[Curative effects of Ningmitai capsules on the residual fragments and postoperative complications following lithotripsy treatment of upper urinary calculi].

Objective: To observe the clinical efficacy of Ningmitai capsules, a traditional Chinese medicine using for clearing heat and dampness, in the treatment of residual fragments and postoperative complications following lithotripsy for upper urinary stones. Methods: During October 2016 and March 2018, patients from Wuhan 1st Hospital, Wuhan 2nd Hospital, Wuhan 3rd Hospital, and Wuhan Puai Hospital having upper urinary residual fragments following minimally-invasive stone treatment were randomly assigned to control group and Ningmitai group with a proportion of 1∶3. The patients in control group were treated with antibiotics or sodium diclofenac suppository on demand, while patients in Ningmitai group took additional Ningmitai capsule orally (4 capsules per time, 3 times per day). The observation was started when a patient was enrolled in this study and continued for a maximum of 12 weeks or until stone-free status. During the observation, the stone expulsion time, stone-free time, stone-free rate were observed, and the difference in curative effect between the two groups on postoperative complications such as pain and infection were compared. Statistical analysis was done using t-test or χ2 test by GraphPad Prism 5 software. Results: Totally 269 cases enrolled in this study. Eighty-six patients were from Wuhan 1st Hospital, 69 patients from Wuhan 2nd Hospital, 58 patients from Wuhan 3rd Hospital, 56 patients from Wuhan Puai Hospital, respectively. There were 66 cases in control group and 203 cases in Ningmitai group. The residual fragments expulsion time in Ningmitai group was significantly earlier than that in control group ((4.5±0.4) days vs. (7.5±1.3) days, t=2.877, P=0.004), the residual fragments clearance time in Ningmitai group was significantly shorter than that in control group ((13.6±1.0) days vs.(25.6±3.8) days, t=4.252, P=0.000), and the stone-free rate within 4 weeks post operation in Ningmitai group was significantly higher than control group (91.6% vs. 68.2%, χ2=22.57, P=0.000). After 12 weeks of treatment, the total effective rate of control group was 89.4%, and the total effective rate of Ningmitai group was 99.5%, with statistically significant difference (χ2=17.65, P=0.000). The proportion of caregivers that offered analgesia in Ningmitai group was significantly lower than that in control group (16.3% vs. 30.3%, χ2=6.212, P=0.013), the recovery rate of routine urinalysis following 4 weeks' treatment was significantly higher in Ningmitai group than that in control group (88.2% vs.71.2%, χ2=10.67, P=0.001). No obvious adverse effects were observed in both groups. Conclusions: Ningmitai capsule can facilitate the stone passage and increase the stone-free rate in the treatment of residual fragments and postoperative complications of upper urinary stones. It is also helpful for the prevention and treatment of postoperative pain, infection and other complications.

Effect of prenatal exposure to polychlorinated biphenyls on cognitive development in children: a longitudinal study in Taiwan.

BACKGROUND: From 1978 to 1979, a group of people in Taiwan were exposed to high levels of heat-degraded polychlorinated biphenyls (PCBs) owing to accidental ingestion of contaminated rice oil. Children born to mothers following the exposure ('Yucheng' children) were known to have hyperpigmented skin and other dysmorphology after birth. AIMS: To determine the effect of prenatal exposure to PCBs on cognitive development in Yucheng children. METHOD: One hundred and eighteen Yucheng children prenatally exposed to PCBs and degradation products, and community-matched control children who were exposed to background levels only, were followed from 1985 to 1998. The Bayley Scale for Infant Development, Chinese version of the Stanford-Binet IQ Test, Raven's Coloured Progressive Matrices and Raven's Standardised Progressive Matrices were used to assess the cognitive development of these children. RESULTS: The Yucheng children scored lower than control children on each of these methods of measurement between the ages of 2 and 12 years. CONCLUSIONS: Prenatal exposure to PCBs and their derivatives has long-term adverse effects on cognitive development in humans.

Menstruation and reproduction in women with polychlorinated biphenyl (PCB) poisoning: long-term follow-up interviews of the women from the Taiwan Yucheng cohort.

BACKGROUND: In 1979 in Taiwan, about 2000 people were poisoned by cooking oil contaminated with heat-degraded polychlorinated biphenyls (PCBs). Victims developed chloracne and other symptoms; the illness is called Yucheng (oil disease). The chemicals persist in the victims' bodies and some are toxic to the female reproductive system in experimental animals. METHODS: In 1993-1994, we identified the living Yucheng women and neighbourhood controls and interviewed them about their reproductive experience. Of the 596 living Yucheng women aged 30-59 years, we found 368, and interviewed 356. We identified 329 controls, and interviewed 312. RESULTS: Of the Yucheng women, 16% reported abnormal menstrual bleeding compared to 8% (P < 0.05) of control women; 4.2% versus 1.7% reported a stillbirth since 1979 (P = 0.068). Other characteristics of the menses, fertility, frequency of intercourse, and age at menopause appeared unaffected. More of the Yucheng women reported that one of their offspring had died during childhood (10.2% versus 6.1%, P < 0. 05), and that they had decided to limit childbearing because of health problems (7% versus 2%, P = 0.01). CONCLUSIONS: These findings suggest that high level PCB/polychlorinated dibenzofuran (PCDF) exposure has some effect on female endocrine and reproductive function.

[The clinical value of click stimuli on the measurement of ipsilateral acoustic reflex thresholds].

OBJECTIVE: To define that click can substitute for pure tone as a stimulus to measure ipsilateral acoustic reflex thresholds, and to find out the effect of probe frequency on acoustic reflex thresholds. METHOD: Using middle ear analyzer (GSI 33, version 2), we measured 23 normal voluntary participants (46 ears) for getting the pure-tone generated ipsilateral acoustic reflex thresholds at different probe frequency and the click evoked ipsilateral acoustic reflex thresholds at click rate 100/s and 180/s for every ear. RESULT: For pure tone, the ipsilateral acoustic reflex thresholds at 500 Hz, 1000 Hz, 2000 Hz, were (84.35 +/- 6.96) dB, (84.65 +/- 5.93) dB, (87.96 +/- 6.36) dB by using 226 Hz probe; (93.13 +/- 6.54) dB, (92.70 +/- 6.33) dB, (93.35 +/- 5.99) dB by using 678 Hz probe; (86.52 +/- 4.72) dB, (87.48 +/- 5.00) dB, (88.30 +/- 6.16) dB by using 1000 Hz probe. For click, the ipsilateral acoustic reflex thresholds at click rate 100/s and 180/s were (89.78 +/- 6.83) dB, (92.07 +/- 7.42) dB by using 226 Hz probe; (90.44 +/- 6.76) dB, (90.65 +/- 6.38) dB by using 678 Hz probe; (88.04 +/- 6.87) dB, (88.69 +/- 7.42) dB by using 1000 Hz probe. The acoustic reflex thresholds for 678 Hz probe were higher than those obtained with 226 Hz and 1000 Hz probes. CONCLUSION: There were no artifact appearance while stimulus had been click at low rate, so click can be used for the measurement of ipsilateral acoustic reflex thresholds.

Effects of vitamin E and/or C on reactive oxygen species-related lead toxicity in the rat sperm.

This study was undertaken to investigate whether treatment with vitamin E (VE) and/or vitamin C (VC) protects rat sperm by inhibiting reactive oxygen species generation induced by lead (Pb) exposure. Male Sprague-Dawley rats were assigned to the following five groups: vitamin-unsupplemented; 150 mg VE/kg chow supplemented; 300 mg VE/kg chow supplemented; 500 mg VC/l drinking water supplemented and 150 mg VE/kg chow + 500 mg VC/l drinking water supplemented group. Rats in each group were divided into Pb-unexposed and Pb-exposed subgroups, received weekly intraperitoneal injection of 10 mg sodium acetate or 10 mg Pb acetate/kg for 6 weeks, respectively. The blood and sperm Pb levels were analyzed by graphite furnace atomic absorption spectrophotometer. Chemiluminescence was measured to evaluate the generation of sperm reactive oxygen species (ROS). Motility and sperm-oocyte penetration rate (SOPR) were measured. In Pb-unexposed rats, epididymal sperm counts, motility, ROS, and SOPR were not different in the five supplemented groups. Lead exposure might decrease the defense capacity of sperm to the oxidative stress and therefore elevate the ROS generation, reduce sperm motility, and reduce SOPR. Supplementation with VE and/or VC reduced ROS generation, prevented loss of motility and capacity of oocyte penetration in Pb-exposed rats. This study suggests that supplementation with VE and/or VC inhibits Pb-related ROS generation, protects spermatozoa from loss of motility and oocyte penetration capability.

Blood serum levels of PCBs and PCDFs in Yucheng women 14 years after exposure to a toxic rice oil.

In 1979, a mass poisoning of more than 2000 people occurred in central Taiwan due to consumption of rice-bran oil contaminated with PCBs and their heat-degraded byproducts. The incident was later referred to as Yucheng (oil disease). Serum samples from 56 women with the 1979 exposure were collected in February 1992 and analyzed for their contaminant content using sample enrichment and isotope dilution mass spectrometry. In most of the samples, levels of PCDFs and PCBs were detectable, and the median values of 2,3,4,7,8-PCDFs and 1,2,3,4,7,8-PCDFs were 1,030 and 2,220 ng/kg serum lipid, respectively. The median level of the total PCBs on a whole weight basis was 8,730 ng/kg. The PCB/PCDF concentrations in Yucheng women 14 years after the toxic exposure were still one to two orders of magnitude higher than controls. Concentrations of PCB levels in 1992 were positively correlated with the 1980-1981 measured PCB levels in these women and both PCBs and PCDFs were negatively correlated with the total duration when these women breast fed their children between 1979 and 1992. It is concluded that serum levels of congener-specific PCBs/PCDFs in exposed women are good indicators of previous exposure and may provide important information for more reliable estimation of dose-response relationship.

Middle-ear disease in children exposed prenatally to polychlorinated biphenyls and polychlorinated dibenzofurans.

During 1978 and 1979, an episode of poisoning from ingestion of rice oil contaminated with polychlorinated biphenyls and polychlorinated dibenzofurans occurred in central Taiwan. We followed-up children who had been born between June 1978 and March 1985, as well as matched unexposed children. The mothers of exposed children had consumed contaminated oils before the children were born. In 1993, otolaryngologists examined the middle ear of each child with a pneumatic otoscope, and they measured the middle-ear pressure by tympanometry with a Rion RS20 impedance audiometer. The exposed children had a significantly higher prevalence of middle-ear diseases than their matched controls. The exposed children who had ear diseases had higher serum levels of 2,3,4,7,8-pentachloro- and 1,2,3,4,7,8-hexachloro-dibenzofurans than the children who did not have similar diseases. Therefore, in this study, children exposed to polychlorinated biphenyls and polychlorinated dibenzofurans had a higher incidence of middle-ear diseases than their controls.

Increased mortality from chronic liver disease and cirrhosis 13 years after the Taiwan "yucheng" ("oil disease") incident.

In 1979, a mass poisoning involving some 2,000 persons occurred in central Taiwan from cooking oil contaminated by polychlorinated biphenyls (PCBs) and their heat-degraded byproducts, including polychlorinated dibenzofurans (PCDFs). The responsible health department registered cases for clinical purposes between 1979 and 1983. The exposed persons are referred to as the "yucheng" (oil disease) cohort. PCBs and PCDFs are toxic chemicals widely dispersed in the environment and in human tissue, which persist long after exposure. The consequences of exposure to these agents are not well understood. We traced the cohort through December 31, 1991, and compared overall and cause-specific mortality of 1,837 "yucheng" subjects with age, gender, and calendar time-specific mortality rates for the Taiwan general population. Eighty-three deaths were identified from 23,404 observed person-years. Even though the overall standardized mortality ratio (SMR) was 0.8 (95% confidence interval (CI) 0.7-1.0), there was a substantial elevation in the mortality rate for chronic liver disease and cirrhosis (10 deaths, SMR = 2.7, 95% CI = 1.3-4.9). Mortality from malignant neoplasms and other causes was not significantly different from that of the Taiwan population. PCB/PCDF exposure appears to promote the development of severe liver disease, perhaps in combination with known risk factors such as infection with hepatitis B virus. Further follow-up of this young cohort is necessary to see if the consequences include hepatic cancer.

Three-year survey of blood lead levels in 8828 Taiwanese adults.

The purpose of this study was to investigate environmental lead exposure in the general Taiwanese population. A total of 8828 Taiwanese adults selected by a multistage sampling method were investigated. Characteristics of the participants were ascertained by questionnaire and 10 ml venous blood was drawn by public health nurses. The blood specimens were distributed to six laboratories for blood lead level (BLL) measurement. A quality control program was applied during the analysis of the BLLs in order to improve precision and accuracy. The arithmetic mean BLL of the 8828 Taiwanese adults was 7.70 +/- 5.23 micrograms/dl, with a maximal level of 69.1 micrograms/dl. The median was 6.5 micrograms/dl and the 90th percentile was 14.0 micrograms/dl. After logarithmic transformation, the geometric mean was 1.84 +/- 0.67 microgram/dl. This study also found that elevated BLLs were associated with certain personal characteristics, i.e., gender, ethnic group, and education level; life-style factors, such as smoking, alcohol consumption, Chinese herbal drug consumption, milk consumption, and sources of drinking water; residential location, i.e., level of urbanization; and occupational history of lead exposure. However, age, floor level of residence, distance from house to road, and betel nut consumption were not associated with elevated BLLs. These results showed that BLLs in the Taiwanese population were not higher than those in developed and developing countries. Most of the influencing factors were also found in other studies; however, local factors such as ethnic group, Chinese herbal drug consumption, and sources of drinking water are important considerations in Taiwan when examining ways to prevent overexposure to lead in the general population.

Growth abnormalities in the population exposed in utero and early postnatally to polychlorinated biphenyls and dibenzofurans.

This article reviews the findings in children exposed to various levels of polychlorinated biphenyls (PCBs) and related compounds in utero and early postnatally. Yu-Cheng ("oil-disease") mothers were Taiwanese women exposed to PCBs and their heat-degradation products from the ingestion of contaminated rice oil in 1979. Children of these mothers were born growth retarded, with dysmorphic physical findings, and delayed cognitive development compared with unexposed children. In this article, findings in Yu-Cheng children born between 1978 and 1985 are summarized and compared with two other well-documented cohorts of children prenatally exposed to different levels of PCBs. Results of the investigation in Yu-Cheng children will provide important information about the toxicities, health effects, and mechanisms of PCB/PCDF exposure and demonstrate that the developing human is more sensitive than the adult to the toxic effects of these chemicals.

Clinical trial of a combination of rice bran fiber and cholestyramine for promotion of fecal excretion of retained polychlorinated dibenzofuran and polychlorinated biphenyl in Yu-Cheng patients.

A clinical trial using the combination of rice bran fiber (RBF) and cholestyramine (CHO) was carried out on Yu-Cheng patients in 1993-1994. By the analysis of blood and stool samples collected from the patients before and after (or during in the case of stool), it was verified that the administration of RBF and CHO is effective for excretion of polychlorinated biphenyl (PCB) (p < 0.05) and polychlorinated dibenzofuran (PCDF), especially 2, 3, 4, 7, 8-pentachlorodibenzofuran (p < 0.05). However, the degree of effectiveness varied upon individual patients from 60 to 160% for 2, 3, 4, 7, 8-pentachlorodibenzofuran, from 30 to 110% for 1, 2, 3, 4, 7, 8-hexachlorodibenzofuran and from 50 to 190% for PCB, respectively.

[Levels of PCDDs, PCDFs and coplanar PCBs in the blood and stool of Taiwanese Yu-Cheng patients].

Levels of PCDDs, PCDFs and coplanar PCBs were measured in the blood and stool obtained from seventeen patients with Yu-Cheng in Taiwan. The average total concentrations of PCDDs, PCDFs and coplanar PCBs in the blood collected from Yu-Cheng patients in January 1993 and August 1994 were 590 and 570 pg Toxic Equivalents (TEQs)/g lipid, respectively. The concentrations of PCDDs, PCDFs and coplanar PCBs in the blood of patients were 21, 540 and 10 pg TEQs/g fat, respectively. On the other hand, the fecal excretion of PCDDs, PCDFs and coplanar PCBs were 26, 720 and 15 pg TEQs/day, respectively. The composition of congeners in the feces was quite similar to the one in the blood. The half lives were estimated as 9.1 and 8.6 years for 2, 3, 4, 7, 8-pentachlorodibenzofuran and 1, 2, 3, 4, 7, 8-hexachlorodibenzofuran based on fecal excretion, respectively.

Blood serum levels of PCDFs and PCBs in Yu-Cheng children peri-natally exposed to a toxic rice oil.

Children secondarily exposed through their mothers to a toxic rice oil containing PCDFs and PCBs in the Yu-cheng incident have shown developmental delay even a decade after the incident. Forty-five serum samples were collected from these children in February 1991 ad small amounts analyzed for their contaminant content using sample enrichment and isotope dilution mass spectrometry. In about one-half the samples, detectable levels of PCDFs and PCBs could still be determined with average values for 2, 3, 4, 7, 8-PnCDF and 1, 2, 3, 4, 7, 8-HxCDF of 300 and 620 ng/kg serum lipid, respectively. The mean of the total PCBs on a whole weight basis was 7.5 micrograms/kg. These concentrations of PCDFs and PCBs are still 10 to 25 times higher than those from a matched control population. Although the serum levels did not correlate with developmental delays, those for the two PCDFs but not the total PCBs correlated with duration of breast feeding indicative of postnatal exposure. The results of this study suggest that estimation of past prenatal exposure of children to PCDFs is best carried out using current mother and not current child blood concentrations.

Blood lead levels in the general population of Taiwan, Republic of China.

The purpose of this study was to investigate the environmental lead exposure of the general population in Taiwan. A total of 2919 residents of Taiwan were selected by multistage sampling methods. The participants were characterized by questionnaires and 10 ml venous blood was collected for blood lead measurement. A quality assurance/quality control program was designed during the analysis of blood lead levels. The mean blood lead level of 2719 residents without occupational lead exposure was 8.29 +/- 5.92 micrograms/dl. After adjustment for age and sex distribution to the Taiwan general population, the mean blood lead level was 8.10 micrograms/dl. Adjusted for an 11% underestimation of blood lead levels among the six laboratories, the mean blood lead level was estimated to be 8.99 micrograms/dl. This study also found that blood lead levels were associated with personal characteristics, i.e., gender, ethnic group, education level; lifestyle factors, i.e., smoking, alcohol consumption, sources of drinking water; and residential location, i.e., levels of urbanization, distance of house from the road. However, age, floor of residence, milk consumption, betel nut consumption, and Chinese herbal drug consumption were not found to be associated with blood lead levels. These results show that blood lead levels in Taiwan residents were not higher than in most developed and developing countries. Environmental lead pollution does not seem to be a serious problem in Taiwan.

Musculoskeletal changes in children prenatally exposed to polychlorinated biphenyls and related compounds (Yu-Cheng children).

Fifty-five Yu-Cheng (oil-disease) children born between 1978 and 1985 to mothers who ate PCB-contaminated rice oil in 1978-1979 were studied and compared to age- and sex-matched control subjects in 1991. The children's growth profiles, bone mineral density and soft tissue composition, joint laxity, and serum parathyroid hormone, vitamin D, calcium, alkaline phosphatase, and phosphate were compared. The Yu-Cheng children were 3.1 cm (p < .05) smaller and had less total lean mass and soft tissue mass as compared to the matched control subjects. All other parameters studied were similar in both groups. The shorter height and decreased total lean mass and soft tissue content were only seen in the Yu-Cheng children who were the first born after the ingestion, but not in subsequent children. This was most likely due to decreased body burdens of the PCBs and related contaminants over time in the mothers.

Cognitive development of Yu-Cheng ("oil disease") children prenatally exposed to heat-degraded PCBs.

OBJECTIVE: To compare the cognitive development in Taiwanese children who had been exposed prenatally to high levels of heat-degraded polychlorinated biphenyls (PCBs) with control children who were exposed to background levels. The disorder was called Yu-Cheng, "oil disease," in Taiwan. DESIGN: Matched-pair cohort study. SETTING: Communities in central Taiwan in which there had been a cooking-oil contamination and mass poisoning by heat-degraded PCBs in 1978 through 1979. PARTICIPANTS: One hundred eighteen children born between June 1978 and March 1985 during or after their mothers' consumption of contaminated rice oil; 118 children matched for age, sex, neighborhood, maternal age, and parental education and occupational class; and 15 older siblings of exposed children, born before the poisoning. MAIN OUTCOME MEASURES: Cognitive development measured from 1985 through 1990 using the Chinese versions of the Stanford-Binet test and the Wechsler Intelligence Scale for Children, Revised, RESULTS: The exposed children scored approximately 5 points lower on the Stanford-Binet test at the ages of 4 and 5 years and approximately 5 points lower on the Wechsler Intelligence Scale for Children, Revised, at the ages of 6 and 7 years. Children born up to 6 years after their mothers' exposure were as affected as children born within a year or two after exposure when examined at 6 and 7 years of age. Older siblings resembled the control children. CONCLUSION: Children prenatally exposed to heat-degraded PCBs had poorer cognitive development than their matched controls. The effect persisted in the children up to the age of 7 years, and children born long after the exposure were still affected.

Cognitive development of children prenatally exposed to polychlorinated biphenyls (Yu-Cheng children) and their siblings.

An intoxication episode resulting from rice-bran oil (Yu-Cheng) contaminated with polychlorinated biphenyls (PCBs) occurred in Taiwan from 1978 to 1979. After that episode, the authors found 15 Yu-Cheng children who were born to intoxicated mothers after their documented consumption of PCB-contaminated oil; these children had older siblings, born before PCB exposure, without prenatal PCB exposure. The cognitive development of these Yu-Cheng children and the youngest of their elder siblings were assessed annually from 1985 to 1990 using the Chinese version of the Wechsler Intelligence Scale for Children, Revised Version (WISC-R) for those over six years of age. Compared with their elder siblings, the Yu-Cheng children scored significantly lower (p < 0.05) on the verbal intelligence quotient, by 6.8-16.1 points; on performance IQ by 10.2-18.4 points; and on full-scale IQ by 8.9-18.5 points, during the six measurements performed from 1985 to 1990. The differences in WISC-R IQ scores between the two groups have remained unchanged during these six years of follow-up.

[Determination of compound preparation containing unknown absorptive background by UV spectrophotometry].

A novel algorithm of target factor analysis has been developed for detection and correction of unknown absorptive background in multicomponent analysis. The algorithm is based on the property that the estimated spectra can gradually approach the true ones by iterative refinements. Paracetamol and antipyrine contained in compound injection of paracetamol were determined by this method without any preliminary chemical separation. The average recoveries were both 100.0% and the coefficients of variation were 1.1% and 1.0% respectively. The results clearly indicate that the proposed method may also provide a new approach to the analysis of traditional Chinese medicine containing some unknown absorptive components.