The effect of supplementing with Saccharomyces boulardii on bismuth quadruple therapy for eradicating Helicobacter pylori: a systematic review and meta-analysis of randomized controlled trials

Background and objective

It remains uncertain if the addition of Saccharomyces boulardii (S. boulardii) to bismuth quadruple therapy (BQT) recommended in the current guidelines can enhance the Helicobacter pylori (H. pylori) eradication rate and decrease the incidence of adverse events. We therefore conducted a meta-analysis of randomized controlled trials (RCTs) to address this issue.

Methods

We performed comprehensive searches in PubMed, Embase, Web of Science, and Cochrane library databases from the inception of the databases through to November 1, 2023. A meta-analysis was conducted to determine the pooled relative risk (RR) with 95% confidence intervals (CI) using a random-effects model. We utilized the revised Cochrane Risk of Bias Tool to assess the risk of bias of included studies.

Results

A total of six RCTs (1,404 patients) included in this meta-analysis. The results of the intention-to-treat analysis showed that the combination of S. boulardii with BQT had a higher eradication rate than BQT alone (87.0% versus 83.3%), with a pooled RR of 1.05 (95% CI: 1.00-1.10, p = 0.03). In the per-protocol analysis, however, there was no statistical significance between the two groups in the eradication rate (93.7% versus 91.0%, RR = 1.03, 95% CI: 1.00-1.06, p = 0.07). The combination of S. boulardii and BQT had a significantly lower rate of overall adverse events (22% vs. 39%, RR = 0.56, 95% CI: 0.44-0.70, p < 0.00001), diarrhea (7.9% vs. 25.7%, RR = 0.29, 95% CI: 0.17-0.48, p < 0.00001), constipation (2.9% vs. 8.4%, RR = 0.35, 95% CI: 0.14-0.88, p = 0.03) and abdominal distention (4.9% vs. 12.7%, RR = 0.41, 95% CI: 0.23-0.72, p = 0.002) than BQT alone. For the assessment of risk of bias, five studies were deemed to have some concerns, while one study was judged to have a low risk.

Conclusion

Current evidence suggests that supplementation with S. boulardii in BQT may not have a major effect on the H. pylori eradication rate, but significantly reduces the incidence of overall adverse events, diarrhea, abdominal distention and constipation. Combining S. Boulardii with BQT can help alleviate symptoms, potentially improving patient adherence.

Systematic review registration

https://osf.io/n9z7c.

[Regional CT value in prediction of proximal femoral fracture]

OBJECTIVE

To investigate CT values of cancellous bone in femoral neck in adults over 60 years with proximal femoral fractures.

METHODS

From January 2020 to December 2020, a retrospective analysis was performed on 280 subjects aged 60 years or older who underwent bilateral hip CT examination, including 85 males and 195 females, 120 on the left side and 160 on the right side, aged 75 (66, 82) years old. One hundred thirty-six patients with proximal femoral fractures were included in study group and 144 patients without fractures were included in control group. GEOptima CT was used to scan and reconstruct horizontal, coronal and sagittal layers of proximal femur. CT values of cancellous bone in femoral neck were measured and compared between two groups. The relationship between CT values of cancellous bone of femoral neck and proximal femoral fracture was analyzed statistically.

RESULTS

In terms of age, fracture group aged 79(73.3, 85.0) years old, non-fracture group aged 69.5 (64.0, 78.8) years old, and had significant difference in age between two groups (P<0.05). In terms of CT value, regional CT value in fracture group was 8.62(-3.62, 27.15) HU, which was lower than that in non-fracture group 34.31(-5.93, 71.74) HU(P<0.05). CT value on coronal view in fracture group was -8.48(-30.96, 17.46) HU, which was lower than that in non-fracture group 40.49(5.55, 80.71) HU (P<0.05). CT value on sagittal view in fracture group was -31.28(-54.91, -5.11) HU, which was lower than that in non-fracture group 7.74(-20.12, 44.54) HU (P<0.05). CT values on horizontal view in fracture group was 0.17(-23.13, 24.60) HU, which was lower than that in non-fracture group 46.40(10.42, 85.18) HU(P<0.05). The mean regional CT values among three planes in the fracture group were lower than those in the non-fracture group. Logistic regression analysis showed coronal CT value was influencing factors of proximal femoral fracture, and it could be written into regression equations that predict probability of fracture.

CONCLUSION

In adults aged over 60 years old, CT values of cancellous bone of femoral neck decreased with increasing age. The smaller CT value of cancellous bone of femoral neck, the greater risk of proximal femoral fracture.

[Application of porous tantalum Jumbo cup in revision of hip arthroplasty]

OBJECTIVE

To investigate the clinical effect of porous tantalum Jumbo cup on acetabular reconstruction in revision of total hip arthroplasty.

METHODS

From September 2014 to December 2017, 18 patients(18 hips) with acetabular defect were reconstructed by porous tantalum Jumbo cup technology, including 6 males and 12 females;the age ranged from 54 to 76 years old with an average of(63.8±15.3) years. There were 6 cases of paprosky typeⅡA, 8 cases of typeⅡB, 2 cases of typeⅡC and 2 cases of type Ⅲ a. Harris score and visual analogue scale (VAS) were performed before and after operation. Imaging examination was performed to evaluate the position of hip rotation center and prosthesis, and to judge whether acetabular loosening, displacement and complications existed.

RESULTS

All cases were followed up for 13 to 49 months, with an average of 20.6 months. Harris score increased from 54.6±4.7 to 86.5±3.2 one year after operation(P<0.01), and VAS score decreased from 6.8±0.7 to 0.8±0.6 one year after operation (P<0.01). The transverse coordinate of hip rotation center was (3.52±0.72) cm before operation and (3.47±0.54) cm after operation (P>0.05). The longitudinal coordinate of hip rotation center was improved from (3.02±0.84) cm before operation to (2.35±0.53) cm after operation (P<0.01). During the follow-up period, the Jumbo cup was well fixed without loosening and displacement, the acetabular cup had bone ingrowth in varying degrees, and no light transmission line and osteolysis around the acetabular cup were found. No complications such as infection and nerve injury occurred.

CONCLUSION

The method of reconstructing acetabular bone defect with porous tantalum Jumbo cup is simple and easy, the early stability of acetabulum is good, and the short-term follow-up effect is good.

[Drug-resistant gene polymorphisms in Plasmodium falciparum isolated from Bioko Island, Equatorial Guinea in 2018 and 2019]

OBJECTIVE

To investigate the genetic polymorphisms of Plasmodium falciparum multidrug resistance protein 1 (PfMDR1), chloroquine resistance transporter (PfCRT) and Kelch 13 (PfK13) genes in Bioko Island, Equatorial Guinea, so as to provide insights into the development of the malaria control strategy in local areas.

METHODS

A total of 85 peripheral blood samples were collected from patients with Plasmodium falciparum infections in Bioko Island, Equatorial Guinea in 2018 and 2019, and genomic DNA was extracted. The PfMDR1, PfCRT and PfK13 genes were amplified using a nested PCR assay. The amplification products were sequenced, and the gene sequences were aligned.

RESULTS

There were no mutations associated with artemisinin resistance in PfK13 gene in Bioko Island, Equatorial Guinea, while drug-resistant mutations were detected in PfMDR1 and PfCRT genes, and the proportions of PfMDR1_N86Y, PfMDR1_Y184F and PfCRT_K76T mutations were 35.29% (30/85), 72.94% (62/85) and 24.71% (21/85), respectively.

CONCLUSIONS

There are mutations in PfMDR1, PfCRT and PfK13 genes in P. falciparum isolates from Bioko Island, Equatorial Guinea.

P1633Age, creatinine, and ejection fraction (ACEF) score continues to predictive prognosis in patients with ischemic cardiomyopathy

Purpose

ACEF (Age, Creatinine, and Ejection Fraction) andACEFMDRD (Modification of Diet in Renal Disease) score have been validated as effective predictors for prognosis in patients undergoing elective cardiac surgery or PCI. However, the predictive value for ICM (Ischemic Cardiomyopathy)was not clear. This study sought to investigate their predictive value in patients with ICM.

Methods

862 ICM patients hospitalized in the Department of Cardiology were prospectively enrolled during November 2014 and December 2017.Inclusion criteria: previous definite diagnosis of myocardial infarction, previous PCI, CABG, or coronary angiographic findings of one or more vessel stenosis >70%; Simpson echocardiography showed LVEF <45%. Exclusion criteria: malignant tumors of any organ or once had a history of malignancies; and other serious diseases with estimated survival time less than one year.The ACEF score was calculated by the formula: age/ejection fraction + 1 (if creatinine >176 μmol/L). As for ACEFMDRD score, estimated glomerular filtration rate (eGFR) was calculated using the MDRD formula. Then using the formula: age/EF +1 point for every 10 mL/min reduction in eGFRMDRD below 60 ml/min per 1.73 m2 (up to a maximum of 6 points). Patients were divided into low, middle and high ACEF, ACEFMDRD tertiles. The median duration of follow-up was 13 months (IQR: 7–23 months). The clinical endpoints were all-cause mortality, cardiac mortality, major adverse cardiovascular and cerebrovascular events (MACCEs) and re-hospitalization for heart failure (HF).

Results

The mean original ACEF and ACEFMDRD score were 1.99±0.63 and 2.53±1.42. Patients in high ACEF and ACEFMDRD tertile were associated with significantly higher all-cause and cardiac mortality, MACCEs and re-hospitalization for HF. Compared with ACEFMDRD score, original ACEF exhibited similar discrimination and predictive ability on all-cause mortality (AUC: 0.739 vs. 0.724, P=0.567), cardiac mortality (AUC: 0.733 vs. 0.717, P=0.525), MACCEs (AUC: 0.635 vs. 0.624, P=0.587) and rehospitalizaiotn (AUC: 0.642 vs. 0.632, P=0.757). In multivariate Cox analysis, the original ACEF or ACEFMDRD score were related with increasing risks of all-cause mortality (HR: 2.00 vs. 1.32, 95% CI: 1.46–2.73 vs. 1.13–1.53, P<0.001), cardiac mortality (HR: 1.97 vs. 1.28, 95% CI: 1.43–2.70 vs. 1.10–1.50, P<0.001 vs. P=0.002), MACCEs and re-hospitalization for HF, respectively.

ROC curves of cardiac mortality

Conclusions

In patients with ICM, the original ACEF and ACEFMDRD score are independent predictors of adverse outcomes during 13-month follow-up, respectively.

Acknowledgement/Funding

None

Sleep and hypertension

PURPOSE

Hypertension is a global public issue, and sleep status was regarded as its risk factor; however, the results were inconsistent. This study aims to deeply investigate the correlation between sleep status and hypertension.

METHODS

The electronic databases Cochrane Library, Pubmed, and Embase updated to May 31, 2019, were retrieved. Studies were selected according to the predefined screening criteria, and their qualities were assessed by using quality check scales. Based on Stata 15.1 software, the associations between sleep status and hypertension were analyzed by meta-analyses, using odds ratio and 95% confidence interval as effect indexes. Furthermore, publication bias and small study bias were evaluated using Begg and Egger's test. In addition, sensitivity analysis was conducted through ignoring one study per time and then observing its influences on the pooled results.

RESULTS

A total of 54 studies (involving 1,074,207 subjects) were eligible for this meta-analysis. Six factors were included in this study. Raised blood pressure was associated with obstructive sleep apnea (OSA), oxygen desaturation index (ODI), short sleep duration, and long sleep duration. The differences in ≤ 5 h, 6 h, ≥ 9 h, and 10 h groups had statistical significances, while there was no significant difference in ≥ 8 h group. Snoring is a risk factor of hypertension (OR = 1.94, 95%CI 1.41-2.67). Subgroup analysis was conducted and results were varied.

CONCLUSIONS

The hypertension risk might be reduced by treated OSA, ODI, and snoring, as well as appropriate sleep duration. More studies with large sample sizes and high qualities should be included to support the findings further.

Application of miniSTR Loci and Its Detection System for Degraded Materials in Forensic Medicine

OBJECTIVES

To establish multiplex system of 16 miniSTR loci, and explore its application value for the degraded materials in forensic medicine.

METHODS

The multiplex system of 16 miniSTR loci was established using a six-dye fluorescence labeling technology and its application value in forensic medicine was assessed.

RESULTS

A six-dye fluorescence labeling miniSTR amplification kit was developed, which enabled 15 autosomal STR loci, Amelogenin locus and DYS391 to be typed simultaneously. This method showed good specificity and could provide stable and accurate typing results with a sensitivity of 50 pg. This system also provided a good test result for the normal biological sample of actual cases.

CONCLUSIONS

The multiplex system of 16 miniSTR loci has application value for degraded and trace materials with the advantages of high sensitivity and database compatibility, which can be used for forensic casework.

[Langerhans cell histiocytosis of the thyroid: a case report]

Langerhans cell histiocytosis (LCH) is a rare monoclonal disease,its clinical presentation is highly variable because it can affect multiple organs, such as lung, bone, skin, lymph nodes, hypothalamopituitary axis, and other multiple sites. LCH involving the thyroid gland is extremely rare, here we reported a rare case of LCH involving thyroid, presenting as painless thyroid goiters.

A new method for identifying causal genes of schizophrenia and anti-tuberculosis drug-induced hepatotoxicity

Schizophrenia (SCZ) may cause tuberculosis, the treatments for which can induce anti-tuberculosis drug-induced hepatotoxicity (ATDH) and SCZ-like disorders. To date, the causal genes of both SCZ and ATDH are unknown. To identify them, we proposed a new network-based method by integrating network random walk with restart algorithm, gene set enrichment analysis, and hypergeometric test; using this method, we identified 500 common causal genes. For gene validation, we created a regularly updated online database ATDH-SCZgenes and conducted a systematic meta-analysis of the association of each gene with either disease. Till now, only GSTM1 and GSTT1 have been well studied with respect to both diseases; and a total of 23 high-quality association studies were collected for the current meta-analysis validation. Finally, the GSTM1 present genotype was confirmed to be significantly associated with both ATDH [Odds Ratio (OR): 0.71, 95% confidence interval (CI): 0.56–0.90, P = 0.005] and SCZ (OR: 0.78, 95% CI: 0.66–0.92, P = 0.004) according to the random-effect model. Furthermore, these significant results were supported by “moderate” evidence according to the Venice criteria. Our findings indicate that GSTM1 may be a causal gene of both ATDH and SCZ, although further validation pertaining to other genes, such as CYP2E1 or DRD2, is necessary.

[New progress of BRAF gene and thyroid cancer]

It is noteworthy that the incidence of thyroid cancer around the world has increased significantly in recent decades, raising an imperative need to research its pathogenesis, diagnosis and treatment. Up to now, fine needle aspiration biopsy (FNAB) of thyroid has been acknowledged to discriminate benign from malignant thyroid nodules with the highest sensitivity and specificity. However, 10% to 40% thyroid nodules cannot be discriminated by FNAB. Therefore, it is vitally important to look for highly-correlated tumor makers in molecule level. BRAF mutation is a focus in thyroid cancer research, and some studies showed that this mutation is essential to the onset and development of thyroid cancer, especially papillary thyroid cancer. Joint detection of BRAF mutation could improve diagnostic sensitivity of thyroid cancer, which is crucial for thyroid cancer diagnosis and classification. As for treatment, the discovery of target gene enabled molecule therapy for thyroid cancer, raising hopes for patients with thyroid cancer that refractory to conventional treatments. Currently, many molecule therapeutics relating to BRAF has already undergone clinical trials. It is believed that further research on BRAF-thyroid cancer relationship could create a new field for diagnosis and treatment of thyroid cancer, and set a mode for discovering others molecule markers.

Baicalin can attenuate the inhibitory effects of mifepristone on Wnt pathway during peri-implantation period in mice

Wnts are considered as important factors in uterus developmental process and embryo implantation. Baicalin has been demonstrated to possess tocolytic properties. In order to investigate the effect of baicalin on the Wnt signaling pathway during the peri-implantation, pregnant Kuming mice were randomly divided into four groups: control group, baicalin group administered with 40mg/kg BW of baicalin through an intragastric gavage on day 2 to 7 of the pregnancy (Pd2-Pd7), mifepristone group treated with 4mg/kg BW of mifepristone, an abortifacient agent, via subcutaneous administration on Pd4, and baicalin+mifepristone group treated with their combination. The concentrations of the implantation-related steroid hormones (progesterone and estradiol) in the blood serum were measured with RIA. The gene and protein expression levels of the important molecules of the Wnt pathway (Wnt4, LRP6, Dkk1 and β-catenin) in the endometrium were detected with RT-PCR and western blot, respectively. The results showed that baicalin decreased (P<0.05) the estradiol levels on Pd4-Pd8 and increased (P<0.05) the progesterone levels on Pd3-Pd8. Mifepristone increased (P<0.05) the estradiol levels on Pd5-Pd8 and decreased (P<0.05) the progesterone levels on Pd6-Pd8. Compared with the control group, baicalin increased the gene and protein expression levels of Wnt4, LRP6 and β-catenin (P<0.05) and decreased the gene and protein expression levels of Dkk1 (P<0.05) during the middle-to-late stage of the experiment in mice uterine tissue. Baicalin alleviated the mifepristone-induced increase or decrease in the serum levels of progesterone and estradiol, and the gene or protein expression levels of Wnt4, LRP6 and β-catenin. The tocolytic properties tocolysis of baicalin may be realized through regulating the levels of estrogen/progesterone and the important components of canonical Wnt signaling pathway during the embryo implantation process intervened with the subcutaneous administration of mifepristone in the mice.

Processing of facial expressions of emotions in healthy volunteers: an exploration with event-related potentials and personality traits

AIMS OF THE STUDY

Previous studies have shown that event-related potentials (ERPs) are modulated by anxiety or psychopathic personality traits. Therefore, we hypothesized that the automatic processing of facial expressions of emotions (FEE) is also correlated with related disordered personality traits.

METHODS

Thirty-seven healthy volunteers underwent both an "oddball" ERP recording to facial expressions of Anger, Happiness, Sadness, and Neutral, and a test of the Dimensional Assessment of Personality Pathology (DAPP).

RESULTS

Mean reaction time was longer in response to anger than to other facial expressions. Facial expressions of Anger, Happiness and Sadness did not affect N1 (N170). By contrast, Happiness elicited a delayed P2, Anger elicited both a smaller N2 and a delayed P3b, and both Happiness and Anger elicited a P3b of higher amplitude. In addition, P3a latencies to Happiness were negatively correlated with DAPP Identity problems, and P3b latencies to Happiness were negatively correlated with DAPP Stimulus seeking, Callousness, Passive aggressivity, and Narcissism.

CONCLUSION

Our study demonstrates that Anger implicitly captures attentional resources, and Happiness triggers more facilitated processing in individuals with dissocial traits.

[Treatment of urinary tract calculi in preschool children with endoscopy]

OBJECTIVES

To investigate the safety and feasibility of endoscopy in treating urinary tract calculi in preschool children.

METHODS

From August 2004 to August 2008, 28 preschool children with urinary tract calculi were treated by endoscopy, 11 cases received ureterolithotripsy (URL) and 17 cases received minimally invasive percutaneous nephrolithotomy (MPCNL).

RESULTS

Of 11 cases with ureteric calculi, 5 cases were rendered stone free in the first session, the other 6 cases received passive dilation by indwelling of ureteric stents for 1 to 3 weeks and underwent successful ureteroscopy with a 8/9.8 Fr rigid ureteroscope. Seventeen cases with renal calculi received MPCNL and were rendered stone free.

CONCLUSION

Our study shows that endoscopy in treating urinary tract calculi is safe and feasible in preschool children.

Toxic Effects in Siganus oramin by dietary exposure to 4-tert-octylphenol

The integrated toxicities of 4-tert-octylphenol (t-OP) on Siganus oramin were investigated by dietary administration at doses of 5, 25 and 125 mg/kg body weight over 28 days. Significant increase was observed in the activity of hepatic glutathione S-transferase at 125 mg/kg on both day 14 and 28 in males, and at all doses on day 28 in females, and in hepatosomatic index at 25 mg/kg on day 14 in both sexes. Plasma levels of testosterone and cortisol decreased significantly at all doses on day 28. Histopathologic changes in liver, spleen, intestine and testis deteriorated with increasing doses and duration. The results suggest that S. oramin is sensitive to t-OP, and the above endpoints may be potential biomarkers for evaluating toxicities of environmental pollutants such as t-OP.

Binding modes of two highly potent and nontoxic inhibitors of HIV-1 integrase

The complex structures of Human Immunodeficiency Virus Type 1 (HIV-1) integrase binding two highly potent and nontoxic inhibitors, lithospermic acid (M/sub 5/22) and lithospermic acid B (M/sub 5/32), were obtained using docking calculations. Docking results provided detailed information of their binding modes. The binding sites of M/sub 5/22 and M/sub 5/32 were similar to the inhibitor 5-CITEP. The lowest docking energies for HIV-1 integrase binding M/sub 5/22 and M/sub 5/32 are in agreement with their corresponding lower IC/sub 50/ values. Our results on the chemical structure difference between M/sub 5/22 and M/sub 5/32 show that the carboxyl and hydroxyl groups on the side-chain of M/sub 5/32 are important chemical groups which could help to increase the effect against HIV-1 IN replication.

[Treating renal carcinoma with ablation or ablation combined with 125I seed implantation: a report of eleven cases]

BACKGROUND & OBJECTIVE

Recently, multi-needles radiofrequency ablation and brachyradiotherapy have been used to treat some solid tumors, such as liver cancer and prostate cancer. This study was to explore the feasibility and efficacy of radiofrequency ablation or ablation combined with 125I seed implantation on treating renal carcinoma.

METHODS

From Jun. 2000 to Feb. 2004, 11 patients with a total of 13 renal carcinoma lesions were treated with ablation or ablation combined with (125)I seed implantation, including 6 cases of renal carcinoma of solitary kidney, 2 cases of renal carcinoma combined with contralateral renal atrophy resulted from ureteric stone, 1 case of bilateral tumor, and 2 cases with general conditions contraindicated to surgery. Of the 13 lesions, 1 was resected by open operation, 6 were treated with multi-needles radiofrequency ablation, and 6 were treated with ablation and simultaneous (125)I seed implantation around tumor margin.

RESULTS

The patients were followed-up for 6-46 months (mean 27 months). One patient died of cardiac muscle infarction 4 months after operation. Of the 10 alive patients, 2 with recurrent tumors 7 months and 13 months after operation were treated with ablation again, 1 with postoperative uremia was treated with intermittent peritoneal dialysis, the rest 7 had normal renal function.

CONCLUSION

Multi-needles radiofrequency ablation or ablation combined with (125)I seed implantation would be an option in the treatment for patients with renal carcinoma of solitary kidney or bilateral kidney lesions, or for patients can't suffer from surgery.

[Endoscopic management of bilateral ureteral obstruction after radiotherapy]

BACKGROUND & OBJECTIVE

It is difficult to stent the obstructed ureters cystoscopically in patients with renal failure caused by radiotherapy for abdominal or pelvic tumors. Commonly draining the kidney with nephrostomy is the only method for the patients. However, external nephrostomy impacts on life quality of the patients. We reported our experience in stenting the obstructed ureters using minimally invasive percutaneous nephrostomy combined with ureteroscopy, and investigated viability of endoscopic treatment for bilateral ureteral strictures following radiotherapy.

METHODS

Indwelling double pigtail stents in ureter by minimally invasive percutaneous nephrostomy combined with ureteroscopy was carried out in 19 patients with bilateral ureteral strictures following radiotherapy. The clinical outcomes including ureteral drainage and renal function were reviewed.

RESULTS

Bilateral retrograde placement of double pigtail stent was performed in 2 cases. Indwelling different size double pigtail stents in unilateral ureters were carried out in 17 cases. The patients were followed-up for 1-24 months. Renal function was improved excellently in 17 cases, with serum creatinine level of 45 micromol/L to 113 micromol/L. Two patients had poor renal function improvement after ureteral stenting and were converted to percutaneous nephrostomy for draining the kidney.

CONCLUSION

Indwelling different size double pigtail stents simultaneously in unilateral ureter by minimally invasive percutaneous nephrostomy is safe, simple, and effective in treating bilateral ureteral obstruction following radiotherapy.

Killing effects of ganciclovir on human pulmonary adenocarcinoma cell A549 transduced with HSV1-TK gene in vitro and in vivo

AIM

To observe the killing effects of ganciclovir (GCV) on the human pulmonary adenocarcinoma cell A549 transduced with Herpes simplex virus I type thymine kinase (HSV1-TK) gene in vitro and in vivo.

METHODS

A retroviral vector containing the TK gene was constructed and transduced into a pulmonary carcinoma cell A549 by electroporation, to observe the sensitivity of the transfected cell to GCV in vitro and the bystander effect (MTT assay). Tumor cell apoptosis caused by the TK/GCV system was observed with a flow cell meter (FCM) and a scan electronic microscope (SEM). Recombination and expression of the TK gene were examined with DNA PCR and in situ hybridization, respectively. The therapeutic effect of GCV on subcutaneous tumor growth between transfected and parental cells was also compared.

RESULTS

The sensitivity of the transfected cell to GCV was 46 times higher than that of the parental cell, and the bystander effect was stronger in high cell density than in low cell density. The subG0G1 peak was shown on the DNA histogram after A549-Tk cell was treated with 50 micromol/L GCV for 3 days by FCM, but not in the A549 cell. A cell cycle analysis showed that the apoptotic cell in the A549-TK and A549 cells were (12.2+/-1.7) % and (1.3 +/- 0.3) %, respectively (P < 0.01). The cell apoptosis features of nuclear condensation, apoptotic vesicle, and nuclear showing semimoon feature were found in the A549-TK cell by SEM, but not in the A549 cell. Recombination and expression of the TK gene were positive in the transfected cell. In vivo, the growth of tumors formed by the transfected cell was apparently inhibited by GCV, but not in the control group.

CONCLUSION

The transfected cell obtained sensitivity to GCV and the bystander effect was closely related to intercellular touch. The TK/GCV system killing tumor cell was related to cell apoptosis. GCV inhibited the growth of tumors which were inoculated by A549-TK cell in vivo.

Pathological changes in human malignant carcinoma treated with high-intensity focused ultrasound

The purpose of this study was to investigate the pathologic changes of extracorporeal ablation of human malignant tumors with high-intensity focused ultrasound (HIFU). HIFU treatment was performed in the 164 patients with liver cancer, breast cancer, malignant bone tumor, soft tissue sarcoma and other malignant tumors at focal peak intensities from 5000 W x cm(-2) to 20,000 W x cm(-2), with operating frequencies of 0.8 to 3.2 MHz. To explore the pathologic impact of extracorporeal HIFU, 30 patients with malignant carcinoma underwent surgical removal after HIFU treatment. Pathologic findings showed that the treated tissues demonstrated homogeneous coagulative necrosis with an irreversible tumor cell death and severe damage to tumor blood vessels at the level of microsvasculature within the HIFU-targeted region. Thermolesions to intervening tissue were never observed. The treated region had a sharp border comprising only several cell layers between the treated and untreated areas. The repair of lesions had the processes of necrotic tissue absorption and granulation tissue replacement. It is concluded that extracorporeal treatment of human solid malignancies with HIFU could be safe, effective and feasible. As a noninvasive therapy, HIFU would be used clinically to treat patients with solid malignancies.

Molecular dynamics simulations of the gramicidin A-dimyristoylphosphatidylcholine system with an ion in the channel pore region

To investigate the process of ion permeation in an ion channel systematically, we performed molecular dynamics (MD) simulations on a gramicidin A (GA)-phospholipid model system with an ion in the channel pore region. Each of the three types of ions (Ca2+, Na+ Cl-) was placed at five different positions along the channel axis by replacing a water molecule. MD simulations were performed on each system at constant pressure and constant temperature. The MD trajectories showed that the Ca2+ and Na+ ions could stably fluctuate in the pore region, but the Cl- ion was pushed out because of the unfavorable interaction with the channel. This result is consistent with experimental data. It was also found that the conformation of the GA channel underwent a significant change due to the presence of the ion, and the two ends of the GA monomer were more flexible than its middle region. In particular, the dramatic change of local pore radius near the ion indicated this kind of deformation. The strong interaction between the ion and carbonyl oxygen atoms of GA was the major contributor to this change. Furthermore, it was found that the ethanolamine group of the GA molecule was the most flexible group in the GA channel and often observed to block the entrance of GA. These results imply that the deformation of channel structure plays a very important factor in ion permeation, and the ethanolamine group may play a key role in regulating ion entry into the pore. In conclusion, our results indicate that the ion has a dominant influence on the structure of the GA channel and that the flexibility of the ion channel is a crucial factor in the ion permeation process.

Phenanthrenequinone-doped poly(methyl methacrylate) photopolymer bulk for volume holographic data storage

We present the design and fabrication of a phenanthrenequinone-doped poly(methyl methacrylate) photopolymer material. Large blocks of samples were made, and the material showed negligible shrinkage after optical exposures. We recorded and reconstructed 250 holograms at a single spot, using a 1-cm(3) block.

[Variation of chemical constituents in processed licorice roots: quantitative determination of saponin and flavonoid constituents in bark removed and roasted licorice roots]

As a continuing study of chemical characterization of crude drug processing, we have been analyzing the chemical constituents in licorice roots before and after processing. At first, we analyzed chemical constituents in licorice roots of various origins. Next, we have developed the HPLC analytical method, by which saponins and flavonoids, major constituents in various licorice roots, were determined simultaneously in a quantitative manner. In this paper, by means of the HPLC analytical method, chemical constituents in licorice roots, processed and unprocessed, were determined. It was found that nonglycosidic flavonoid constituents were mostly lost while root bark removing, whereas, in roasted licorice roots, sugar chains in the saponin and glycosidic flavonoid constituents were hydrolyzed stepwise during roasting through hydrothermolysis.

Inhibitory effect of Ginkgo biloba extract on the expression of inducible nitric oxide synthase in endothelial cells

Excessive production of nitric oxide (NO) may have cytotoxic effects through the formation of peroxynitrite with superoxide. The extract of Ginkgo biloba leaves (EGb) has been demonstrated to be a potent scavenger of free radicals. Although EGb has been shown recently to inhibit NO production in macrophages, its effect on NO production in endothelial cells is largely unknown. The objective of this study was to elucidate the mechanism by which EGb affects NO production in a human endothelial cell line (ECV304). After cells were incubated with EGb (10-100 microg/mL) for 2 or 4 hr, the amounts of NO metabolites released by the cells were quantitated, and cellular NOS activities were determined following the conversion of [3H]arginine to [3H]citrulline. NOS protein expression was determined by western immunoblotting analysis. mRNA levels were examined by reverse transcription-polymerase chain reaction (RT-PCR) analysis. EGb (50 microg/mL) caused a 30% reduction of NO metabolites released by endothelial cells. Following EGb treatment, cellular inducible NO synthase (iNOS) activity was reduced by 28% with a concomitant reduction in the levels of iNOS protein mass and mRNA. There was no change in the activity or protein mass of constitutive NO synthase in these cells. EGb inhibited NO production by attenuating the level of iNOS mRNA in ECV304 cells. Selective inhibition of iNOS by EGb may be therapeutically relevant in modulating NO production in endothelial cells.

Constructing the suitable initial configuration of the membrane-protein system in molecular dynamics simulations

A method for constructing the suitable initial configuration of the membrane-protein system for molecular dynamics (MD) simulations is presented. This method could provide some hydrated initial configurations and help us to determine the best surface area of the system by contracting the surface area and comparing the optimized lowest energy of the system by energy minimization. The gramicidin A (GA) channel in;the fully hydrated dimyristoylphosphatidylcholine (DMPC) bilayer was used as our model. Three configurations with different surface areas were selected and applied for one 400 ps and two 300 ps MD simulations at constant pressure and temperature. All simulations were fairly stable without any constraints. Through analysis of the MD trajectories we found that the system with the best surface area was more stable than the other two systems, whose sizes were changed in the simulations. Further analysis of the bilayer normal length and the order parameters of the lipid alkyl tails indicates that the system with the best surface area shows some characteristics of the L(alpha) phase, while both the smaller and the larger size systems have distinct deviations from the L(alpha) phase that we expect. This illustrates that the correct surface area and the suitable initial configuration have an important influence on the phase of the membrane in the MD simulation. In addition, by comparing the root mean square differences of GA relative to the initial structure and interaction energy between different components of the system for all three systems, we find that the state of the DMPC bilayer has exerted a significant influence on the structure of GA. All these results demonstrate the validity of our method for constructing the initial configuration of the membrane-protein system for MD simulations.

[Quantitative determination of constituents in various licorice roots by means of high performance liquid chromatography]

During the course of our studies on the chemical constituents of botanically identified Chinese licorice roots of various origins, we have identified 15 kinds of saponins and 49 kinds of flavonoids (including flavonoid glycosides). With these chemical constituents at hand, we have carried out the chemical evaluation studies of licorice roots available in Japan by means of high performance liquid chromatography (HPLC). In the HPLC analysis using an ODS reversed-phase column, a combination of 1% aqueous acetic acid and acetonitrile was used as the mobile phase in a gradient solvent system, and the eluate was monitored with UV absorption at 254 nm (for saponins with a diene or a conjugated carbonyl moiety, liquiritin, and liquiritin apioside) or at 350 nm (for other flavonoid constituents). By our analytical method described here, quantitative analyses of saponin and flavonoid constituents were effected simultaneously. We have found an interesting piece of information concerning the origin of parent plants and their characteristic constituents such as saponins and flavonoids.

[Inhibition of guan-fu base A on delayed rectifier current (Ik) in guinea pig ventricular myocytes]

Guan-fu base A (GFA) is a terpenoid alkaloid isolated from the tuber of Aconitum coreanum, which has been shown to prolong cardiac repolarization in vivo and in vitro. In the present study, the effects of GFA on the delayed rectifier current (Ik) were investigated using the whole cell patch-clamp technique in isolated guinea pig ventricular myocytes. In the presence of CdCl2 100 mumol.L-1, Ik was observed upon depolarizing pulses to +50 mV from a holding potential -40 mV for variable duration (550, 1100, 1650, 2200, 2750, 3300, 3850 ms). The magnitude of Ik after a 2200 ms pulse was 293 +/- 90 pA prior to drug and 227 +/- 59 pA in the presence of GFA 100 mumol.L-1. In a 3850 ms pulse, the magnitude of Ik decreased from 290 +/- 90 to 231 +/- 66 pA after exposure to GFA. The inhibitory effects of GFA on Ik was not dependent on the duration of depolarization. The inward rectifier current (Ik1) was not affected by GFA 100 mumol.L-1. It is concluded that GFA has inhibitory effects on Ik, which may contribute to its prolongation of cardiac repolarization.

Protective effects of Ginkgo biloba extract against lysophosphatidylcholine-induced vascular endothelial cell damage

AIM

To study the protective effects of Ginkgo biloba extract (GbE) against endothelial cell damage induced by lysophosphatidylcholine (LPC).

METHODS

The vasorelaxation response to acetylcholine (ACh) were investigated in the isolated rabbit thoracic aorta. Lipid peroxidation products were determined by measuring thiobarbituric acid reactive substance.

RESULTS

GbE attenuated the inhibition of vasorelaxation response to ACh and prevented the LPC-induced increase of malondialdehyde (MDA) content both in thoracic aortae. GbE prevented the leakage of LDH and the increase of MDA content in cultured endothelial cells in a concentration-dependent manner. GbE also markedly increased epoprostenol level in cultured endothelial cells treated with LPC.

CONCLUSION

GbE protected endothelial cells against LPC-induced damage due to reduction in lipid peroxidation and facilitation of synthesis and/or release of epoprostenol.

Investigating the dielectric effects of channel pore water on the electrostatic barriers of the permeation ion by the finite difference Poisson-Boltzmann method

In this paper, the finite difference Poisson-Boltzmann (FDPB) method with four dielectric constants is developed to study the effect of dielectric saturation on the electrostatic barriers of the permeation ion. In this method, the inner shape of the channel pore is explicitly represented, and the fact that the dielectric constant inside the channel pore is different from that of bulk water is taken into account. A model channel system which is a righthanded twist bundle with four alpha-helical segments is provided for this study. From the FDPB calculations, it is found that the difference of the ionic electrostatic solvation energy for wider domains depends strongly on the pore radius in the vicinity of the ion when the pore dielectric constant is changed from 78 to 5. However, the electrostatic solvation energy of the permeation ion can not be significantly affected by the dielectric constant in regions with small pore radii. Our results indicate that the local electrostatic interactions inside the ion channel are of major importance for ion electrostatic solvation energies, and the effect of dielectric saturation on the electrostatic barriers is coupled to the interior channel dimensions.

[Protective effects of extract of Ginkgo biloba (EGb) on lysophosphatidylcholine induced damages of vascular endothelial cells in vitro]

Effects of EGb on cultured bovine aortic endothelial cells (BAEC) damaged by lysophosphatidylcholine (LPC) were investigated. When endothelial cells were incubated with LPC (2.5 micrograms.ml-1) for 24 h, the endothelial cells turned round pyknotic, exfoliated and broken, and the contents of malondialdehyde (MDA), lactate dehydrogenase (LDH) and plasminogen activator inhibitor (PAI) were markedly increased and the superoxide dismutase (SOD) activity was inhibited. Treatment with EGb at concentrations of 125 and 250 micrograms.ml-1, caused a reduction in MDA, LDH and PAI contents, while the SOD activity in the medium was increased and the morphologically damaged BAECs were alleviated. These results suggest that EGb afforded protection against BAECs damages induced by LPC and that the protective effect of EGb may be due to anti-lipid peroxidation via free-radical scavenging activity.

Effects of matrine on mouse splenocyte proliferation and release of interleukin-1 and -6 from peritoneal macrophages in vitro

AIM

To investigate the mechanisms of anti-inflammatory effect of matrine (Mat), its effects on mouse splenocyte proliferation, and release of interleukin-1 (IL-1) and interleukin-6 (IL-6) from mouse peritoneal macrophages.

METHODS

Splenocyte proliferation was assayed by [3H] TdR incorporation. IL-1 and IL-6 activities were measured by thymocyte proliferation assay and B9 cell proliferation MTT colorimetric method, respectively.

RESULTS

Mat (125-500 mg.L-1) obviously inhibited concanavalin A (Con A, 5 mg.L-1)- and lipopolysaccarides (LPS, 10 mg.L-1)-induced splenocyte proliferation and LPS-induced release of IL-1 and IL-6 from mouse peritoneal macrophages.

CONCLUSION

Mat inhibited splenocyte proliferation and release of IL-1 and IL-6 in vitro.

[Clinical study of effect of zhengda zhenhua 851-R oral liquor on delayed aging process]

A study was conducted on the effects of Zhengda Zhenhua 851-R (ZZ-851-R) oral liquor on middle aged-old patients with Kidney and Spleen Deficiencies. It was found that ZZ-851-R was able to relieve the symptoms of aging, improve the memory and fluency of speech, the activity of superoxide dismutase (SOD) GSH and GSH-peroxidase (GSH-Px) increased remarkably and serum lipid peroxide (LPO) level decreased significantly. Improvements of immunity, function of the pituitary-gonad axis were also noticed in the study, with decreased E2/T ratio and improved ability of total antioxydation. In summary, the ZZ-851-R has the effect of antisenility, without obvious side-effect.

Expression of p53 in oesophageal squamous cell carcinoma in Hong Kong Chinese

We studied p53 overexpression in a series of 99 primary oesophageal squamous cell carcinomas (28 well-differentiated, 42 moderately-differentiated and 29 poorly-differentiated squamous cell carcinomas) from Chinese patients using the p53 protein specific mouse monoclonal antibody DO-7 on paraffin sections. The p53 protein was detected in 30% (30 cases) of the tumours. A significantly higher positive rate was noted in the poorly-differentiated tumours (11% for the well-differentiated, 31% for the moderately-differentiated and 48% for the poorly-differentiated tumours). In addition, strong positive p53 staining was identified only in the less differentiated tumour cells in the periphery of the tumour cell nests in all the cases and the expression was weaker in the better differentiated foci. The central keratinizing areas and the immediately adjacent tumour cells were always negative for p53. The adjacent normal oesophageal mucosa was all negative for p53 protein but the non-invasive dysplastic epithelium next to the tumours could also be strongly positive for p53 protein (four out of 14 cases in which the dysplastic epithelium adjacent to the tumour was adequately sampled). In two out of these four cases, the dysplastic epithelium showed staining for p53; even the adjacent invasive tumour was negative for p53. It is concluded that there is a strong relationship between p53 overexpression and tumour cell differentiation in oesophageal squamous carcinoma and overexpression of p53 can occur in non-invasive tumour cells.

[Effects of zhengda zhenhua 851 on improvement of memory and fluency of language of kidney deficiency patients]

A study was conducted on the effects of Zhengda Zhenhua 851-R oral liquor on the improvement of memory and fluency of language of patients suffering from Kidney Deficiency and control group. It was found that the treated group did better in memory tests and the index of mental quotient (MQ) was higher than that of control group. They had markedly higher scores in the tests of directional memory which requires one's initiative and the free recollection of pictures. The scores achieved by the treated group were significantly higher than that of control on the tests of the fluency of language and expressions, particularly with words of different categories. The results showed that Zhengda Zhenhua 851-R oral liquor obviously had the function of improving the memory and fluency of language for Kidney Deficiency patients.

Chemical studies of Chinese licorice-roots. I. Elucidation of five new flavonoid constituents from the roots of Glycyrrhiza glabra L. collected in Xinjiang

From the air-dried roots of Glycyrrhiza glabra L. (Leguminosae) collected in Xinjiang province, China ("Shinkyo-Kanzo" in Japanese), five new flavonoid compounds named glucoliquiritin apioside (1) (a flavonone bisdesmoside), prenyllicoflavone A (5) (a bisprenylflavone), shinflavone (7) (a prenylated pyranoflavanone), shinpterocarpin (9) and 1-methoxyphaseollin (12) (both pyranopterocarpans), were isolated together with eight known saponins, seven known flavonoid glycosides, and eleven flavonoids. The structures of the new compounds have been elucidated on the basis of their chemical and physicochemical properties.

Expression of the p53 gene in trophoblastic cells in hydatidiform moles and normal human placentas

In this study we compared the expression of p53 in six early placentas and eight hydatidiform moles using Northern blotting. A higher expression of p53 in hydatidiform moles as compared to normal placentas of comparable gestational age was observed. Immunohistochemical studies did not detect mutant protein of p53 in the hydatidiform moles. DNA sequencing was performed on four of the hydatidiform moles with increased expression of p53, but no mutations could be detected. The possible role of p53 in the pathogenesis of hydatidiform mole is discussed.

Saponin and sapogenol. L. On the constituents of the roots of Glycyrrhiza uralensis Fischer from Xinjiang, China. Chemical structures of licorice-saponin L3 and isoliquiritin apioside

From the air-dried roots of Glycyrrhiza uralensis Fischer collected in Xinjiang province, China ("Shinkyo-Kanzo" in Japanese), a new oleanene-type triterpene oligoglycoside named licorice-saponin L3 and a new chalcone oligoglycoside named isoliquiritin apioside were isolated together with glycyrrhizin, 18 alpha-glycyrrhizin, apioglycyrrhizin, araboglycyrrhizin, licorice-saponins A3, E2, G2, and H2, and six known flavonoid glycosides. On the basis of chemical and physicochemical evidence, the structures of licorice-saponin L3 and isoliquiritin apioside were elucidated as 3 beta-[alpha-L-rhamnopyranosyl(1-->2)-alpha-L-arabinopyranosyl(1--> 2)-beta-D-glucuronopyranosyloxy]-22 beta-acetoxy-24-hydroxyolean-12-en-30-oic acid (1) and 4-O-[beta-D-apiofuranosyl(1-->2)-beta-D- glucopyranosyl]isoliquiritigenin (6), respectively.

The significance of proliferating cell nuclear antigen in human trophoblastic disease: an immunohistochemical study

The expression of proliferating cell nuclear antigen (PCNA) in human trophoblastic disease was assessed immunohistochemically in tissue from 29 spontaneous abortions, 33 partial moles, 40 complete moles and 23 choriocarcinomas using the monoclonal antibody PC10. PCNA immunoreactivity occurred predominantly in the cytotrophoblasts in each of the four types of tissues. Quantitative analysis showed that the choriocarcinoma group gave a statistically significant higher PCNA index than the other three. There was no significant difference between the groups of spontaneous abortion, partial or complete mole. Sixteen of the 73 patients with partial and complete moles developed persistent gestational trophoblastic disease and there was no significant difference between the patients requiring chemotherapy and those who did not. We conclude that choriocarcinoma has a significantly higher PCNA proliferative index whilst hydatidiform moles cannot be distinguished from abortions by such analysis. The PCNA index does not appear to be useful in predicting the progression of molar pregnancies to persistent trophoblastic diseases.

Hemodynamic actions of guan-fu base A in anesthetized rats

Guan-fu base A (GFA) is a terpenoid alkaloid isolated from the tuber of Aconitum coreanum in this institute. GFA exhibited anti-arrhythmic effects in various experimental arrhythmia animal models, and bradycardic actions. In this paper, the hemodynamic action of GFA was investigated. GFA 20 mg.kg-1 iv decreased in heart rate from 420 +/- 51 to 305 +/- 60 bpm (P less than 0.05). The changes of SBP, DBP, LVSP, +/- dP/dtmax, and LVEDP were much smaller or insignificant. GFA (1, 3, 10, 30, 60 mg.kg-1 cumulative iv) increased the heart periods (HP) and QT-intervals in a dose-dependent manner, accompanied by a small increase in PQ-interval, but did not affect QRS complex. The increase in HP from 138 +/- 11 to 321 +/- 48 ms (P less than 0.01) was mainly due to a prolongation of the diastolic period from 22 +/- 12 ms to 156 +/- 46 ms (P less than 0.01). The triple product of HR x LVET x SBP was also decreased with every dose of GFA. This hemodynamic profile suggests that the bradycardic action of GFA can reduce myocardial oxygen consumption and improve myocardial blood supply, which may be of use in certain cardiac patients.

The first epidemic of dengue hemorrhagic fever in the People's Republic of China

The first epidemic of dengue in China associated with significant severe and fatal hemorrhagic disease which met the World Health Organization case definition occurred on Hainan Island in 1985-1986. The epidemic began in Zhan County in September 1985, spread throughout the coastal areas, and ultimately involved 13 counties and cities of the island in 1986. The mosquito vector was Aedes aegypti. The morbidity associated with dengue infection on Hainan Island was 1,913 per 100,000 residents, with a case fatality rate of 0.25%. Severe disease was more prevalent in the 10-29-year-old age group. Principal clinical features in laboratory-confirmed cases were fever, osteoarthralgia, hemorrhage and/or shock, and thrombocytopenia. Complications such as acute intravascular hemolysis, diffuse intravascular coagulation, hemoconcentration, pleural effusion, altered mentality, and pneumonia were also observed. One hundred twenty-five isolates of dengue 2 virus were recovered from acute-phase serum samples from 278 patients, and 5 strains of this same virus serotype were isolated from 5 pools of adult Ae. aegypti.

[Effects of guan-fu base A on spontaneous rate of isolated sinoatrial node of guinea pig]

Guan-fu base A (GFA) is a new alkaloid isolated from the tuber of Aconitum coreanum in our institute. Its effects on spontaneous electrical discharge rate of intact sinoatrial node preparations were investigated. Unipolar Ag-AgCl2 electrodes and DC-amplification were used to record unipolar electrograms from the endocardial surface of the isolated right guinea pig atria. GFA (4.29-214.5 micrograms/ml) decreased the spontaneous electrical discharge rate of sinoatrial node in a dose-dependent manner. The most effective concentration (214.5 micrograms/ml) of GFA resulted in sinus rate of 115 +/- 8 bpm (n = 7, control rate 208 +/- 13 bpm) within 30 min. Low external Ca2+ (0.18 mmol/L) enhanced the rate in lowering effect of GFA, in contrast with high external K+ (10.8 mmol/L) diminishing the effect of GFA. The ratios of IC30 of negative inotropic effects over IC30 of negative chronotropic effects were 9.38 for GFA and 1.73 for verapamil. GFA antagonized the positive chronotropic effect of isoproperenol but did not antagonize the positive inotropic effect of isoproterenol. The consequence of lowering sinus rate by GFA was not interfered by propranolol (0.15 micrograms/ml) or atropine (0.05 micrograms/ml). These results suggest that the bradycardia by GFA is a direct effect on sinoatrial node, but not due to the calcium channel block or beta adrenoceptor block.

HDV (delta factor) infection complicated with subacute fulminant hepatitis B. A morphological and immunohistochemical observation

In 75 patients with subacute fulminant hepatitis B (SAFH), HDAg positive liver cells were observed in 14 cases (18.67%) by direct enzyme labelled method. It was found further that HDV (delta factor) infection was an important cause in producing massive necrosis of liver cells and superinfection of HDV with hepatitis B was identified as one of the causes of SAFH. This experiment also showed that the number of HDAg positive cells was in direct proportion to the area of liver necrosis. No obvious lymphocytic infiltrations and cytotoxic phenomena around the necrotic foci and HDAg positive cells could be found, while the cytoplasmic type HDAg positive cells showed distinct degeneration or even atrophy. Hence it was suggested that HDV could be a direct pathogenesis. No obvious characteristic changes in morphology of HDV infection could be found.

[Antineuronal antibodies and neuropsychiatric systemic lupus erythematosus]

Determination of antineuronal antibodies was carried out by a solid phase radioimmunoassay, in which the neuronal cells SK-N-SH were cultured as the target antigens, the positive rate in sera and CSF of neuropsychiatric SLE patients being 85% and 77.8% respectively, all with quite high level of antibodies. Although 66.7% sera of SLE patients without CNS involvement were also positive for the antibodies, yet the antibody levels of them were distinctly lower, and only 3 of them showed weak positive reactions in their CSF. It was shown that 90% of neuropsychiatric SLE patients with diffuse CNS manifestations had increased antineuronal antibodies, compared with only 20% in cases with local CNS involvements. The antibody levels both in sera and CSF decreased remarkably following the patients' recovery from the neuropsychiatric attack. It is concluded that the antineuronal antibodies might play a role in the pathogenesis of neuropsychiatric lupus and the determination of them in CSF might be useful in the diagnosis and differential diagnosis of neuropsychiatric lupus.

Development and localization of enkephalin and substance P in the nucleus of tractus solitarius in the medulla oblongata of human fetuses

The presence of enkephalin and substance P-positive neurons and fibers were studied by immunohistochemistry (peroxidase-antiperoxidase or avidin-biotin-peroxidase complex methods) in 26 human fetuses ranging from 11 weeks of gestation to 40 weeks of gestation. Enkephalin-positive neurons were localized in the commissural, medial and intermediate subnuclei as early as 11-12 weeks' gestation. Positive enkephalin fibers were localized around 12 weeks' gestation and in many subnuclei, notably the medial, commissural, intermediate, ventrolateral, ventral and dorsolateral subnuclei. Substance P-positive neurons were localized in the commissural and medial subnuclei around gestation age 13 weeks. Positive substance P fibers appeared even earlier, around 11 weeks of gestation in many subnuclei, notably the medial, intermediate, ventral, ventrolateral and dorsolateral subnuclei. Increase in both enkephalin- and substance P-positive fibers was evident in the later stages of development (e.g. around 26 weeks of gestation). The importance of the early appearance of enkephalin and substance P neurons and fibers of the pain pathways in the major subnuclei connecting with the cardiovascular, gastrointestinal and respiratory functions in the human has to be stressed.

[Electrophysiological effects of changrolin on single ventricular myocytes isolated from adult guinea pig]

Calcium tolerant single ventricular cardiomyocytes were dispersed from adult guinea pig hearts by retrograde perfusion with collagenase solution. More than 50% of the isolated cells retained rod shaped configuration and showed normal electrical activities with resting potentials (RP) at -82 +/- 2 mV and action potential amplitude (APA) at 116 +/- 6 mV. The effects of changrolin (CRL, 4-[3', 5'-bis [(N-pyrrolidinyl)-methyl]-4'-hydroxyanilino]-quinazoline) on the transmembrane action potentials of the single cells were measured with intracellular glass microelectrodes. At the concentration of 50 mumol/L, CRL caused profound reductions of APA, maximal rate of phase 0 depolarization (Vmax), and action potential duration (APD). The effective refractory period (ERP) was prolonged. The action of CRL on Vmax showed use- and frequency-dependences. Trains of stimuli in the studied range of frequencies led to an exponential decline in Vmax to a new plateau and the maximal reduction was at the highest frequency. At 1 Hz, the onset rate of this action was 0.036 +/- 0.004 AP-1. CRL did not cause a resting state block of Vmax. These findings suggest that CRL is a slow type, class I anti-arrhythmia drug.

[Effects of guan-fu base A on fast response action potentials of papillary muscles of guinea pigs]

Guan-fu base A is a new alkaloid first isolated from the tuber of Aconitum coreanum in China. The electrophysiological effects of guan-fu base A were examined on the isolated papillary muscles of guinea pigs by glass-microelectrode technique coupled with microcomputer real-time analysis. Guan-fu base A 50 micrograms/ml had less effect on RP, but markedly decreased Vmax and APA of the fast response action potentials. The action potential duration was shortened at all voltage levels and plateau height was lowered. ERP was prolonged relatively and activation voltage became more negative. The inhibition of guan-fu base A on Vmax showed frequency dependent effects. The above results suggested that guan-fu base A could block the fast Na+ channels and exhibited anti-arrhythmic action.

Long-term observation after radiotherapy for nasopharyngeal carcinoma (NPC)

One thousand one hundred twenty-seven cases of nasopharyngeal carcinoma were treated with routine radiotherapy from October 1969 to March 1976, of which 436 cases have survived for more than 5 years, 323 cases have survived for over 10 years. The follow-up rate was 98.4%. The present paper analyzes the factors involved in these 436 cases. All patients were treated with tele60Co unit, and in the neck some cases were treated with orthovoltage therapy. The total dose to the primary lesion was 60-75 Gy in 6-8 weeks and in a few cases over 80 Gy were needed, and 50 Gy were applied bilateral cervical lymphatic chain. In this series of cases the 10-year overall survival rate was 28.7%, with Stage I being 66.7%, Stage II 46.5%, Stage III 28.0%, and Stage IV 18.6%, respectively. Statistically, 68 cases died of cardiovascular and other diseases and should be eliminated for net survival calculations. Therefore, we could obtain an actual 10-year survival rate of 30.5%. However, it should be noted that most of these cases were advanced, with Stage III, IV accounting for 82.3%, thus at Stage I, II the 10-year survival rate was 48%, while at Stage III, IV rate was down to 24.5%, which was statistically significant (p less than 0.01). Local and cervical recurrence as well as distant spread of diseases, for these cases started from the fifth to the tenth year after radiotherapy, the mortality caused by the above-mentioned three sites together was 76.9%. According to these findings, we propose that follow-up after radiotherapy in NPC exceeds 10-years. Of the 323 NPC cases, 10 were nasopharyngeal local recurrence which were re-irradiated, accounting for 3.1%. This paper shows that the 3-year survival rate in the local recurrence which were re-irradiated was 34.5%, the 5-year survival rate was 14.8%, and the 10-year survival rate was 11.5%. The failure after re-irradiation was caused by local recurrence and metastasis with a mortality of 83.6%. These results emphasize that the success of initial irradiation is important.

[Cytotoxic effects of changrolin, lidocaine and amiodarone on ultrastructure of cultured rat beating cardiac myocytes]

Ultrastructural and morphological alterations of cultured rat beating cardiac myocytes treated with changrolin (CRL), lidocaine (Lid), and amiodarone (Ami) were studied. After the cultures were treated with CRL 100 micrograms/ml for 24 h, the beating of the myocytes stopped, the configuration and fine structure were destroyed, while the nuclei showed pyknotic deformation and reduced in size. The membrane and structures of mitochondria were disrupted and myofibrils fragmented and disrupted. In addition, a lot of vacuoles with characteristic dense particles were found in the cytoplasm. Similar alterations were seen when Lid 1000 micrograms/ml and Ami 50 micrograms/ml were added to the cultures. Normal beating networks of myocytes were examined under inverted microscopy after the cultured cells were treated with CRL 25 micrograms/ml, Lid 250 micrograms/ml or Ami 6.25 micrograms/ml. The ultrastructure of some regions of the myocytes showed very slight damage. The results indicated that the dosage of CRL and Lid generally used in anti-arrhythmic therapy basically exerted no harm to myocytes. However, caution should be taken when Ami was given intravenously, since its effective serum concentration was close to the dosage which could cause slight damage to the ultrastructure of cultured cells.