[Preliminary echocardiographic evaluation on prosthetic valve replacement of preserving the subvalvular apparatus with artificial chorade for mitral stenosis]

The purpose of this study was to evaluate the preliminary results after prosthetic valve replacement of preserving the subvalvular apparatus with artificial chorade for mitral stenosis. 20 patients had received operation with expanded polytetrafluoroethylene(e-PTFE) as artificial chordade. The patients were followed up by means of echocardiography. The time of follow-up study varied from 4 to 18 months with a mean of 6 months. The left atrial, ventricular dimension as well as ventricular function were assessed. In addition, the length of artificial chorade and obstruction of left ventricular outflow track were observed. The results showed that left atrial diameter (LAD, from 57.59 +/- 13.51 mm to 47.05 +/- 9.55 mm), left ventricular end-diastolic dimension (LVEDD, from 46.23 +/- 12.56 mm to 42.41 +/- 10.86 mm), left ventricular end-systolic dimension (LVESD, from 33.50 +/- 10.20 mm to 29.68 +/- 8.40 mm) decreased (P < 0.01), and ejection fraction (EF, from 52.59 +/- 11.89% to 58.36 +/- 8.03%) increased (P < 0.05) after operation. There were no significant changes of fractional shortening (FS, from 29.23 +/- 8.99% to 31.05 +/- 6.08%). The length of artificial chorade ranged from 2.6 cm to 4.3 cm (the mean, 3.2 cm). There was no case of obstruction of left ventricular outflow track. It is believed that the result of preliminary echocardiographic observation on prosthetic valve replacement of preserving the subvalvular apparatus with artificial chorade for mitral stenosis is satisfactory.

[Evaluation of modified maze procedure by Doppler tissue imager]

Since 1998 the cardiac surgeons of WCUMS have performed modified maze procedure for treating the patients with rheumatic mitral valve disease accompanied with chronic atrial fibrillation (Af). In this study, echocardiography, especially Doppler Tissue Imager (DTI), was used to evaluate atria contraction and function of such patients before and after the operation. 14 rheumatic mitral disease patients, aged 27-60 years, were chosen; among them, 11 had mitral stenosis, 3 mitral regurgitation. The control group consisted of 16 cases, aged 24-67 years, with normal echocardiogram. Before and half-1 year after the operation, left atrium, left ventricle, right atrium and ventricle were measured, and cardiac function and posterior wall motion of left atrium were measured. Velocity of mitral valve annual and tricuspid valve annual was measured in DTI. The results showed: There was no age difference between the two groups. The motion of posterior wall of left atrium was 4.18 +/- 0.37 mm in the operation group, 4.09 +/- 0.29 mm in the control group (P > 0.05). No difference in velocity of mitral/tricuspid valve annual between the two groups was observed; 3 peaks of mitral valve annual were S 0.11 +/- 0.02, e 0.11 +/- 0.01, a 0.09 +/- 0.01 (m/s) in operation group, and S 0.08 +/- 0.00, e 0.10 +/- 0.01, a 0.08 +/- 0.01 (m/s) in control group, (P > 0.05, respectively); 3 peaks of tricuspid valve annual were S 0.10 +/- 0.01 vs 0.11 +/- 0.08, e 0.11 +/- 0.08 vs 0.10 +/- 0.01, a 0.10 +/- 0.10 vs 0.09 +/- 0.01 (m/s), (P > 0.05, respectively). The diameter of left atrium after operation in cases of mitral stenosis decreased significantly, compared with that before operation (P < 0.01). The diameter of right atrium after operation decreased significantly, compared with that before operation (P < 0.01). There was no significant change in right ventricle/left ventricle/EF and FS. The diameter of left atrium after operation in cases of mitral regurgitation decreased significantly, compared with that before operation (P < 0.01). The diameter of left ventricle after operation decreased significantly, compared with that before operation (P < 0.05). No significant change in right ventricle/right atrium/EF and FS was noted. The authors conclude the DTI, as a new diagnostic method in echocardiography, has high sensitivity and is less influenced when used to observe motion of atrium-ventricle annual influenced. It can avoid the error caused by deviation of blood displacement. In the rheumatic mitral valve disease patients who had mitral valve replacement and modified maze procedure, atrial contraction respores, the risk of thromboembolism decreases and prognosis improves. So the operation is worth doing.

[Transmission grating spectrograph for soft X-ray spectrum measurements with a pre-optics]

A novel diffraction spectroscopic instrument consisting of a large area transmission grating and a grazing-incidence pre-optics comprising of a toroidal mirror, a slit and a cylindrical mirror has been implemented. A nearly perfect stigmatism and a medium spectral resolution are due to the separation of the focusing and dispersing function. The experimental results show that it is possible to construct large area transmission grating spectrograph with high collecting efficiency and good spatial resolution.

[Study of bacterial adhesion to prosthetic valve materials in vitro]

This article reports a study of the bacterial adhesion to prosthetic valve materials in vitro. The method for assessing the degree of bacterial adhesion to prosthetic valve materials was established primarily. The capacities of staphylococcus aureus(SA), staphylococcus epidermidis(SE), Escherichia Coli(EC) and Pseudomonas aeruginosa(PA) for adhesion to Dacron, Pyrolytic carbon and polytetrofluoroethylene (PTFE) were quantitatively determined by the plate counting and Gamma-ray counting of 125I radiolabeled bacteria in vitro. The results showed that the capacities of four types of bacteria for adhesion to Dacron, Pyrolytic carbon and PTFE coincided with the bacterial-growth curve. The capacities of four bacteria for adhering to Dacron were stronger. The adhesion of SE to Pyrolytic carbon was the strongest. The adhesion of PA Kept up a high level. The capacities of EC and PA for adhering to PTFE were the strongest. The results indicate that the capacities of different types of bacteria for adhesion to the same prosthetic valve material are different, and the capacities of one type of bacteria for adhesion to different materials are also different.

[The expression of E-cadherin-catenin complex in human salivary adenoid cystic carcinoma]

OBJECTIVE: The aim of this study was to investigate the expression of the E-cadherin-catenin(E-cad-cat) complex in human salivary adenoid cystic carcinoma(ACC) and determine the effects of E-cad-cat expression on tumor differentiation,metastasis and invasion as well as their clinical significance. METHODS:The expression of adhesion molecules,which included E-cadherin,alpha-catenin and beta-catenin,in 10 cases of normal salivary glands,50 cases of human salivary ACC was investigated by immunohistochemistry.RESULT:Co-expression of E-cadherin,alpha-catenin and beta-catenin was detected in 29(58%) of the 50 ACC specimens.Positive staining of E-cad-cat complex was detected in 7(39%) of the 18 ACC primary sites which had aggressive phenotype of nerve and vasculature.CONCLUSION:Strong positive signals of E-cad-cat complex were showed in normal salivary glands,and the down regulation expression was observed in ACC cases,The expression of E-cad-cat complex was associated with a more aggressive phenotype on nerve and vasculature.No association with various histopathologic subtypes was found;Down-regulation of E-cad-cat complex may be associated with canceration of normal salivary glands.

[Effect of activated donor-type NK cells on allogeneic bone marrow transplantation in mice]

OBJECTIVE

To study the effect of activated donor-type NK cells on allogeneic bone marrow transplantation(BMT).

METHODS

Four hours before or 72 hours after transfusing bone marrow cells(containing T cells), the activated donor-type NK cells were injected into tumor-bearing mice conditioned by irradiation. The effect of these NK cells were assessed by CFU-S, CFU-GM, survival, body weight, histopathology and lung metastases in the recipients.

RESULTS

The transfusion of activated donor-type NK cells markedly increased CFU-S and CFU-GM numbers. When these NK cells were transfused 4 hours before BMT, they augmented GVT yet inhibited GVHD as evidenced by increases in survival duration and body weight, reduction in grade of histopathological changes and decrease in lung metastases. However, when activated donor-type NK cells were transfused 72 hours after BMT, they exacerbated GVHD.

CONCLUSIONS

The activated donor-type NK cells could prevent GVHD and produce significant GVT effects and also resulted in greater hematopoietic reconstitution if they were at the initial stage of allogeneic BMT in mice. Thereafter, the activated donor-type NK cells were detrimental and could exacerbate the subsequent GVHD, these results also demonstrated that GVT and GVHD could be dissociable phenomena.

[Left ventricular function evaluation after mitral valve replacement with preservation the subvalvular apparatus]

The objective of this study was to evaluate the left ventricular function after mitral valve replacement (MVR) with preservation of all chordae. Fourteen patients with a diagnosis of mitral regurgitation were studied. These patients, 4 males and 10 females, age from 24 to 59 years, who underwent mitral valve replacement, in which all chordae tendineae were preserved. The mean follow-up interval was 6 months. Preoperation and postoperation multigated equilibrium radionuclide angiography was performed by Elscint Helix Apex SPECT. Each patient was injected with 740MBq 99mTc-HSA, rest ejection fraction (global EF) of LV (%), regional ejection fraction (EF) of LV (%), PER/S and PFR/S were measured. Regional EF was calculated by the method of dividing the left ventricle into five segments by radial axis. The results showed that the postoperative EF of the whole left ventricle of the chordae-preserved patients was significantly greater than their preoperative EF (40.0% +/- 17.8%, to 51.6% +/- 18.2%, P < 0.02), and also the regional EF at the lateral wall of the chordae-preserved MVR was significantly greater than the preoperative regional EF (an increase from 51.0% +/- 18.1% to 69.7% +/- 21.2%, P < 0.01). MVR with preservation of all chordae, the patient's left ventricular function remarkably improved.

[Immunohistochemical study of basement membrane proteins expression in adenoid cystic carcinoma of salivary glands]

OBJECTIVE

To investigate the expression of the basement membrane proteins in adenoid cystic carcinoma (ACC) of the salivary glands and discuss the relationship between the expression of the proteins and the differentiation as well the prognosis of ACC.

METHODS

101 patients which were confirmed pathologically were collected and made a follow-up, and 30 cases of them were selected to detect the basement membrane proteins (type IV collagen, fibronectin, laminin and heparan sulfate proteoglycan) by the means of immunohistochemistry.

RESULTS

The cribriform pattern of ACC had a more favorable prognosis than the solid pattern which had a lower rates of metastasis of/and recurrence. The positive locations and the degrees of the four proteins varied with the histological patterns of ACC. The cribriform pattern had the strongest positive expression and the solid pattern the weakest. In addition, the staining of fibronectin were weaker in all three patterns of ACC.

CONCLUSION

The degree of the positive expression of the four proteins has a negative relation to the differentiation of the tumor cells. The lower degree of differentiation the tumor cells are, the weaker positive signals they express. Of the four substances in the basement membrane, laminin is the main material which adhere the parenchymal cell to the collagen in basement membrane of the tumor. Basement membrane proteins could be regarded as one of the basis to evaluate the prognosis of ACC.

[Experimental study of LAK and activated NK cells affecting hematopoiesis in mice]

OBJECTIVE

To study the relationship between LAK/activated NK cells and hematopoiesis as well as the effects of LAK/activated NK cells on hematopoietic reconstitution after syngeneic bone marrow transplantation(BMT) in mice.

METHODS

1. LAK/activated NK cells were cocultured with bone marrow cells(BMC) in semi-solid agar medium to determine their effects on CFU-GM formation. 2. Syngeneic LAK/activated NK cells were transferred with BALB/c BMCs into lethally irradiated syngeneic recipients to determine their effects on hematopoietic reconstitution.

RESULTS

When BMC were cultured under optimal growth conditions in the presence of exogenous hematopoietic growth factors, the effects of LAK/activated NK cells were mainly inhibitory. However, when BMCs were cultured under growth-limiting conditions without exogenous hematopoietic growth factors, the LAK/activated NK cells could support CFU-GM formation. Syngeneic LAK/activated NK cells significantly increased CFU-S and CFU-GM numbers after syngeneic BMT, and also significantly improved platelet and white blood cell count.

CONCLUSIONS

LAK/activated NK cells could be bidirectionally regulate CFU-GM formation in vitro and promote hematopoietic reconstitution after syngeneic BMT in mice.

[Expression of p53 protein and PCNA in premalignant lesions of oral mucosa and its clinical significance]

OBJECTIVE:The study was to investigate the expression features of p53 protein and PCNA antigens in premalignant lesions of oral mucosa and further to discuss its clinical significance.METHODS: 50 samples were retrieved from the biopsy of the patients with suspicious premalignancy.Followed by the diagnosis pathologically,the sections were labeled with p53 and PCNA antigens by immunohistochemistry. RESULTS: In premalignant lesions,the progression staining with p53 and PCNA antigens were positively corresponding to the epithelial dysplasia from the basal layer to the keratinous layer. CONCLUSION: The p53 and PCNA antigens expressed synchronously in premalignant lesions of oral mucosa and exhibited direct correlation with the degree of epithelial dysplasia;The positive signals with p53 and PCNA antigens in the premalignant lesions may be the earlier incidence in carcinogenesis, which may initiated at the earlier stage of epithelial dysplasia.This phenomenon is deserving of clinicians' attention for discovering the premalignant lesions earlier;The detection of p53 and PCNA antigens would be helpful to find out the lesion which has the tendency turning to dysplasia.

[Functional improvement of remnant stomach after proximal subtotal gastrectomy for cardiac cancer]

OBJECTIVE

To evaluate the function of the remnant stomach after proximal subtotal gastrectomy for cardiac cancer and to improve the life quality of post-surgical patients.

METHODS

17 patients with cardiac cancer underwent proximal subtotal gastrectomy combined with disconnection of pyloric sphincter (PSG + DPS) by finger pressing. Intraoperative pyloric manometric studies were performed in the 17 patients before and after DPS. Five subjects who underwent laparotomy for non-esophagogastric reasons was taken as controls. Total bile acids (TBA) in gastric juice was tested in the 17 patients at 5th postoperative day, and radionuclide gastric emptying was also studied from the 18th to 20st postoperative day.

RESULTS

Both pyloric resting pressure and pyloric contracting pressure were significantly decreased after DPS (P > 0.01). In comparison with normal subjects, PCP was increased before DPS (P > 0.01) and decreased after the procedure (P < 0.05). However, PRP did not show significant differences before (P > 0.05) and after (P > 0.05) DPS. There were no significant differences regarding TBA content in gastric juice in PSG + DPS group, PSG group, and normal subjects (P > 0.05). The time required for the stomach to empty half of its radioactive contents (T1/2) was longer in the patients having PSG only than those undergoing PSG + DPS (P < 0.01) and normal controls (P < 0.05). However, there were no significant differences regarding T1/2 between the patients with PSG + DPS and normal controls (P > 0.05).

CONCLUSIONS

The emptying of remnant stomach after subtotal gastrectomy for cardiac cancer is delayed because of the increase of emptying-resistance and decrease of peristalsis. PSG combined with DPS not only improves gastric emptying, but also prevents duodenogastric reflux. Consequently, postoperative life quality of the patients with cardiac cancer can be effectively improved.

Use of neuroendocrine hormones to promote reconstitution after bone marrow transplantation

A survey of the previous literature and the data shown here indicate that neuroendocrine hormones such as growth hormone and prolactin may be of potential clinical use after bone marrow transplantation (BMT) to promote hematopoietic and immune recovery. The amounts of hormones used in our model do not promote weight gain suggesting that their lymphohematopoietic actions were independent of their anabolic effects. While the hormones may not produce the same extent of immune/hematopoietic effects when compared to conventional hematopoietic and immune stimulating cytokines (i.e. IL-2 or G-CSF), their pleiotropic effects and limited toxicity after systemic administration makes them attractive to test in the post-BMT setting. However, more work needs to be performed to understand the mechanism(s) of their action, particularly with regard to T-cell function and development.

[Effect of ischemia/reperfusion in cardiac surgery with cardiopulmonary bypass on nitric oxide levels of peripheral blood in patients]

To examine the effect of ischemia/reperfusion in cardiac surgery with cardiopulmonary bypass (CPB) on nitric oxide (NO) levels of peripheral blood, venous levels of NO2- and NO3- were measured at multiple time-points before, during, and after CPB by means of high-pressure liquid chromatograph to reflect NO concentration indirectly in 20 patients. The results showed there was a linear regression between the decreased trend of NO release at the period of peri-CPB is related to the endothelial cell activation caused by ischemia/reperfusion at the same time. Therefore it is necessary to explore the regulation and action of NO release during systemic inflammatory response procedure in CPB.

[Multiple subpial transection in surgical treatment of intractable epilepsy]

OBJECTIVE

To increase the effect of epilepsy surgery, we use multiple subpial transection (MST) clinically on the basis of experimental study.

METHOD

We analyzed the seizure type and course of 116 intractable epilepsy patients treated with MST and surgical technique were modified.

RESULT

100 patients were followed up for 1 to 5 years. Complete control of seizure was obtained in 62 patients (62%), significant reduction (over 75%) in 20 (20%), reduction (over 50%) in 12 (12%), and no change in 6 (6%). The total effective rate was 94%, and the significant effective rate was 82%. No functional defect was found in any patients.

CONCLUSION

MST is a effective in surgical treatment of intractable epilepsy and can replace conventional methods. Combined bilateral frontal lobe MST and anterior callosotomy is a good way to treat intractable generalized epilepsy.

CT-guided stereotactic biopsy of deep brain lesions: report of 310 cases

OBJECTIVE

To evaluate the accuracy of CT-guided stereotactic biopsy in making correct pathological diagnosis and choosing corresponding management of brain tumors.

METHODS

From 1991 to 1995, CT-guided stereotactic biopsy was performed in 310 patients with intracerebral lesions which were deep-seated or located in certain main functional areas. The patients were 198 men and 112 women. Their ages ranged from 4.5 to 70 years (average: 39.3 years). The lesions were located in the deep cerebrum (74 patients), the sellar area (62), the basal ganglion (51), the posterior part of the third ventricle (38), other intraventricleular area (21), the cerebellum (17) and the brain stem (9), and intracranial multiple lesions were found in 38 patients.

RESULTS

Brain tumors were diagnosed pathologically in 266 patients (85.8%); inflammatory process in 25 (8.1%), other lesions in 8 (2.6%) and uncertain cases were 11 (3.6%). The overall positive rate of biopsy was 96.4% and the positive rate for brain tumor was 85.8%. Intracranial hematomas after biopsy were found in 5 patients (1.6%). There were no deaths induced by the biopsy or other serious complications.

CONCLUSIONS

The results suggest that CT-guided stereotactic biopsy is a reliable method for histopathological diagnosis of brain tumors and it is also of great help in selecting appropriate management.

[The predominant expression of Th2 type cytokines in human tumor cells]

OBJECTIVE

To observe the expression of Th1 versus Th2 type cytokines in human tumor cells.

METHODS

The gene expression of Th1/Th2 cytokines in human tumor cells was detected by RT-PCR and RNA dot hybridization using IL-2 and IFN gamma as Th1 type cytokine genes, IL-4, IL-10 and IL-13 as Th2 type cytokine genes.

RESULTS

There were predominant expressions of Th2 type cytokines in 20 different human tumor cell lines including 11 solid tumor and 9 hematogenous tumor cells.

CONCLUSION

Predominant expression of Th2 type cytokines by tumor cells may be related to the evasion of tumor cells from immune surveillance.

Renal angiomyolipoma: diagnosis with B-ultrasonography, CT scanning, DSA and its interventional treatment

From 1989, 15 cases of renal angiomyolipoma (AML) have been diagnosed by ultrasonography. CT scanning and digital subtraction angiography (DSA) at our hospital. In 8 patients with uneven hyperechoes on B-mode ultrasonography (B-US) (8/15) and 7 with low density of fat on CT scanning (7/12) accurate diagnosis was established preoperatively. DSA revealed the "berry-like" pseudoaneurysms in the arterial phase (14 cases), the defined lucent area in the nephrogram phase (10 cases) and the "onion-peel appearances" during venous phases (8 cases), correct diagnosis was achieved in all patients. 8 cases were surgically treated and 7 treated by subselective embolization of renal artery. Effects in all cases were good. The diagnostic value of B-US, CT scanning, DSA and interventional treatment of AML was discussed. It was believed that the diagnosis with DSA was a technique with high specificity, and embolization therapy was simple and effective for AML.

Antitumor effects of nonconjugated murine Lym-2 and human-mouse chimeric CLL-1 monoclonal antibodies against various human lymphoma cell lines in vitro and in vivo

Lym-2 is a murine monoclonal antibody (MoAb) directed towards a human class II molecule variant reactive with both normal and neoplastic human B lymphocytes. Previous studies have shown that signals transmitted by class II molecules that stimulate normal lymphocytes can be inhibitory for B-cell lymphoma growth by signaling activation-induced cell death. Therefore, we sought to evaluate the effects of nonconjugated murine Lym-2 and a human-mouse chimeric Lym-2 (chCLL-1; with murine variable regions and human constant regions) MoAb on the growth of various human lymphomas by using both in vitro and in vivo assays. Cell lines derived from Burkitt's lymphomas, diffuse large cell B-cell lymphomas, anaplastic large-cell lymphomas, and Epstein-Barr virus-induced B-cell lymphomas were incubated with Lym-2 or chCLL-1 in vitro, and effects on proliferation were determined by [3H]-thymidine incorporation. The effects of Lym-2 in vitro were also compared with those of Lym-1, which is a similar MoAb that has been evaluated clinically. After immobilization, which enhances crosslinking of the MoAbs, both Lym-2 and chCLL-1 were capable of directly inhibiting the growth of various lymphoma lines in vitro. These human lymphomas were then transferred into mice with severe combined immunodeficiency to evaluate the efficacy of these MoAbs in vivo. Treatment with either murine Lym-2 or the chimeric chCLL-1 were significantly effective in improving the survival of tumor-bearing mice. These results indicate that stimulation by nonconjugated chCLL-1 may offer a biological approach to the treatment of various human lymphomas.

[Colony formation of bone marrow hematopoietic progenitor cells in patients with severe aplastic anemia and its relation to the results of immunosuppressive therapy]

OBJECTIVE

To explore the defect of hematopoietic stem cell and analyze the relationship between the colony formation capacity of bone marrow hematopoietic progenitor cells and the results of immunosuppressive therapy (IST) in severe aplastic anemia (SAA) patients.

METHODS

Methylcellulose semisolid culture was used.

RESULTS

Thirty patients with SAA at diagnosis were studied. In 90% of the patients, the CFU-E and CFU-GM yields were strikingly decreased and in 56.7% of the patients there was no colony formation at all. Nevertheless, there was still 10% of the patients having normal CFU-E, BFU-E or/ and CFU-GM yields. After IST, 59.1% of the patients showed colony formation improvement. The difference between the results obtained pre- and post-IST(for CFU-E and BFU-E, P < 0.01, for CFU-GM, P < 0.05) was significant. In the majority of the patients, the colony formation capacities were still under the normal post-IST. Moreover, 22.7% of the patients remained no colony formation post-IST. The IST response rates between the patients with or without colony formation had no statistically difference (80% versus 50%, P < 0.05). The increment of colony formation appeared later than the therapeutic effect did, but frequently concurred with the appearance of magkaryocytes in the bone marrow smear.

CONCLUSION

In the majority of SAA patients, the hematopoietic stem cells or progenitors were defective perhaps caused by immune damage; IST can improve the hematopoiesis in vitro and in vivo of SAA patients.

[SERS and electrochemistry studies on the structure of thiourea adsorption layer on silver electrode]

The structure of thiourea adsorption layer on silver electrode was studied by SERS and electrochemistry. It was found that the thiourea can be adsorbed on the electrode surface and can inhibit the reaction of hydrogen separation. And a change in structure of the thiourea adsorption layer on electrode surface took place at the voltage of about -0.6V. The further SERS experiment showed that the thiourea adsorption layer has a loose structure at about -0.9V and a compact structure at about -0.3V - -0.5V. The transition region is at about -0.6V - -0.8V.

[Colony-stimulating activities of serum from patients with severe aplastic anemia]

OBJECTIVE

To investigate the correlation between colony-stimulating activities of serum from patients with severe aplastic anemia (SAA) and their responses to immunosuppressive therapy (IST).

METHODS

In vitro effects of sera from SAA patients before and after IST and from normal subjects on human marrow colony growth were examined in a semisolid methylcellulose culture system for burst promoting activity (BPA) and granulocyte/macrophage colony-stimulating activity (GM-CSA). Serum erythropoietin (Epo) level was also measured by ELISA method before and after IST in SAA patients.

RESULTS

Serum BPAs in SAA patients at diagnosis were significantly higher than that in normal controls (P<0.001), but serum GM-CSAs in 13 of 22 SAA patients were normal,and in 9 of 22 extremely low as compared with normal values. After IST, serum BPA and GM-CSA in SAA patients had no changes. Serum Epo levels in SAA patients at diagnosis were significantly higher than that in normal controls (P<0.001). After IST,serum Epo levels declined in responded patients, while further increased in nonresponded.

CONCLUSION

Serum GM-CSA of SAA patients was a predictive factor for responsiveness to IST, and a normal value was associated with a good response.

[HLA-DR-positive T lymphocytes in the bone marrow and peripheral blood of patients with severe aplastic anemia and their in vitro inhibitory effecton BFU-E and CFU-GM]

OBJECTIVE

[corrected] To elucidate the role of immunodysfunction in the pathogenesis of severe aplastic anemia (SAA).

METHODS

HLA-DR+ T cells were detected in bone marrow (BM) and peripheral blood (PB) of 20 SAA patients and controls (9 for BM and 11 for PB). PHA-LYCM conditioned medium was prepared, and its in vitro effect on normal bone marrow BFU-E and CFU-GM was studied.

RESULTS

The percentages of HLA-DR+ T lymphocytes in BM and PB of newly diagnosed SAA patients were significantly higher than that of controls (P<0.001), and that of recovered SAA (rSAA) patients after ALG therapy (P<0.05). Compared with controls, the PBA-LYCMs from newly diagnosed SAA patients showed significant inhibitory effect on normal BFU-E and CFU-GM (P<0.001).

CONCLUSION

The activated T lymphocyte may play an important role in the pathogenesis of SAA.

Chemical modification and structure-activity relationships of pyripyropenes. 3. Synthetic conversion of pyridine-pyrone moiety

Structure-activity relationships of the pyridine-pyrone moiety in pyripyropene A (1), a potent acyl-CoA: cholesterol acyltransferase (ACAT) inhibitor of fungal origin, were studied. Several kinds of aromatic or hetero ring substituents for the pyridine moiety were synthesized using unique degradation reaction, following by gamma-acylation. All the six synthesized analogs decreased the inhibitory activity with 20 to 200 times larger IC50 values than that of 1. Furthermore, the pyridine-pyrone substituent also dramatically decrease the inhibitory activity. Thus, the pyridine-pyrone moiety is important for eliciting potent ACAT inhibition.

[Activating blood circulation and removing stasis in treating polycythemia vera: clinical observation and therapeutical mechanism]

OBJECTIVE

To assess the efficacy of "method of activating blood circulation and removing stasis (ABCRS)" in treating polycythemia vera.

METHODS

28 cases of polycythemia vera were treated with ABCRS and observed with bone marrow colonies.

RESULTS

15 casses were responsibe, of them 4 cases reached clinical remission, 11 cases were improved. Both bone marrow colonies of colony forming unit-erythroid dependent of erythropoietin (EPO + CFU-E) and colonies of CFU-E independent of EPO. (EPO-CFU-E) from these cases decreased significantly, especially the latter. ABCRS mainly suppressed the proliferation and differentiation of EPO-CFU-E. In addition, bone marrow colonies of colony formng unit-fibroblastoids (CFU-F) from these cases also changed obviously.

CONCLUSION

ABCRS is effective in treating polycythemia vera.

[Blocking action of tetrandrine on the cell proliferation induced by PDGF in human lung fibroblasts and liver Ito cell of rats]

OBJECTIVE

To investigate the mechanism of hepatic fiberosis, the effects of platelet-derived growth factor (PDGF) on cell proliferation activity and collagen synthesis in human lung fibroblasts (HLF) and Ito cells of rat liver as well as the blocking action of tetrandrine on the cell proliferation induced by PDGF.

METHODS

The Ito cells were separated from liver of rats by using the perfusion of collagenase and density pradient centrifugation. The cell proliferation was observed with the incorporation method of H-TdR and 3H-L-proline.

RESULTS

Under condition of cell culture with 1% serum, PDGF could significantly enhance DNA synthesis, cell proliferation and collagen synthesis, which increased in degree with a rising of concentration of PDGF. This occurred in culture without serum, but under the same condition, if PDGF was applied together with insulin-like growth factor (IGF), it enhanced cell proliferation. The result also showed that the dose of tetrandrine below the level of inhibiting cell DNA synthesis could antagonize the stimulation action of PDGF on cell proliferation and collagen synthesis.

CONCLUSION

Tetrandrine plays the blocking action in the promoting cell proliferation induced by PDGF.

Chemical modification and structure-activity relationships of pyripyropenes. 1. Modification at the four hydroxyl groups

Four hydroxyl groups of pyripyropenes have been modified and evaluated for their ability to inhibit microsomal acyl-CoA:cholesterol acyltransferase (ACAT) activity in vitro and to lower cholesterol absorption in vivo in a cholesterol-fed hamster. 7-O-n-Valeryl derivative (8c) improved the in vitro ACAT inhibitory activity (IC50 = 13 nM) about 7 times better than pyripyropene A. Introduction of methanesulfonyl group at 11-hydroxyl group (17a) increased both in vitro activity (IC50 = 19 nM) and in vivo efficacy (ED50 = 10 mg/kg).

Enzyme immunoassay of two nicergoline metabolites, 10 alpha-methoxy-9, 10-dihydrolysergol (MDL) and 1-methyl-10 alpha-methoxy-9, 10-dihydrolysergol (MMDL)

Specific and sensitive enzyme immunoassays for two nicergoline metabolites, 10 alpha-methoxy-9, 10-dihydrolysergol (MDL) and 1-methyl-10 alpha-methoxy-9, 10-dihydrolysergol (MMDL) have been developed. The hydroxyl group of hydroxymethyl at position 8 of either MDL or MMDL was carboxymethylated to introduce a carboxyl group for protein conjugation. Antibodies generated from O-carboxymethyl MDL or MMDL recognized the spacer arm between the hapten and the carrier protein and the molecular domain near the conjugation site as well. A heterologous bridge strategy was used to improve the affinity of the hapten-enzyme conjugate to the antibodies. The sensitivity of both assays was greatly increased by using such an approach. Both antibodies are specific for their own haptens. Little cross reactivity was observed with nicergoline and other metabolites. Determination of MDL and MMDL from both spiked plasma and urine showed nearly quantitative recovery. Detection of MDL and MMDL can be as sensitive as 10 pg/ml.

[Stereotactic intratumoral irradiation of huge craniopharyngioma]

Craniopharyngioma, often with cystic diliatation, is difficult to resect radically. Fifty patients with huge craniopharyngioma (diameter of tumor was over 5 cm) treated with intratumoral irradiation of radioactive isotopes (32P and 90Y) through CT-guided Leksell stereotactic system are reported. The patients were 2 to 69 years of age with the disease of 1- to 12-year duration. Of the 50 patients, 21 had recurrent tumor after craniotomy, 29 without surgery operation before. All tumors were confirmed pathologically. The major clinical symptoms were as follows: visual field defect, headache, vomiting, diabetes insipidus, hemiplegia and growth retardation in juvenile cases. There was no death or serious complications following the treatment procedure. Partial response (> 50% reduction of tumor size on CT scanning with improvement of symptoms and signs) rate of the treatment was 82.0% at one month and 62.0% at 2 to 7 years after treatment.

Stereotactic intratumour irradiation with nuclide for craniopharyngiomas

OBJECTIVE

Craniopharyngiomas is a kind of intractable tumor in neurosurgery. Since the radical excision is very difficult and occasionally hazardous because of its deep location and close neighbouring to critical cerebral structures, it is necessary to look for a simple and effective method.

PATIENTS AND METHODS

Stereotactic intratumour irradiation with instillation of nuclide colloid was performed in 220 patients with craniopharyngiomas (altogether 265 times), of whom, 130 were male and 90 female. Their ages ranged from 5 to 69 years. The syndromes of optic path's impairment were present in all of the patients. CT or MRI scan showed cystic tumour in 125 patients, solid and cystic in 80 and solid in 15. No severe complications and death were related to the operation.

RESULTS

150 patients were followed up for 2 months to 7 years (average 3.5 years). Tumours disappeared in 92 patients (61.4%), decreased dramatically in 20 (13.4%), decreased less than 50% in 19 (12.6%), and increased in 15 (10%); and there were 4 deaths (2.6%).

CONCLUSIONS

Stereotactic intratumour irradiation with instillation of nuclide colloid is effective in the patients with craniopharyngiomas. Beta-emitting isotopes (P-32 and Y-90) are the preferred internal radiation source because of their limited penetration of the energy released and the greater ease of handling. A calculated dose of 20 000 rads to the cyst wall is recommended.

[Karyological studies on the fruit of Gardenia jasminoides Ellis]

This paper reports the karyological studies on the fruit of Gardenia jasminoides and G. jasminoides var. grandiflora. The chromosome numbers are 2n = 22 and the places of centromere are metacentric and submedian. The fruit of G. jarminoides is more primary than Gardenia jarminoidce var. grandiflora in karyotype.

Determination of a cyclic guanine monophosphate phosphodiesterase inhibitor (SCH 51866) in rat serum using capillary zone electrophoresis

A capillary zone electrophoretic (CZE) assay was developed for the determination of cis-5,6a,7,8,9,9a-hexahydro-2-[4-(trifluoromethyl)phenylmethyl]-5-methyl - cyclopent[4,5]imidazo[2,1-b]purin-4(3H)-one, SCH 51866 (I), a cyclic guanine monophosphate phosphodiesterase inhibitor, in rat serum using acetonitrile deproteination as a clean-up step before injection. The calibration curve was linear over a serum concentration range of 0.5 to 10 micrograms/ml serum with a correlation coefficient (r) > 0.99. The limit of quantitation (LOQ) was established at 0.5 micrograms/ml. Fifty microliters of serum were used for analysis, which allowed serial bleeding (8 samples) from a single rat to characterize the pharmacokinetic profile of I after either oral or intravenous drug administration. In traditional pharmacokinetic and toxicokinetic studies in rodents, one animal provides only one serum sample since 1 to 2 ml of sample volume is required for chromatographic analysis, resulting in the use of a large number of animals per study. This assay yields a significant reduction in the use of animals, hence providing a large reduction in resources and time in drug discovery and development.

Multiple subpial transection for treatment of intractable epilepsy

On the basis of experimental study, we applied multiple subpial transection (MST) to treat 50 patients with intractable epilepsy in which epileptigenic lesion involved functional areas such as pericentral gyrus, postcentral gyrus, Broca's area, Wernicke's area, visual cortex, etc. They were followed up for 6 to 40 months. Complete control of seizures was obtained in 32 patients, significant reduction of seizure (more than 50%) in 13, reduction (less than 50%) in 3, and no effect in 2. The total effective rate was 96%. No functional defect was found in all patients. The mechanism of the disease and surgical technique were discussed in detail. We consider that MST could replace some standard excisional therapy for local epilepsy.

[Epidemiologic studies on three episodes of acute bacillary dysentery outbreak]

Three episodes of illness outbreak, with major symptoms of acute abdominal pain and diarrhea, occurred in 1990 to 1991 in the army forces stationed in Beijing. Bacillary dysentery outbreak caused by Shigella dysentariae were confirmed with epidemiological investigations and pathogen identification. Drug sensitivity tests with Kirby-Bauer method for the strain isolated showed it had obvious resistance to 13 of 14 kinds of antibiotics tested. Detection of plasmid with Birnboim method showed most of the strains had R-plasmid of 120-140 Md and few had small plasmid. It suggested inherent connection between drug-resistance of the strains and plasmid.

A specific enzyme immunoassay (EIA) with selective extraction for quantitation of a topical anti-inflammatory agent, SCH 40120, in human plasma

SCH 40120 is a potent anti-inflammatory agent under development for the topical treatment of dermal inflammatory and allergic disorders such as atopic dermatitis, contact dermatitis and psoriasis. We have previously described a sensitive enzyme immunoassay (EIA) for SCH 40120 in unextracted human plasma to support clinical studies. However, severe cross-reaction with unknown metabolites was observed during validation using samples from rats dosed with 14C-SCH 40120. Therefore, a selective extraction procedure was developed to remove the unknown plasma metabolites of SCH 40120 prior to EIA quantitation. The modified EIA using extracted plasma was cross-validated with an LC method using plasma samples from dosed subjects (human and rat), thereby confirming the specificity of the assay. The EIA can reliably quantitate SCH 40120 in plasma samples from 100 pg ml-1 to 10 ng ml-1 with good linearity, accuracy and precision, and is suitable for pharmacokinetic studies in man.

Effects of C alpha-methyl substitution on the conformation of linear GnRH antagonist analogs

We have examined the effect of C alpha-methyl groups on the conformational ensemble of GnRH analog peptides by comparing 1H 2D NMR data from two analogs, Ac-D-Nal1-D-4-Cl-C alpha-Me-Phe2-D-Pal3-Ser4-Tyr5-D-Arg6-Leu7-Arg8-Pro9-D-Al a10- NH2 (1) and Ac-D-Nal1-D-4-Cl-C alpha-Me-Phe2-D-Pal3-Ser4-C alpha-Me-Tyr5-D-Arg6- Leu7-C alpha-Me-Arg8-Pro9-D-Ala10-NH2 (2). The two additional C alpha-methyl groups in residues 5 and 8 of 2 do not influence significantly the pattern of the observable main chain NOE intensities, or of the backbone HN proton chemical shifts, which indicates that they do not produce global changes in the conformational ensemble of the peptide. A local change induced by the substitution was observed in the conformation at D-Arg8-Pro9.

[Studies on the constituents of the roots of Acorus calamus L]

A new tricyclic sesquiterpene, named calamenone (1), and two known sesquiterpenes, calamendiol (2) and isocalamendiol (3), were isolated from the roots of Acorus calamus L. The structure of the new compound was elucidated on the basis of spectral and X-ray diffraction data.

A sensitive enzyme immunoassay (EIA) for quantitation of the topical anti-inflammatory agent SCH 40120 in unextracted human plasma

SCH 40120 is a potent acute anti-inflammatory agent under development for topical treatment of dermal inflammatory and allergic disorders such as atopic dermatitis, contact dermatitis and psoriasis. In order to support percutaneous absorption studies, a competitive enzyme immunoassay (EIA) was developed to determine SCH 40120 in unextracted plasma samples. SCH 38280, a carboxylated analogue of SCH 40120, was used as the hapten and conjugated with bovine thyroglobulin (Thy). The hapten-Thy conjugate was used as the immunogen to immunize rabbits for antibody production. The hapten was also coupled to horseradish peroxidase (HRP) to form SCH 38280-HRP, which was used as the tracer. The EIA can detect SCH 40120 concentrations as low as 50 pg ml-1 of plasma, and can reliably quantitate SCH 40120 in plasma samples from 100 pg ml-1 to 10 ng ml-1 with good linearity, accuracy and precision. A variety of structurally related compounds and potential metabolites did not significantly cross-react with the antibodies, except for a few analogues. The availability of this sensitive assay makes it possible to evaluate the pharmacokinetics of SCH 40120 in man.

Synthesis of phosphotyrosine-containing peptides by the solid-phase method. A re-examination of the use of Boc-Tyr(PO3Bzl2)-OH

A practical and convenient procedure for making phosphotyrosine-containing peptides by the solid-phase method was developed. Phosphotyrosine was incorporated via Boc-Tyr(PO3Bzl2)-OH. The completed peptide was cleaved from the solid support by treatment with 1 M TMSBr-thioanisole-TFA. By gel-phase 31P-NMR spectroscopy we found that one of the benzyl protecting groups on phosphate was completely removed by two consecutive runs of Boc deprotection with 50% TFA-DCM. However, the other benzyl group remained intact throughout the synthesis (35 cycles).

Amino- and guanidinoacylryanodines: basic ryanodine esters with enhanced affinity for the sarcoplasmic reticulum Ca(2+)-release channel

Amino- and guanidinoacyl esters of ryanodine were prepared to evaluate the effect of basicity on the binding affinity of these derivatives for the sarcoplasmic reticulum Ca(2+)-release channel (SR CRC). In the presence of DCC and DMAP Cbz-beta-alanine reacts with ryanodine in CH2Cl2 to give O10eq-Cbz-beta-alanylryanodine (3a), which on hydrogenolysis yields the beta-alanyl ester (4a). N,N'-bis-Cbz-S-methylthiourea reacts with 4a to yield beta-N,N'-bis-Cbz-guanidinopropionylryanodine (5a). O10eq-beta-guanidinopropionylryanodine (6a) is obtained on hydrogenolytic deprotection of 5a. The binding affinity of beta-alanine ester (4a) and its glycyl congener (4b) is 2-3-fold greater, and that of the beta-guanidinopropionyl ester (6a) and its acetyl congener (6b) 3-6-fold greater, than that of ryanodine. The effect of ryanodine on SR Ca2+ flux is of a biphasic nature: nanomolar levels open (activate) the channel, while micromolar levels close (deactivate) it. The base-substituted esters 4a and 6a both display a unidirectional effect: they only open the channel. An understanding of ryanodine's mode of action and the design of effective SR CRC activating and deactivating ryanoids for possible therapeutic application are major research objectives.

[Clinical observation of the effect of pretreatment with nifedipine in preventing oxygen free radicals in the cardiopulmonary release bypass operation]

The effect of pretreatment with nifedipine in preventing oxygen free radicals release was observed in the cardiopulmonary bypass (CPB) operation. Twenty cases were divided into two groups for comparison. Nifedipine (0.6 mg/kg) was given to the test group. MDA, XO, UA and SOD were measured. These examinations were taken at pre-aortic clamping, 15 min after aortic clamping, and 30, 60, 120, 180 min after reperfusion. The results indicated that pretreatment with nifedipine reduced oxygen free radicals release in the CPB operation.

Removal of Qa-2 antigen alters the Ped gene phenotype of preimplantation mouse embryos

Embryo survival is influenced by both genetic and environmental factors. Previous research in our laboratory has identified one gene associated with embryonic survival, the Ped gene, a gene that is linked to the major histocompatibility complex (MHC) of the mouse. The Ped gene has been shown to influence the rate of preimplantation embryonic cleavage division, as well as litter size, birth weight, and weaning weight. Genetic mapping of the Ped gene has located it in the Q region of the MHC and has suggested that possible Q region genes encoding the Ped gene are Q3, Q5, Q6, Q7, Q8, and/or Q9. Whereas the protein products of the Q3 and Q5 genes are unknown, the protein product of the very similar Q6, Q7, Q8, and Q9 genes is the Qa-2 antigen. Two forms of membrane-bound Qa-2 antigen are known: glycosylphosphatidylinositol (GPI)-linked and transmembrane bound. Only the GPI-linked form is sensitive to cleavage by phosphatidylinositol phospholipase C (PI-PLC). The first purpose of the present study was to determine the nature of the linkage of the Qa-2 antigen to the cell surface of preimplantation mouse embryos. It was found that all detectable Qa-2 antigen on the embryonic cell surface is sensitive to cleavage by PI-PLC and is therefore bound to the cell membrane by a GPI linkage. Furthermore, removal of Qa-2 antigen from the embryonic cell surface slows down the rate of development of preimplantation mouse embryos. These results suggest the likelihood that the Qa-2 antigen is the Ped gene product.

Synthesis of optically pure C alpha-methyl-arginine

Optically pure L-(+)-C alpha-methyl-arginine and D-(-)-C alpha-methyl-arginine were synthesized. Experimental results indicated that DL-C alpha-methyl-arginine methyl ester could be resolved by trypsin, but workup posed a technical difficulty. Chemical resolution at the stage of DL-C alpha-methyl-ornithine, followed by selective guanidination using N,N'-di-Cbz-S-methylisothiourea and hydrogenolysis provided a effective and practical method for the synthesis of optically pure C alpha-methyl-arginine.

A competitive enzyme immunoassay for the direct determination of mometasone furoate (SCH 32088) in human plasma

Mometasone furoate (SCH 32088) is a synthetic corticosteroid which has a topical anti-inflammatory activity with a minimal potential for suppressing hypothalamic-pituitary-adrenocortical (HPA) axis. A sensitive competitive enzyme immunoassay (EIA) for measuring SCH 32088 in unextracted human plasma has been developed. The 3-(O-carboxymethyl)oxime (CMO) of SCH 32088 was synthesized and conjugated with bovine thyroglobulin, and the product was used for the production of antibodies in rabbits. SCH 32088-3-CMO was also conjugated with horseradish peroxidase, which was used as the tracer. The EIA thus developed can detect 1 pg SCH 32088 per assay or 25 pg per ml of human plasma. It can reliably quantitate SCH 32088 in human plasma from 50 pg ml-1 to 2.5 ng ml-1 with good linearity, accuracy and precision. The assay can be extended to measure SCH 32088 in plasma of laboratory animals. The availability of this sensitive assay makes it possible to evaluate the pharmacokinetics and toxicokinetics of SCH 32088 in laboratory animals and man.

The diagnostic significance of gastrin measurement of bronchoalveolar lavage fluid for lung cancer

In this study, determination of gastrin concentration in bronchoalveolar lavage fluid and serum has been detected by radioimmunoassay in 30 cases of lung cancer and 24 cases of non-cancer pulmonary diseases. The results show that the gastrin concentration and its positive rate of lavage fluids from cancer lung are much higher than those from healthy lung and serum in lung cancer patients, and those from serum and both disease and healthy lung in non-cancer pulmonary disease patients (P less than 0.01). The gastrin ratio of lavage fluids from cancer lung to serum is also significantly higher than the ratio of lavage fluid from healthy lung to serum and all the ratios in the non-cancer pulmonary disease group. These results suggest that there is a high gastrin concentration in local tissue of lung cancer, which is signified by the high concentration of gastrin and its high positive rate in lavage fluids from the lung with cancer. Therefore, the gastrin determination in lavage fluids and gastrin ratio of lavage fluids to serum are more reliable in the differential diagnosis of benign from malignant pulmonary diseases than gastrin determination of serum alone.

[Consecutive observation of the plasma MDA, XO and UA levels and erythrocyte SOD in 10 cases of cardiopulmonary bypass]

The plasma malonaldehyde (MDA), xanthine oxidase (XO) and uric acid (UA) levels and erythrocyte superoxide dismutase (SOD) were measured in 10 cases during cardiopulmonary bypass (CPB) operation. These examinations were taken at pre-aortic clamping, 15 min after aortic clamping, 30, 60, 120 and 180 min after reperfusion respectively. The results showed that MDA, XO and UA rise but SOD decreases after reperfusion. We believe that a lot of oxygen free radicals (OFR) release during peri-operative period and the XO may be an important pathway of OFR release.

[Application of ultrafiltration during cardiopulmonary bypass]

The ultrafiltration (UF) was employed in 20 patients undergoing open-heart operation with cardiopulmonary bypass (CPB). The number of controls was 10. The average UF duration was 24.7 +/- 9.6 min (12-49) and the average amount of ultrafiltrate was 1433.5 +/- 482.6 ml (650-2,350 ml). The volume load of UF group was similar with that of the control group. The output volume of UF group was greater than that of the control group (P less than 0.01). After UF, the degree of increase in hematocrit, plasma albumin and total plasma protein was 33.8%, 34.7%, and 26.0%, respectively. Moreover, we did not find any abnormal increase in blood viscosity. No additional adverse actions of UF were found.