The histone deacetylase inhibitor chidamide induces intermittent viraemia in HIV-infected patients on suppressive antiretroviral therapy.

OBJECTIVES: To evaluate the safety and efficacy of chidamide to reverse HIV-1 latency in vivo and to compare the effects of four clinically tested histone deacetylase (HDAC) inhibitors on non-histone proteins in vitro. METHODS: Participants received chidamide orally at 10 mg twice weekly for 4 weeks while maintaining baseline antiretroviral therapy. The primary outcome was plasma viral rebound during chidamide dosing and the secondary outcomes were safety, pharmacokinetic and pharmacodynamic profiles, changes in cell-associated HIV-1 RNA and HIV-1 DNA, and immune parameters. Western blotting was used to compare the in vitro effects of the four HDAC inhibitors on HSP90, NF-κB and AP-1. RESULTS: Seven aviraemic participants completed eight oral doses of chidamide, and only grade 1 adverse events were observed. Cyclic increases in histone acetylation were also detected. All participants showed robust and repeated plasma viral rebound (peak viraemia 147-3850 copies/mL), as well as increased cell-associated HIV-1 RNA, during chidamide treatment. Furthermore, we identified an enhanced HIV-1-specific cellular immune response and a modest 37.7% (95% CI: 12.7-62.8%, P = 0.028) reduction in cell-associated HIV-1 DNA. Compared with the other three HDAC inhibitors, chidamide had minimal cytotoxicity in vitro at clinically relevant concentrations and showed mechanistically superior effects on non-histone proteins, including HSP90, NF-κB and AP-1. CONCLUSIONS: Chidamide safely and vigorously disrupts HIV-1 latency in vivo, which makes it a promising latency-reversing agent.

NtBRC1 suppresses axillary branching in tobacco after decapitation.

Axillary branching is controlled by a very complex mechanism involving various endogenous and environmental factors. Previous studies have shown that Tb1/BRC1 is the point of integration in the network of molecular mechanisms regulating axillary branching in plants. In this study, we cloned the Tb1/BRC1 ortholog, NtBRC1, from Nicotiana tabacum and functionally analyzed its role in the control of axillary branching in tobacco. Overexpression of NtBRC1 resulted in significant retardation of axillary branching, and downregulation of this gene resulted in significant acceleration of axillary branching after decapitation. This indicates a negative role for this gene in the regulation of axillary branching. In-line with previous reports, NtBRC1 was found to be expressed predominantly in axillary buds. Additionally, as expected, expression was decreased 8 h following decapitation, which further confirms its role in the suppression of axillary branching. Furthermore, the expression of NtBRC1 was significantly downregulated by cytokinin, but was not affected by GR24, a synthetic strigolactone. Based on the data collected in the present study, we demonstrate that NtBRC1 negatively regulates axillary branching in tobacco after decapitation and functions downstream of the cytokinin signaling pathway inside axillary buds.

Tobacco serine/threonine protein kinase gene NrSTK enhances black shank resistance.

A serine/threonine protein kinase gene (NrSTK) was cloned from Nicotiana repanda based on the sequence of a previously isolated resistance gene analog (RGA). Expression of RGA was induced by challenge with the pathogen black shank. The NrSTK gene was predicted to encode a protein kinase that contained an ATP binding site at residues 41-69 and a serine/threonine protein kinase activation sequence spanning the region 161-173. Overexpression of NrSTK in the susceptible tobacco variety Honghuadajinyuan significantly enhanced resistance to black shank, indicating that NrSTK plays a role in incompatibility reactions between tobacco and the pathogen. Characterization of NrSTK will help elucidate the molecular mechanisms involved in black shank resistance in N. repanda.

Effects of dietary propyl gallate and Lactobacillus plantarum addition on growth, intestinal morphology, antioxidant capacity, and immune functions of Pekin ducks.

The interaction between probiotic bacteria and polyphenol antioxidants can potentially enhance animal health. The present study examined the effects of propyl gallate and Lactobacillus plantarum supplementation on the growth, intestinal morphology, antioxidant capacity, and immune functions of Pekin ducks. A total of 128 male Pekin ducks (7-day-old) were allocated to four treatment groups with four replicates of eight birds each. The ducks were fed the corn-soybean based diet (the control), supplemented with either propyl gallate (100 mg/kg), Lactobacillus plantarum (4 × 109 CFU/kg), or both, for 5 weeks. Dietary supplementation with propyl gallate and Lactobacillus plantarum had no significant effect on feed intake (P > 0.05), but increased average daily gain (P < 0.05). Lactobacillus plantarum also reduced the feed/gain ratio (P < 0.05). Villus height (VH) in the duodenum and ileum was increased by supplementation, while only propyl gallate supplement increased VH in the jejunum (P < 0.05). Supplementation had no effect on small intestine crypt depth (P > 0.05). Enhanced total superoxide dismutase activity was observed with supplementation (P < 0.05), but no effects were seen on catalase, malondialdehyde, total antioxidant capacity, and glutathione peroxidase values (P > 0.05). Serum immunoglobulin G was increased with Lactobacillus plantarum (P < 0.05), but not with propyl gallate (P > 0.05). No change in IgA and IgM concentrations was observed with supplementation. In conclusion, dietary supplementation with propyl gallate, Lactobacillus plantarum, or both, enhanced the villus height of the small intestines, improving the growth rate of Pekin ducks. The synergistic effects of both propyl gallate and Lactobacillus plantarum on the villus height and serum total superoxide dismutase activity surpassed the individual effects of each supplement in Pekin ducks.

Effects of citric acid supplementation on growth performance, intestinal morphology and microbiota, and blood parameters of geese from 1 to 28 days of age.

This study was conducted to investigate the effects of citric acid (CA) supplementation on growth performance, intestinal morphology, intestinal microbiota, and blood parameters of geese from 1 to 28 d of age and evaluate the optimum additional level of citric acid. A total of 180 one-day-old male goslings were randomly allotted to 5 treatment groups of 36 birds with 6 replications. The control group was fed a basal diet, and the other groups were fed the basal diet supplemented with 0.25, 0.50, 1.00, and 2.00% of citric acid, respectively. The results showed that goslings fed the diet supplemented with 1.00% CA had higher final body weight (FBW) and average daily gain (ADG) than other groups (P < 0.05). The CA supplementation at 0.25 to 1.00% improved the morphology of duodenum or jejunum (P < 0.05). The jejunal content pH value was significantly reduced with the addition of CA compared with the control group (P < 0.05). As citric acid levels increased, the IgA concentrations in plasma increased and then decreased, and the goslings fed 1.00% CA supplementation had the highest IgA concentrations (P < 0.05). The supplementation of 1.00% and 2.00% CA in diet significantly reduced the malondialdehyde (MDA) concentration in plasma (P < 0.05). No significant difference was found on some indices related to liver function in plasma (P > 0.05), while creatinine significantly increased by the 2.00% CA supplementation (P < 0.05). Besides, the higher Coliform level in cecal content and worse intestinal morphology were observed when CA supplementation was up to 2.00%. Hence, the dietary CA supplementation (especially 1.00%) in goslings improves the growth performance, intestinal morphology, immunity and antioxidant, while excessive CA addition may cause negative effects. According to the quadratic polynomial model, the addition of CA in diet for obtaining maximum average daily feed intake (ADFI) should be 1.09% (10.9 g/kg diet) for goslings from 1 to 28 d of age.

Effects of drinking water temperature in winter on growth performance, water consumption, surface temperature, and intestinal development of geese from 21 to 49 days of age.

This research aimed to investigate the effects of drinking water temperatures on growth performance, water consumption, surface temperature, organ indices, blood parameters, and intestinal development of geese, and determine the optimal drinking water temperature for 21 to 49-d geese. A total of 192 twenty-one-day male Yuzhou white geese were allocated randomly to 4 groups with 8 replicate pens per group according to the drinking water temperature (drinking water temperature [7℃-12℃] at ambient temperature [TC], 18℃ [T1], 27℃ [T2], and 36℃ [T3], respectively). The results showed that increasing drinking water temperature did not significantly improve the BW, ADG, and ADFI of geese (P > 0.05), whereas drinking warm water of 36℃ for geese had a trend to increase FCR (0.05 < P < 0.1). Geese in group T2 drank the most water per day on average, whereas geese in group TC drank the least (P < 0.001). Geese in groups T1, T2, and T3 had higher eyes temperatures than group TC (P < 0.001). No significant differences were found on the organ indices and blood biochemical parameters (P > 0.05). Geese from group T1 had higher crypt depth and muscularis thickness of duodenum (P < 0.05), and lower ratio of villus height to crypt depth than other groups (P < 0.001). Geese from group T1 had higher activities of trypsin in duodenum and jejuna and amylase in jejuna at 49 d than other groups (P < 0.01). Overall, these data indicate drinking water at 18℃ can increase water consumption and eyes temperature, and improve the activity of digestive enzymes and promote intestinal development. Under our experimental conditions, we recommend that the optimal drinking water temperature for geese from 21 to 49 d of age is 18°C.

Multiple pathologies are common in Alzheimer patients in clinical trials.

OBJECTIVE: To determine the frequency of multiple pathology [Alzheimer Disease (AD) plus Vascular Dementia and/or Dementia with Lewy Bodies] in patients enrolled in clinical trials of AD therapy, and to compare the cognitive and functional assessments between patients with pure AD and AD with multiple pathology. METHODS: We conducted a retrospective analysis of patients with a clinical diagnosis of AD who were enrolled in AD therapy clinical trials and subsequently received an autopsy for confirmation of their diagnosis from 2000 to 2009. Performance on cognitive screening tests, namely Modified Mini Mental state (3MS) exam, Mini Mental state Exam (MMSE) and Functional Rating Scale (FRS) were compared between patients with pure AD and multiple pathology. RESULTS: Autopsy reports were available for 16/47 (34%) of deceased patients. Of these 16 patients, 5 (31%) had pure AD pathology, 10 (63%) had AD with other pathology, and 1 (6%) had non-AD pathology. Compared to patients with pure AD, patients with AD mixed with other pathology had poorer baseline FRS in problem-solving (p<0.01) and community affairs (p<0.02). CONCLUSION: While the strict enrollment criteria for clinical trials identified the presence of AD pathology in the majority of cases (15/16), multiple pathology was more common than pure AD in our series of autopsied patients. Premortem biomarkers that can distinguish between pure AD and AD with multiple pathology will be beneficial in future clinical trials and dementia patient management.

Effects of ambient temperature on growth performance, blood parameter, and fat deposition of geese from 14 to 28 days of age.

An experiment was conducted to investigate the effects of ambient temperature on the growth performance, blood parameter, and fat deposition in geese from 14 to 28 d of age in order to establish their optimal temperature requirements. A total of 150 14-day-old geese were allocated randomly to 5 environmentally controlled chambers with ambient temperature set at 18, 21, 24, 27, and 30°C from 14 to 28 d of age, respectively. As ambient temperature increased from 18 to 30°C, the feed intake decreased linearly (P < 0.05) and was accompanied by linearly or quadratically (P < 0.05) decreasing 28-day-old body weight, weight gain, and feed/gain. The upper critical level of ambient temperature from 14 to 28 d of age for 28-day-old body weight and weight gain were 25.83 and 26.17°C, respectively. There were no differences in plasma biochemical parameters or plasma hormones between geese fed at ambient temperature regimen at 18, 21, 24, 27, and 30°C. The abdominal fat weight and abdominal fat rate decreased linearly (P ≤ 0.05) with higher ambient temperature, but the ambient temperature had no effect on subcutaneous fat thickness or intermuscular fat width. It was concluded that the upper critical temperature of the ambient temperature for geese from 14 to 28 d of age was 26.17°C and high ambient temperature could lead to growth depression.

[Resection and free flap repair of recurrent maxillofacial and paranasal sinus skull base malignant tumor: report of 9 cases].

Objective: To investigate the treatment method and effect of surgical resection and free flap repair of recurrent malignant tumors of maxillofacial paranasal sinus and skull base. Methods: The clinical data of 9 patients with recurrent maxillofacial paranasal sinus and skull base malignant tumors who underwent surgical resection and free flap repair in the Department of Otorhinolaryngology Head and Neck Surgery of Shandong Provincial Hospital from August 2009 to May 2019 were analyzed retrospectively, including 5 males and 4 females, aged 32-69 years. There were 4 cases of squamous cell carcinoma, 3 cases of adenoid cystic carcinoma, 1 case of myoepithelial carcinoma and 1 case of malignant fibrous histiocytoma. All patients were repaired with anterolateral femoral flap. The treatment process and postoperative effect were analyzed by descriptive statistics. Results: All patients were followed up from 16 months to 6 years. There were 6 cases of recurrence after operation, including 1 case of local recurrence and 5 cases of skull base and craniocerebral recurrence. The median tumor free survival time of recurrent patients was 35 months. Conclusion: Surgical resection and free flap repair can effectively prolong the life of patients with recurrent maxillofacial paranasal sinus and skull base malignant tumors.

Regulation of GADD153 induced by mechanical stress in cardiomyocytes.

BACKGROUND: Growth arrest and DNA damage-inducible gene 153 (GADD153), an apoptosis regulated gene, increased during endoplasmic reticulum stress. However, the expression of GADD153 in cardiomyocytes under mechanical stress is little known. We aimed to investigate the regulation mechanism of GADD153 expression and apoptosis induced by mechanical stress in cardiomyocytes. MATERIALS AND METHODS: Aorta-caval shunt was performed in adult Sprague-Dawley rats to induce volume overload. Rat neonatal cardiomyocytes grown on a flexible membrane base were stretched by vacuum to 20% of maximum elongation, at 60 cycles min(-1). RESULTS: The increased ventricular dimension measured using echocardiography in the shunt group (n = 8) was reversed to normal by treatment with chaperon 4-phenylbutyric acid (PBA) (n = 8) at 500 mg kg(-1) day(-1) orally for 3 days. GADD153 protein and mRNA were up-regulated in the shunt group when compared with sham group (n = 8). Treatment with PBA reversed the protein of GADD153 to the baseline values. The TUNEL assay showed that PBA reduced the apoptosis induced by volume overload. Cyclic stretch significantly increased GADD153 protein and mRNA expression after 14 h of stretch. Addition of c-jun N-terminal kinase (JNK) inhibitor SP600125, JNK small interfering RNA and tumour necrosis factor-alpha (TNF-alpha) antibody 30 min before stretch, reduced the induction of GADD153 protein. Stretch increased, while GADD153-Mut plasmid, SP600125 and TNF-alpha antibody abolished the GADD153 promoter activity induced by stretch. GADD153 mediated apoptosis induced by stretch was reversed by GADD153 siRNA, GADD153-Mut plasmid and PBA. CONCLUSIONS: Mechanical stress enhanced apoptosis and GADD153 expression in cardiomyocytes. Treatment with PBA reversed both GADD153 expression and apoptosis induced by mechanical stress in cardiomyocytes.

[The correlation studies between ambulatory blood pressure and OSA in non-hypertensive patients].

Objective:To discuss the changes and rules of nighttime blood pressure in obstructive sleep apnea(OSA) patients without hypertension.Method:Eighty-nine non-hypertensive patients whose office blood pressure was lower than 130/85 mmHg and diagnose with OSA by PSG in sleep monitoring room were choose as the research group.Forty non-hypertensive and polyp of vocal cord or vocal nodules patients whose office blood pressure was lower than 130/85 mmHg and diagnose with non-OSA by PSG were choose as matched group.All the patients were in treatment in our hospital from December 2017 to June 2018. All the patients got PSG,and the same time got the ambulatory blood pressure monitoring based on pulse transit time all night.Compared the mean value of systolic blood pressure,the mean value of diastolic blood pressure.Higher than 12 mmHg blood pressure rise index,the mean rise in blood pressure. The highest increase in blood pressure, maximum systolic pressure between the study group and the marched group all night.Result:The difference of all the test index between the study group and the marched group was significant(P<0.05).In OSA patients.The difference of all the test index between the severe OSA group and the mild OSA group or the moderate OSA group was significant(P<0.05).In severe OSA group.The difference between the fluctuation of blood pressure caused by respiratory events and spontaneous blood pressure fluctuation was significant(P=0.004).The difference of the mean value of diastolic blood pressure(P=0.032) blood pressure rise index(P=0.037) the mean rise in blood pressure(P=0.045) between age 55 or older patients and under 55years old patients.Conclusion:Ambulatory blood pressure monitoring synchronizatied in PSG contribute to the early diagnosis and prevention of hypertension in OSA patients.

APACHE II score: a useful tool for risk assessment and an aid to decision-making in emergency operation for bleeding gastric ulcer.

BACKGROUND: Operating for bleeding gastric ulcer remains controversial. Gastric resection bears a higher surgical risk while limited operation may result in more postoperative hemorrhage. There has been little discussion of effective risk assessment of patients. The aim of this study is to define surgical risk by using the APACHE II scoring system, and to determine optimal management. STUDY DESIGN: Records from October 1990 to December 1996 were retrospectively reviewed for patients (n=101) with bleeding gastric ulcer who had undergone emergency operation after failed endoscopic therapy. Mortality rates were examined according to different APACHE II scores, and the surgical risk was defined. From January 1997 to December 1997, 35 consecutive patients were enrolled for prospective study. Partial gastric resection (PGR) was performed for patients with huge ulcers (>2 cm) and for low-risk patients with ulcers at the antrum or angularis, while limited operation (oversewing or excision of bleeding ulcer) was reserved for others. The results were compared with the retrospective study. RESULTS: In the retrospective study, the mortality rates for the group with a score < 15 and > or = 15 were 5% (3 of 63) and 58% (22 of 38), respectively (p < 0.05). In the group with a score < 15, PGR was performed on 27 patients, and one died. For those patients with a score > or = 15, PGR carried a lower mortality than limited operation, although this was not statistically significant (47% vs 65%). Limited operation resulted in an overall rate of 22% postoperative hemorrhage and 12% reoperation rate, in which all patients with a score > or = 15 died. In the prospective study, the mortality rates in those scoring <15 and > or = 15 were 6% and 50%, respectively. This is not significantly different than the retrospective study. However, the rate of postoperative hemorrhage was diminished (5%). CONCLUSIONS: APACHE II score is a useful tool for assessing risk in patients with bleeding gastric ulcer. The mortality is minimal in those with a score <15, and PGR can be performed with low risk. Although high-risk patients have dreadful outcomes, limited operation cannot improve them if postoperative hemorrhage occurs. Decision making in emergency operation for such patients should be based on the ulcer conditions and the patient's hemodynamic status.

Effects of norepinephrine on apoptosis in rat neonatal cardiomyocytes.

BACKGROUND AND PURPOSE: Norepinephrine (NE) is elevated in heart failure and can induce apoptosis in adult cardiac myocytes. However, it is not known whether NE can induce apoptosis in neonatal cardiac myocytes. This study examined the ability of NE to stimulate apoptosis in rat neonatal cardiac myocytes in vitro. METHODS: Neonatal rat cardiac myocytes were exposed to NE alone, NE + propranolol, or NE + prazosin for 24 hours. Apoptosis was assayed by DNA laddering with agarose gel electrophoresis and immunofluorescent terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) staining. Reverse transcription polymerase chain reaction was used to evaluate the expression of Mcl-1. Creatine kinase activity in the cultured medium was used as a measure of the toxicity of NE on myocytes. RESULTS: NE increased DNA laddering on agarose gel electrophoresis and increased the number of apoptotic cells in a dose-dependent manner. No increase in apoptosis was found in response to NE doses between 1 and 50 mumol/L. NE at concentrations of 100 to 400 mumol/L increased apoptosis from 10% to 31% of cells. The ability of NE to stimulate apoptosis in rat neonatal cardiac myocytes was completely blocked by propranolol, but not prazosin. NE treatment at high concentrations sharply reduced the level of Mcl-1 mRNA, coincident with the increase in the number of apoptotic cells. Creatine kinase activity in the cultured medium was similar among the controls and NE-treated myocytes. CONCLUSIONS: Our results showed that NE at high concentrations stimulated apoptosis in rat neonatal cardiac myocytes in vitro. Apoptosis induced by NE was associated with down-regulation of Mcl-1. However, NE at the same concentration was not toxic to rat neonatal cardiac myocytes.

Cyclical mechanical stretching increases the expression of vascular endothelial growth factor in rat vascular smooth muscle cells.

BACKGROUND AND PURPOSE: Mechanical forces have profound effects on vascular smooth muscle cells (VSMCs). The mechanism by which mechanical stimuli regulate vascular endothelial growth factor (VEGF) expression and regulation has yet to be elucidated. We investigated the effect of cyclical mechanical stretching on regulation of the VEGF gene in VSMCs. MATERIALS AND METHODS: Cultured rat VSMCs grown on a flexible membrane base were stretched by applying a vacuum at 60 cycles/minute. VEGF concentration in the cultured media was determined by enzyme-linked immunoassay. VEGF gene expression was determined by Western blot and Northern blot. The location of VEGF in the VSMC was studied immunohistochemically. Chimeric constructs of the VEGF promoter were deleted and the promoter activity was determined by luciferase activity. RESULTS: VEGF concentration increased by 21 to 32% as early as 10 minutes after stretching and remained at this level for up to 12 hours. The concentration of VEGF reached a maximum of 2.8-fold over that in control cells by 2 hours after stretching and declined slightly thereafter. The amount of VEGF mRNA in stretched cells increased as early as 1 hour after stretching, reached a maximum of 3.2-fold over the amount in control cells by 2 hours, and remained at this level for up to 6 hours after stretching. Immunohistochemical study confirmed increased VEGF expression in VSMCs after stretching. Stretched cells transfected with a Sac-Nhe fragment showed only 46% of the luciferase activity of unstretched control cells. However, stretched cells transfected with chimeric plasmids containing a Spe-Nhe fragment showed 2.8-fold luciferase activity over that in control cells. CONCLUSIONS: Cyclical mechanical stretching upregulates expression of the VEGF gene in VSMCs at the transcription level. The VEGF 5'-flanking region contains a negative stretch-response element located in the 0.4-kb Sac-Pst fragment and a positive stretch-response element located in the 0.6-kb Spe-Sac fragment.

Surgical treatment of hepatocellular carcinoma with biliary tumor thrombi.

Treatment is always abandoned in those HCC with jaundice, because it is usually attributed to the underlying liver cirrhosis and extensive tumor. In this series, 7 cases (0.8%) of HCC with jaundice were caused by bile duct invasion and tumor thrombi (BTT). 57% of cases showed Charcot's triad. 57% of BTT were small HCC, significantly higher than the 1.7% of total cases (p<0.05). The growth pattern of BTT was all spreading type, significantly higher than the 42% of total operation cases (p<0.05). The DNA ploidy of BTT was all aneuploid. 57% of BTT had AFP level higher than 400 IU/ml, but it was 27% in total cases. The prognosis is poor in those treated with palliative tube drainage. Aggressive hepatic resection was proved to be safe and achieved the best results in our limited experience. Choledochotomy to remove tumor thrombi is contraindicated because it easily causes tumor seeding. It is advocated to search BTT for resection from the group of HCC with jaundice.

Laparoscopic versus open preperitoneal prosthetic herniorrhaphy for recurrent inguinal hernia.

BACKGROUND: Laparoscopic herniorrhaphy (LH) shares the same repair principle as open preperitoneal prosthetic herniorrhaphy (PPH). Theoretically, the recurrence rate of LH for recurrent inguinal hernia will match the low recurrence rate of PPH (1.2-3%). METHODS: One-hundred forty-five cases of recurrent inguinal hernia were retrospectively studied between 1990 and 1994. Forty-two cases receiving LH were compared to 103 cases receiving PPH. RESULTS: There were no differences in operative time, hospital stay, morbidity rate, satisfaction scale and recurrence rate between the LH group and the PPH group. The LH group showed significantly less postoperative pain and 2 times shorter convalescence (p<0.01). Unsuspected asymptomatic contralateral hernia was found in 4.8% of patients receiving LH. 11.9% of patients had bilateral hernia repairing at the same time in the LH group. CONCLUSIONS: LH is suitable for recurrent inguinal hernia, but further investigation of this technique is required before its wide application.

Intravenous pretreatment of hypertonic saline can prevent systemic hypotension induced by spinal anesthesia.

BACKGROUND: Hypertonic saline improves organ perfusion and patient survival during hemorrhagic shock because it expands plasma volume and increases tissue oxygenation. Its beneficial results have been reported in patients suffering from hypotension during spinal anesthesia. The purpose of this study was to compare the influence between prehydration with 3% hypertonic saline and with isotonic lactated Ringer's solution on the hemodynamic changes and serum electrolyte concentrations in patients undergoing spinal anesthesia. METHODS: Sixty ASA class I patients scheduled for herniorrhapy under spinal anesthesia were assigned randomly into two groups. Group 1 = patients were prehydrated with isotonic lactated Ringer's solution at 7 mg/kg (n = 30); Group 2 = patients were given prehydration with 3% hypertonic saline at 7 ml/kg (n = 30). Following prehydration, arterial blood pressure and heart rate were recorded and serum electrolyte concentrations were measured. RESULTS: The incidence of hypotension was 17/30 (57%) in the isotonic lactated Ringer's solution group as against 7/30 (23%) in the hypertonic saline group (p < 0.05). There was no significant difference between two groups in relation to the level of anesthesia or maximal heart rate, and electrolyte imbalance did not occur in either group. CONCLUSIONS: Prior to spinal anesthesia, hydration with small amount of hypertonic saline is effective to minimize hypotension associated with spinal anesthesia. If so administered it would not increase bodily sodium load and unlike isotonic crystalloid solution it dose not cause accumulation of water in the body on equipollent basis.

[Extraction and separation of antitumor components from Ganoderma lucidum (Leyss. ex Fr.) Karst].

OBJECTIVE: To examine the variation of alcohol extraction rates of Ganoderma lucidum spores with different rates of wall-wrack, and analyze the antitumor components of alcohol extract by chromatography. METHOD: The G. lucidum spores were soaked and extracted with absolute alcohol. The alcohol extract was chromatographed on a silica gel column and HPLC in proper order, and the antitumor activity of every eluted fraction was represented by its cytotoxicity towards Hela cells. RESULT: Extraction rates 5%, 25% and 33% corresponded to wall-wrack rates 0%, 60%-80% and 99% respectively. The alcohol extract from spores with the highest wall-wrack rate was chromatographed on a silica gel column, eluting successfully with CHCl3, EtOAc and CH3OH in order. The CHCl3 fraction had not any antitumor activity, while this activity of CH3OH fraction was 34 times greater than that of EtOAc fraction. HPLC analysis found out that two mixtures(II1 and II3) possess significant antitumor activity in vitro. CONCLUSION: The weight of alcohol extract from spores with wall-wrack was far greater than that of spores without. The antitumor components of G. lucidum spores could be analyzed with methanol-water on a reverse HPLC.