Examining the Role of GLU/GABA to GLN Metabolic Cycle in the Pathogenesis of Post-Stroke Depressive Disorder and Insomnia

Objective

This study aims to elucidate the potential links between the GLU/GABA to GLN metabolic cycle disruptions and the onset of depressive and insomnia disorders following a stroke. We particularly focus on understanding if these disorders share a common underlying pathogenic mechanism.

Methods

We examined 63 patients with post-stroke insomnia, 62 patients with post-stroke depression, and 18 healthy individuals. The study involved assessing insomnia using the Acute Insomnia Scale (AIS) and depression using the Hamilton Depression Rating Scale. We measured serum concentrations of GLN, GLU, and GABA and analyzed their correlations with AIS and HAMD scores.

Results

Our results indicate no significant difference in the serum levels of GLN, GLU, and GABA between the post-stroke insomnia and depression groups. However, these levels were notably lower in both patient groups compared to the healthy control group. A negative correlation between AIS scores and GABA levels was observed in the post-stroke insomnia group, suggesting a potential link between GABAergic disturbances and insomnia. Conversely, no significant correlation was found between Hamilton Depression Rating Scale scores and the levels of GABA, GLU, or GLN in the post-stroke depression group.

Conclusion

The study highlights that abnormalities in the GLU/GABA to GLN metabolic cycle, particularly the levels of GLN, GABA, and GAD, might be intricately linked to the pathogenesis of post-stroke insomnia and depression. Our findings suggest that GABAergic imbalances could be indicative of post-stroke insomnia, serving as potential biological markers for differential diagnosis in clinical settings. Further research is warranted to explore these relationships in greater depth, potentially leading to new diagnostic and therapeutic approaches for post-stroke neuropsychiatric disorders.

An investigation on the changes of serum CCK-8, substance P, and 5-HT in patients with post-stroke insomnia

BACKGROUND

At present, the pathogenesis of post-stroke insomnia (PSI) is still inconclusive.

OBJECTIVE

To explore the changes and significance of serum cholecystokinin-8 (CCK-8), substance P (SP), and 5-hydroxytryptamine (5-HT) in patients with PSI.

METHODS

Ninety-one patients with stroke were selected as the research subjects, and according to the score of the Athens Insomnia Scale (AIS), they were divided into the insomnia group and the non-insomnia group. The serum levels of CCK-8, SP, and 5-HT in the two groups were compared to explore their relationships with PSI.

RESULTS

Among the 91 patients, 56 were in the insomnia group and 35 were in the non-insomnia group, and the incidence of insomnia was 61.5%. There was no significant difference in the serum levels of CCK-8, SP, and 5-HT between the two groups (P= 0.696, 0.980, and 0.809, respectively). One-way analysis of variance showed that there was no significant correlation between the serum levels of CCK-8, SP, 5-HT, and the AIS score (P= 0.7393, 0.9581, and 0.5952, respectively).

CONCLUSION

The incidence of PSI was relatively high, but it could not be proved that CCK-8, SP, and 5-HT were involved in the pathogenesis of PSI. There might exist other neurotransmitters involved in the pathophysiological process of PSI, which should be further explored.

[A cross-sectional investigation on the current status and influencing factors of kinesiophobia in adult burn patients]

Objective: To investigate the current status and influencing factors of kinesiophobia in adult burn patients. Methods: A single center cross-sectional research method was conducted. A total of 170 adult burn patients, meeting the inclusion criteria, were admitted to the Department of Plastic Surgery and Burns of the West China Hospital of Sichuan University from October 2018 to December 2019. On admission, the self-made general information questionnaire was used to investigate the gender, age, education level, marital status, payment method of medical expenses, injury factors, and total burn area of patients. One month after admission or before discharge, the presence and degree of kinesiophobia of patients were evaluated by the Tampa Scale for Kinesiophobia (TSK), their pain degrees (results averaged) at the time of burn, debridement and dressing change, after burn operation, and at rest were evaluated by the Visual Analogue Scale, their social support levels were evaluated by the Social Support Revalued Scale, and their degrees of anxiety and depression were evaluated by the Hospital Anxiety and Depression Scale. According to the TSK score, the patients with score >37 points were included into kinesiophobia group, and the patients with score ≤37 points were included into non-kinesiophobia group. The general information of patients in the two groups, as well as the pain score, social support level score, anxiety score, and depression score mentioned above, were recorded. Data of patients between the two groups were statistically analyzed with unifactor analysis including chi-square test, independent sample t test, and Mann-Whitney U test. The factors with statistically significant differences in unifactor analysis were used as variables for multivariate logistic regression analysis to screen out the independent influencing factors of kinesiophobia in adult burn patients. Results: Questionnaires and scales of 170 patients were collected, and the recovery rate was 100%. The data of two patients complicated with cranial fracture aggravation were removed, and 168 valid data were obtained, with the effective rate of 98.82%. Among the 168 patients, 88 were male (52.38%) and 80 were female (47.62%), aged from 18 to 71 (41±6) years. Most of the patients had secondary school education or below, were married, and with no out-of-pocket medical expenses. The main factors of injury were flame and hydrothermal fluid, and the total burn area was 2%-75% ((28±5)%) total body surface area. The TSK score was (41±5) points, the pain score was 4.0 (2.6, 7.0) points, the social support level score was (40±5) points, the anxiety score was 8.5 (7.0, 13.0) points, and the depression score was 9.5 (6.5, 12.0) points. A total of 98 patients had kinesiophobia, and the incidence of kinesiophobia was 58.33%. There were no statistically significant differences in gender, age, educational level, marital status, or injury factors of patients between kinesiophobia group and non-kinesiophobia group (P>0.05). The percentage of out-of-pocket expenses, total burn area, pain score, anxiety score, and depression score of patients in kinesiophobia group were significantly higher than those in non-kinesiophobia group (χ²=6.402, t=2.39, Z=-8.05, -6.68, -7.89, P<0.05 or P<0.01), and the social support level score of patients in kinesiophobia group was significantly lower than that in non-kinesiophobia group (t=5.22, P<0.01). The multivariate logistic regression analysis showed that total burn area, pain score, social support level score, anxiety score, and depression score were the independent influencing factors for the development of kinesiophobia in adult burn patients (odds ratio=0.79, 1.45, 0.78, 1.15, 1.17, 95% confidence interval=0.80-0.92, 1.24-1.74, 0.65-0.91, 1.06-1.29, 1.03-1.24, P<0.01). Conclusions: The incidence of kinesiophobia in adult burn patients is high, and the degree of kinesiophobia is mainly affected by total burn area, pain, social support level, anxiety and depression degrees, and so on. Thus these factors should be taken into consideration when designing interventions to reduce the incidence and degree of kinesiophobia.

Clinical characterization and prognostic implications of metabolic syndrome in patients undergoing peritoneal dialysis at a Chinese center

Objective

Metabolic syndrome (MS) is a common clinical condition associated with cardiovascular disease in patients undergoing peritoneal dialysis (PD); however, its prognostic implication among patients receiving PD remains controversial.

Methods

In a prospective study from January 2013 and June 2016, we enrolled 190 patients undergoing PD and followed them for 46.4 ± 30.7 months. We assessed the associations of clinical characteristics and measurements with diabetes mellitus (DM) status, MS, and prognostic outcomes among the included patients.

Results

We found that DM was associated with shortened duration of dialysis and poor survival. The prevalence of MS was 58.9% among all patients. We found significant differences in age, body weight, body mass index, triglycerides, high-density lipoprotein cholesterol, fasting plasma glucose, leukocytes, platelets, neutrophil percentage, and pre-albumin between patients with and without MS. We found a negative correlation trend between serum intact parathyroid hormone and MS among our patients. The arteriosclerosis index was significantly elevated in the MS group compared with the non-MS group. Serum calcium concentration and frequency of hospital admissions were significantly associated with mortality and technique failure.

Conclusions

MS was positively associated with cardiovascular disease. DM, and hypocalcemia. Frequent hospital admissions can predict poor prognosis in patients undergoing PD.

Epidemiology of fetal cerebral ventriculomegaly and evaluation of chromosomal microarray analysis versus karyotyping for prenatal diagnosis in a Chinese hospital

Objective

To evaluate the efficiency and incremental value of chromosomal microarray analysis as compared with standard karyotyping for the identification of genomic abnormalities in fetal DNA.

Methods

This retrospective study enrolled female patients with ultrasonographically diagnosed fetal ventriculomegaly. The prevalence, associated anomalies and clinical outcomes of ventriculomegaly were evaluated based on data from a single maternal and child health hospital in southwest China.

Results

A total of 943 cases of ventriculomegaly were analysed in this study, which were diagnosed at a mean ± SD gestational age of 23.8 ± 8.2 weeks. Non-isolated ventriculomegaly cases had a significantly higher maternal age than isolated cases (29.6 ± 5.5 versus 27.9 ± 4.2 years, respectively) and were also associated with a larger proportion of bilateral (56.1% versus 46.7%, respectively) and severe (12.8% versus 3.7%, respectively) ventriculomegaly. There were 97 cases detected by both karyotyping and microarray analysis. All apparent chromosome abnormalities identified upon karyotyping were detected with the use of microarray analysis. Microarray analysis also reported genetic abnormalities in 20 additional cases not detected by karyotyping. Of these additional 20 cases, 9.3% of pregnancies reported standard genetic variants for clinically relevant information, whereas 11.3% reported uncertain genetic abnormalities.

Conclusion

Chromosomal microarray analysis is an efficient tool, significantly increasing the diagnostic power for prenatal diagnosis.

Sevoflurane inhibits migration and invasion of colorectal cancer cells by regulating microRNA-34a/ADAM10 axis

Sevoflurane is frequently used volatile anesthetic in cancer surgery. It has been suggested that treatment with sevoflurane could suppress migration and invasion of several human cancer cells in vitro. However, the effects of sevoflurane on colorectal cancer (CRC) remains largely unclear. In this study, CRC HCT116 and SW480 cells were treated by various concentrations of sevoflurane. MTT assay and Transwell assay were applied to evaluate the cell viability, migration and invasion abilities of CRC cell lines, respectively. Real-time quantitative PCR (RT-qPCR) was used to examine the expression level of miR-34a, and western blot assay was employed to detect the protein level of ADAM10. The target interaction between miR-34a and ADAM10 was verified through bioinformatics analysis, luciferase reporter gene assay system. We found Aberrant inhibitory effects induced by sevoflurane on the cell viability, migration and invasion abilities of HCT116 and SW480 cells in a dose-dependent manner were observed. Up-regulation of miR-34a strikingly suppressed the cell proliferation, migration and invasion abilities of the two cell lines. Sevoflurane could facilitate the miR-34a expression and its suppressor effects on CRC cells was reversed by pre-treatment with miR-34a inhibitors. ADAM10 was identified as a downstream gene of miR-34a, and down-regulated by miR-34a. Overexpression of ADAM10 reverted both miR-34a and sevoflurane-induced repression in the cell proliferation, migration and invasion abilities of CRC cells. Our data showed Sevoflurane inhibits the migration and invasion of colorectal cancer cells by regulating microRNA-34a/ADAM10 axis.

[Genetic characteristic of hemagglutinin of avian influenza A (H7N9) virus in Guizhou Province in 2017]

The number of H7N9 bird flu cases was high and the situation was grim in guizhou province in 2017. To understand the molecular characteristics of the hemagglutinin gene (HA) and the risk of human infection with avian influenza virus A(H7N9) in Guizhou Province, 2017. Homology, genetic evolution and pivotal sites related to receptor binding regions, pathogenicity and potential glycosylation of 14 avian influenza viruses A(H7N9) were analyzed by a series of bioinformation softwares. It was cleared that there was 95.9%-100% similarity among 14 strains in nucleotide of the HA gene, and there were 96.8%-97.8% and 96.8%-97.9% similarities with vaccine strains A/Shanghai/2/2013 and A/Anhui/1/2013 recommended by WHO, respectively. Phylogenetic analysis showed that 14 HA genes were directly evolved in the Yangtze River Delta evolution branch, but they could be derived from five diffenrent strains. Then 13 of 14 strains cleavage site sequences of HA protein revealed they were low pathogenic avian influenza viruses, while A/Guizhou-Weining/CSY01/2017 was high pathogenic avian influenza virus. Mutation G186V at the receptor binding sites in the HA was found in all 14 strains, and mutation Q226L in 13 strains besides A/Guizhou-Weining/CSY01/2017. All five potential glycosylation motifs in the HA were conservative.

Global analysis of population stratification using a smart panel of 27 continental ancestry-informative SNPs

Over the last decade, several panels of ancestry-informative markers have been proposed for the analysis of population genetic structure. The differentiation efficiency depends on the discriminatory ability of the included markers and the reference population coverage. We previously developed a small set of 27 autosomal single nucleotide polymorphisms (SNPs) for analyzing African, European, and East Asian ancestries. In the current study, we gathered a high-coverage reference database of 110 populations (10,350 individuals) from across the globe. The discrimination power of the panel was re-evaluated using four continental ancestry groups (as well as Indigenous Americans). We observed that all the 27 SNPs demonstrated stratified population specificity leading to a striking ancestral discrimination. Five markers (rs728404, rs7170869, rs2470102, rs1448485, and rs4789193) showed differences (δ > 0.3) in the frequency profiles between East Asian and Indigenous American populations. Ancestry components of all involved populations were accurately accessed compared with those from previous genome-wide analyses, thereafter achieved broadly population separation. Thus, our ancestral inference panel of a small number of highly informative SNPs in combination with a large-scale reference database provides a high-resolution in estimating ancestry compositions and distinguishing individual origins. We propose extensive usage in biomedical studies and forensics.

[Analysis of adverse reaction induced by articaine hydrochloride and epinephrine tartrate injection in 75 cases]

Objective: To investigate the causes and clinical manifestation of adverse reaction of articaine hydrochloride and epinephrine tartrate injection. Methods: A retrospective analysis was conducted on the adverse drug reactions (ADR) of local anesthetic articaine hydrochloride and epinephrine tartrate injection. Results: In 75 cases of adverse reactions, there were 40 cases of female and 35 cases of male. Adverse reactions occured more frequently at the age of 3-10 [33% (25/75)] and 1-10 min and one day after injection, respectively accounting for 20% (15/75), and two days, accounting for 15% (15/75), 10-21 days accounting for 8% (6/75). The main manifestations were injection site ulcers, followed by skin reactions such as pain, swelling, necrosis and pruritus at the injection site. Conclusions: The main adverse reactions of articaine hydrochloride and epinephrine tartrate injection are the injection site ulceration, followed by injection site pain, rash, pruritus and drowsiness, nausea and dizziness, palpitations, sweat and hypotension. Doctors should ask the medical history in detail and pay close attention to the patient's medication safety.

Abstract WP198: Intracranial Arterial Calcification Predicts Stroke Recurrence: an 11-year Follow-up Study

Introduction: Intracranial arterial calcification (IAC) is frequently observed on brain computed tomography (CT) in stroke patients. However, the association between IAC and stroke recurrence after hospital discharge has received little attention. In this study, we aim to explore the effect of IAC on the long-term stroke recurrence.

Subjects and methods: We prospectively recruited consecutive patients with ischemic stroke or transient ischemic attack during December 2004 and March 2005 from a population-based stroke registry at Prince of Wales Hospital. Demographic characteristics, stroke risk factors, and stroke etiology were recorded at baseline. IAC volume and IAC Agatston score were both measured on 16-slice CT with a semi-automatic system. All patients were regularly followed up for stroke recurrence till July 2016.

Results: Total 694 patients (age 71.6±12.4; male sex 50.3%; median follow-up period 8.8 years) were followed up. Stroke recurred in 156 patients (22.5%). Multivariate Cox proportional hazard model found higher IAC Agatston score was predictive factor for both recurrent stroke (HR per 1-SD increment 1.301; 95% CI, 1.084-1.561, p =0.005) and stroke death (HR per 1-SD increment, 1.441; 95% CI, 1.061-1.956, p =0.019). In addition, among different stroke etiological subtypes, IAC Agatston score was independent risk factor of stroke recurrence for index small-vessel occlusive stroke patients (HR per 1-SD increment, 1.674; 95% CI, 1.061-2.639, p =0.027).

Conclusions: Quantitative-evaluated IAC scores can predict long-term stroke recurrence and stroke death.

Quick rehabilitation nursing improves the recovery of colon cancer patients after laparoscopy

Colon cancer is a common malignant tumor with particularly high morbidity and mortality. The aim of this study was to compare the effect of quick rehabilitation nursing and routine nursing in postoperative recovery of patients with colon cancer after laparoscopic surgery. Two hundred forty patients with colon cancer were classified into four random groups (A, B, C and D, with 60 patients in each group). All patients underwent surgery to remove the colon tumor by laparoscopy under general anesthesia. Patients in groups A and B received quick rehabilitation nursing for post-surgery recovery. In group C patients, local anesthesia associated with quick rehabilitation nursing for post-surgery recovery was used. Group D was used as control group and the patients were treated based on routine nursing. Time to get out of bed, first bowel movement time and the average time of hospitalisation in group A was lower than group D (p less than 0.05), postoperative leukocyte level as well as the occurrence rate of nausea and vomiting, ankylenteron and pelvic adhesion was decreased in group A compared to group D (p less than 0.05), but the postoperative albumin and total protein level was higher than group D (p less than 0.05). The serum level of C-Reactive Protein (CRP) and interleukin 6 (IL-6) in group A was decreased compared to group D several days after surgery (p less than 0.05); group B had 4 cases of intestinal obstruction after surgery that could be cured through conservative treatment, while group D had 10 cases of intestinal obstruction, 8 of which could be cured through conservative treatment and two needed surgery (p less than 0.05); VAS for pain degree of group C in active state was clearly lower at 1h, 5h, 7h, 15h, 30h and 42h after surgery, and side effects of postoperative analgesia were clearly reduced. Time to get out of bed was obviously decreased, while there was no evident effect on postoperative dosage, chronic pain and complications. Adopting quick rehabilitation nursing can effectively reduce occurrence of complications and postoperative pain, speed up the recovery of gastrointestinal function, shorten the length of stay, and improve patients’ satisfaction.

Increased expression of STIM1/Orai1 in platelets of stroke patients predictive of poor outcomes

BACKGROUND AND PURPOSE

The platelet activation that is mediated by store-operated Ca²⁺ entry via stromal interaction molecule (STIM1) and Orai1 Ca²⁺ influx channels has been shown to play a key role in ischaemic stroke (IS). This study aimed to evaluate the impact of platelet STIM1/Orai1 protein expression on outcomes of IS.

METHODS

A total of 160 patients with acute non-cardioembolic IS, among whom 45 patients had small-vessel diseases and 115 patients had large-vessel diseases, were evaluated. Patients were divided into two groups according to their baseline platelet STIM1/Orai1 protein expression: high-expression group (HG) (n = 80) and low-expression group (LG) (n = 80). Univariate and multivariate regression models were used to assess the correlation between STIM1/Orai1 expression and clinical outcomes, which included stroke severity that was measured based on the National Institutes of Health Stroke Scale and Stroke Impact Scale (SIS) at baseline and during the 3-month follow-up.

RESULTS

There were no significant differences in age, sex and cardiovascular risk factors between patients in HG and LG. However, HG had very high levels of biomarkers such as glycosylated hemoglobin, C-reactive protein, homocysteine and high mobility group box-1 protein (all P < 0.05). Although the baseline stroke severity (National Institutes of Health Stroke Scale score) was not obviously higher in HG than in LG, patients showed a better recovery score (SIS score) in LG than in HG (90.75 ± 13.65 vs. 80.68 ± 7.09; P = 0.022). STIM1/Orai1 expression was an independent predictor of the 3-month stroke recovery (hazard ratio, 4.543; 95% confidence interval, 1.941-29.145; P = 0.029).

CONCLUSIONS

A high expression level of platelet Orai1/STIMI1 was associated with poor clinical outcome (mortality and recurrence) and functional recovery (SIS scores) during the 3-month follow-up. Thus, we propose that these proteins are strongly predictive of life quality in patients with IS.

Speckle noise removal applied to ultrasound image of carotid artery based on total least squares model

An ultrasonic image speckle noise removal method by using total least squares model is proposed and applied onto images of cardiovascular structures such as the carotid artery. On the basis of the least squares principle, the related principle of minimum square method is applied to cardiac ultrasound image speckle noise removal process to establish the model of total least squares, orthogonal projection transformation processing is utilized for the output of the model, and the denoising processing for the cardiac ultrasound image speckle noise is realized. Experimental results show that the improved algorithm can greatly improve the resolution of the image, and meet the needs of clinical medical diagnosis and treatment of the cardiovascular system for the head and neck. Furthermore, the success in imaging of carotid arteries has strong implications in neurological complications such as stroke.

Identification of vaginal fluid, saliva, and feces using microbial signatures in a Han Chinese population

In recent years, forensic scientists have focused on the discrimination of body fluids using microbial signatures. In this study, we performed PCR-based detection of microbial signatures of vaginal fluid, saliva, and feces in a Han Chinese population. We investigated the 16S rRNA genes of Lactobacillus crispatus, Lactobacillus gasseri, Lactobacillus jensenii, Lactobacillus iners, and Atopobium vaginae in vaginal fluid, the 16S rRNA and the glucosyltransferase enzyme genes of Streptococcus salivarius and Streptococcus mutans in saliva, and the 16S rRNA genes of Enterococcus species, the RNA polymerase β-subunit gene of Bacteroides uniformis and Bacteroides vulgatus, and the α-1-6 mannanase gene of Bacteroides thetaiotaomicron in feces. As a result, the detection proportions of L. crispatus, L. gasseri, L. jensenii, L. iners, and A. vaginae were 15/16, 5/16, 8/16, 14/16, and 3/16 in 16 vaginal fluid donors, respectively. L. crispatus and L. jensenii were specifically detected in vaginal fluid; L. gasseri, L. iners, and A. vaginae were also detected in non-vaginal fluid. S. salivarius and S. mutans were not specifically detected in saliva. The detection proportions of Enterococcus species, B. uniformis, B. vulgatus, and B. thetaiotaomicron in 16 feces samples were 16/16, 12/16, 15/16, and 11/16, respectively. B. uniformis and B. thetaiotaomicron were specifically detected in feces. In addition, DNA samples prepared for the identification of body fluid can also be used for individual identification by short tandem repeat typing. The mean detection sensitivities of L. crispatus and L. jensenii were 0.362 and 0.249 pg/uL, respectively. In conclusion, L. crispatus, L. jensenii, B. uniformis, and B. thetaiotaomicron can be used as effective markers for forensic identification of vaginal fluid and feces.

The association of CYP1A1 genetic polymorphisms and additional gene-gene interaction with ischemic stroke in the eastern Han of China

The aim of this study was to investigate the association between CYP1A1 gene polymorphism and ischaemic stroke (IS) risk, and the impact of gene-gene interaction on IS risk based on a Chinese Han case-control study. A total of 1162 subjects (612 men and 550 women), with a mean age of 63.1 ± 12.5 years old, were selected, including 580 IS patients and 582 normal controls. Logistic regression was performed to investigate association between single-nucleotide polymorphisms (SNP) and IS risk, and generalized multifactor dimensionality reduction (GMDR) was used to analyze the gene-gene interaction. Logistic regression analysis showed that the frequency for rs4646903 minor alleles was lower in cases than that in normal controls, and C allele of rs4646903 was 20.7 % in ischemic stroke cases and 27.1 % in controls subjects (p < 0.001). Logistic analysis showed the significant association between genotypes of variants in rs4646903 and decreased ischemic stroke risk. GMDR analysis indicated that there was a significant two-locus model (p = 0.0107) involving rs4646903 and rs1048943, indicating a potential gene-gene interaction between rs4646903 and rs1048943. Overall, the two- locus models had a cross-validation consistency of 9 of 10, and had the testing accuracy of 60.72 %. Subjects with TC or CC of rs4646903 and AG or GG of rs1048943 genotype have lowest ischemic stroke risk, compared to subjects with TT of rs4646903 and AA of rs1048943 genotype, and OR (95 % CI) was 0.63 (0.42-0.89). rs4646903 minor alleles and interaction between rs4646903 and rs1048943 were associated with decreased IS risk.

Under- and over-consumption intermittent TB treatment among rural TB patients in south-west China

OBJECTIVE

To assess adherence to intermittent directly observed treatment (DOT) during the 2-month intensive phase of tuberculosis (TB) treatment in south-west rural China.

DESIGN

A cross-sectional study was conducted in Simao Prefecture, Yunnan Province, China. One hundred and thirty new TB patients registered under DOTS and treated during the 2-month intensive phase and their observers were separately interviewed at their homes using structured questionnaires. Numbers of packs of TB drugs were checked on the spot.

RESULTS

Of 130 visits, the same percentage (3.1%) of patients and their observers reported missing > or =2 consecutive weeks of treatment (prevalence-adjusted kappa = 0.94). The percentages who missed > or =20% of the packs, as reported by patients and observers, were 3.8 and 2.3, respectively (prevalence-adjusted kappa = 0.969). According to the pill count, nine patients (7%) had missed > or =20% of the packs, 10 had over-consumed TB drugs and two had lost respectively five and six packs. Eight of the 10 who had over-consumed had done so due to confusion in the days of the month, and two because they wanted a quicker recovery.

CONCLUSIONS

Intermittent regimens in China need to be more carefully monitored to avoid over-consumption of anti-tuberculosis drugs in addition to non-adherence due to under-consumption.

[Studies on the chemical constituents of seed from Nigella glandulifera]

Seven compounds were isolated from the seed of Nigella glandulifera. Their structures were identified as kaempferol-3-O-beta-D-galactopyranosyl (1-->3)-beta-D-glucopyranosyl(1-->3)-beta-D-glucopyranoside (N-I), 2-O-[alpha-D-galactopyranosyl (1-->4)-beta-D-glucopyranosyl]-beta-D-fructofuranoside (N-II), N, N-dimethyl-1, 2-dimethoxy-10, 11-dihydric aporphine quaternary ammonium chloride (N-III), 3-O-[beta-D-xylo-pyranosyl (1-->3)-alpha-L-rhamnopyranosyl (1-->2)-alpha-L-arabinopyranosyl]- 28-O -[alpha-L-rhamnopyranosyl (1-->4)-beta-D-glucopyranosyl (1-->6) beta-D-glucopyranosyl]-hederagenin (N-IV), sucrose(N-V), beta-sitosterol(N-VI) and cyclolandenol(N-VII). Compounds N-I and N-II are new compounds, named nigeglanoside and nigeglanose, respectively. Apart from ten fatty acids in its oil have also been analysed. It is the first time for the study on chemical constituents of the seed of Nigella glandulifera.

[Immunopotentiating effects of polysaccharides isolated from Medicago sativa L]

In vitro experiments showed that 250-500 micrograms.ml-1 of the polysaccharides isolated from Medicago sativa L (MSP) increased mouse lymphocyte uptake of [3H]thymidine (TdR) induced by PHA-p (0.15%), Con A (5 micrograms.ml-1), LPS (20 micrograms.ml-1), and PWM (2 micrograms.ml-1) at maximum by 5.13 +/- 0.81, 0.75 +/- 0.08, 4.52 +/- 0.36, and 0.86 +/- 0.24 folds, respectively. After MSP ip for 5 d, the average count of mouse splenic lymphocytes in 125 mg.kg-1 x d-1 group increased from 1.4 +/- 0.4 (x 10(7))/mouse to 3.6 +/- 0.5 (x 10(7))/mouse; in 250 mg.kg-1 x d-1 dose group increased to 13.5 +/- 0.3 (x 10(7)). MSP 125 mg.kg-1 x d-1 or 250 mg.kg-1 x d-1 ip for 5 d partially or completely antagonized the effect of cyclophosphamide (200 mg.kg-1 x d-1 x 1 d) on lymphocyte decrease, the average number of lymphocytes/mouse recovered from 1.04 +/- 0.23 (x 10(7)) to 2.1 +/- 0.4 (x 10(7)) and 2.9 +/- 0.6 (x 10(7)), respectively. In addition, the lymphocyte reactivity to Con A in MSP ip 125 mg.kg-1 x d-1 x 5 d group enhanced by 60%, in 250 mg.kg-1 x d-1 x 5 d group by 156%. The abilities of PWM-induced antibody production were elevated 51% and 78%, respectively.

Augmentation of various immune reactivities of tumor-bearing hosts with an extract of Cordyceps sinensis

In order to enhance general reactivity of immune system in the tumor-bearing host, we employed extract of Cordyceps sinensis (CSE) as a biological response modifier. Cordyceps sinensis is an interesting material produced by a kind of mushroom parasitic to larval moths and was used to hasten recovery from exhaustion in ancient China. In this experiment, C57BL/6 mice implanted subcutaneously with syngeneic EL-4 lymphoma cells were employed as the host. Oral administration of the extract leads to a reduction of tumor size and prolongation of the host survival time. As judged by plaque-forming cells against T-dependent (sheep erythrocytes) and T-independent (bacterial lipopolysaccharide) antigens, CSE showed to augment the antibody responses. As for the activities of peritoneal macrophages, chemotaxis was dramatically depressed within a few days after EL-4 transplantation up to the end of life, but treatment with CSE at -14, -7, -4, +4, +7 and +10 days after the tumor transplantation augmented the activity about four times stronger than that of control. Phagocytic activity of macrophages was also decreased in tumor-bearing mice treated with cyclophosphamide (100 mg/kg) 3 and 5 days after tumor transplantation. But administration of CSE restored the activity to more than the normal level. The overall efficacy of CSE was tested with protective activity against systemic infection by Salmonella enteritides. The tumor-bearing mice receiving this medicine lived significantly longer than any other groups without CSE.

Antitumor activity of an extract of Cordyceps sinensis (Berk.) Sacc. against murine tumor cell lines

A warm water-extract (ECS) prepared from dried Cordyceps sinensis (Berk.) Sacc., a Chinese traditional medicine, was tested for antitumor activity in vivo and in vitro. Ehrlich ascites carcinoma cells (EAC), allogeneic to ICR mice and Meth A fibrosarcoma (Meth A), syngeneic to BALB/c mice were used as the target tumor cell lines. Mice were inoculated i.p. with 1 x 10(6) EAC or 1 x 10(5) Meth A on Day 0, and ECS or saline (control) was injected i.p. to the mice from Day 1 to Day 4. ECS-treatment increased the median survival time of the allogeneic mice inoculated with EAC to 316% of the control. Eight of the 10 ECS-treated mice survived on the 60th day (Day 60) after EAC implantation. ECS-treatment also increased the median survival time of the syngeneic mice inoculated with Meth A to 312% of the control. Half of the ECS-treated mice survived on Day 60. On the other hand, no cytotoxic effect of ECS was found on either EAC or Meth A in vitro. The antitumor effect of ECS seen in the allogeneic mice was significantly reduced when the mice received whole body X-irradiation (5 Gy) before EAC implantation. These results suggest that the antitumor effect of ECS may be mediated through its immunomodulating action.

Further studies on the effect of aldosterone on Mg2+-HCO3(-)-ATPase and carbonic anhydrase from rat intestinal mucosa

The main purpose of this study is to elucidate the effect of adrenocorticoids on Mg2+-HCO3(-)-ATPase and carbonic anhydrase which are thought to be related to anion transport in mammalian intestinal mucosa and renal tubulus. Rat duodenal mucosa, large intestinal mucosa and kidney cortex were excised and homogenized with mannitol-Tris buffer (pH 7.1) and brush border fraction and cytosol were obtained by a differential fractionation procedure. Brush border Mg2+-HCO3(-)-ATPase and cytosol carbonic anhydrase activities in the duodenal mucosa decreased to 70% and 37% of normal values, respectively 5-11 days after adrenalectomy. Adrenalectomy also decreased significantly both enzyme activities in large intestinal mucosa; on the other hand, renal enzyme activities did not change. Four hours after a single injection of 20-80 micrograms/kg of aldosterone, ip, to adrenalectomized rats, Mg2+-HCO3(-)-ATPase and carbonic anhydrase activities in duodenal mucosa increased gradually to normal or near normal in dose-dependent fashion. Both enzyme activities in large intestinal mucosa were also increased by a larger dose of aldosterone. Again, renal enzyme activities were not affected by any dose of aldosterone. In contrast, corticosterone (1 mg and 4 mg/kg) and dexamethasone (50 micrograms 200 micrograms/kg) had no replacement effect on enzyme activities in all organs. These results showed that the mineralocorticoid, but not glucocorticoids, is a regulator of the enzyme activity of Mg2+-HCO3(-)-ATPase and carbonic anhydrase from intestinal mucosa. The true mechanisms by which both enzymes are activated by aldosterone are not clear at present.

[Chemical structure of podocarpamide isolated from Zanthoxylum podocarpum Hemsl]

A new amide named podocarpamide (IX) was isolated from the bark of Zanthoxylum podocarpum Hemsl. By means of spectral analysis combined with chemical reactions, the structure has been elucidated.