The Correlation between Blood Uric Acid and Goldstein Grading in Hepatolenticular Degeneration Patients with Different Chinese Medical Syndrome Types / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe blood uric acid levels and Goldstein grading, as well as their correlation in Wilson's disease (WD) patients with different Chinese medical syndrome types.</p><p><b>METHODS</b>Totally 906 WD patients in line with inclusive criteria were assigned to 6 groups, i.e., the heart spirit confused by phlegm group (HSCP, 26 cases), the phlegm-fire disturbing heart group (PFDH, 90 cases), the retention of damp-heat group (RDH, 113 cases), deficiency of qi and blood group (DQB, 168 cases), the deficiency of Gan-yin and Shen-yin group (DGYSY, 327 cases), the deficiency of Gan and Shen group (DGS, 182 cases) due to different Chinese medical syndrome types. Recruited were another 160 healthy subjects having similar ages and diet structures, who came for medical examinations, as the healthy control group. Venous blood was collected from the medial cubital vein of each-patient on an empty stomach in early mornings to detect blood uric acid levels. Results Blood uric acid levels were lower in each syndrome type group than in the healthy control group (146.08 +/- 67.24 micromol/L in the HSCP group; 157.08 +/- 69.77 micromol/L in the PFDH group; 162.58 +/- 97.72 micromol/L in the RDH group; 156.20 +/- 62.63 micromol/L in the DQB group; 161.83 +/- 111.23 micromol/L in the DGYSY group; 194.41 +/- 90.01 micromol/L in the DGS group; 242.39 +/- 87.55 micromol/L in the healthy control group, P < 0.01). Blood uric acid levels were higher in the DGYSY group than in the other 5 syndrome groups (P < 0.01). Correlation analyses between Goldstein grading and blood uric acid showed that, along with increased Goldstein grade (that was aggravating disease conditions), WD patients' blood uric acid levels decreased (P < 0.01).</p><p><b>CONCLUSIONS</b>WD patient's blood uric acid levels decreased more. Blood uric acid levels and Goldstein grading were different in various Chinese medical syndrome types. Blood uric acid levels had certain value in assessing the severity of WD.</p>

Multiple pharmacological actions of Yiqi Huatan Decoction in a model of depression in rats / 中国结合医学杂志

<p><b>OBJECTIVE</b>To investigate the influence of Yiqi Huatan Decoction (, YHD) on a model of depression in rats under different pathological conditions.</p><p><b>METHODS</b>Thirty-two male SD rats were randomly divided into 4 groups of 8: normal, model, YHD, and maprotiline. The model group, YHD group and maprotiline group used separate feeding and rats were exposed to chronic and unpredictable stress to build the depression model. From day 2, the YHD group and maprotiline group were respectively given YHD (7 g/kg) and maprotiline (10 mg/kg) by gastrogavage once daily. The normal and model groups were given the same volume of drinking water. The medication duration were 21 days. At the end of the experiment, the serum levels of copper and zinc were determined by atomic absorption spectroscopy, plasma concentrations of adrenocorticotropic hormone (ACTH) and cortisol (COR) were detected by radioimmunoassay, and levels of norepinephrine (NE), dopamine (DA), and 5-hydroxytryptamine (5-HT) in the hypothalamus were analysed by high performance liquid chromatography-eletricochemistry.</p><p><b>RESULTS</b>Compared with the content of copper and zinc in the serum of rats in the normal group, serum copper levels in model rats were significantly increased and zinc content was significantly reduced (both P<0.05). Plasma concentrations of ACTH and COR in the model group were significantly increased compared with those in the normal group (P<0.05, P<0.01). The contents of NE, DA, and 5-HT in the hypothalamus of rats in the model group were significantly reduced compared with those of the normal group (P<0.05 or P<0.01). Compared with those in the model group, the serum copper content and plasma concentrations of ACTH and COR were significantly decreased (all P<0.05); meanwhile, serum zinc content and hypothalamic contents of NE, DA, and 5-HT were significantly increased in rats of the YHD group (all P<0.05). The same effects were also shown in the maprotiline group except for 5-HT (all P<0.05)</p><p><b>CONCLUSION</b>The pharmacological actions of YHD for depression might be related to improving trace-element anomalies, reversing endocrine dysfunction, and modulating the disorders of monoaminergic neurotransmitters.</p>

Executive dysfunction in patients with hepatolenticular degeneration / 中华神经医学杂志

Objective To assess the characteristics of executive dysfunction in patients with hepatolenticular degeneration (HLD) through neuropsychological tests and explore its mechanism. Methods One hundred and two patients with HLD were chosen and divided into CT/MRI positive (n=70) and CT/MRI negative (n=32) groups in accordance with cerebral imaging and the other 30 healthy subjects were selected as normal control group. These three groups were recorded the results of such imaging data as Raven's standard progressive matrices (R'SPM) test, Stroop color-word test (CWT), trail making test (TMT). Results Imaging data indicated a statistical change of frontal-striatal loops in patients with HLD. Significant differences of the total scores, perception discrimination, serial relationship and abstract reasoning of R'SPM test were showed in the three groups and the word interference time of CWT, B items time-consuming and interference effects of TMT in these groups were statistically different (P<0.05). Conclusion Executive dysfunction appears commonly in patients with HLD. The CT/MRI positive group showed a more serious degree and area of the damage as compared to that in the CT/MRI negative group. Damages of frontal-striatal loops may be one of the important mechanisms of executive dysfunction in patients with HLD.

Effects of electroacupuncture on behavior, plasma COR and expressions of PKA and PKC in hippocampus of the depression model rat / 中国针灸

<p><b>OBJECTIVE</b>To probe into the mechanism of acupuncture for treatment of depression.</p><p><b>METHODS</b>Thirty-two healthy SD male rats were randomly divided into a normal group, a model group, an electroacupuncture (EA) group and a Maprotiline group. The depression rat model was made in the latter three groups, and from the second day of the experiment EA was given at Baihui (GV 20), "Yintang" (EX-HN 1), "Zusanli" (ST 36) and "Fenglong" (ST 40) in the EA group, once every other day; the rats in the Maprotiline group were treated with oral administration of Maprotiline hydrochroride, once each day. After treatment of 3 weeks, changes of behaviors, plasma cortisol (COR) level and expressions of protein kinase A (PKA) and protein kinase C (PKC) in hippocampus were observed in the rats.</p><p><b>RESULTS</b>In the depression model rats, the body weight increased slowly, and horizontal and vertical activities and consumption of sugar liquid significantly decreased; plasma cortisol content significantly increased; expressions of PKA and PKC in the hippocampus significantly reduced. In the rats of EA group, the score of behaviors, the consumption of sugar liquid and the increase of body weight were not significantly different to those in the model group, but the plasma cortisol level significantly decreased and closed to the normal level, and positive expressions of PKA and PKC in the hippocampus could be effectively reversed. In the Maprotiline group, the consumption of sugar liquid significantly increased and plasma cortisol level significantly decreased, and expressions of PKA and PKC in the hippocampus increased as compared with those in the model group.</p><p><b>CONCLUSION</b>The depression model rat has dysfunction of the hypothalamus-pituitary-adrenal axis (HPAA) and EA can regulate functions of HPAA. The mechanism is possibly carried out by regulating functions of relative enzymes in the signal transduction pathway in hippocampal cells.</p>

Effect of Gandou Decoction IV combined with short-term decoppering therapy with sodium dimercapto-sulphonate on serum indexes of hepatic fibrosis in patients with Wilson' s disease / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the effect of Gandou Decoction IV (GDIV) on serum indexes of hepatic fibrosis and liver function in patients with Wilson's disease (WD).</p><p><b>METHODS</b>Sixty-one WD patients were assigned to two groups, 30 patients in the sodium dimercaptosulphonate (DMPS) group and 31 patients in the GD IV group. Both groups received 8 courses of DMPS treatment with 6 days as one course, and the GD IV group was given GD IV additionally. Serum indexes of liver function were examined, serum matrix metalloproteinase-1 (MMP-1) and tissue inhibitor of metalloproteinase-1 (TIMP-1) were detected by double antibody sandwish ABC enzyme-linked immunosorbent assay (ELISA), and serum hyaluronic (HA), laminin (LN), procollagen III (PC III) and collagen type IV (C-IV) were determined by radioimmunoassay (RIA).</p><p><b>RESULTS</b>After treatment, all indexes of hepatic fibrosis and liver function had no significant change in the DMPS group, while in the GD IV group, the serum TIMP-1 level markedly decreased (P <0.05), the ratio of MMP-1/TIMP-1 significantly increased (P <0.01), and serum indexes of liver function markedly decreased (P < 0.05), but the changes in serum levels of HA, LN and PCIII, as well as in serum MMP-1 and C-IV were insignificant (P> 0.05), though they showed a trend of decreasing or increasing, respectively.</p><p><b>CONCLUSION</b>Short-term decopper-ing treatment with DMPS alone has no significant effect on hepatic function and serum fibrosis indexes in WD patients, while combined with GD IV, it can improve liver function and display an anti-fibrosis effect through inhibiting the serum TIMP-1 level and increasing the ratio of MMP-1/TIMP-1.</p>

Clinical study on manifestation of hepatolenticular degeneration complicated with epilepsy and therapeutic effect of integrative Chinese and Western medicine treatment / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the clinical manifestation of 155 patients with hepatolenticular degeneration (HLD) complicated with epilepsy and the therapeutic effect of integrative Chinese and Western medicine treatment on them.</p><p><b>METHODS</b>Clinical manifestation of patients and its relationship with abnormalities in cranial CT and/or MRI were observed. Patients were treated by combined treatment of copper repellent with sodium dimercaptosulfonate 20 mg/kg per day by intravenous dripping, and modified Gandou Decoction (GDD) by oral intake and antiepileptics as well, after treatment for 8-10 courses, the clinical effect, copper levels in urine and serum were compared between groups.</p><p><b>RESULTS</b>In the 155 HLD patients, 96 were complicated with petit mal and 59 with grand mal. In the CT and/or MRI conducted in 72 patients, all showed abnormal images, besides such frequently met images as bilateral symmetrical basal ganglia focal lesion in 65 case-episode (90.3%) and brain atrophy of various degrees in 61 case-episode (84.7%), the massive lesions in cerebral white matter as principal, with the cortex involved, were also found in 54 patients (74%), which were mostly bilateral and symmetric or located in 2 adjecent lobes of brain, the sites of damage, in sequence of occurrence, were frontal lobe, parietal lobe, temporal lobe and callosal gyrus. Brain atrophy was found in all the remained patients without above-mentioned lesions. Abnormal EEG was shown in 29 patients (40.2%), which mainly manifested as theta wave of moderate to high potential and/or short paroxysmal spike-slow or sharp-slow complex wave evoked. The urinary copper level in patients after treatment was 34.5 +/- 21.6 micromol/24 hrs, significantly higher than that before treatment, 4.49 +/- 1.93 micromol/24 hrs (P < 0.01). And the serum copper level in patients also lowered significantly (P< 0.01). Epileptic seizure was controlled completely along with the gradually improving of extrapyramidal symptoms.</p><p><b>CONCLUSION</b>Partial seizure was the most common type of seizure of HLD patient complicated with epilepsy, the next is systemic seizure. Cerebral damage lesion and obvious brain atrophy could be the main etiological factors of HLD complicated with epilepsy, combined copper repellent therapy of integrative Chinese and Western medicine, and antiepileptics produced good clinical effect on the patients.</p>

Study on relationship between Arg778Leu/Gln gene mutation spot in ATP7B and TCM syndrome type in Chinese patients with Wilson disease / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To investigate the relationship between Arg778Leu/Gln gene mutation spot in ATP7B and TCM Syndrome type in Chinese patients with Wilson disease (WD).</p><p><b>METHODS</b>Exon 8 of ATP7B of 90 WD patients and 30 healthy controls were amplified by PCR and analysed by restriction enzyme Msp I, the TCM Syndrome type of the patients was differentiated at the same time.</p><p><b>RESULTS</b>In the 90 WD patients, 34 with Arg778Leu/Gln of exon 8 were detected, among them 20 cases belonged to the TCM Syndrome type of endogenous Liver-Wind agitation.</p><p><b>CONCLUSION</b>Onset age of WD patients with Arg778Leu/Gln mutation is later than that without this mutation. Arg778Leu/Gln mutation might be related to the TCM Syndrome type of endogenous Liver-Wind agitation.</p>