1993年 · 第106卷第03期

Fatty acid composition of serum cholesteryl esters (CEs) in Chinese and 9 species of laboratory animals was analysed. Polyunsaturated fatty acids (PUFAs) were the predominant fatty acids in CEs. A close correlation between PUFAs to saturated fatty acids ratio (P/S) in CEs and susceptibility to atherosclerosis (AS) was observed in different species. Animals with high P/S such as mice (13.0), tree shrews (9.0) and rats (9.0) were AS-resistant, and those with low P/S such as rabbits (2.9) were susceptible to AS. The P/S value in men (4.9) was between those of the above two kinds of animals, and similar to those of pigs (4.2) and monkeys (3.7). Marked physiological significance of the rich PUFAs in CEs may be expected. As the main constituent of low density lipoprotein (LDL), CEs may provide PUFAs for cells efficiently via LDL receptor. It is assumed that PUFAs in CEs may play an important role in the metabolism of cholesterol and the development of AS by regulating LDL receptor activity, platelet function and prostaglandin metabolism.

Serum lipids, lipoproteins, malondialdelyde (MDA) and metal levels were determined in 86 patients with coronary heart disease (CHD) proved angiographically and 33 controls subjects. Serum concentrations of TC, LDL-C, AI, MDA and Cu were significantly elevated and serum HDL-C, Zn and Mg contents were decreased markedly in patients. Correlation analyses indicated that the severity of coronary arterial lesions was related positively to serum TC, LDL-C, AI, MDA and Cu levels, and inversely to HDL-C levels; both the serum Cu and MDA contents were related positively to TC and LDL-C levels. These data suggest that serum Cu and MDA might have effects on the extent of CA lesions during the progress of atherosclerosis in patients with CHD.

Antibodies to hepatitis C virus (anti-HCV) were determined in Chinese blood donors from the city of Wuhan by ELISA screening tests and confirmatory recombinant immunoblot assay (RIBA). 281 and 222 sera were sampled under similar conditions in 1989 and 1990, respectively. The first collection of sera was sent to Sweden in lyophilized form, the second directly as fresh, unfrozen sera. A high proportion (22%) of the lyophilized sera were positive in the screening assay but only 6 (2.10%) were positive by RIBA with antibodies against both the C100-3 and 5-1-1 peptides. HCV RNA could be detected by polymerase chain reaction (PCR) analysis in 3 of the 6 sera and in one reacting with C100-3 only. In the second material of fresh sera only 3 were positive in the screening anti-HCV ELISA, but none was RIBA or PCR positive. Thus, the overall prevalence of anti-HCV among the 503 Chinese blood donors as identified by RIBA was 1.2%, and that of HCV RNA by PCR was 0.8%. The confirmed antibody prevalence is higher than that reported in the western literature.

T cell subsets in peripheral blood were phenotyped in 56 patients with different stages of Schistosomiasis japonica, including 17 with acute, 14 with chronic and 25 with advanced infection. The activity of interleukin-1 (IL-1) produced by peripheral blood mononuclear cells (PBMC) induced by lipopolysaccharide (LPS) in vitro was simultaneously detected in these three groups of patients. It was found that the percentages of CD3+ (total T cell), CD4+ (helper/inducer T cell) and CD8+ (suppressor/cytotoxic T cell) T cell and the level of IL-1 were significantly increased in the group of acute Schistosomiasis japonica. In the groups of chronic and advanced Schistosomiasis japonica, the proportion of CD3+ T cell, the ratio of CD3+/CD4+ and the level of IL-1 were remarkably reduced, and the percentage of CD8+ T cell was increased. The rate of CD4+ T cell was obviously decreased in cases patients with advanced Schistosomiasis japonica. The percentage of CD4+ T cell was positively correlated to the level of IL-1 in the three groups of patients. These results indicate that T cell subsets and IL-1 may play an important role in the immunoregulation of Schistosomiasis japonica.

The saliva samples from 13 patients with hepatocellular carcinoma and a control group of 21 random healthy adults were measured for alpha-fetoprotein (AFP), using a highly sensitive sandwich enzyme immunoassay specific for human AFP. In patients with hepatocellular carcinoma, significantly higher levels of saliva AFP were observed (mean±Sx: 3 552.6±2 829.9 ng/L) when compared with the value of the normal controls (mean±Sx 18.1±3.8 ng/L, P<0.001). There was significant correlation between saliva and serum AFP in both normal controls (rs=0.526, n=21, P<0.005) and patients with hepatocellular carcinoma (rs=0.931, n=13, P<0.001). In patients with hepatocellular carcinoma, those with positive serum AFP had positive saliva AFP, while those whose serum AFP was negative showed saliva AFP negative as well. It is likely that saliva AFP is derived from plasma by passive seepage. It is promising that the saliva AFP surveillance may be helpful in detection of AFP positive hepatocellular carcinoma, because of its noninvasiveness, acceptableness by almost every person, simplicity in technique, and the strong correlation between saliva and serum AFP.

EDAP piezoelectric shock wave lithotripsy combined with oral ursodeoxycolic acid dissolution of stones was used to treat 1055 patients with gallbladder stones. 926 of them (87.8%) were followed up for more than 1 year. The patients were divided into two groups: Group I, 637 patients with functioning gallbladders containing one radiolucent stone less than or equal to 20 mm in diameter or 2 to 3 stones each less than or equal to 12 mm, and Group II: 289 patients with stones exceeding the above criteria. The stone fragmentation rate was 96.2% and 94.1% respectively in Group I and in Group II. Gallbladder stones disappeared in 18.5%, 35.0%, 46.2% and 52.4% of the patients in Group I in 1, 3, 6, and 12 months after treatment and 7.3%, 11.4%, 20.1%, and 27.7% in Group II. The treatment was more effective for solitary stones less than or equal to 20 mm in diameter. No serious complications were noted. The midterm curative effect was satisfactory. Further study is required to raise the curative effect and prevent stone recurrence.

The two step small-bowel transplantation was performed experimentally in pigs. Both ends of heterotopic segmental allografts of 100 cm small bowel were enterostomized during the first operation. After 4-6 weeks, the allograft was interposed in the continuity of the intestine. Rejection was developed in Group I (n=6) without immunosuppression. The mean survival time of the grafts was 17.7±7.6 days, and recipients were alive after resection of necrotic grafts. The animals of Group II (n=6) were treated by cyclosporine concomitantly with azathioprine and methylprednisolone. Two pigs were killed for severe pneumonia on day 92, 97 and the grafts were alive, the other four recipients and their grafts survived for more than 300 days, 270 days, 260 days and 260 days respectively. No GVHD was observed and rejection was the major problem in segmental intestinal transplantation.

Neuroretinal rim area (NRA) is the only clinical measurement that reflects the real amount of nerve fibers in optic disc. We measured the photographs of the optic disc in 132 eyes of 132 subjects in 6 groups: normal subjects with small cups, normal subjects with large cups, suspected glaucoma with small cups and those with large cups, primary open angle glaucoma (POAG), low tension glaucoma (LTG). The mean NRAs of POAG, LTG and suspected glaucoma with large cups were less than those of normal subjects with large cups. In normal subjects, a high correlation between cup area and disc area was found, while NRA correlated weakly with disc area. Both semiquantitative scores of diffuse and localized retinal nerve fiber layer defects were correlated significantly with NRA. We suggest that measurement of NRA and examination of retinal nerve fiber layer defect could improve the detection of acquired changes of optic disc in early glaucoma.

We studied the ultrastructural changes of the corneal epithelium of the experimental rabbit dry eye and the effects of three topically applied eye-drops. Fourty rabbits were divided into experimental rabbit dry eye group, 0.1% bromhexine-treated group, 50% Chinese medicinal herb-treated group and 0.01% retinoic acid-treated group. Ten days after surgical removal of lacrimal gland, nictitating membrane and Harder's gland of the rabbit eyes, and corroding the conjunctiva with 50% trichloroacetic acid, the rabbit eyes showed typical dry eye signs. A lot of pathologic ultrastructural changes of the corneal epithelium were observed. Fourteen days after topically applying the three eye-drops, no significant effect was found on the ultrastructural changes of the dry eye corneal epithelium in the 0.1% bromhexine-treated and 50% Chinese medicinal herb-treated groups. However, in the 0.01% retinoic acid-treated eyes, normal microvilli and microplicae reappeared, denuded corneal epithelium was covered by new epithelial cells, no cell swelled, degenerated mitochondria recovered, basement membrane returned completely, and the completely recovered corneal epithelial cell count showed a significant difference compared with the control (P<0.01). We conclude that removing the lacrimal gland, nictitating membrane and Harder's gland of rabbit eye, and corroding the conjunctiva with 50% trichloroacetic acid can result in rabbit dry eye and topically applying 0.01% retinoic acid can promote the recovery of the dry corneal epithelium.

From April 1986 to March 1992, flaps were used in the surgical treatment of 17 patients with congenital bladder exstrophy. Eleven of these patients had had surgery in other hospitals but all failed. Using the flap method for the repair all of them had procured a functional bladder except one who could not have a complete control of urination. The longest follow-up period was 3 years, and the renal and bladder functions were completely normal. The immediate result in 14 patients was good in the control of urination right after the removal of the catheter. The follow-up results were good in 16 cases. The flaps used included 8 types of skin flaps, fasciae and vascular pedicles. Provided with the central vascular supply, the new series of procedures were suitable for the treatment of a variety of exstrophy deformities.