1994年 · 第107卷第03期

From 1988 to 1992, 2479 volunteers were immunized by inactivated Meriones unguiculatus kidney cell (MUKC) vaccine. Their seroconversion rates of neutralizing antibody were about 90% after 3 doses of the vaccine. No side effects were found. The vaccine stored for 14 months at 4 ℃ still had good immunogenicity. It was shown that the vaccine was safe, effective and stable. Detailed observation was made in 75 volunteers. The results showed that the seroconversion rate by plaque reduction neutralization test in 3 doses group was higher than that in 2 doses group; but the results by reversed passive hemagglutination (RPHI), immunofluorescence assay (IFA) and ELISA were similar. Different immunization procedures (3×1 ml during 28 days or 3×1 ml during 60 days), injection routes (im or sc) and vaccine forms (containing adjuvants or not) showed no significant difference. If secondary immunization (one dose) was given one year after primary immunization, geometric mean titre of the neutralizing antibody was two fold higher than that after primary immunization.

From 1986 to 1989, 324 aortae from accidental death aged 15-39 were collected from two locations, one of higher prevalence (Beijing in North China), and the other of lower prevalence (Nanning in South China) of atherosclerosis (AS) and coronary heart disease (CHD). Morphometry and biochemical analyses, were used in the study with emphasis on the changes of smooth muscle cells (SMC) in the aortic intima and on the aortic proteoglycans (PGs) of specimens from both locations to elucidate their relationship with the pathogenesis and development of AS and to find ways, if any, for the prevention and control of AS. The results showed that the densities, especially the area density of the cell nuclei of aortic SMC were significantly higher in specimens from the North than those from the South (P<0.01). Nuclear densities of SMC negatively correlated with alcian blue-positive substances; both total PGs and Heparin sulfate PG (HSPG, inhibitory to SMC proliferation) of the aortic intima and media were lower in specimens from the North than those from the South (P<0.01). The percentage of sudanophilic lesion (SL) in the total intimal area, showing the extent of fatty infiltration of aortae from the two locations, was similar except that of the male abdominal aortae which was higher in the North (P<0.01). The above findings showed that decreased content of HSPG which is inhibitory to SMC proliferation might be one of the causes of the augmentation of aortic SMC proliferation in Beijing specimens; and also the increased serum cholesterol concentration of the population in Nanning was reflected in the SL of the aortic intima. The latter should call our attention to the prevention of AS or CHD.

A total of 105 patients with idiopathic dilated cardiomyopathy (IDCM) underwent Holter monitoring. The prevalence of arrhythmias was as follows: ventricular premature beats (VPB) 100%, including complex VPB 58.1%, short runs of ventricular tachycardia (VT) 25.7%, A-VB or BBB 46.7%, atrial arrhythmias 38.1%, sinus node dysfunction 6.6%, ST-T change 38.1%. The incidence of ventricular arrhythmia (VA) was not related to severity of cardiac dysfunction (NYHA), duration of illness and sex. The most common arrhythmia was VA, the second one was heart block and atrial arrhythmia. Serum norepinephrine and epinephrine levels were 743.4±252.5 and 688.0±452.4 pg/ml, respectively, which were higher than those in control group (P<0.01). Isoproterenol sensitivity test (ICD25) 8.43±11.21 μg, was also much higher than that in control group (P<0.01). Average H-V interval was 69.4±13.3 msec in HBE. Eight patients died. Two died of congestive heart failure (class Ⅱ-Ⅳ), and six cases were diagnosed as sudden cardiac death resulting from VT and VF.

A study was carried out on the alternate activation of factor Ⅸ (FⅨ) by bovine FⅦ and human tissue factor (TF) rather than by activated factor Ⅺ (FⅪa). The reaction product of bovine FⅦ and human TF functioned as a FⅨ activator in the assay system used. Published studies suggest that in the presence of Ca2+ ions, the complex of human FⅦ-TF readily activates both human FIX and human FⅩ, and at low TF concentrations, FⅨ appears to be the preferred substrate for the reaction product of FⅦ and TF. This may explain the discrepancy between the mild bleeding of hereditary FⅪ deficiency and the severe bleeding of hereditary FⅨ deficiency. The results obtained with bovine FⅦ and a crude human TF preparation confirm that at low TF concentrations, bovine FⅨ is the preferred substrate rather than FⅩ. At higher TF concentrations, bovine FⅩ was rapidly activated.

Twenty-two cases of cerebellar infarction were diagnosed by clinical findings, computerized tomography (CT), magnetic resonance image (MRI) and autopsy. Most of the infarctions occurred in the territory of the posterior inferior cerebellar artery (18/22). The most common and earliest symptoms were dizziness or vertigo (19/22), which occurred repeatedly and were accompanied by nausea and vomiting. The symptoms and signs of cerebellar lesion such as unsteady gait, limb and/or trunk ataxia, dysarthria were also the main clinical manifestations. However, in a number of patients there were no cerebellar symptoms or signs (9/22). Rapid deterioration of consciousness suggested acute compression of the brainstem, where the prognosis would be poor. CT scan made it possible to diagnose cerebellar infarction in the patients. But CT is not a satisfactory instrument in identifying this disease. MRI without bony artifacts from the posterior fossa has much higher resolution and renders the infarction to be visualized earlier. It may be regarded as the most ideal instrument in diagnosing this disease.

Using the murine monoclonal antibodies against human gastric cancer cell antigens designated MG7 and MGd1, we developed a sandwich ELISA to detect the levels of antigen-specific immune complexes (IC) in human sera. By this assay, only 6.7%(6/90) of healthy blood donors and 9.2%(6/65) of patients with chronic gastritis had antigen-specific IC in sera exceeding the cut-off value. Whereas 21.4%(6/28) of patients with colorectal cancer, 18.2%(4/22) of patients with hepatocellular cancer, 11.4%(4/35) of patients with lung cancer and 9.5%(2/21) of patients with breast cancer had elevated levels of the antigen-specific IC. In contrast, 58.7%(54/92) of patients with gastric cancer and 53.3%(24/45) of patients with esophageal cancer were positive for this antigen-specific IC. Determination of levels of antigen-specific IC in sera may be useful in serologic diagnosis of patients with gastric and esophageal cancer.

The effect and mechanism of kappa opiate receptor agonist and high-frequency electrostimulation of acupoints in treating spinal spasticity were studied. The spinal spastic models were made by gradual mechanical compression on the cervical spinal cord of rabbits. 24 prepared rabbits were divided into 3 groups randomly, and each group with 8 rabbits was given intrathecally kappa-receptor agonist 66A-078, kappa-receptor antagonist +66A-078 and normal saline respectively. The degree of spasticity was quantified by both clinical score and electrophysiological examinations. The result showed that the spasticity was markedly inhibited by intrathecal injection of 66A-078 and that the kappa-receptor antagonist (naloxone) reversed this effect. We can infer that the antispastic effect of 66A-078 is mediated by kappa-receptors. This result is helpful in explaining the immediate antispastic mechanism of high-frequency electrostimulation of acupoints discussed in previous study.

Of the 25 cases of entrapment, or compression syndrome of the posterior interosseous nerve of the forearm reported, 23 were treated surgically. The compressing or entrapping factors found during the operations consisted of 14 sites in tendinous tissues, 12 in vessels, 6 in scar adhesions, and 3 unclear. Of 11 cases each had 2 or more compression sites. 19 patients underwent local decompression. And 4 cases had membranous and degenerated nerves resection and end-to-end anastomoses. Hypertrophy and inflammation appeared to be the main pathological changes in 10 cases. The causes and pathology are discussed and the early diagnosis and treatment emphasized.

Microencapsules for pituitary transplantation was successfully developed with sodium alginate and poly-L-lysine (average molecular weight MW 70,000). The permeability of the capsular membrane (CM) was tested. The results showed that 60% of growth hormone (GH), thyroid stimulating hormone (TSH), prolactin (PRL) have passed through the membrane within 3 hours, and reached equilibrium up to 6 hours, suggesting that pituitary hormones (MW 20,000) could pass through CM freely. Bovine serum albumin (MW 67,000) in 50% could also permeate the CM in 3 hours and reached equilibrium up to 24 hours. While immunoglobulin (Ig, MW>150,000) did not penetrate the CM completely. This study revealed that the microencapsular membrane we made effected immuno-isolation and could be used for pituitary transplantation.

We studied the relations of intracranial pressure (ICP), creatine kinase (CK) and brainstem auditory evoked potential (BAEP) in 44 patients with traumatic brain edema who were admitted to our hospital from June 1990 to February 1991. There were 30 males and 14 females, with age range from 9 to 67 years. The results showed that the abnormal BAEP could reflect the severity of cerebral edema in acute head injury and was related to ICP and serum CK levels. When ICP>30 mmHg (4kPa), the abnormality of BAEP was more obvious than that of the control group (P<0.05); the serum CK levels were also elevated markedly. In patients with ICP over and below 4kPa, the rate of abnormal BAEP was 38.46% and 77.78% respectively (P<0.05). The serum CK level in the normal group or in the group with moderate abnormality of BAEP was significantly different from that in the group with severe abnormality or lack of BAEP (274.8±98.24 U/L vs 705.3±364.27 U/L; P<0.001). After treatment, the ICP returned to normal, and the BAEP normalized too, but the serum CK level decreased. The results showed that BAEP may provide some indirect evidences for the relevant biochemical and biophysical changes after the occurrence of traumatic brain edema and an important clinical index for judging the severity of the edema.

Qigong as a part of the traditional Chinese medicine is similar to western "meditation", Indian "Yoga" or Japanese "Zen", which can all be included in the category of traditional psychotherapy. A series of physiological and psychological effects occur in the course of Qigong training, but inappropriate training can lead to physical and mental disturbances. Physiological effects include changes in EEG, EMG, respiratory movement, heart rate, skin potential, skin temperature and finger tip volume, sympathetic nerve function, function in stomach and intestine, metabolism, endocrine and immunity systems. Psychological effects are motor phenomena and perceptual changes: patients experienced warmness, chilliness, itching sensation in the skin, numbness, soreness, bloatedness, relaxation, tenseness, floating, dropping, enlargement or constriction of the body image, a sensation of rising to the sky, falling off, standing upside down, playing on the swing following respiration, circulation of the intrinsic Qi, electric shock, formication, during Qigong exercise. Some patients experienced dreamland illusions, unreality and pseudohallucination. These phenomena were transient and vanished as the exercise terminated. Qigong deviation syndrome has become a diagnostic term and is now used widely in China.