1988年 · 第101卷第01期

Leishmania donovani antigens were successfully identified in the sera of kala-azar paticnts by monoclonal antibody (McAb). The serum antigens were absorbed onto nitrocellulose paper, then bound to high titer McAb-C2 against L. donovani and detected by ELISA (McAb-AST). Of 51 serum samples tested, 48 were McAb-AST positive, while sera from 367 controls (normal individuals from kala-azar endemic or non-endemic areas and patients with other infectious or parasitic diseases) were all negative. The difference between positive and negative results (ELISA color reaction expressed in ISA) was distinct and the positive degree (+-+++) decrcased with the increase of serum dilution. Follow-up study of 8 kala-azar cases pre- and post-specific therapy demonstrated that McAb-AST results correlated well with their clinical symptoms and L. donovani amastigote findings. The circulating antigens in sera of kala-azar patients were found to be glycoproteins by PAS stain and trypsin digestion. They separated into 4 bands (Rf 0.35, 0.25, 0.20 and 0.06) by PAGE. By SDS-PAGE, they migrated as 3 bands (MW 96, 52 and 30 KD). Their isoelectric point (pl) as determined by IEF was between pH8.71-9.16 and showed 7 bands. These findings indicate that the circulating antigens were a group of glycoproteins with different molecular weights and pIs.

Orthotopic and heterotopic small bowel transplantations were done in rats. 25% of small bowel was used as graft in the orthotopic model in 30 rats, in which 17 survived without immunosuppression over 3 days, the longest being 35 days (mean, 7.8 days). In 31 rats receiving heterotopic transplants, pathologic changes were observed. Rejection occurred in two strain rats combination while no graft versus host reaction was observed. No significant difference in time and severity of rejection was found in segmental and total small bowel groups.

154 patients with 158 open fractures of tibial shaft received standard wound care including debridcment and primary wound closure from 1960 to 1978. In these patients the severity of soft tissue injuries ranged from grade I to III. Of the 158 fractures, 63 were treated by cast immobilization, 10 by traction, 59 by internal fixation, and 26 by minimal internal fixation combined with external fixation. The rate of skin necrosis and infection was 27%, of which deep infection and osteomyelitis in leg accounted for 5%, and the nonunion rate was 7.1%. These figures indicate the relationship between skin necrosis, infection, prognosis, and primary wound closure, and that high incidences of skin necrosis and nonunion are key problems despite the low infection rate in our series. We conclude that as an alternative method, delayed primary wound closure is indicated for open tibial fractures of Grade II and III while for open fractures of other locations, primary wound closure is still indicated.

The neutralizing antigens of eliterovirus type70 (E70) are characterized immunochemically. It was found that all of the 7 neutralizing McAbs tested could cambine with both naturally-occurring topcomponents (NTC) and virions in immunodot test, five of them could combine with VP1 in the immnuno-blot system, and patient sera and antibodies from immune and hyperimmune animals could only cambine with VP1. Furthermore, 10 McAbs (including the mentioned 7) were used to analyse the antigenic differences of 8 E70 strains isolated in China in 1985 and the prototype virus J670/71. The results indicate that the 10 McAbs can neutralize all 9 viruses almost equally. The data indicate that VP1 is immuno-dominant and stable enough to keep neutralizing antigenicity during treatment in the immunoblot system.

152 patients received extraperitoneal ileal conduit during 1960-1987. Indications for the operation, operative procedure, postoperative complications, mortality and results of follow-up are discussed. Our experience proved that extraperitoneal procedure is superior to the intraperitoneal one (Bricker's operation) in decreasing mortality and complications.

Penetrating keratoplasty was done in 73 patients with eyeballs enucleated from donors aged l-49 years 2-12 h.ours after death and kept in the human cord serum or in moist condition. The operation started with a grafc of diameter being 68 mm and continuous suture with 10-0 nylon thread under operating micro- scope. B.fore penetrating keratoplasty, Olympus pho- tomicroscope was used to record the number of donor en.dothelial cells but after operation contact specular photomicroscope EB-160 Model III was used Lo observe and photograph donor grafting endothelial cells for evatuating their activity density and activity ratc. After graft was taken, the remained corneal ring schcduled for observation was stained by modi- ficcl stocker's method with trypan blue. Follow-up for 0.5-6.5 years in our 73 patients showed that using the cndothelial cell activity density as a standard for evaluating donor grafts is of clinical value in eye bank.

Cross-neutralizing assays were done on 85 strains of poliovirus type I with 5 groups of monoclonal antibodies. According to the antigenic differences, these 85 type I strains were classified into 10 subgroups. There were remarkable differences in the antigenicity among the 10 subgroups, of which P1-2 (27.06%) and P1-5 (40%) are dominant and have been found to be epidemic in China in recent years. These two sub-groups were antigenically different from the Sabin-1 strain, but shared common antigenic epitopes with the Mahoncy strain and the Brunhilde strain according to their responses to group C monoclonal antibodies. Similarly, 91 strains of type III poliovirus were classified into 6 subgroups with other 5 groups of monoclonal antibodies. The results showed that the strain P3/Yunnan/2/84 which was isolated from cases of pliomyelitis in Yunnan Province of China in 1984 and the strain P3/Finland/23127/84 which was isolated in Finland in 1984 were both antigenically different from the Sabin-3 strain and the reference virulent strain.

13C-methacetin breath test (MBT) was conducted in 69 subjects to assess its clinical use. From the data obtained, the parameter Ω might offer reliable and sensitive information. The lower limit of the normal Ω value was 18.5. According to the fact that the Ω value in cirrhotic patients was far below normal, the decrease of Ω value was parallel to the clinical status of cirrhosis and it was in good correlation with the retention of ICG. The authors recommend MBT as a useful quantitative test for hepatocellular malfunction.

This paper reviews 1131 renal biopsies performed in two major regional hospitals in Hong Kong between 1977 and 1986. In 973 cases, diagnosis of glomerulonephritis was made and classified according to the World Health Organisation. IgA nephropathy was the commonest glomerulonephritis with 25.6% of all cases and was characterized by a slight female preponderance and the existence of a nephrotic subset. Lupus nephritis was the second most frequent (18.1%) and the majority of cases showed a severe pathology at the time of biopsy. Minimal change nephropathy ranked third (15%), but it was the commonest glomerular disease in children (33.7%) and the most common cause of nephrotie syndrome. The incidences of mesangiocapillary glomerulonephritis, focal glomerulosclerosis and idiopathic membranous nephropathy were lower than other populations. Patients with glomerular disease showed a significantly higher prevalence of hepatitis B anti-genemia when compared with the general population (21.0%). The pathogenetic implication of hepatitis B virus is discussed.

Whole blood viscosity (WBV) was measured by NZ-4 type cone-plate viscometer at different shear rates (2,4,10,20,40,100 S-1). Erythrocytc deformability (ED) was measured with a self-made device and domestically produced nuclepore filter (pore diameter 5 μm). ED was determined by erythrocyte filterability index (EFI); smaller parameters of EFI mean increased deformability of erythrocytes. Ligus-trazine was injected into rabbits at 2 mg/kg, it caused a marked decline of WBV but no significant changes in ED were observed. Anisodamine given iv to rabbits at 0.5 mg/kg caused not only decrease in rabbit EFI but also significant decrease in WBV.