1992年 · 第105卷第09期

The effects of recombinant human G-CSF (rhG-CSF) and retinoic acid (RA) were studied on the proliferation and differentiation of HL-60 cells and human acute myeloid leukemic cells. Synergistic effect on granulocyte differentiation was observed when HL-60 cells and primary acute promyelocytic leukemic cells were cocultured with RA plus rhG-CSF. rhG-CSF combined with RA increased more significantly the percentage of mature cells than RA alone and greatly increased NBT reduction activity (P<0.001). These results suggested that proliferated effect of rhG-CSF on leukemic cells may be important for inducing differentiation of myeloid leukemic cells. But this effect might expose the patients to the risk of acute myeloblastic leukemia if G-CSF was used alone. However, RA could not only rule out the latter situation but retain former merit as well. The authors suggest that the combined use of G-CSF with RA is probably a new approach to the treatment of leukemia.

Plasma ammonia level (PAL) was studied in 43 cases of acute leukemia (AL). PAL was 39.21±26.2 mumol/L in normal controls and 38.8±16.6 mumol/L in leukemic patients before chemotherapy. High PAL was found in 40 cases after chemotherapy. Six cases showed clinical manifestations due to severe hyperammonemia, including dizziness, lethargy, confusion, coma and mental changes of various degree, and there was also respiratory alkalosis. After ammonia-trapping therapy, 4 of the 5 patients recovered. The authors believe that high PAL is not uncommon after chemotherapy in leukemic patients. Respiratory alkalosis and unexplained mental and neurologic changes following intensive chemotherapy are useful clues for the diagnosis of hyperammonemia syndrome. Early diagnosis and treatment with ammonia-trapping may improve the rates of remission and survival.

The clinical manifestations of 20 cases of insular cistern hematoma were characterized by sudden onset violent headache, vomiting, bloody CSF, and subhyaloid hemorrhage (1/3 cases). CT scan showed semilunar high density image centering on the insular cistern with serrate internal edge. The average volume of the hematoma was 20 ml. By means of cerebral angiography, operation and/or autopsy, 7 cases were identified as aneurysm of middle cerebral artery, 6 as aneurysm of posterior communicating artery, and 2 as amyloid angiopathy. In the other 5 cases, the etiology was unknown.

In this study it was shown that 1000 μg/L hGH in serum-free medium promoted the attachment, spreading and formation of monolayer of islet cells. The radioactivity test indicated that hGH significantly stimulated the DNA synthesis of islet cells (P<0.001). Furthermore, after 48 h exposure to hGH (1000 μg/L), both the insulin contents and release of islet cells significantly increased (P<0.001); hGH also enhanced the responsiveness of fetal islet cells to high-concentration glucose plus theophylline stimulation (P<0.001). However, the effect of hGH in the medium containing 10% newborn calf serum was not so prominent in comparison with that in the serum-free medium. The morphologic assay for mitotic cells showed a combination of 1000 μg/L hGH and 10% serum was the most efficient for inducing the mitosis, the mitotic index being 5.95%. We conclude that hGH is an important growth factor for human islet cells.

Time-concentration studies of clonazepam (CZP) were performed in 7-, 14-, and 28-day-old Sprague-Dawley rats. Blood samples and brains were collected at specific intervals following a single subcutaneous (SC) injection of 2.5 mg/kg of CZP. CZP concentrations were measured both in plasma and brain samples by high performance liquid chromatography. Pharmacokinetic parameters were calculated using R-Strip for each age group. The results were compared between the age groups and with those of a similar study in our laboratory using lower dose CZP (1 mg/kg) SC injections in adult Sprague-Dawley rats. Younger rats had slower, delayed and higher peak concentrations, larger areas under the curve (AUC), longer elimination half lives (T1/2), smaller volumes of distribution (Vd) and slower clearances (C1). 28-day-old rats showed the fastest C1, smallest AUC and largest Vd. These data suggest that the pharmacokinetic behavior of CZP is age-dependent. If this is true in human, it is implicated in dosing of neonatal or pediatric patients.

Previous studies have shown the effects of atrial natriuretic factor (ANF) on rats with renovascular hypertension (RVH). In the present study low dose α-hANF (0.025 μg/kg/min) was administered intravenously for 60 minutes to seven RVH patients. Results demonstrated an inhibition of renin-angiotensin-aldosterone system (RAAS), reduction of plasma catecholamine and arginine vasopressin(AVP), diuresis and natriuresis, increase of hematocrit and creatinine clearance, and slight decrease of blood pressure. These results showed that most factors involved in the establishment and maintenance of RVH are affected by ANF infusion.

Serum lipoproteins and apolipoproteins were analyzed in 199 patients with acute myocardial infarction (CCU group), and in 211 normal healthy individuals (control group). It was shown that serum lipoprotein abnormalities, especially elevated low density lipoprotein (LDL) levels, are closely related to atherogenesis in relatively young patients and in subjects with severe coronary lesions. The frequency of apo E4 was higher and that of E2 was lower in the CCU group than in the control group. Apo E mutants, E7 and E5, were also frequent in the CCU group. Subjects with an E3/2 phenotype had reduced LDL and increased VLDL levels, and those with an E4/3 phenotype had increased LDL levels in serum. These results suggest that apo E4 is a positive risk factor and apo E2 a negative risk factor for atherosclerosis. The action of apo E isoproteins to increase or decrease serum LDL levels may be one of the mechanisms of atherosclerosis. Furthermore, the effect of apo E isoforms on serum lipoproteins was evident even in childhood. The mutant apo E binding to LDL receptors were investigated to clarify the metabolism of apo E5 and apo E7. The affinity of apo E5 was twice that of the wild form of apo E3. Apo E7, however, had a lower receptor affinity than apo E3. Therefore, the authors postulate that individuals with apo E5 have increased risk of developing hypercholesterolemia and subsequent atherosclerosis. From the binding data of apo E7, the action of apo E7 is considered similar to that of apo E2.

The effects of prostaglandin E2(PGE2) in vivo and in vitro on cementless fixation of porous coated implant were studied. The results revealed that high levels of PGE2 in the local tissue benefit bone ingrowth in the early stage of implantation. Co-Cr-Mo alloy itself hampers the growth of osteoblasts and decreases the local secretion of PGE2. In the early stage of arthroplasty, the use of PGE2 inhibitors should be forbidden, and proper loading stimulation is preferable. High level PGE2 of local tissue in the later stage indicates bone resorption.

Thirty rabbits were divided equally into 5 groups randomly. A hole, 6 mm in diameter and 2 mm deep, was bored on each iliac crest. Two pieces of alumina were implanted into the hole of one side, while the opposite side served as control. These rabbits were killed on 10, 20, 40, 60 and 90 days after operation. Calcium, phosphorus and aluminium contents of iliac bone on both sides were determined by Inductively Coupled Plasma--Atomic Emission Spectrometry. The results showed that the aluminium content of the implanted side in each group was higher than that of the control and difference was significant in 10, 40 and 60 day groups (P<0.05). This shows that the implant releases aluminium into the bone. Moreover, the calcium and phosphorus contents were significantly lower on the implanted side than on the control side in 10 and 20 day groups (P<0.05-0.001). Apparently, the aluminium released from the implant in the early stage can interfere with the local calcium and phosphorus metabolism and delay the mineralization of the bone.

Two kinds of synthetic biomaterial, porous tricalcium phosphate (PTCP) and magnetic porous tricalcium phosphate (MPTCP) ceramic granules were implanted in rat femur. In the period of 4 months, the assessment of serial histological sections, scanning electron microphotographs and quantitative analysis of bone formation in the sections showed that both ceramics are biocompatible and degradable in vivo. More new bone formation occurred in the MPTCP group. Endochondral ossification was seen in both groups. The quantitative analysis in this study is reliable, and may be suitable to the similar experimental models.

In a 56-year-old female patient with a mass at the proximal end of the left third finger for 22 years, the lesion enlarged obviously during the last 4 years. Initial diagnosis was chondroma with malignant change, and disarticulation of the finger was performed. Pathological diagnosis was "secondary chondrosarcoma". Microscopically, the mass contained a large amount of amorphous basophilic phosphate deposits surrounded by fibrous capsule. The pyrophosphate deposits consisted of birefringent needle shaped or rhomboid crystals which can be identified by polarizing microscope. It can be distinguished as tumoral calcium pyrophosphate dihydrate deposition disease, differing from tophaceous pseudogout, tumoral calcinosis and chondrocalcinosis. Nine cases were collected from the literature and the clinical, radiological and pathological features were discussed.

A nurse, 27, primary sterility for 5 years, had normal menstruation, normal size of uterus anterior. HSG: Rt. tube was not visible, Lt. tube slightly enlarged at ampulla. Ovaries were over-stimulated by clomiphene, HMG and hCG.8 ova were taken through vaginal aspiration under B-mode ultrasound scanning. Direct introduction of ova and washed sperms simultaneously into the uterus on Sept. 19, 1991 resulted in successful single pregnancy up to 36+1 weeks. A 2 250 g normal baby boy was delivered on May 15, 1992 spontaneously. The base and prospect of this manoeuver are discussed with a reference to Craft's procedure.

Though melioidosis has been reported since 1912, it is still a new problem for most Chinese physicians and medical scientists. Because of the lack of understanding and clinical experiences in melioidosis, none had been reported until 1990 in the mainland of China. In view of China's open policy and health work the natural foci of Pseudomonas pseudomallei in South China, ie. Hainan, Guangdong and Guangxi Provinces, should be given sufficient concern. Efforts should be made in training physicians in the endemic areas to improve their knowledge about the disease and to avoid misdiagnosis.