[Clinical effect of polyvinyl alcohol particles combined with chemoembolization in treatment of hepatocellular carcinoma complicated by hepatic arteriovenous shunt and related and prognostic factors]

Objective: To investigate the clinical effect of polyvinyl alcohol (PVA) particles combined with chemoembolization using chemotherapeutic agents or chemotherapeutic agents lipiodol emulsion (CALE) in the treatment of hepatocellular carcinoma (HCC) complicated by hepatic arteriovenous shunt (HAVS) and related prognostic factors. Methods: A retrospective analysis was performed for the clinical data of 133 patients with HCC complicated by HAVS. HAVS was classified into slow-flow HAVS, intermediate-flow HAVS, and high-flow HAVS, which were treated with 300-500μm, 500-710μm, and 710-1000μm PVA particles, respectively. The patients with slow-flow and intermediate-flow HAVS underwent embolization with PVA combined with chemotherapeutic agents followed by CALE, while those with high-flow HAVS underwent the treatment with PVA combined with chemotherapeutic agents alone. The survival time, progression-free survival time, and postoperative complications were followed up and analyzed. The Kaplan-Meier method was used to calculate cumulative survival rate and the Cox proportional hazards model was used to determine prognostic factors. Results: The median overall survival (OS) of 133 patients was 9.1 months, and the 6-, 12-, and 24-month survival rates were 73.7%, 36.2%, and 10.2%, respectively. The median OS of slow-flow group (36 patients), intermediate-flow group (58 patients), and high-flow group (39 patients) were 7.3, 9.1, and 10.8 months, respectively. And the 6- and 12-month survival rates were 69.2%/19.0%, 72.4%/39.2%, and 77.8%/42.7%, respectively. There was no significant difference in survival time between the patients with different types of HAVS (χ²= 2.865,P= 0.239). The incidence rates of postoperative gastroesophageal variceal bleeding and acute liver failure were 1.1% and 0.4%, respectively. The results of Cox regression analysis showed that preoperative alpha-fetoprotein level≥400 ng/ml (HR= 2.105,P= 0.006) was an independent risk factor, while multiple embolizations (HR= 0.482,P= 0.011), tumor remission (HR= 0.431,P= 0.041), and multimodality therapy (HR= 0.416,P= 0.004) were independent protective factors. Conclusion: PVA particles combined with chemotherapeutic agents or CALE is safe and effective in the treatment of HCC complicated by HAVS. Patients with multiple embolizations, tumor remission, and multimodality therapy tend to have good prognosis, while those with a high level of alpha-fetoprotein before embolization often have poor prognosis.

A meta-analysis and systematic review of prophylactic endoscopic treatments for postpolypectomy bleeding

PURPOSE

The aim of this meta-analysis and systematic review was to determine whether bleeding prophylaxis benefits patients after colonoscopic polypectomy.

METHODS

A systematic review of the literature was performed to find prospective randomized controlled trials of postpolypectomy hemorrhage prophylaxis. Studies were selected according to specific criteria and analyzed to generate pooled data.

RESULTS

Eight studies encompassing 2,595 polyps met the criteria for the meta-analysis. The rate of early bleeding was significantly decreased relative to the control when a single prophylactic technique was used [2.58% vs. 8.15%, OR = 0.34 (95% CI, 0.20-0.58), P < 0.0001]. The use of multiple prophylactic techniques resulted in a lower early postpolypectomy hemorrhage rate compared with the use of a single prophylactic technique [0% vs. 8.41%, OR = 0.12 (95% CI, 0.03-0.47), P = 0.002]. The late bleeding rate did not differ significantly between the monotherapy and control groups [0.61% vs. 1.39%, OR = 0.37 (95% CI, 0.11-1.28), P = 0.12], and the use of combined preventative techniques did not significantly decrease the late postpolypectomy bleeding (PPB) rate compared with use of a single prophylactic method [1.43% vs. 2.05%, OR = 0.70 (95% CI, 0.32-1.55), P = 0.38].

CONCLUSION

Prophylactic endoscopic treatments are effective at reducing early PPB after colonoscopic polypectomy. However, patients with late PPB may not benefit from bleeding prophylaxis.

The differences between American and Chinese patients with Crohn's disease

AIM

The effect of race on Crohn's disease (CD) remains uncertain. This study compared the characteristics of American white patients and Chinese patients with CD.

METHOD

A retrospective chart review was conducted for patients who required management of colorectal CD between 1985 and 2004 at either Cleveland Clinic Florida (CCF) or at the 301 Hospital in China. Data included a family history of CD, smoking history, location of the CD and histopathology.

RESULTS

The mean age of onset in the 153 patients was 29.8 ± 16.4 years for American white patients and 32.4 ± 15.3 years for Chinese patients (not significant). Sixty per cent of American white patients were women vs 37% of Chinese patients (P = 0.003). Twelve per cent of American white patients vs 1% of Chinese patients had a family history of CD (P = 0.016). American white patients had significantly higher rates of arthritis (32%vs 4%), abscess (19%vs 0%), rectal and perineal fistula (52%vs 0%), and disease involving the colon and rectum when compared with Chinese patients (all P < 0.05). American white patients had more colorectal sites involved and higher rates of extraintestinal diseases (40%vs 20%) than Chinese patients (all P < 0.05). Chinese patients had higher rates of ileocaecal disease (82%vs 52%) and deep ulcers (66%vs 24%) in the colorectum (all P < 0.001). There were no statistical differences in the incidence of smoking, perforation, intra-abdominal fistula, stenosis, bowel obstruction, toxic megacolon or granuloma formation.

CONCLUSION

This study found that colorectal CD had a more severe clinical presentation and pathological involvement in American white patients than in Chinese patients.

The differences between American and Chinese patients with Crohn's disease

AIM

The effect of race on Crohn's disease (CD) remains uncertain. This study compared the characteristics of American white patients and Chinese patients with CD.

METHOD

A retrospective chart review was conducted for patients who required management of colorectal CD between 1985 and 2004 at either Cleveland Clinic Florida (CCF) or at the 301 Hospital in China. Data included a family history of CD, smoking history, location of the CD and histopathology.

RESULTS

The mean age of onset in the 153 patients was 29.8 ± 16.4 years for American white patients and 32.4 ± 15.3 years for Chinese patients (not significant). Sixty per cent of American white patients were women vs 37% of Chinese patients (P = 0.003). Twelve per cent of American white patients vs 1% of Chinese patients had a family history of CD (P = 0.016). American white patients had significantly higher rates of arthritis (32%vs 4%), abscess (19%vs 0%), rectal and perineal fistula (52%vs 0%), and disease involving the colon and rectum when compared with Chinese patients (all P < 0.05). American white patients had more colorectal sites involved and higher rates of extraintestinal diseases (40%vs 20%) than Chinese patients (all P < 0.05). Chinese patients had higher rates of ileocaecal disease (82%vs 52%) and deep ulcers (66%vs 24%) in the colorectum (all P < 0.001). There were no statistical differences in the incidence of smoking, perforation, intra-abdominal fistula, stenosis, bowel obstruction, toxic megacolon or granuloma formation.

CONCLUSION

This study found that colorectal CD had a more severe clinical presentation and pathological involvement in American white patients than in Chinese patients.

Short communication: responses to increasing amounts of free alpha-linolenic acid infused into the duodenum of lactating dairy cows

Increasing the alpha-linolenic acid (LNA; 18:3 cis-9,cis-12,cis-15) content of milk fat might help promote consumers' health. The objective of this study was to determine the potential to alter the content of LNA in milk by duodenal infusion of a free fatty acid mixture rich in LNA. Four multiparous lactating Chinese Holstein cows fitted with duodenal cannulas were administered 2 treatments in a crossover design: an LNA-rich fatty acid infusion at varying concentrations (0, 40, 80, 120, and 160 g/d) versus a basal infusate control. Dry matter intake was not affected by LNA infusions. Milk production tended to decrease and was quadratically affected as LNA infusion increased, but 4% fat-corrected milk yield was not changed. Milk fat content tended to increase linearly with LNA infusion. Milk protein content was not changed by LNA infusion, whereas milk lactose content and yield were decreased quadratically as LNA infusion increased. Increasing the amount of LNA infused into the duodenum linearly increased concentrations of 18:3 cis-9,cis-12,cis-15 (0.61 to 25.4 g/100g of total fatty acids) and 18:2 cis-9,cis-12 in milk fat. Increasing LNA decreased the percentages of 4:0, 14:0, and 16:0 fatty acids linearly. Increasing LNA also linearly decreased the percentages of 18:1 cis-9 and 18:2 cis-9,trans-11 in milk fat. Milk fat content of 20:5 cis-5,cis-8,cis-11,cis-14,cis-17 was quadratically affected, whereas concentrations of 18:0, 18:1 trans-9, 18:1 trans-11, and 18:2 trans-10,cis-12 were not affected. Increasing the supply of 18:3 cis-9,cis-12,cis-15 to the small intestine linearly increased 18:3 cis-9,cis-12,cis-15 in milk fat and markedly altered milk fat composition.

Toxicity effect of phenol on aerobic granules

Aerobic granular sludge cultivated in a pilot-scale sequencing batch reactor, through mechanical separation using metal sieves, was categorized into five size categories of0.09 (flocs), 0.35, 0.82, 1.65 and 2.54 mm in mean diameter. Granule microbial activiy of each size category and the activity of the sludge flocs were determined after exposure to phenol (0-3000 mg L(-1)) at various exposure times of 4, 12, and 24 hours. The microbial activity reduction follows a linear relationship with the increase in phenol concentration for both granules and sludge flocs. The C50 value, i.e., the phenol concentration causing 50% inhibition of the microbial activity, decreased significantly with the exposure time, but it increased with granule size. The C50 increased by 18% from 1273 mg L(-1) for sludge flocs to 1497 mg L(-1) for granules of size 2.54 mm at an exposure time of 24 hours. The results indicated that the granular structure could protect the microbial cells from phenol toxicity. The application of aerobic granules in wastewater treatment could provide an improved ability to tolerate toxic chemical shock, particularly at longer exposure times.

Startup of pilot-scale aerobic granular sludge reactor by stored granules

The startup of a pilot-scale aerobic granular sludge reactor was investigated by seeding with 4-month stored aerobic granules. Two liters of granules were inoculated into the reactor (5.9% of reactor volume), which gave a biomass concentration of 1.03 g l(-1). Experimental results showed that seeding granules could be successfully maintained in the reactor. The microbial activity of seeding granules could be fully recovered to that of fresh granules after 2 days of operation, and new granules started to grow after day 5. Newly developed aerobic granules at stable period had similar size and morphology as seeding granules, and a biomass concentration of 6.0 g l(-1) was achieved in the reactor. The experiment demonstrated for the first time that stored aerobic granules could be used for easy and quick startup of aerobic granular sludge reactor.

The effect of upflow air velocity on the structure of aerobic granules cultivated in a sequencing batch reactor

The effect of upflow air velocity on the formation and structure of aerobic granules was studied in three column sequencing batch reactors. Upflow aeration would be the major cause of hydrodynamic shear force in the column reactor. Results showed that high upflow air velocity resulted in more compact, denser, rounder, stronger and smaller aerobic granules, while high biomass retention in the reactor was achieved. It was found that high upflow air velocity could induce granular sludge to secrete more cell polysaccharides which in turn contributed to the compact and strong structure. It appears from this study that the structure of aerobic granules could be controlled by manipulating the upflow air velocity.

Substrate concentration-independent aerobic granulation in sequential aerobic sludge blanket reactor

The development of aerobic granules was studied in four column-type sequential aerobic sludge blanket reactors fed with different substrate concentrations ranging from 500 to 3000 mg l(-1) COD. Results showed that aerobic granules successfully formed in all reactors fed with different substrate concentrations, indicating that the formation of aerobic granules is independent of the substrate concentration. The granule size, roundness, compactness, physical strength, as well as cell surface hydrophobicity and cell polysaccharides contents of the cultivated aerobic granules were investigated. It was shown that aerobic granules formed with different substrate concentrations had similar roundness and compactness. However, the size of aerobic granules slightly increased with an increase in substrate concentration, while granule strength decreased with substrate concentration. It was found that there was a significant increase in cell surface hydrophobicity and cell polysaccharides of the aerobic granules compared to that of seed sludge. The high cell surface hydrophobicity and high cell polysaccharides contents were believed to play an important role in the formation of aerobic granules. However, substrate concentration seems not to be a governing factor for the formation of aerobic granules. The results of this study would be useful for developing aerobic granules-based bioreactor and for better understanding of the mechanism of aerobic granulation. It was also clearly demonstrated that aerobic granules-based bioreactor would have great potential in the treatment of high-strength wastewater.

Characteristics of aerobic granules grown on glucose and acetate in sequential aerobic sludge blanket reactors

Aerobic granules were cultivated in two column-type sequential aerobic sludge blanket reactors fed with glucose and acetate, respectively. The characteristics of aerobic granules were investigated. Results indicated that the glucose- and acetate-fed granules have comparable characteristics in terms of settling velocity, size, shape, biomass density, hydrophobicity, physical strength, microbial activity and storage stability. Substrate component does not seem to be a key factor on the formation of aerobic granules. However, microbial diversity of the granules is closely associated with the carbon sources supplied to the reactors. Compared with the conventional activated sludge flocs, aerobic granules exhibit excellent physical characteristics that would be essential for industrial application. This research provides a complete set of characteristics data of aerobic granules grown on glucose and acetate, which would be useful for further development of aerobic granules-based compact bioreactor for handling high strength organic wastewater.

Aerobic granulation in sequential sludge blanket reactor

Aerobic granulation was studied in a column-type of sequential sludge blanket reactor. Reactor was operated 4 hours per cycle under a chemical oxygen demand (COD) loading rate of 6.0 kg/m3/d by using acetate as substrate. Results showed that aerobic granules with a mean diameter of 0.35 mm were observed at cycle 42. With granulation proceeding, the sludge volume index (SVI) value gradually decreased, and to an average value of 50 mL/g at stable granulation period. Observation of granules' microstructure by scanning electron microscopy (SEM) showed that rod bacteria were dominant in granules with lots of cavities presented. An increase in cell hydrophobicity was observed after the appearance of aerobic granules. The cell hydrophobicity of sludge was found to be about 50% higher after granulation. It appears that high hydrophobicity could induce cell attachment and further strengthen cell-cell interaction; cell hydrophobicity might therefore play a major role in the formation of aerobic granules.

The effects of shear force on the formation, structure and metabolism of aerobic granules

The effect of shear force on aerobic granulation was studied in four column-type, sequential aerobic sludge blanket reactors. Hydrodynamic turbulence caused by upflow aeration served as the main shear force in the systems. Results showed that aerobic granulation was closely associated with the strength of shear force. Compact and regular aerobic granules were formed in the reactors with a superficial upflow air velocity higher than 1.2 cm s(-1). However, only typical bioflocs were observed in the reactor with a superficial upflow air velocity of 0.3 cm s(-1) during the whole experimental period. The characteristics of the aerobic granules in terms of settling ability, specific gravity, hydrophobicity, polysaccharide and protein content and specific oxygen utilization rate (SOUR) were examined. It was found that the shear force has a positive effect on the production of polysaccharide, SOUR, hydrophobicity of cell surface and specific gravity of granules. The hydrophobicity of granular sludge is much higher than that of bioflocs. Therefore, it appears that hydrophobicity could induce and further strengthen cell-cell interaction and might be the main force for the initiation of granulation. The shear-stimulated production of polysaccharides favors the formation of a stable granular structure. This research provides experimental evidence to show that shear force plays a crucial role in aerobic granulation and further influences the structure and metabolism of granules.

The role of cellular polysaccharides in the formation and stability of aerobic granules

AIMS

This paper attempts to investigate the role of cellular polysaccharides in the formation and stability of aerobic granules.

METHODS AND RESULTS

Three column sequential aerobic sludge blanket reactors (R1, R2 and R3) were operated at a superficial air upflow velocity of 0.3 cm s(-1), 1.2 cm s(-1) and 2.4 cm s(-1), respectively. Aerobic granules appeared at cycle 42 in R2 and R3 with a mean size of 0.37 mm in R2 and 0.35 mm in R3, however, aerobic granulation was not observed in R1. After the formation of aerobic granules, the sludge volume index (SVI) decreased to 55 ml g(-1) in R2 and 46 ml g(-1) in R3. Aerobic granulation was concurrent with a sharp increase of cellular polysaccharides normalized to cellular proteins, which increased from 5.7 to 13.0 mg per mg proteins in R2, and 7.5-13.9 mg per mg protein in R3. The content of polysaccharides in aerobic granules was 2-3 times higher than that in the bioflocci cultivated in R1. The disappearance of aerobic granules in R2 was tightly coupled to a drop in cellular polysaccharides. After the reappearance of bioflocci in R2, the content of cellular polysaccharides were found to be restored to the level observed in R1.

CONCLUSION

It appears that the production of cellular polysaccharides could be stimulated by hydrodynamic shear force and contributes to the formation and stability of aerobic granules.

SIGNIFICANCE AND IMPACT OF THE STUDY

It is expected that this study would provide useful information for better understanding the mechanisms of aerobic granulation.

Microscopic observation of aerobic granulation in sequential aerobic sludge blanket reactor

AIMS

This paper attempts to provide visual evidence of how aerobic granulation evolves in sequential aerobic sludge blanket reactors.

METHODS AND RESULTS

A series of experiments were conducted in two column-type sequential aerobic sludge reactors fed with glucose and acetate as sole carbon source, respectively. The evolution of aerobic granulation was monitored using image analysis and optical and scanning electron microscopy. The results indicated that the formation of aerobic granules was a gradual process from seed sludge to compact aggregates, further to granular sludge and finally to mature granules with the sequential operation proceeding. Glucose- and acetate-fed granules have comparable characteristics in terms of settling velocity, size, shape, biomass density and microbial activity. However, the microbial diversity of the granules was associated with the carbon source supplied. In this work, an important aerobic starvation phase was identified during sequential operation cycles. It was found that periodical aerobic starvation was an effective trigger for microbial aggregation in the reactor and further strengthened cell-cell interaction to form dense aggregates, which was an essential step of granulation. The periodical starvation-induced aggregates would finally be shaped to granules by hydrodynamic shear and flow.

CONCLUSION

Aerobic granules can be formed within 3 weeks in the systems. The periodical starvation and hydrodynamic conditions would play a crucial role in the granulation process.

SIGNIFICANCE AND IMPACT OF THE STUDY

Aerobic granules have excellent physical characteristics as compared with conventional activated sludge flocs. This research could be helpful for the development of an aerobic granule-based novel type of reactor for handling high strength organic wastewater.

Selective modulation of excitatory transmission by mu-opioid receptor activation in rat supraoptic neurons

Opioid peptides have profound inhibitory effects on the production of oxytocin and vasopressin, but their direct effects on magnocellular neuroendocrine neurons appear to be relatively weak. We tested whether a presynaptic mechanism is involved in this inhibition. The effects of mu-opioid receptor agonist D-Ala(2), N-CH(3)-Phe(4), Gly(5)-ol-enkephalin (DAGO) on excitatory and inhibitory transmission were studied in supraoptic nucleus (SON) neurons from rat hypothalamic slices using whole cell recording. DAGO reduced the amplitude of evoked glutamatergic excitatory postsynaptic currents (EPSCs) in a dose-dependent manner. In the presence of tetrodotoxin (TTX) to block spike activity, DAGO also reduced the frequency of spontaneous miniature EPSCs without altering their amplitude distribution, rising time, or decaying time constant. The above effects of DAGO were reversed by wash out, or by addition of opioid receptor antagonist naloxone or selective mu-antagonist Cys(2)-Tyr(3)-Orn(5)-Pen(7)-NH(2) (CTOP). In contrast, DAGO had no significant effect on the evoked and spontaneous miniature GABAergic inhibitory postsynaptic currents (IPSCs) in most SON neurons. A direct membrane hyperpolarization of SON neurons was not detected in the presence of DAGO. These results indicate that mu-opioid receptor activation selectively inhibits excitatory activity in SON neurons via a presynaptic mechanism.

Extracellular calcium regulates responses of both alpha3- and alpha7-containing nicotinic receptors on chick ciliary ganglion neurons

Neuronal nicotinic receptors are generally both permeable to calcium and potentiated by it. We have examined acute calcium regulation of both native alpha7-containing and the less abundant alpha3-containing nicotinic receptors on chick ciliary ganglion neurons. Most of the receptors are concentrated on somatic spines tightly overlaid in situ by a large presynaptic calyx. Whole cell patch-clamp recording from dissociated neurons using perforated patch-clamp techniques indicates that the rapidly desensitizing nicotinic response of alpha7-containing receptors achieves maximum amplitude in 2 mM calcium; both lower and higher concentrations of calcium are less effective. Barium and strontium but not magnesium can substitute for calcium in potentiating the response. Neither calcium current through the receptors nor calcium action at intracellular sites is necessary. These latter conclusions are supported by current-voltage analysis of the nicotine-induced response, ion substitution experiments, and internal perfusion of the cells with 1,2-bis-(2-aminophenoxy)-ethane-N,N,N',N'-tetraacetic acid (BAPTA) via a conventional patch pipette. Varying the agonist concentration indicates that some of the calcium-dependent enhancement may involve a shift in the dose-response curve for agonist binding, but much of the effect is also likely to involve increased receptor responsiveness. Blockade of alpha7-containing receptors with alpha-bungarotoxin showed that the heteromeric alpha3-containing nicotinic receptors also undergo calcium-dependent potentiation. Calcium did not have a major effect on the desensitization rate of either receptor class but did have a selective effect on the rise time of alpha7-containing receptors. Analysis of stably transfected cells expressing an alpha7 gene construct showed that the calcium potentiation observed for native receptors did not require neuron-specific modifications or components and that it could be seen with the natural agonist acetylcholine. Receptor dependence on extracellular calcium may provide a regulatory mechanism for constraining synaptic signaling, avoiding local depletion of external calcium, and limiting calcium buildup in postsynaptic compartments.

Kainate acts at presynaptic receptors to increase GABA release from hypothalamic neurons

Recent reports suggest that kainate acting at presynaptic receptors reduces the release of the inhibitory transmitter GABA from hippocampal neurons. In contrast, in the hypothalamus in the presence of alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) and N-methyl-D-aspartate (NMDA) receptor antagonists [1-(4-methyl-7,8-methylenedioxy-5H-2,3-benzodiazepine (GYKI 52466) and D,L-2-amino-5-phosphonopentanoic acid (AP5)], kainate increased GABA release. In the presence of tetrodotoxin, the frequency, but not the amplitude, of GABA-mediated miniature inhibitory postsynaptic currents (IPSCs) was enhanced by kainate, consistent with a presynaptic site of action. Postsynaptic activation of kainate receptors on cell bodies/dendrites was also found. In contrast to the hippocampus where kainate increases excitability by reducing GABA release, in the hypothalamus where a much higher number of GABAergic cells exist, kainate-mediated activation of transmitter release from inhibitory neurons may reduce the level of neuronal activity in the postsynaptic cell.

[Whole-cell recordings of the supraoptic nucleus neurons from rat hypothalamic slices in vitro]

Fifty-two supraoptic nucleus neurons in rat slice preparations were studied using whole cell patch-clamp technique. The mean passive and active membrane properties were measured as follows: resting membrane potential, 59 +/- 8 mV; input resistance, 535 +/- 129 M omega; time constant, 32 +/- 9 ms; amplitude of the action potentials, 99 +/- 11 mV; overshoot, 37 +/- 13 mV (n = 39). Most of these neurons showed a prominent slow after-hyperpolarization potential or current in response to depolarizing pulse. In votage-clamp condition, it was found that virtually all supraoptic neurons (n = 13) were invaded by spontaneous synaptic inputs. Pharmacological experiments showed that the excitatory postsynaptic currents (EPSCs) were mediated by non-NMDA glutamate receptors, whereas inhibitory postsynaptic currents (IPSCs) by GABAA receptors.

Nitric oxide inhibits neuronal activity in the supraoptic nucleus of the rat hypothalamic slices

The presence of abundant nitric oxide synthase (NOS) in magnocellular neurons of the rat hypothalamus suggests that nitric oxide (NO) may be involved in controlling the release of oxytocin and vasopressin. To test this possibility, we examined the effect of NO-related drugs on extracellular discharges of 124 supraoptic nucleus (SON) neurons from slices of rat hypothalamus in vitro. Twenty-three (43%) of 53 neurons were inhibited by sodium nitroprusside (SNP), a spontaneous releaser of NO, at 1-3 mM. This inhibition was prevented by preincubation of the slices with 1 microM hemoglobin, an inactivator of NO (n = 14), whereas hemoglobin alone enhanced neuronal activity in seven (35%) of 20 neurons. L-Arginine (1 mM), a precursor of NO, inhibited neuronal activity in five (36%) of 14 neurons, while D-arginine (1 mM), the inactive counterpart of L-arginine, was ineffective (n = 12). N-omega-nitro-L-arginine methyl ester (L-NAME, 10 microM), an inhibitor of NOS, also enhanced neuronal activity in five (29%) of 17 neurons, while N-omega-nitro-D-arginine methyl ester (DNAME, 10 microM), the inactive enantiomer of L-NAME, was without effect (n = 11). Together, our data show that NO exerts predominantly an inhibitory effect on SON neurons and may serve as a negative feedback loop in controlling release of oxytocin and vasopressin.

[Opposite actions of ACh on excitatory and inhibitory synaptic transmission in cultured rat cortical neurons]

Effect of ACh on spontaneous EPSC and IPSC in cultured postnatal rat cortical neurons was studied using whole-cell voltage-clamp technique. EPSC was blocked by a non-NMDA glutamate receptor antagonist DNQX, while IPSC was blocked by a GABAA receptor antagonist bicuculline. When ACh (10-100 mumol/L) was applied by puff pipettes to the cells recorded, the frequency of EPSC was enhanced greatly, but the amplitude distribution was not changed significantly. However, the frequency of IPSC was attenuated by ACh even at a quite low concentration (1 mumol/L). The effect of ACh on EPSC and IPSC could be blocked by M type ACh receptor antagonist atropine (1 mumol/L). ACh had no significant effect on whole-cell currents activated by glutamate and GABA. The above results provide evidence that ACh has opposite effects on excitatory and inhibitory synaptic transmission in rat cortex by acting at presynaptic sites. It is also suggested that ACh plays an important role in the maintenance of excitability of cortical neurons.

[Nicotinic currents of cultured rat superior cervical ganglion neurons and use-dependent block by mecamylamine]

AIM

Comparison of action of nicotinic agonists and antagonists on nicotinic acetylcholine receptor (nAChR) in superior cervical ganglion (SCG) neurons.

METHODS

Whole-cell recordings were made from cultured neonatal rat SCG neurons. Cholinergic drugs were applied by local pressure perfusion.

RESULTS

The neurons were activated by nicotinic agonists and peak current were acetylcholine (ACh), 443 +/- 183 pA; nicotine, 1175 +/- 377 pA; dimethylphenylpiperazinium (DMPP), 2946 +/- 358 pA, respectively. The nicotinic responses were blocked by mecamylamine (Mec), hexamethonium and curare, the efficacies were 435 +/- 154 pA, 725 +/- 320 pA, 887 +/- 214 pA, but not by alpha-bungarotoxin. The block by Mec was use-dependent, i.e., it was dependent on repeated presentation of the agonists. The first 6 peak currents were expressed as percentage of the first response as following: 100, 64 +/- 3, 50 +/- 3, 41 +/- 4, 32 +/- 3%.

CONCLUSION

The present data suggest that nAChR of SCG neurons have different pharmacological characteristics from that of muscle or central neurons.

[Whole cell recording of sodium, potassium and calcium currents of cultured neonatal rat sympathetic neurons]

Na, K and Ca currents and other electrophysiological characteristics of cultured neonatal rat superior cervical sympathetic neurons were studied using whole cell clamp technique. The mean passive and active membrane properties measured are as follows: resting membrane potential, -51 +/- 6 mV; input resistance, 1432 +/- 389 M omega; time constant, 130 +/- 32 ms; amplitude of action potential, 96 +/- 10 mV; overshoot, 42 +/- 6 mV. Na, K and Ca currents were isolated upon pharmacological manipulations. The predominant type of K current was a noninactivating delayed rectifier. Voltage-clamp studies also showed the presence of a high voltage-activated sustained inward Ca current, while low voltage could not elicit any transient Ca current.

[The use of laser ignited mini-explosive technique in treating 100 cases of gastric bezoars]

The experience of breaking gastric bezoars endoscopically with a laser ignited mini-explosive head was reported. After successful application of this technique in vitro and in experimental animals, we began to use it clinically in January 1988. In a period of more than four years, we treated 100 cases of gastric bezoars, 80 cases being male and 20 female, aged from 5 to 65 years. 70 cases were cured after one treatment, 24 after two and the remaining 6 cases after three times of treatment. The cure rate was 100%. Except one case complicated with gastric perforation, no other complications were observed. The etiology and prevention of gastric bezoars, as well as the new method and experience in treating this disease were discussed.

D2 dopamine receptor involvement in spinal dopamine-produced antinociception

Experiments were performed on 79 lightly pentobarbital-anesthetized rats. Rats displayed a dose-dependent increase in tail-flick latencies following the injection of dopamine (DA) into the lumbar subarachnoid space through an intrathecal tube. Sulpiride, a D2-subtype receptor antagonist, antagonized the DA-induced analgesia (antinociceptive) effect; while SCH-23390, a D1-subtype receptor antagonist, had no effect even in a higher dose. To further investigate whether the well-known spinal serotonergic, noradrenergic and opioidergic receptor systems were involved in DA-induced antinociception, their antagonists, methysergide, phentolamine, and naloxone were tested respectively. The results showed that phentolamine, but not methysergide or naloxone, could block the DA-induced antinociception. The present data provide evidence that DA exerts antinociceptive effects through D2-subtype dopamine receptor(s) at the spinal level, and that spinal alpha-adrenergic receptors may mediate this effect.

[Effects of xin-fu-ning IV on experimental congestive heart failure in rabbits]

By use of pentobarbital sodium to produce experimental congestive heart failure (CHF) in 40 rabbits, they were treated with xin-fu-ning IV (XFN IV), the plasma atrial natriuretic factor (ANF) levels and atrial tissue ANF levels of rabbits were measured. The results showed that XFN IV had elevated ANF levels of the rabbits with CHF. It showed that XFN IV could improve endocrine function of heart, and it also showed good curative effect on CHF.

[Diagnosis and treatment of the cruciate ligament injury of knee joint]

During 1959 to 1986, 62 Cases with cruciate ligament injury of the knee joint were treated in our hospital. Thirty of these cases were anterior cruciate ligament injuries and 32 cases were posterior The diagnosis of the cruciate ligament injuries was made by stability tests of the cruciate ligament. When the knee was greatly swollen with multiple ligament injuries, a series of X-ray films should be taken to test the knee stability under local or nerve block anesthesia. Fresh tear of the cruciate ligament (33 cases) was treated with immediate surgical repair except in one. Old ligament injuries (28 cases) were treated by conservative method (10 cases) or surgical reconstruction (18 cases). All patients were followed for 2 to 18 years (mean 6 years). The results showed that the fresh tear of the cruciate ligament treated surgically had excellent and good rates in 87.9% (29/33). In the conservative treatment group, only 27.3% (3/11) obtained good result, and most of them were complicated with meniscal lesions and osteoarthritis. Eighteen cases treated by ligament reconstruction gave 34.5% (8/18) good result.