OBJECTIVETo investigate the species of Ligularia distributed in the northwestern China and their medicinal uses in the local area.

METHODField investigation, specimen collection, taxonomic study and datum check were adopted.

RESULTThere are 29 species and 1 varieties of Ligularia distributed in the northwestern China, and 18 species of them had been used as folk medicines with the function of resolving phlegm, relieving cough, clearing heat and toxins.

CONCLUSIONThe northwestern China is abundant in medicinal resource of Ligularia.

Anti-Asthmatic Agents ; isolation & purification ; pharmacology ; Antitussive Agents ; isolation & purification ; pharmacology ; Asteraceae ; chemistry ; classification ; China ; Conservation of Natural Resources ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Ecosystem ; Humans ; Hypnotics and Sedatives ; isolation & purification ; pharmacology ; Pharmacognosy ; Plants, Medicinal ; chemistry ; classification

Congenital nephrogenic diabetes insipidus (CNDI) is a rare inherited disorder characterized by insensitivity of the kidney to the antidiuretic effect of vasopressin. There are three inheritance patterns of CNDI: the X-linked recessive form associated with vasopressin V2 receptor gene mutations, and the autosomal recessive and dominant forms associated with aquaporin-2 gene (AQP2) mutations. The evaluation for polyuria and polydipsia in a one-month-old Korean girl revealed no response to vasopressin and confirmed the diagnosis of CNDI. Because the child was female without family history of CNDI, her disease was thought to be an autosomal recessive form. We analyzed the AQP2 gene and detected a compound heterozygous missense point mutation: (70)Ala (GCC) to Asp (GAC) in exon 1 inherited from her father and (187)Arg (CGC) to His (CAC) in exon 3 inherited from her mother. The first mutation is located within the first NPA motif of the AQP2 molecule and the second one right after the second NPA motif. This is the first report to characterize AQP2 mutations in Korean patients with autosomal recessive CNDI, and expands the spectrum of AQP2 mutations by reporting two novel mutation, (70)Ala (GCC) to Asp (GAC) and (187)Arg (CGC) to His (CAC).
Aquaporin 2/*genetics ; Base Sequence ; Child, Preschool ; DNA/genetics ; DNA Mutational Analysis ; Diabetes Insipidus, Nephrogenic/congenital/*genetics ; Female ; Genes, Recessive ; Heterozygote ; Humans ; Infant ; Male ; Mutation, Missense ; Point Mutation ; Research Support, Non-U.S. Gov't

OBJECTIVETo clarify the resource of medicinal plants of genus Polygonum s. lat. distributed in Anhui Province.

METHODConducting field investigation and consulting related specimens and data.

RESULT AND CONCLUSIONThe distribution, growing environment and medicinal use of 32 taxa have been clarified. A scientific basis for further study for these medicinal plants has been provided.

Analgesics, Non-Narcotic ; pharmacology ; Antidiuretic Agents ; pharmacology ; China ; Conservation of Natural Resources ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Ecosystem ; Pharmacognosy ; Plants, Medicinal ; anatomy & histology ; chemistry ; classification ; Polygonum ; anatomy & histology ; chemistry ; classification

BACKGROUNDThe hybrid procedure for coronary heart disease combines minimally invasive coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) and is an alternative to revascularization treatment. We sought to assess the predictive value of four risk-stratification models for risk assessment of major adverse cardiac and cerebrovascular events (MACCE) in patients with multivessel disease undergoing hybrid coronary revascularization.

METHODSThe data of 120 patients were retrospectively collected and the SYNTAX score, EuroSCORE, SinoSCORE and the Global Risk Classification (GRC) calculated for each patient. The outcomes of interest were 2.7-year incidences of MACCE, including death, myocardial infarction, stroke, and any-vessel revascularization.

RESULTSDuring a mean of 2.7-year follow-up, actuarial survival was 99.17%, and no myocardial infarctions occurred. The discriminatory power (area under curve (AUC)) of the SYNTAX score, EuroSCORE, SinoSCORE and GRC for 2.7-year MACCE was 0.60 (95% confidence interval 0.42 - 0.77), 0.65 (0.47 - 0.82), 0.57 (0.39 - 0.75) and 0.65 (0.46 - 0.83), respectively. The calibration characteristics of the SYNTAX score, EuroSCORE, SinoSCORE and GRC were 3.92 (P = 0.86), 5.39 (P = 0.37), 13.81 (P = 0.32) and 0.02 (P = 0.89), respectively.

CONCLUSIONSIn patients with multivessel disease undergoing a hybrid procedure, the SYNTAX score, EuroSCORE, SinoSCORE and GRC were inaccurate in predicting MACCE. Modifying risk-stratification models to improve the predictive value for a hybrid procedure is needed.

Aged ; Angioplasty, Balloon, Coronary ; adverse effects ; methods ; Coronary Artery Bypass ; adverse effects ; methods ; Coronary Artery Disease ; mortality ; surgery ; therapy ; Female ; Humans ; Male ; Middle Aged

OBJECTIVETo investigate the safety and efficacy of basiliximab as induction agent in preventing early acute rejection post heart transplantation.

METHODSBasiliximab (20 mg, iv) was administered one hour before and 4 days post operation to patients (n = 47) underwent heart transplantation between June 2004 and Feb 2005 in our department. Intravenous methylprednisolone (500 mg at operation beginning and repeated immediately post operation, followed by 125 mg every 8 hours for the first day). Prednisone was then initiated at 1 mg.kg(-1).d(-1) tapered 10 mg every 3 days to 10 mg/d. Mycophenolate mofetil (MMF, 0.5 - 1.0 g twice daily) was also administered post intubation, oral Cyclosporine A (CsA, 3 to 6 mg.kg(-1).d(-1)) was prescribed after transplantation if serum creatinine was < 150 micromol/L. The dose of CsA was individually adjusted to achieve a target serum concentration of 180 - 300 ng/ml. Endomyocardial biopsies were performed 3 weeks (19.7 +/- 9.6) d post heart transplantation. Biopsy specimens were graded according to the standardized criteria of the International Society for Heart and Lung Transplantation (ISHLT). Echocardiograms were routinely performed weekly within the first 3 weeks post-operation.

RESULTSAll 47 consecutive patients [mean age (44.9 +/- 13.4) years, range 13 - 63 years, 38 men] survived the operation and the underlying diseases was idiopathic cardiomyopathy (42.5%), ischemic heart disease (25.5%), arrhythmogenic right ventricular cardiomyopathy (17.0%), hypertrophic cardiomyopathy (4.2%), heart tumor (4.25%), valve heart disease (2.1%), hypertensive cardiomyopathy (2.1%) and giant cell myocarditis (2.1%). There were 4 patients with pre-operation PRA > 10% and CDC was less than 5% in all patients. The grades of the acute rejection in biopsy specimens were as follow: Grade (G) 0 in 30 (63.8%), G IA in 11 (23.4%), G IB in 3 (6.3%) and GII in 3 (6.3%) patients. The average dose of MMF was (1.2 +/- 0.3) g/d. The initial time of receiving CsA was (3.4 +/- 2.1) day post operation. The average cumulative dose of CsA was (4.1 +/- 1.2) mg.kg(-1).d(-1) before endomyocardial biopsy. The average serum concentration of CsA was (237.0 +/- 76.2) ng/ml. Left ventricular ejection fraction assessed by echocardiogram was normal in all patients within the first 3 weeks. Five patients suffered from respiratory infections and recovered post antibiotic and symptomatic therapies.

CONCLUSIONBasiliximab as induction agent in combination with conventional triple immunosuppressive therapy is safe and effective in preventing acute rejection in Chinese cardiac transplantation receipts.

Adolescent ; Adult ; Antibodies, Monoclonal ; adverse effects ; therapeutic use ; Female ; Graft Rejection ; prevention & control ; Heart Transplantation ; adverse effects ; immunology ; Humans ; Male ; Middle Aged ; Recombinant Fusion Proteins ; adverse effects ; therapeutic use ; Young Adult

IgA nephropathy(IgAN) is the most common glomerulonephritis(GN) in worldwide, and accounts for 20% to 40% of all patients with primary GN in Korea. IgAN has diverse clinical courses, but the risk factors affecting the deterioration of renal function are not established. Recently, there were some suggestions that systemic or local expression of peptides of angiotensin system exerts several effects on the progression of renal disease, and the genetic polymorphisms may associated with peptide expression. To evaluate the role of genetic polymorphism of angiotensin I converting enzyme(ACE) polymorphism in the progression of IgAN, the genotypic distributions in 278 biopsy-proven cases of IgAN were studied, which had undergone a renal biopsy at Seoul National University Hospital, between 1979 and 2000. We also compared the genotypes with clinical manifestations to evaluate the clinical implications of genetic polymorphism. The study shows that there was no difference in the ACE genotype frequencies between the patients (II : 26.6%, ID : 55.0%, DD : 18.4%) and normal controls(II : 31.4%, ID : 57.4%, and DD : 11.2%). Seventy- two percent and 48% of patients maintained renal function for 10 years and 20 years after the initial diagnosis in 278 patients, respectively. However, in 153 patients who were followed more than 5 years, the DD genotype was more prevalent in patients with deteriorating renal function than in those with stable renal function(31.8% vs. 13.8%; p=0.0146). Presence of systemic hypertension increased the risk of renal disease progression(OR=3.3), and it was showed 7.4 fold risk whenever the creatinine was increased by 1 mg/dL. Renal disease progression is not associated with DD genotype among normotensive patients at the biopsy. But, in patients with hypertension, II and DD/ID genotypes have an increased risk for disease progression when compared with II genotype of normotensive patients(OR=1.4, OR=7.8; respectively). ACE polymorphisms did not have any interaction with the levels of serum creatinine at the time of biopsy in our patients. Our results suggested that ACE genotypes(D allele) affected the progression of IgAN, especially in hypertensive patients. One of the prospects of the present study is the potential for screening high risk individuals, thus helping to develop a practical application of the molecular findings in clinical practice.
Angiotensin I* ; Angiotensins* ; Biopsy ; Creatinine ; Diagnosis ; Disease Progression ; Genotype ; Glomerulonephritis, IGA* ; Humans ; Hypertension ; Immunoglobulin A* ; Korea ; Mass Screening ; Peptides ; Peptidyl-Dipeptidase A* ; Polymorphism, Genetic ; Risk Factors ; Seoul

Uteroglobin(UG) is an anti-inflammatory/immunomodulatory protein secreted by the epithelial cells of vertebrates. Targeted disruption of UG rendered mouse glomerulonephritis resembling IgA nephropathy(IgAN). Sequence analysis on exon 1 of UG showed several putative binding sites for transcription factors, and genetic polymorphisms in this site might influence the expression level of UG as a competitive protein. We speculated that the single nucleotide polymorphism at the 38th nucleotide from the transcription initiation site of UG exon 1 would impact the progression of IgAN. PCR-RFLP was instituted to determine the genetic polymorphism in 60 patients with IgAN. Other measures like SSCP and direct sequencing were also adopted for the verification of polymorphic sites. Seventeen patients with IgAN(28%) were homozygous for adenine at position 38(38AA), 26 patients(43%) were heterozygous(38AG), and 17 patients(28%) were homozygous for the polymorphism(38GG), which was similar to the pattern obtained from the 60 normal controls. The amount of daily proteinuria, presence of hypertension, the level of IgA, and the amount of IgA-fibronectin(FN) complexes was similar between the genotypes. Serum IgA-FN level did not influence the progression of disease. However, 8 out of 17 patients (47%) with the AA genotype had progressive disease(PD), 10 of 26 patients(38%) with the AG genotype had PD, and only 1 of 17 patients(6%) with GG homozygocity had PD after 94+/-30.1 months of follow-up(mean+/-S.D.). The odds ratio for the progression of renal disease in patients with the AA genotype was 14.93(p=0.0355) and in patients with AG genotype was 12.94(p=0.0496) compared with patients have the GG genotype. Moreover, serum creatinine at the time of kidney biopsy was higher in patients with AA and AG genotypes than in patients with the GG genotype(1.5+/-0.69 : 1.3+/-0.53 : 1.0+/-0.31mg/dL; AA : AG : GG; p=0.0137 AA vs. GG; p=0.0269 AG vs. GG). Our results suggest that polymorphism at the 5' UTR region of UG exon 1 is an important marker for the progression of IgAN.
5' Untranslated Regions* ; Adenine ; Animals ; Binding Sites ; Biopsy ; Creatinine ; Epithelial Cells ; Exons* ; Genotype ; Glomerulonephritis ; Glomerulonephritis, IGA* ; Humans ; Hypertension ; Immunoglobulin A* ; Kidney ; Mice ; Odds Ratio ; Polymorphism, Genetic ; Polymorphism, Single Nucleotide ; Polymorphism, Single-Stranded Conformational ; Proteinuria ; Sequence Analysis ; Transcription Factors ; Transcription Initiation Site ; Uteroglobin* ; Vertebrates

OBJECTIVETo evaluate the efficacy of one-stop hybrid coronary revascularization [simultaneous minimally invasive direct coronary artery bypass surgery (MIDCAB) and percutaneous coronary intervention (PCI) procedures performed in an enhanced (or called "hybrid") operative unit] for the treatment of unprotected left main coronary artery (ULMCA) disease.

METHODSFrom June 2007 to April 2009, 14 patients [13 male, mean age: (60.4 +/- 15.4) years] underwent the one-stop hybrid approach in the "hybrid" operating room. Proximal lesions were evidenced in 5 patients and distal or bifurcation lesions in 11 patients. MIDCAB procedure for grafting of the left intramammary artery (LIMA) with the left anterior descending (LAD) artery was first performed via lower partial ministernotomy on the beating heart, followed by PCI on the LMCA disease and non-LAD coronary lesions.

RESULTSOperation was successful in all patients underwent the one-stop hybrid procedure. LIMA grafts were used in all 14 patients and confirmed to be patent by angiography. A total of 25 non-LAD coronary lesions were treated by PCI and 29 stents (27 drug-eluting stents and 2 bare-mental stents) were implanted to 23 lesions and coronary angioplasty was performed in the remaining lesions. There was no death, perioperative myocardial infarction, stroke or repeat revascularization during the procedure and the follow-up period. All the patients remained free from angina during the 7.9 months (range 1 - 15 months) follow-up period. LIMA grafts and stents were patent in 5 patients at 1-year follow-up.

CONCLUSIONSOur initial experience demonstrates that one-stop hybrid coronary revascularization provides a reasonable, feasible and safe alternative for selected patients with LMCA diseases.

Adult ; Aged ; Aged, 80 and over ; Angioplasty, Balloon, Coronary ; Coronary Artery Bypass, Off-Pump ; Coronary Artery Disease ; therapy ; Female ; Humans ; Male ; Middle Aged ; Myocardial Revascularization ; methods ; Treatment Outcome

Recent studies indicate that insulin-sensitizing activity of TZDs occurs through the inhibition of PPARγ Ser273 phosphorylation mediated by cyclin-dependent kinase 5(Cdk5), which is resulted from the binding activity for PPARγ. While, the side effects of TZDs may be related to the agonistic potency for PPARγ. In this article, 15 target compounds were designed and synthesized based on the structure of PPAR γ partial agonist INT131, with the aim of maintaining the insulin-sensitizing activity and reducing the side effects of INT131. The structures of these compounds were confirmed by ¹H NMR and ESI-MS, and their binding activities and agonistic potencies for PPARγ were measured. The binding activity of compound 15 is 88.47% of rosiglitazone, which is similar to INT131 (98.55%), but the agonistic potency of compound 15 is 1.41% of rosiglitazone, obviously lower than INT131 (15.18%).