[A new telemedicine system]

A new telemedicine system and its application are introduced in this paper. Many new technologies, such as multiteleconference, multibind of MODEM and ISP, are adopted, which greatly improve the performance of the system.

The prevalence of NIDDM and IGT and related factors among residents in some areas of Hubei Province, China

The epidemiological survey of prevalence of NIDDM (non-insulin dependent diabetes mellitus) and IGT(impaired glucose tolerance) was conducted among 9450 residents aged 25-70 in some areas of Hubei Province, China. The results show that NIDDM and IGT prevalences are 2.62% and 4.48%, respectively. There is no significant difference between male and female (P > 0.05). The NIDDM prevalence in cities is slightly higher than that in countryside, but the difference is not significant (P > 0.05). However, the IGT prevalence in city is significantly higher than that in countryside (P < 0.01). The prevalence of both NIDDM and IGT is increasing along with the age of the population. It is also significantly related to the family history of NIDDM, hypertension, and high body mass index (BMI). By using stepwise logistic regression to analyse the risk factors of NIDDM, age (OR = 1.86), BMI(OR = 2.69), family history (OR = 2.84) and hypertension (OR = 2.23) entered the model (significance level is alpha = 0.05).

[Identification of turtle shell, tortoise plastron and their counterfeit products]

OBJECTIVE

To identify the commercial Chinese medicines turtle shell and tortoise plastron.

METHOD

Morphological identification and differential thermal analysis (DTA).

RESULT

2 kinds of counterfeit turtle shell and 3 kinds of counterfeit tortoise plastron were found, and their morphological and DTA identification features were proposed.

CONCLUSION

Sea turtle shells presently on the market are sham commodities of turtle shell, which derive from Lissemys punctata and Pelochelys bibroni indigenous to south Asia, while plastrons of Ocadia sinensis, Chelonia mydas and Lepidochelys olivacea are counterfeit products of tortoise plastron. Turtle shells, tortoise plastrons and their counterfeit products may be exactly distinguished by morphological and DTA features.

[Complexity analysis of surface EMG signals]

OBJECTIVE

Since the neurophysiological system is a highly nonlinear dynamic system, nonlinear dynamic information of EMG signals were extracted to describe its characteristics.

METHOD

Two-channel surface EMG signals were extracted and analyzed to reflect the complexity degree of the dynamics of the neurophysiological system.

RESULT

Complexity measures of four kinds of forearm motions were calculated and compared. They showed a good separability.

CONCLUSION

Experimental results proved that this measure, having a simple algorithm, is suitable for short data sets and suitable for real time processing. It provides a new measurable index for both physiological and pathological analysis.

[A surface EMG signal identification method based on short-time Fourier transform]

A surface EMG signal identification method based on short-time fourier transform is presented in this paper. To fully utilize the nonstationary character of the EMG signal, short-time fourier transform is employed to get the signal's time-frequency representation. Singular value decomposition is then used in the spectrogram to extract feature vector for pattern identification. Four types of movement of forearm, hand grasp, hand extension, wrist pronation and wrist supination can be identified from surface EMG signals. Experimental results show that it is a stable and efficient method for extracting features.

[AM signals' digital demodulation and its application in physiological signals' remote transmission]

Taking advantage of the characteristics of digital systems, a new digital method is given in this article to overcome the difficulties in demodulating AM signals using digital methods. Physiological signals can't be transmitted through telephone networks because they are full of ultra-low frequency components. However, if they are modulated (such as AM), they can be transmitted to the receiving end through telephone networks. Then phaselocked loops can be employed to trace the frequency of the signals' carriers so that we can demodulate and transmit them in the end.

Protein phosphorylation signaling mechanisms in carotid body chemoreception

Chemotransduction in the carotid body occurs in specialized type I cells and likely involves a complex series of regulated events which culminates in the release of neurotransmitter agents and the excitation of afferent nerve fibers. Previous studies have shown that multiple factors, including the levels of calcium and cyclic nucleotide second messengers, are important regulators of the chemoreceptor transduction cascade in type I cells. In addition, increases in electrical excitability induced in type I cells by chronic exposure to hypoxia are mimicked by agents which elevate intracellular cyclic AMP levels [Stea et al., J Neurosci 1995;15:2192-2202]. These and other findings suggest that protein kinases, and the phosphorylation of specific protein targets are important components of the hypoxic transduction machinery. Moreover, protein kinase-mediated cascades may participate in the well-known physiological adjustments which occur in the carotid body during prolonged stimulation. In the current study, our data demonstrate (1) the presence of specific protein kinases and target phosphoproteins in the carotid body, and also in the morphologically similar small intensely fluorescent cells of the superior cervical sympathetic ganglia. (2) Nitric oxide production and efferent inhibition in the chemosensory tissue is reduced in the presence of the specific tyrosine kinase inhibitor, lavendustin A. (3) Hypoxia-induced catecholamine release from type I cells is inhibited by the protein kinase A antagonist, Rp-cAMPs. And finally (4), exposure to chronic hypoxia up-regulates the expression of the tyrosine kinase, fyn, and an important growth regulatory phosphoprotein, growth associated protein-43 (GAP-43). These findings suggest that second messenger-mediated phosphorylation and dephosphorylation of specific protein targets is a mechanism capable of regulating diverse cellular functions in the carotid body during acute and chronic stimulation.

A quantitative immunocytochemical approach to the analysis of type I cells in the cat carotid body

Digital image analysis of immunostained semithin plastic sections indicates that experimentally induced changes in levels of transmitter-related reaction product in single cells fails to support the concept of clearly defined subsets of type I cells in the carotid body. This objective approach to the quantitation of staining product on a cell-by-cell basis appears to indicate that the observed changes are related to global shifts in the expression of a given neuronal marker throughout a single population of highly labile chemoreceptor elements.

Low frequency of the ccr5delta32 HIV-resistance allele in mainland China: identification of the first case of ccr5delta32 mutation in the Chinese population

A 32-bp deletion on the CCR5 gene (ccr5delta32) confers resistance to HIV-1 infection. This deletion is common in Caucasians, but rare in Asians. Since the frequency of the ccr5delta32 allele of Chinese in mainland China has been unknown we investigated the ccr5delta32 mutation in a cohort of 407 Chinese people in this area. A 225-bp fragment of CCR5 encompassing the 32-bp region was analysed by PCR, hybridization and sequencing. Only 1 out of 407 subjects was heterozygous for ccr5delta32 and no homozygotes were detected. The frequency of ccr5delta32 in this cohort is thus 0.00123, i.e. much lower than that of Caucasians. The ccr5delta32 heterozygote is a healthy young man. To our knowledge this is the first ccr5delta32 mutant found in Chinese people. The results indicate that ccr5delta32 does exist in Chinese people, but at very low frequency. This suggests that ccr5delta32 is not a significant factor for the genetic resistance to HIV-1 in Chinese people.

A cytotoxic triterpene saponin from the root bark of Aralia dasyphylla

A novel triterpene saponin (1) was isolated from an ethanol extract of the root bark of Aralia dasyphylla. Its structure was elucidated as 3-O-[beta-D-glucopyranosyl (1-->3)-beta-D-galactopyranosyl(1-->2)]-beta-D-glucuronopyranosyl- ole anolic acid-28-O-beta-D-glucopyranoside, according to spectral and chemical evidence. Compound 1 showed significant cytotoxic activity against KB and Hela-S(3) cells.

Detecting ventricular tachycardia and fibrillation by complexity measure

Sinus rhythm (SR), ventricular tachycardia (VT) and ventricular fibrillation (VF) belong to different nonlinear physiological processes with different complexity. In this study, we present a novel, and computationally fast method to detect VT and VF, which utilizes a complexity measure suggested by Lempel and Ziv [1]. For a specific window length (i.e., the length of data segment to be analyzed), the method first generates a 0-1 string by comparing the raw electrocardiogram (ECG) data to a selected suitable threshold. The complexity measure can be obtained from the 0-1 string only using two simple operations, comparison and accumulation. When the window length is 7 s, the detection accuracy for each of SR, VT, and VF is 100% for a test set of 204 body surface records (34 SR, 85 monomorphic VT, and 85 VF). Compared with other conventional time- and frequency-domain methods, such as rate and irregularity, VF-filter leakage, and sequential hypothesis testing, the new algorithm is simple, computationally efficient, and well suited for real-time implementation in automatic external defibrillators (AED's).

Modeling the relationship between concurrent epicardial action potentials and bipolar electrograms

A signal analysis approach to building the relationship between concurrent epicardial cell action potentials (AP's) and bipolar electrograms is presented. Wavelet network, one nonlinear black-box modeling method, is used to identify the relationship between cell AP's and bipolar electrocardiograms. The electrical signals were simultaneously measured from the epicardium of isolated Langendorff-perfused rabbit hearts during three different rhythm conditions: normal sinus rhythm (NSR), normal sinus rhythm after ischemia (NSRI), and ventricular fibrillation (VF). For NSR and NSRI, the proposed modeling method successfully captures the nonlinear input-output relationship and provides an accurate output, but the method fails in case of VF. This result suggests that a time-invariant nonlinear modeling method such as wavelet network is not appropriate for VF rhythm, which is thought to be time-varying as well as chaotic, but still useful in detection of VF. A new arrhythmia detection algorithm, with potential application in implantable devices, is proposed for identifying the time of rhythmic bifurcation.

Metabolic stabilization of muscle nicotinic acetylcholine receptor by rapsyn

Although the metabolic half-life of muscle endplate acetylcholine receptor (AChR) changes during development and after denervation in the adult, little is known about the molecular mechanisms that influence receptor stability. We have investigated the effect on AChR turnover of its interaction with rapsyn, a 43 kDa peripheral membrane protein that is closely associated with the AChR in muscle cells and is required for its clustering at endplates. Both in transfected COS cells and in cultured myotubes from rapsyn-negative and rapsyn-positive mice, we have found that the presence of rapsyn slows the turnover of AChRs by as much as twofold. The effect was similar for both embryonic (alpha2betadeltagamma) and adult (alpha2betadeltaepsilon) AChRs and for AChRs whose beta subunit lacked a putative tyrosine phosphorylation site. Neither colchicine nor cytochalasin D altered AChR turnover or prevented the rapsyn effect. Mutant rapsyn proteins whose N-terminal myristoylation signal was eliminated, or whose C terminus or zinc-finger domains were deleted, failed to change the rate of receptor turnover. Each of these mutations affects the association of the AChR with rapsyn, suggesting that AChR stability is altered by interaction between the two proteins. Our results suggest that, in addition to its role in AChR clustering, rapsyn also functions to metabolically stabilize the AChR.

[Studies on the triterpenoid saponins of the root bark of Aralia taibaiensis]

Four triterpenoid saponins were isolated from the root bark of Aralia taibaiensis Z. Z. Wang et H. C. Zheng. On the basis of their chemical properties and spectral data, they were identified as oleanolic acid-3-O-[beta-D-xylopyranosyl(1-->2)] [beta-D-glucopyranosyl(1-->3)]-beta-D-glucuronopyranoside (1), tarasaponin V (2), 3-O-¿beta-D-xylopyranosyl(1-->2)[beta-D-glucopyranosyl (1-->3)]-6'-O-ethyl-beta-D-glucuronopyranosyl¿-oleanolic acid-28-O-beta-D-glucopyranoside (3) and 3-O-¿beta-D-xylopyranosyl(1-->2) [beta-D-glucopyranosyl(1-->3)] -6'-O-butyl-beta-D-glucuronopyranosyl¿-oleanolic acid-28-O-beta-D-glucopyranoside (4). Compound 1 is a new natural product named taibaienoside VI. 2 was isolated from the title plant for the first time. 3 and 4 are new compounds and named taibaienoside VII and taibaienoside VIII, respectively.

Changes in tyrosine hydroxylase and substance P immunoreactivity in the cat carotid body following chronic hypoxia and denervation

Long-term hypoxia elicits functional changes in the cat carotid body which are manifest as altered chemosensitivity in response to hypoxia. Previous studies have suggested that these functional adjustments may be mediated by changes in neurotransmitter levels in chemosensory type I cells. Neurotransmitter metabolism in the carotid body has also been shown to be regulated by the neural innervation to the organ. The present study using the cat carotid body demonstrates profound changes in the levels of immunoreactivity of the catecholamine-synthesizing enzyme, tyrosine hydroxylase, and the neuropeptide, substance P, in response to a two-week exposure to hypoxia (10% O2 in 90% N2). Furthermore, these changes were modulated both by sensory and sympathetic denervation of the organ. For TH, the intensity of immunostaining in type I cells was markedly increased by long-term hypoxia in both normal and chronic carotid sinus nerve-denervated carotid bodies, but this effect was blocked following chronic sympathectomy. Substance P immunoreactivity in type I cells was dramatically attenuated by hypoxia in both intact and chronic carotid sinus nerve-denervated preparations, but this effect was reduced following chronic sympathectomy. Tyrosine hydroxylase- and substance P-positive axon terminals were observed to innervate type I cells. These axons were also present in chronically sympathectomized preparations, but they disappeared following chronic carotid sinus nerve-denervation suggesting that they very likely arise from sensory neurons in the petrosal ganglion. Our data indicate that chronic chemoreceptor stimulation by hypoxia elicits multiple neurochemical adjustments in the cat carotid body. These changes suggest that catecholaminergic enzymes and neuropeptides play a significant role in the adaptive mechanisms of chemoreceptor function which occur in response to chronic physiological stimulation. Furthermore, the data suggest that neurotrophic mechanisms may influence neurotransmitter metabolism in chemosensory type I cells.

Giant cell arteritis in association with cerebral amyloid angiopathy: immunohistochemical and molecular studies

Giant cell arteritis (GCA) usually manifests as a transmural vascular infiltrate of mononuclear and multinucleated giant cells (MNGC). We describe six patients with GCA associated with severe cerebral amyloid angiopathy (CAA), all with cerebral hemorrhage or varying degrees of cerebral infarct, and histological evidence of Alzheimer's disease (cortical CAA often predominating over senile plaques and neurofibrillary tangles). One case showed mostly cortical involvement (with old microhemorrhages), and the others were primarily leptomeningeal (with involvement of the underlying cortex and extensive encephalomalacia of adjacent brain). Many vessels with CAA exhibited a pronounced adventitial and perivascular infiltrate of lymphocytes, histiocytes, and MNGC. Immunohistochemical staining showed deposition of beta/A4 peptide primarily in the thickened media of CAA vessels, and within the cytoplasm of MNGC--suggesting phagocytosis of insoluble peptide. Cystatin C antibody stained vascular amyloid and diffusely highlighted astrocytic and MNGC cytoplasm. HAM56-positive macrophages were frequently seen around amyloid-laden vessels. Anti-smooth muscle actin immunohistochemistry suggests the occurrence of medial destruction by amyloid, with relative preservation of intimal cells. Ultrastructural studies performed in one case confirmed the presence of intracytoplasmic amyloid in MNGC. The GCA seen in these cases of CAA most likely represents a foreign body response to amyloid proteins, causing secondary destruction of the vessel wall. DNA from brain tissues of five affected patients was examined to assess whether mutations were present in exon 17 of the APP gene or exon 2 of the cystatin C gene, a finding that might explain the foreign body giant cell response to amyloid proteins in these cases. However, restriction fragment mapping of amplified gene segments showed that previously described mutations were not present in these cases.

[Studies on triterpenoids and their glycosides from Aralia dasyphylla Miq]

The structures of two triterpenoids and their glycosides were isolated from Aralia dasyphylla Miq. Their structures have been identified to be oleanoic acid(I), 16 beta-hydroxy-18 beta-H-oleanoic acid(II), oleanoic acid-28-O-beta-D-glucopyranoside(III) and 16 beta-hydroxy-18 beta-H-oleanoic acid-28-O-beta-D-glucopyranoside(IV), respectively, mainly through interpretation of UV, IR, MS, 1H and 13CNMR, DEPT, HMQC and HMBC spectra data. The stereochemistry of II has been confirmed by NOESY. Pharmacological experiments showed that the total saponins exerted preventative effect on CCl4-induced liver injury of male mice and hypoglycemic effect on a model of alloxan-induced diabetes in rats.

[Oleanolic acid saponins from the root bark of Aralia taibaiensis]

Five oleanolic acid saponins were isolated from the root bark of Aralia taibaiensis Z.Z. Wang et H.C. Zheng. By spectroscopic and chemical methods, they were identified as araloside A (1), 3-O-[alpha-L-arabinofuranosyl(1-->4)-6'-O-n-butyl-beta-D- glucuronopyranosyl]-oleanolic acid-28-O-beta-D-glucopyranoside (2), 3-O-[alpha-L-arabinofuranosyl(1-->4)-6'-O-ethyl-beta-D- glucuronopyra-nosyl]-oleanolic acid-28-O-beta-D-glucopyranoside (3), stipuleanoside R2(4) and 3-O-(beta-D-glucopyranosyl(1-->3) [alpha-L-arabinofuranosyl(1-->4)]-6'-O-ethyl-beta-D- glucuronopyranosyl)-oleanolic acid-28-O-beta-D-glucopyranoside (5). Saponin 1 and 4 were isolated from the title plant for the first time. 2, 3 and 5 are new compounds and named taibaienoside I, taibaienoside II and taibaienoside III, respectively.

Microvascular degeneration in hereditary cystatin C amyloid angiopathy of the brain

Hereditary cystatin C amyloid angiopathy (HCCAA), an autosomal dominant form of cerebral amyloid angiopathy (CAA) occurring primarily in Iceland, is characterized by a variant cystatin C amyloid deposition in the walls of cerebral parenchymal and leptomeningeal vessels. Cystatin C is also found to colocalize with amyloid beta/A4 protein in cerebral vessel walls of patients with Alzheimer's disease (AD), sporadic CAA, and hereditary cerebral hemorrhage with amyloidosis, Dutch type (HCHWA-D). The abundance of cystatin C deposition in cerebral blood vessel walls suggests that cellular elements of the vessel wall itself may play a role in its deposition. Microvascular changes in the brains of HCCAA patients were investigated by single- and double-label immunohistochemistry. We found that cystatin C amyloid immunoreactivity was present not only in cerebral cortical and leptomeningeal vessels, but also in white matter parenchymal vessels. Cystatin C deposition was more prominent in the media of parenchymal vessels and in the adventitia of leptomeningeal vessels. Smooth muscle (sm) cells were few or could not be identified within vessel walls showing extensive cystatin C deposition, suggesting progressive loss of these cells as cystatin C accumulates. However, in less severely affected vessels, cystatin C was present in cells that also had the phenotype of sm, suggesting that sm cells synthesize or process cystatin C. Cystatin C immunoreactivity was in addition, detected in some neuronal cell bodies throughout the cortex in patients with HCCAA and AD-related CAA. Our results indicate that cellular components of the vessel walls may play an important role in cystatin C deposition, as they do in beta/A4 deposition in AD-related CAA. Cystatin C deposition within the vascular media and adventitia, with associated vessel wall injury as manifested by sm cell loss, represents microvascular degeneration that leads to cerebral hemorrhage.

Assembly of the nicotinic acetylcholine receptor. The first transmembrane domains of truncated alpha and delta subunits are required for heterodimer formation in vivo

To investigate the mechanism of assembly of the mouse muscle acetylcholine receptor, we have expressed truncated N-terminal fragments of the alpha and delta subunits in COS cells and have examined their ability to fold, to associate into heterodimers, and to form a ligand-binding site. Truncated fragments of the alpha subunit that include all, part, or none of the first transmembrane domain (M1) folded to acquire alpha-bungarotoxin binding activity. Neither the full-length alpha subunit nor any of the fragments were expressed on the cell surface, although the shortest folded fragment lacking a transmembrane domain was secreted into the medium. When coexpressed with the delta subunit, the alpha subunit fragment possessing M1 formed a heterodimer containing a ligand-binding site, but shorter fragments, which lack transmembrane segments, did not associate with the delta subunit. N-terminal delta subunit fragments gave similar results. An N-terminal delta subunit fragment that contains M1 associated with the alpha subunit to form a heterodimer, while a fragment lacking M1 did not. These results show that a complete M1 domain is necessary for association of truncated N-terminal alpha and delta subunits into a heterodimer with high affinity ligand binding activity.

Membrane tethering enables an extracellular domain of the acetylcholine receptor alpha subunit to form a heterodimeric ligand-binding site

The first step of assembly of the nicotinic acetylcholine receptor (AChR) of adult skeletal muscle is the specific association of the alpha subunit with either delta or epsilon subunits to form a heterodimer with a ligand-binding site. Previous experiments have suggested that het erodimer formation in the ER arises from interaction between the luminal, NH2-terminal domains of the subunits. When expressed in COS cells with the delta subunit, however, the truncated NH2-terminal domain of the subunit folded correctly but did not form a heterodimer. Association with the delta subunit occurred only when the NH2-terminal domain was retained in the ER and was tethered to the membrane by its own M1 transmembrane domain, by the transmembrane domain of another protein, or by a glycolipid link. In each case, the ligand-binding sites of the resulting heterodimers were indistinguishable from that formed when the full-length alpha subunit was used. Attachment to the membrane may promote interaction by concentrating or orienting the subunit; alternatively, a membrane-bound factor may facilitate subunit association.

Brain parenchymal and microvascular amyloid in Alzheimer's disease

Brains of patients with Alzheimer disease/senile dementia of Alzheimer type (AD/SDAT) develop a progressive accumulation of amyloid, which deposits primarily in the form of characteristic parenchymal 'plaques' (senile or neuritic plaques/SP's) and as mural deposits in the walls of capillaries and arterioles (cerebral amyloid angiopathy /CAA). A major component of this amyloid is a small and unique peptide composed of 39-43 amino acids, beta/A4, which is cleaved from a much larger precursor protein (APP) that has several isoforms. Brain amyloid can be detected in autopsy or biopsy brain tissue by classical, immunohistochemical and ultrastructural (including immuno-electron microscopic) methods of varying sensitivity and specificity. Beta/A4 amyloid deposition is remarkably variable (e.g. predominantly parenchymal or vascular, or a mixture of parenchymal and vascular) among patients with AD/SDAT. Despite its abundance in the brains of AD/SDAT patients, the precise role of beta/A4 in the pathogenesis of the neurological deficit, neocortical atrophy and progressive synapse loss associated with AD/SDAT has yet to be determined. However, mutations in the gene that encodes APP are clearly associated with familial AD syndromes in which there is significant brain amyloid deposition. CAA, in addition to its association with AD/SDAT, can result in hemorrhagic and (possibly) ischemic forms of stroke. Work with recently developed transgenic mice which express large amounts of beta/A4 in the central nervous system is likely to elucidate mechanisms by which the protein is selectively or deposited in the brain in a parenchymal or microvascular form, and how it contributes to the pathogenesis of neurodegeneration.

An unbiased parametric imaging algorithm for nonuniformly sampled biomedical system parameter estimation

An unbiased algorithm of generalized linear least squares (GLLS) for parameter estimation of nonuniformly sampled biomedical systems is proposed. The basic theory and detailed derivation of the algorithm are given. This algorithm removes the initial values required and computational burden of nonlinear least regression and achieves a comparable estimation quality in terms of the estimates' bias and standard deviation. Therefore, this algorithm is particular useful in image-wide (pixel-by-pixel based) parameter estimation, e.g., to generate parametric images from tracer dynamic studies with positron emission tomography. An example is presented to demonstrate the performance of this new technique. This algorithm is also generally applicable to other continuous system parameter estimation.