liver histological findings (36.4% vs 5.4%, p less than 0.005). In conclusion, the prevalence of HCV superinfection in symptomatic chronic hepatitis B patients is low and HCV superinfection is not an important factor in acute exacerbation of chronic hepatitis B. However, the superinfection with HCV may exacerbate the existing liver disease and accelerate its progression.

Sexual transmission of hepatitis D virus infection in Taiwan

Multivariate analysis of the risk factors for hepatitis D virus infection among 53 men with acute hepatitis D virus superinfection, 59 men with acute exacerbation of chronic hepatitis B and 54 asymptomatic male hepatitis B carriers revealed that sexual contact with prostitutes and use of nondisposable needles were the factors significantly associated with hepatitis D virus infection in Taiwan (odds ratio = 5.5, 95% confidence interval = 3.3 to 9.2; odds ratio = 2.4, 95% confidence interval = 1.3 to 4.4, respectively). The prevalence of antibody to hepatitis D virus antigen among hepatitis B virus carriers with histories of sexual exposure to prostitutes was 10.3% (14 of 136) and the prevalence of hepatitis D virus antigen among the female prostitutes who were hepatitis B virus carriers was 59% (24 of 51). Among those who admitted to sexual contact with prostitutes, testing for hepatitis D virus antigen revealed positive correlations with the frequency of such sexual contacts and with the frequency of history of venereal diseases. Among the female prostitutes, the prevalence of hepatitis D virus antigen had a positive correlation with the frequency of sexual contact and a negative correlation with age. Analysis of serum hepatitis D virus RNA among those with hepatitis D virus antigen revealed that 4 of the 9 with sexual exposure to prostitutes and 3 of the 24 prostitutes were positive. From these findings, we conclude that these two groups are not only at high risk for hepatitis D virus infection but also form a reservoir of this virus.

Enzyme loading in a solid support with nonuniform pore size distribution

The concept of pore size distribution is incorporated into the Clark model of enzyme immobilization in the present study. This refined model predicted that in the case of small harmonic pore radius with the same surface area and porosity of the support, more enzyme could be loaded in a support with nonuniform pores than that with uniform pores. In comparing the enzyme loading efficiency of the support with two different pore size distributions, the one with Gaussian distribution had the greater amount of enzyme immobilized than the other one with Rajagopalan's distribution. Furthermore, more enzyme could be loaded in a support with wider Gaussian pore size distribution than that with narrower distribution. The immobilized enzyme profile in the solid support with pore size distribution displayed a stepwise pattern which differed appreciably from the sigmoidal profile predicted for the support with uniform pore size. This stepwise enzyme distribution profile became sigmoidal with decreasing h(T) or increasing k. The new model could be used for designing protocols for an enzyme immobilization process.

Isoniazid-rifampin-induced hepatitis in hepatitis B carriers

From January 1984-December 1987, 1783 patients received combination therapy of isoniazid, rifampin, and ethambutol for the control of tuberculosis. Forty-two developed symptomatic hepatitis during the period of treatment. Fifteen were hepatitis B virus carriers, and the remaining 27 were noncarriers. The peak serum transaminase and bilirubin levels were higher in carriers. Seven carriers died of fulminant or subacute hepatic failure, and only 1 noncarrier died. Eleven carriers had detectable serum hepatitis B virus deoxyribonucleic acid during the acute stage of hepatitis. The roles of isoniazid-rifampin combination therapy and hepatitis B virus in the adverse outcomes of carriers were discussed.

Effects of phentolamine and propranolol on the changes of pain threshold and contents of MEK and LEK in rat brain after EA

The contents of Met-enkephalin (MEK) and Leu-enkephalin (LEK) in striatum and MEK in hypothalamus of rat increased markedly after electroacupuncture analgesia (EAA). Intraperitoneal injection of phentolamine, a blocker of alpha receptor, potentiated the EAA and abolished the effects of EA increasing MEK and LEK contents; while injection of propranolol, a blocker of beta receptor, partially inhibited the EAA, as well as abolished the effects of EA increasing MEK and LEK concentrations in the striatum and the hypothalamus, and also elevated the MEK and LEK contents in hippocampus and MEK level in cortex. The results indicate that EA regulates metabolism of MEK and LEK, as well as EAA partially via alpha and beta receptors.

[Studies on protective monoclonal antibodies to Leishmania donovani]

Kala-azar is increasing in incidence in some endemic areas of China, such as provinces of Sichuan and Gansu. Monoclonal antibodies have been shown to interfere with the cutaneous leishmaniasis infection in the experimental animals. We have now raised McAb against membrane antigen of promastigotes of L. donovani canine isolate (the pathogen of visceral leishmaniasis). In this paper we report 3 McAb which inhibit the growth of promastigotes in vitro culture by incorporation of 3H-thymine deoxyriboside, such as McAb 2B12-A8, 2H6-E3, in the presence of complement, showing strong inhibiting effects with a decrease in incorporation of 3H-TdR, 94-99.3% rate of inhibition, whereas the inhibition rate induced by McAb 1B1-C2 fluctuated in a range of 68-95%, which is identical with the results of macrophage infection inhibition test by the same McAb, 61-87%. The results of ultrastructural localization of L. donovani antigen by protective McAb 2H6-E3 with immunogold technique showed the gold particles, in clumps, widely distributed on the outer side of promastigotes membrane. According to the high density of localized gold particles, it is suggested that this antigen is abundant on the plasma membrane.

Lymphocyte subset analysis to predict progression to AIDS in a cohort of homosexual men in San Francisco

A group of 10 leukocyte and lymphocyte subsets were measured by simultaneous dual immunofluorescence and flow cytometry in a group of homosexual men from the San Francisco General cohort. Absolute numbers and percentages of lymphocytes were determined in 30 individuals who progressed to AIDS and 29 who did not over a 44-month period at annual intervals. At entry into the study, all subjects were asymptomatic, HIV seropositive, and had multiple changes in lymphocyte subsets compared to HIV-negative controls. In progressors, large changes occurred from the first visit to the last visit before progression in both absolute numbers and percentages of CD4 cells. The percentage of HLA-DR-bearing CD8 cells also increased. We utilized a proportional hazards model to assign a predictive value for progression to AIDS to lymphocyte subsets in both univariate and multivariate tests. Increased DR-positive CD8 cells, decreased CD4 cells, and increased CD8-positive, Leu 7-positive cells independently predicted progression to AIDS at P less than 0.006 (relative hazard 5.8-4.0). In a multivariate model, the most useful tests were either increased numbers or percentages of DR-positive CD8 cells. These data suggest parsimonious approaches to following HIV-positive individuals and further support the possibility of autoreactive T cells in the pathogenesis of HIV-associated diseases.

Effect of electroacupuncture on brain enkephalins content at different times in rats

The basic level of methionin-enkephalin (MEK) in rat medulla oblongata plus pons was the highest at 05:00 o'clock and the lowest at 23:00. In both hypothalamus and striatum at 05:00 it was higher than at 11:00, 17:00 and 23:00. In both hippocampus and midbrain at 05:00 and 23:00 it was higher than those at 11:00 and 17:00. In the cortex it was higher at 05:00 than at 11:00 and 17:00. The basic level of leucine enkephalin (LEK) in the medulla oblongata plus pons was the highest at 11:00 and the lowest at 17:00 and 23:00. Electroacupuncture (EA) at 05:00 increased the MEK content in the medulla oblongata plus pons and the LEK level in the hypothalamus. It decreased the MEK content in the hypothalamus and the LEK level in the cortex; EA at 11:00 produced decreases of MEK concentrations in the medulla oblongata plus pons and the midbrain and increases of MEK content in the cortex, hypothalamus and striatum. At 17:00 it increased the MEK level in the hypothalamus and the LEK content in the hippocampus. At 23:00 it reduced the levels of MEK and LEK in the hippocampus. The results suggest that there are very marked circadian rhythms in the MEK basic levels of the six discrete brain regions observed and the LEK of the medulla oblongata plus pons; EA at different times produces different effects on brain MEK and LEK levels.