[Evaluation of the efficacy of phenobarbital in treatment of epilepsy in rural areas: study of 2455 patients in rural China].

OBJECTIVE: To evaluate the efficacy of phenobarbital in treatment of patients with convulsive forms of epilepsy in rural areas and to develop a suitable relevant model for rural China. METHODS: A demonstration protocol was conducted in the rural areas of 8 counties from 6 provinces and municipality in China, Heilongjiang, Ningxia, Henan, Jiangsu, Shanxi, and Shanghai from December 2001 to June 2004. Epidemiological investigation of the prevalence and treatment gap of epilepsy was carried out. Patients with convulsive forms of epilepsy thus screened underwent treatment of phenobarbital. Physicians of township hospitals received short-term training to be in charge of the treatment and regular follow-up of the patients. RESULTS: A total of 2455 patients with generalized tonic-clonic seizures in these 6 rural areas were screened and entered the treatment group. 347 patients (26.2%) had been seizure-free during the period of these 2 years, 415 patients (31.3%) had their seizure frequencies decreased by > 75% as compared with those during the period of 6 months before treatment, and the conditions of 26.1% of the patients did not change or even became worse. About 26.1% of the patients had mild side effects, 3.7% had moderate side effects, and only 0.3% had severe side effects when the dosage of phenobarbital in the first 3 months was increased. 597 patients (24.3%) withdrew from the treatment group because of various reasons. CONCLUSION: This protocol was suitable to the rural areas of China. The trained physicians are capable of fulfilling the task to treat the patients with epilepsy. Phenobarbital is an effective drug for most patients with convulsive seizures and has no severe side effect.

[Analysis of 994(G--> T) mutation in the plasma platelet-activating factor acetylhydrolase gene in the patients with cerebral infarction].

OBJECTIVE: To investigate the relationship between plasma platelet-activating factor acetylhydrolase (PAF-AH) gene 994(G--> T) mutation in exon 9 and the patients with cerebral infarction in Chinese Hans. METHODS: The authors conducted a case-control study including 108 patients in three groups (atherosclerotic cerebral infarction group, lacunar infarction group and cerebral embolism group) and 215 normal subjects as controls. Genomic DNA was analyzed for the mutant allele by a specific polymerase chain reaction. RESULTS: The frequency of the mutant genotype in the 102 patients with cerebral infarction was 35.19%(32.41% heterozygotes and 2.78% homozygotes), and was 38.10%(34.92% heterozygotes and 3.18% homozygotes) in the atherosclerotic cerebral infarction group, being all significantly higher than the control group's 20.46% (18.60% heterozygotes and 1.86% homozygotes)(P< 0.01); however, the frequencies of the mutant genotype in the lacunar infarction group and cerebral embolism group were 32.35% (29.41% heterozygotes and 2.94% homozygotes) and 27.27% (27.27% heterozygotes and 0 homozygotes) respectively, being not statistically different from those of the controls (P> 0.05). CONCLUSION: These findings show that the 994(G--> T) mutation of plasma PAF-AH gene may be an independent risk for atherosclerotic cerebral infarction, but not for lacunar infarction.

Age-related increase of plasma platelet-activating factor concentrations in Chinese.

BACKGROUND: Platelet-activating factor (PAF) is a potent bioactive phospholipid, which may be one of the determinants of atherogenesis. The purpose of this study was to investigate the relationship between the concentrations of plasma platelet-activating factor and age in a common Chinese population. METHODS: Two-hundred seventy-nine Han nation subjects (male: n=162; female: n=117) who had visited two hospitals for overall health survey, as an annual medical check-up or for other reasons by clinical examinations were recruited and divided into six age groups (21-30, 31-40, 41-50, 51-60, 61-70, 71-80 years). PAF was extracted from their plasma and purified by thin-layer chromatography (TLC). The PAF concentrations were detected by radioimmunoassay. RESULTS: The PAF concentrations (pg/ml) in plasma showed significantly age-related increase (r=0.3348, P<0.01, n=279). In the 21-30-year group, the PAF concentration was 338+/-96 pg/ml. Except for the 31-40-year group, the PAF concentrations in other four groups were all higher than that of the 21-30-year group (P<0.05, P<0.01, P<0.001 and P<0.001, respectively). CONCLUSIONS: Considering PAF is one of the key factors relevant to progression of atherogenesis, and the high concentrations of plasma PAF may therefore serve as a marker for the risk of atherosclerosis. Adjustment of the concentrations of plasma PAF correlated with aging may be helpful to reducing the prevalence rate of multi-senile arteriosclerosis occlusive diseases.