AIMTo observe the injured effect of homocysteine (HCY) on cardiomyocytes and investigate its signal transduction mechanism as well as the key regulatory link.

METHODSCardiomyocytes were isolated from neonatal Wistar rats. After incubation with HCY, the survival rate of cardiomyocytes was determined by trypan blue stained assay, while the apoptosis rate was measured by TUNEL and FCM. Western blot and EMSA were used to tested ERK2 protein phosphorylation and NF-kappaB active expression in cardiomyocytes, respectively.

RESULTSThe survival rate of cardiomyocytes treated with HCY was reduced significantly in dose- and time- dependent manner. It was found that 10(-3) mol/L HCY could increase the apoptosis rate of cardiomyocytes to the peak (7.65%) at 4 h stress. Several HCY levels revealed the strong inhibitory effect on ERK2 protein phosphorylation, especially, 10(-3) mol/L HCY decreased the level of active ERK2 expression to 3.04% of control at 4 h (P < 0.01). NF-kappaB activation was also inhibited significantly by several HCY level for different time in cardiomyocytes.

CONCLUSIONHCY plays an important role in injury of cardiomyocytes and apoptosis is a form of HCY-induced injury to cardiomyocytes. HCY can block ERK2 protein phosphorylation and NF-kappaB activation, which contribute to the injury of cardiomyocytes.

Animals ; Apoptosis ; drug effects ; Cells, Cultured ; Homocysteine ; pharmacology ; Myocytes, Cardiac ; drug effects ; metabolism ; NF-kappa B ; metabolism ; Rats ; Rats, Wistar ; Signal Transduction

Traditional Chinese medicine (TCM) dispensing is the final step of TCM used for clinical treatment, the stability of TCM dispensing is the guarantee of good clinical effect. Establishment of effect-constituent equivalence for Chinese herbal pieces based on clinical efficacy, can not only guarantee the stability of TCM dispensing, but also relate to the precision of clinical effect. This study chose Coptidis Rhizoma as the model, established effect-constituent equivalence of Coptidis Rhizoma, based on the effect-constituent index already established by our research group, and taking into consideration of homogeneity of clinical dosage and compliance of decoction, the uniformity of dispensing for different specification of Coptidis Rhizoma decoction pieces was studied. This research model was then applied to guide the specification-optimization of Coptidis Rhizoma and its clinical dispensing. The result indicated, effective constituent equivalence could reflect the fluctuation of specification, dosage and decoction to the fluctuation of efficacy; Optimized Coptidis Rhizoma decoction pieces had the characteristic of high homogeneity as for clinical dispensing, good compliance as for decoction, and high effective constituent equivalence. In conclusion, effective constituent equivalence could improve relevance of methods of TCM dispensing control to clinical effect. Preparated Superior-standard Decoction Pieces based on effective constituent equivalence was featured by good quality and a good practice of adjustable dosage, which could promote the development of TCM decoction pieces toward precision medicine.
Chemistry, Pharmaceutical ; methods ; Coptis ; chemistry ; Drugs, Chinese Herbal ; chemistry ; Quality Control ; Rhizome ; chemistry ; Therapeutic Equivalency

OBJECTIVETo study the protective effect of an extract of Guipi Pill () against radiation-induced damage.

METHODSA total of 100 Kunming mice were randomly divided into normal group, model group, positive drug group (treated with radioprotective agent "523", 5 mg/kg at 24 h before irradiation) and two treatment groups, with 20 mice in each group. The extract of water extraction-alcohol precipitation (WAP) from Guipi Pill were administered orally to the mice in the two treatment groups at the dose of 500 and 1,000 mg/kg, respectively, for 6 days prior to whole body radiation (8 Gy). Fifty mice with 10 in each group were used to observe the survival rate 30 days after radiation. The other 50 mice with 10 in each group were sacrificed on day 10 after radiation (6 Gy) in order to take blood, liver and unilateral femur.

RESULTSPretreatment prior to irradiation with WAP resulted in a significantly higher 30-day survival rate of mice after exposure to a potentially lethal dose of 8-Gy radiation. WAP could significantly increase the total white blood cell count and DNA content of bone marrow, and it also increased the activity of various antioxidant enzymes, such as superoxide dismutase, catalase, total antioxidant capacity and glutathione peroxidase in liver tissue of mice, which were reduced by radiation treatment. Maleic dialdehyde level and bone marrow micronucleus rate were significantly reduced by WAP, which were increased after 6-Gy radiation.

CONCLUSIONWAP of Guipi Pill could increase the 30-day survival rate and the antioxidant capacity as well as protect bone marrow in mice. WAP of Guipi Pill is an effective radioprotective agent.

Animals ; Antioxidants ; metabolism ; Bone Marrow ; pathology ; Chemical Precipitation ; DNA ; metabolism ; Drugs, Chinese Herbal ; therapeutic use ; Leukocyte Count ; Liver ; metabolism ; pathology ; radiation effects ; Male ; Mice ; Micronuclei, Chromosome-Defective ; Phytotherapy ; Plant Extracts ; pharmacology ; therapeutic use ; Protective Agents ; pharmacology ; therapeutic use ; Radiation Injuries, Experimental ; blood ; drug therapy ; prevention & control ; Survival Analysis ; Water

Fournier gangrene is a relatively rare clinical critical disease, and its clinical symptoms are not specific and easily unrecognized by some clinicians. It has the features of acute onset, quick development, severe illness, and often accompanied by infection shock which is seriously life-threatening. It is difficult in treatment with high medical costs and long length of hospitalization, which increases pain for patients and relatives and brings heavy economic and psychological burden on patients, society, and medical workers. By reviewing the literature home and abroad and combined with clinical practice, I summarize the researches on concept, epidemiology, clinical manifestation, diagnosis and treatment of Fournier gangrene, in order to provide reference for vast number of clinical workers.

OBJECTIVETo study the efficacy of the protocol of combination of lamivudine with low dosage hepatitis B immuno-globulin (HBIG) to prevent HBV reinfection and of the treatment for HBV reinfection after liver transplantation.

METHODSFrom December 2000 to May 2003, 11 patients (follow-up is more than 1 year) had been transplanted due to HBV related end-stage liver disease or hepatocellular carcinoma. All patients received the protocol of combination of lamivudine with low dosage HBIG to prevent HBV reinfection after liver transplantation. Lamivudine was administered for more than 2 weeks. Preoperatively patients with HBV-DNA(-) and HBeAg(-) accepted HBIG 2000 IU intramuscular injection. Patients with HBV-DNA(+) or HBeAg(+) before operation accepted HBIG 4000 IU intramuscular injection, and patients with both HBV-DNA(+) and HBeAg(+) before operation accepted HBIG 6000 IU intramuscular injection. All patients took long-term lamivudine postoperatively. They accepted HBIG 800 IU/d for 1 week after transplantation. Two weeks after operation, dosage of HBIG was adjusted so that the titer of HBsAb was higher than 500 IU/L, but lower than 1000 IU/L, and this treatment lasted for 6 months. 6 months after operation, dosage of HBIG was adjusted so that tite of HBsAb higher than 300 IU/L but lower than 500 IU/L, and this treatment lasted for 6 months. One year after operation, dosage of HBIG was adjusted so that tite of HBsAb was higher than 100 IU/L but lower than 300 IU/L, and this treatment lasted for a long time. Examinations of liver function, HBV-DNA and hepatitis B were regularly taken. To observe the early turning to be negative rate, the later HBV reinfection rate, and the efficacy of the treatment for HBV reinfection.

RESULTSHBsAg, HBeAg and HBV-DNA in all patients turned to be negative in 1-4 days after operation. All patients responded to HBIG, and level of titer of HBsAb was elevated gradually. All patients was alive during the observation time. The regular examination of HBsAb showed that of HBsAb was in line with our expectation. Hepatitis B recurrence occurred in 1 patient 25 months after transplantation. Through using adefovir and adding the dosage of HBIG, the hepatitis B is in control.

CONCLUSIONSThe protocol of combination of lamivudine with low dosage HBIG proved to be highly effective and safe in preventing the recurrence of HBV after liver transplantation. It also reduced the cost obviously.

Administration, Oral ; Adult ; Antiviral Agents ; therapeutic use ; Carcinoma, Hepatocellular ; surgery ; Combined Modality Therapy ; Female ; Hepatitis B, Chronic ; prevention & control ; Humans ; Immunization, Passive ; Immunoglobulin G ; administration & dosage ; Injections, Intramuscular ; Lamivudine ; therapeutic use ; Liver Failure ; surgery ; Liver Neoplasms ; surgery ; Liver Transplantation ; Male ; Middle Aged ; Retrospective Studies ; Secondary Prevention

OBJECTIVETo retrospectively evaluate the effects of Gamma knife in the treatment of cerebral hemangioblastomas.

METHODSFrom 1993 to 1996, seventeen patients with 29 hemangioblastomas were treated with Gamma knife. The patients mean age was 35 years (range: 16 - 61 years). The mean tumor diameter was 16 mm (range: 6 - 55 mm). Thirteen patients had recurrent or residual hemangioblastomas. Four with primary hemangioblastomas were diagnosed using CT, MRI and DSA. The maximum dose to the tumors was 21.0 - 50.0 Gy, with mean dose of 33.7 Gy. The radiation dose to the periphery of tumors was 12.0 - 24.0 Gy, with mean dose of 17.6 Gy.

RESULTSAll the patients had been followed up for 18 to 62 months, with mean 46 months. Five patients experienced clinical improvement and reduction in tumor volume, and 5 remained stable and tumor unchanged in volume during the follow-up period. Three patients died of tumor progression, surgery and cancer after treatment 18, 22, 25 months respectively. Four patients underwent surgery respectively at 3, 4, 29 and 48 months after gamma knife operation. The local control rate of the tumors at 1 year was 92%, 2 years 88%, 3 years 80% and 4 years 75%. Pathological findings in these patients showed varying degrees of small vessel thickening and occlusion together with degeneration, necrosis in the center of tumor and loss of tumor cells at periphery.

CONCLUSIONSGamma knife is not adequately reliable for the control of hemangioblastoma cysts, it is an effective treatment of small or medium-size solid tumors, but long-term follow-up is needed. The recommended dose is 16 to 20 Gy.

Adolescent ; Adult ; Brain Neoplasms ; surgery ; Female ; Follow-Up Studies ; Hemangioblastoma ; surgery ; Humans ; Male ; Middle Aged ; Radiosurgery ; adverse effects ; methods ; Treatment Outcome ; Young Adult

Adult ; Female ; Hamartoma ; complications ; diagnosis ; surgery ; Humans ; Kidney Calculi ; complications ; Spleen ; pathology ; surgery ; Splenectomy ; methods ; Splenic Diseases ; complications ; diagnosis ; surgery

OBJECTIVETo investigate and compare therapeutic effects of sphincter-preserving operation and Miles operation for rectal cancer.

METHODSA retrospective analysis was carried out in 572 cases of rectal cancer operations performed from January 1980 to December 2006.

RESULTSSphincter-preserving operation was carried out in 403 cases and Miles procedure in 169 cases. The follow-up rate was 76.2% (436/572) with a period of 0.5 - 25.0 years (median, 9.5 years). Local recurrence occurred in 6.3% (20/317) of sphincter-preserving operation and 7.6% (9/119) of Miles operation, the differences was not significant (chi2 = 1.3942, P > 0.05). Distal metastasis was found in 50 cases (15.7%) of sphincter-preserving operation and 19 cases (16.2%) of the Miles operation with no significant difference (chi2 = 0.6672, P > 0.05). There was no significant difference in five-year survival rate between the two groups, with 67.8% in sphincter-preserving operation and 67.2% in Miles operation.

CONCLUSIONSSphincter-preserving operations can improve the quality of life in rectal cancer although with the same five-year survival rate and recurrence rate as Miles operation. The operation for rectal cancer should be performed individually according to the location, the bionomics and the clinical stage.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anal Canal ; Female ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Quality of Life ; Rectal Neoplasms ; mortality ; surgery ; Retrospective Studies ; Surgical Procedures, Operative ; methods ; Survival Rate ; Treatment Outcome

OBJECTIVETo investigate the clinical efficacy, feasibility and safety of sphincter-preserving procedure by casing anastomosis of colon and rectal mucosa in low rectal cancer.

METHODSA retrospective analysis was carried out in 231 cases of low rectal cancer performed casing anastomosis.

RESULTSOne hundred and ninety-seven (197/231, 85.3%) cases were followed up, the median time of the follow up was 5.9 years (range, 2 months-14 years). Eight (3.4%) cases of stoma leak and 3 (1.2%) cases of stoma stenosis were found post operation. Defecating function recovered normally (1 - 3 times per day) in 12 - 24 weeks after operation in all patients. Local recurrence was found in 5.1% (10/197) of the cases. Hepatic and lung metastasis was found in 15.2% (30/197) and 2.5% (5/197) of the patients, respectively. The five-year survival rate was 71.6% totally.

CONCLUSIONSThe casing anastomosis procedure with sphincter preservation is safe and efficacy for low rectal cancer. With the procedure, the anal function can be preserved well, stoma leak is decreased, and the five-year survival rate is the same as Miles operation.

Adult ; Aged ; Aged, 80 and over ; Anal Canal ; Anastomosis, Surgical ; methods ; Feasibility Studies ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Rectal Neoplasms ; surgery ; Retrospective Studies ; Treatment Outcome