[Effect of hemin in treating hemorrhagic anemia and toxicity]

AIM

To study the effect of hemin in treating hemorrhagic anemia and toxicity.

METHODS

Fifty rats with hemorrhagic anemia were randomly divided into 5 groups with different dosage of hemin (93, 168, 300 mg.kg-1.d-1), ferrous gluconate (FG 300 mg.kg-1.d-1), and water, ig for 7 d. Twenty mice fed with hemin (6.0 g.kg-1.d-1) in 24 h for observing acute toxicity effects. Long-term toxicity were observed in 80 rats given hemin (0.65, 1.3, 2.6 g.kg-1.d-1) in 3 months.

RESULTS

Hb of the rats of corresponding groups were 66-->121, 71-->141, 66-->148, 69-->140, and 67-->112 g.L-1. There were no adverse effects observed on acute toxicity test. No abnormalitis were found in hemogram, liver renal function test, and autopsy.

CONCLUSION

Hemin had a better effect than FG and no adverse effect was found in hemin.

Biochemical interaction between Tamm-Horsfall glycoprotein and Ig light chains in the pathogenesis of cast nephropathy

BACKGROUND

Cast nephropathy in multiple myeloma patients is caused by heterotypic aggregation of Tamm-Horsfall glycoprotein (THP) with monoclonal light chains (Bence Jones protein, BJP). Co-aggregation of these proteins is triggered by the binding of BJP to a specific peptide portion of THP. Defining those factors that alter the interaction between BJP and THP may help to understand further the pathogenesis of cast nephropathy and serve to decrease the morbidity and mortality of cast nephropathy. We hypothesized that pH, calcium, furosemide, and the carbohydrate moiety of THP all modulate the protein-protein interaction between BJP and THP.

EXPERIMENTAL DESIGN

Binding affinity and aggregation rate of human THP with two human nephrotoxic BJP were tested at pH 8.5, 7.4, and 5.0. The effects of calcium, furosemide, and free sialic acid were also evaluated. Binding and aggregation of BJP with THP purified from normal volunteers treated with oral colchicine were observed. The carbohydrate components of THP were also analyzed.

RESULTS

An acidic environment increased initial binding rate and produced a parallel increase in the aggregation rate of THP with BJP. Calcium and furosemide enhanced aggregation rates without interfering with binding. Colchicine treatment decreased the amount of sialic acid linked alpha(2-6) to galactose (NeuAc alpha 2-6Gal) and sialic acid linked alpha(2-3) to galactose (NeuAc alpha 2-3Gal) on THP and thereby decreased the aggregation rate with BJP without altering binding. Addition of free sialic acid did not alter binding but did decrease aggregation rates of the two proteins.

CONCLUSIONS

Environmental conditions modulate BJP-THP interactions and may be responsible for inducing case nephropathy in multiple myeloma. Modification of carbohydrate components of THP or use of oligosaccharides may decrease or prevent cast nephropathy.

Pathogenesis of glomerulosclerosis in light chain deposition disease. Role for transforming growth factor-beta

The glomerulopathy of monoclonal immunoglobulin light chain deposition disease is a progressive disorder characterized by accumulation of monoclonal light chains and matrix proteins in the mesangium. To define the role of light chains in this process, cultured rat mesangial cells were exposed to different light chains and human albumin. Two light chains were purified from the urine of patients who had biopsy-proven light chain deposition disease. These proteins inhibited mesangial cell proliferation and increased production of matrix proteins, including type IV collagen, laminin, and fibronectin. By immunocytochemistry and bioassay, transforming growth factor-beta (TGF-beta) production and activity increased when mesangial cells were exposed to these proteins. Furthermore, anti-TGF-beta antibody abolished the inhibition of cell proliferation and the increase of extracellular matrix protein production caused by these light chains. These findings were not observed in mesangial cells exposed to human albumin and two other light chains previously characterized to be tubulopathic. We concluded that the glomerulopathic light chains increased TGF-beta, which inhibited mesangial cell proliferation and increased matrix protein production. Together with overexpression of TGF-beta in affected glomeruli of light chain deposition disease, light chain-mediated stimulation of mesangial cells to produce TGF-beta appears to be a key pathological mechanism of this disease.

[Effect of Astragalus membranaceus on T-lymphocyte subsets in patients with viral myocarditis]

The efficacy of Astragalus membranaceus (AM) oral liquor combined with routine therapy and routine therapy alone on T-lymphocyte subsets of peripheral blood in viral myocarditis patients have been studied. The results showed that the T-lymphocyte subsets profile and OKT4/OKT8 ratio of peripheral blood were significantly lower in viral myocarditis patients than that in healthy control (P < 0.05, 0.01). Routine therapy combined with AM could significantly enhance OKT3, OKT4 and OKT4/OKT8 ratio in the above-mentioned patients (P < 0.05, 0.01). The possible pharmacodynamic mechanism of improved cell immunity in viral myocarditis patients by combining routine therapy with AM was discussed.

[Effects of selective hepatic duct embolization on normal, cirrhotic livers and hepatocellular carcinomas]

Variant gross and pathology features were observed on effects of selective hepatic duct embolization (SHDE) in contrast to selective hepatic duct ligation (SHDL). Glue TH was used in SHDE that performed on normal liver, induced cirrhotic liver and hepatocellular, carcinoma. The results demonstrated that SHDL has weak effected, while SHDE causes the embolized liver lobes to acute ischemic necrosis, followed by atrophy and fibrosis, accompanied by quickly hypertrophy of the uninvolved lobes. All tumors on the embolized liver lobes also showed acute tumors on the embolized liver lobes also showed acute tumor ischemic necrosis, atrophy and fibrosis. The reason for the above variations is that pressure and tension of SHDE expand the embolized bile duct tree, especially the Hering duct, which will continuously obstruct the dual blood supply to the liver tumor. Effectively and thoroughly annihilating or restricting the tumor, SHDE may lead the tumors to "spontaneous excision", with the unoperated lobes hypertrophy to compensate liver functions simultaneously. These studies indicated that SHDE will be a new method in liver cancer clinic.

[Antitumor activity of thevetoside alone and in combination with chlormethine in vivo]

Thevetoside (TS) is one of the cardiac glycosides. A study of antitumor activity was carried out in 6 types of murine tumors in vivo, such as the ascitic tumors H22, EAC, P388, and solid tumors S180, U14, Lewis lung carcinoma, which were treated with i.p. TS 1.5 mg.kg-1.d-1 alone or in combination with chlormethine (Chl) 0.3, 0.5, or 1.0 mg.kg-1.d-1. TS only showed a remarkable inhibition on the growth of 3 types of solid tumors with inhibition rates of 48.7%-56.7%. The effect of the combination therapy was much pronounced than that of independent administration. The life span under combined therapy was increased 82.4% to > 122.1%. For solid tumors, the combined administration gave inhibition rates of 65.6%-72.5%.

Bence Jones proteins bind to a common peptide segment of Tamm-Horsfall glycoprotein to promote heterotypic aggregation

Bence Jones proteins (BJPs) are the major pathogenic factor causing cast nephropathy ("myeloma kidney") by coaggregation with Tamm-Horsfall glycoprotein (THP). Understanding the interaction between these proteins is therefore important in developing treatment strategies to prevent renal failure from cast formation in multiple myeloma. We developed an enzyme-linked immunoassay to examine this phenomenon. Five different human BJPs (four kappa and one lambda immunoglobulin light chains) were used in this assay that demonstrated these proteins bound THP with different affinity. BJPs competed among themselves for binding to THP. The binding site was a peptide portion of THP since these proteins also bound deglycosylated THP. Also, one monoclonal antibody directed against a peptide segment of human THP prevented binding of THP to BJPs. By altering the conformation of THP, reducing agents decreased binding between these two proteins in concentration-dependent fashion. In turbidity studies, the monoclonal antibody that prevented binding and a reducing agent, dithiothreitol, decreased coaggregation. Deglycosylated THP did not coaggregate with BJPs. We concluded that ionic interaction between BJPs and a specific peptide binding site on THP promoted heterotypic coaggregation. The carbohydrate moiety of THP was also essential for coaggregation, perhaps by facilitating homotypic aggregation of THP.

Surgical treatment of hilar bile duct carcinoma. Clinical and pathological studies

Resection of the extrahepatic bile tract for hilar bile duct carcinoma was performed at the PLA General Hospital, with a resectability rate of 62% (31/50) and no operative mortality. Hepatic lobectomy was performed at the same time in 16 cases (51.6%). Reoperative resections were successfully done in 5 cases; 4 cases are still living 1-4 years after the second operation. The cause of late death was mainly biliary infection due to local recurrence and bile duct obstruction. The median survival period was 15 months. 32 cases were studied pathologically, of which 27 were resected surgical specimens and 5 autopsies. The tumors were histologically classified into 4 types: papillary adenocarcinoma (6 cases); well differentiated adenocarcinoma (21); poorly differentiated adenocarcinoma (3); and simple carcinoma (2). The importance of early diagnosis of hilar bile duct carcinoma at its subclinical stage before appearance of clinical jaundice is stressed.

[Research of the relation between the type of asthenia of the spleen and kidney and platelet associated antibodies and T-lymphocyte subsets in idiopathic thrombocytopenic purpura]

Idiopathic thrombocytopenic purpura (ITP) is a kind of disease associated with immunity. At present a great quantity of study on ITP has been made on humoral and cellular immunity. But there are few reports about the relationship between the types based on the differential diagnosis of TCM and immune rationale of ITP. In order to deeply explore the relationship between the types based on differential diagnosis of TCM and immune rationale of ITP., the authors measured PAIg and T lymphocyte subsets of 34 ITP patients of asthenia of both Spleen and Kidney. The value of PAIgG increased in both types of Spleen failing to control blood (SFCB) and deficiency of Spleen-yin and Kidney -yin (DSYKY), and the value of PAIgG of the type of DSYKY was significantly higher than that of SFCB (P less than 0.01). OKT3, OKT4/OKT8 of the type of SFCB remarkably decreased (P less than 0.05), OKT4, OKT4/OKT8 of DSYKY also remarkably decreased (P less than 0.001), while OKT8 significantly increased (P less than 0.001). The above results suggested that the type of DSYKY has more serious immune dysfunction than the type of SFCB, and the types of SFCB and DSYKY has close relationship with PAIg T lymphocyte subsets.

Parallel stranded DNA under the scanning tunnelling microscope

Using scanning tunnelling microscopy, we have directly observed parallel stranded DNA helixes of 43 nucleotides in length. The double helix is right-handed and has an average spacing, 17.43 A (+/- 1 S.D.: 2.30 A), and an average apparent depth, 4.79 A (+/- 1 S.D.: 1.04 A) for each groove. The average pitch of the helical turn is 34 A (+/- 1 S.D.: 3.35 A) and consists of no more than ten base pairs. The diameter of the helix is approx. 17-20 A. Our results provide direct evidence for the existence of a parallel structure of DNA in vitro and some details of its fine structure.

Treatment of hypercholesterolemia: comparison of younger versus older patients using wax-matrix sustained-release niacin

OBJECTIVE

Compare lipid response, side effect profile and toxicity of younger (less than 50 years) versus older (50 to 70 years) hypercholesterolemic subjects taking wax-matrix sustained-release niacin (Endur-acin).

STUDY DESIGN

An 8-week randomized double-blind placebo controlled trial.

SETTING

General community.

PARTICIPANTS

Volunteers from community cholesterol screening programs and chart review of patients at family practice clinics. Male and female subjects, age 20 to 70, with baseline low density lipoprotein cholesterol level within the 75th to 95th percentile, excluded if on medications that affect lipids or if a history of diabetes, gout, peptic disease, or liver disease is present.

INTERVENTION

Nicotinic acid dosage schedules were 1,000 mg/day, 1,250 mg/day, 1,500 mg/day, or 2,000 mg/day for 8 weeks.

MAIN OUTCOME MEASURES

Change in blood lipids and blood chemistries, side effects, and pill compliance.

RESULTS

158 subjects (79%) completed the study. Higher dose groups (1,500 mg and 2,000 mg) demonstrated improvements in total cholesterol, LDL-cholesterol, HDL cholesterol, and total-to-HDL-cholesterol ratio (P less than 0.05) compared to baseline and controls. Higher-dose older subjects demonstrated significantly greater improvements than younger subjects on comparable doses for total cholesterol, HDL cholesterol, total-to-HDL-cholesterol ratio, and triglycerides, P less than 0.02). Adherence to medication schedules was better and incidence of side effects and toxicity no greater in older subjects compared to younger.

CONCLUSION

Wax-matrix niacin (Endur-acin) was shown to be effective and well tolerated for the pharmacological treatment of hypercholesterolemia. Older persons, ages 50 to 70, appear to experience greater benefits with no greater side effects when compared to younger subjects on similar doses.

[Risk factors of acute pancreatitis]

A total of 689 operative cases of acute necrotic pancreatitis (ANP) were collected from 42 hospitals all over the country by the ANP Cooperative Study Group in the years of 1987 to 1989. General data, laboratory findings, pathology of the pancreas and the type of surgical treatment were analysed according to the outcome of the patient. The results showed that 37% of the cases were related to cholelithiasis, the highest incidence was in age above 60, and female patients were predominant and with higher mortality. Laboratory findings at admission, WBC greater than 20,000/mm3, Hb greater than 15 g%, blood sugar greater than 200 mg%, serum bilirubin greater than 5 mg%, BUN greater than 20 mg%, and serum calcium less than 7 mg% were related to the markedly elevated mortality rate. Operative findings noted in patients with bloody or cloudy peritoneal fluid, necrotic changes up to 75% of the pancreas, more than 2 areas of extrapancreatic involvements and resection of a large portion of the pancreas was found to be necessary were all related to a higher mortality. And emergency operations performed within 24 hours after the onset of the disease was also related with a highest mortality rate.