1994年 · 第107卷第11期

In recent years, tumor-infiltrating lymphocytes (TILs) have been reported to be effective for tumors in experimental and clinical research. In order to increase the therapeutical effect, we modified some steps of Rosenberg's approach: a. cold digestion with collagenase at 4 ℃ for 24 hours; b. sedimentation instead of centrifugation; c. elimination of tumor cells before the cultivation procedure. Compared with the original approach, the proliferation, activity and cytotoxicity of TILs obtained by the modified procedure were much improved. TILs' expansion-fold was greater than that with the original approach. Cytotoxicity against tumor cells was more potent. Increased TILs' subsets were CD3 and CD8 cells. Meanwhile, we took tumor cells from tumor tissues to test their in vitro chemosensitivities to different drugs in order to select highly sensitive antitumor drugs for treatment of cases with advanced tumors. According to the design of using highly active TILs and highly sensitive drugs (H & H therapy), preliminary clinical results of 50 cases showed higher response rates than those in treatment with TIL/IL2, LAK/IL2 and TIL+IL2+CTX. Less toxic side effects were observed in 14 patients.

The cell-killing effect and its possible mechanism of berberine used alone or in combination with argon ion laser treatment on 9L rat glioma cells were studied. The survival fraction of 9L cells after single treatment of berberine has been investigated using both colony formation and microtitration (MTT) method, the half lethal dose of berberine (LD50) has been estimated to be 60 μg/ml. After the addition of low energy laser treatment, the LD50 of berberine markedly decreased to 10 μg/ml. The inhibitory effect of berberine on biosynthesis for DNA, RNA, and protein of 9L cells was enhanced by argon ion laser. Moreover, when morphologic change was examined, the 9L cells showed lysis, encystation, and degeneration after berberine treatment; the laser treatment enhanced the cell-killing effect. The study proves the cell-killing effect of berberine combined with laser treatment on 9L rat glioma cell line, hence introducing the possibility of berberine as a photosensitive agent.

The serum IgG subclass concentrations in 47 cases and specific IgG subclass antibodies against pneumococcal polysaccharides (PnPs) were measured in 18 cases with iron deficiency. IgG subclass deficiencies were found in 28 (59.6%) cases with the frequency in order as IgG4 (27.7%, 13/47), IgG1 (21.3%, 10/47), IgG3 (14.9%, 7/47), and IgG2 (2.1%, 1/47). Compared with age-matched healthy children, the mean concentration of serum IgG4 and IgG1, and PnPs specific IgG1, IgG2 antibodies were decreased in children with iron deficiency. Decreased CD4+ cells and CD4+/CD8+ ratio in peripheral blood, low interleukin-6 (IL-6) activity, reduced lymphocyte proliferative responsiveness and increased recurrent respiratory tract infections (RRTI) were found in iron deficiency children. These results suggested that serum IgG subclass and PnPs specific IgG subclass antibody deficiencies caused by dysfunction of the regulation of T lymphocyte on B lymphocyte may be related to the susceptibility to RRTI in children with iron deficiency.

Eight hundred and ten pedigree members of 110 patients with Graves' disease were studied. In 700 first-degree relatives, inquiry of medical history, physical examination (including eyes, thyroid, heart rate, etc), thyroid function tests (serum T3, T4 and TSH levels), determinations of thyroglobulin antibodies (TgAb) and thyroid microsomal antibodies (TmAb) were performed. For male (female) probands, the incidence of Graves' disease in male (female) first-degree relatives were investigated and their serum TgAb and TmAb were analysed. The incidence of these two kinds of autoantibodies in the male (female) first-degree relatives of familial and nonfamilial Graves' disease were analysed. Eighteen persons with positive TgAb and TmAb from 5 pedigrees had been followed up one year after initial determinations. Our results suggest that the positive rates of TgAb and TmAb in the first-degree relatives of Graves' disease were coincident with the incidence of Graves' disease, and the positive results of TgAb and TmAb in the first-degree relatives of Graves' disease may be an indicator of pre-Graves' disease or pre-autoimmune thyroid diseases.

The aim of this study is to investigate the effects of nitric oxide, formed from L-arginine, on the production of endothelin-1 in vivo and in cultured endothelial cells. In mechanically ventilated anesthetized dogs (n=5), mean pulmonary arterial pressure (PAPm) and pulmonary vascular resistance (PVR) during hypoxic ventilation (FIO2=0.10) was 25±3.1 kPa and 68.7±10.2 kPa.s/L respectively. NG-nitro-L-arginine methylester (L-NAME), an inhibitor of nitric oxide synthase, increased the peak value of PAPm and PVR during hypoxic ventilation to 36.6±4.7 kPa and 158.4±25 kPa.s/L and its effect lasted for 2-3 hours. Meanwhile, plasma endothelin-1 level in the femoral artery increased by 20.9±7.1, 25.6±7.7, 28.6±7.9 pg/ml at the 60th, 120th, 180th minute after the injection of L-NAME respectively (P<0.05 vs hypoxic control before the injection). In cultured endothelial cells from umbilical veins, endothelin-1 level of culture medium in control group was 35.1±5.9 pg/105 cells/ml (n=9). L-NAME increased endothelin-1 level to 42.8±4.9pg/105 cells/ml (n=9, P<0.05) in case of 10-11 mol/L and to 43.0±4.7 pg/105 cells/ml in case of 10-7 mol/L (n=9, P<0.05). These findings indicate that endogenous nitric oxide is an inhibitory modulator of hypoxic pulmonary vasoconstriction and that nitric oxide inhibits the production of endothelin-1 in vivo and in cultured vascular endothelial cells.

Using enzymatic assay and radioimmunoassay, we studied the functional status of pancreatic islet in 50 patients with acute leukemia. Oral glucose tolerance test and insulin and C peptide release were made in 40 patients before and after treatment. 14 patients who revealed diabetic curve and delayed insulin and C peptide release before treatment showed normal values in 6 after therapy. Five patients with impaired glucose tolerance and decreased insulin and C peptide release before treatment showed normalization of these parameters following therapy. Five patients with normal pretreatment values disclosed abnormal post-treatment results. The remaining 16 patients displayed normal results both before and after therapy. Anti-insulin antibodies were negative, and glucagon level was normal in all the 50 patients. The red cell insulin receptor binding rate analysed in 47 patients was significantly higher than in controls (P<0.001). We considered that the disturbed glucose metabolism in acute leukemia was not uncommon mainly due to the dysfunction of pancreatic islet β cells as a result of islet damage by leukemic cells, the effect of corticosteroid and chemotherapy and the preexisting diabetes. Impaired glucose metabolism had no influence on therapeutic effect.

Anastomotic false aneurysm (AFA) of the aorta is a potentially lethal complication after prosthetic grafting. Nineteen aneurysms were encountered in 18 patients within a 30-year period (1960-1991). There were 10 men and 8 women, aged 27-80 years (mean 58 years). In 14 patients, the prostheses were made of silk, in 2 were PTFE, and in 1 each Dacron or silk-Dacron cross-weaved. Patients with an intact AFA had a pulsatile abdominal mass, abdominal pain, an occluded graft and peripheral emboli. Five patients were asymptomatic. Clinical onset of AFA varied from 2 weeks to 12 years (mean 5 years). The accurate rate of diagnosis of single plane angiography was 75% (3 of 4), and computed tomography 100% (ten of ten). Ultrasound was used only once and suggested an AFA. Four AFAs were less than 5cm in diameter. Five patients refused operation and died in 2 years from rupture. Operative mortality was 11% (1 of 9). Treatment was resection of AFA and replacement with a new graft. Life-long follow-up is required for patients with an aortic aneurysm. All ratroperitoneal AFAs should be resected, since the outcome of rupture is poor.

By means of histological method and ultrasound cardiographic (UCG) examination, the left-right ratio of transectional area of muscle fiber of latissimus dorsi muscle (LDM) after non-dynamic cardiomyoplasty was 77.4±11.7% in Group I (3 weeks after operation), and 78.4±11.6% atrophy and hyperplasia of LDM, but the basical structure was retained. The ejection fraction (EF) decreased significantly after operation (P<0.05), but the difference between two groups was non- significant. Also, dynamic cardiomyoplasty was performed on a sheep. UCG showed the increased cardiac systolic function after operation. ATPase, succinodehydrogenase (SDH) and PAS examination implied the strengthening of fatigue-resistant ability in skeletal muscles after long-term electrical stimulation. So cardiomyoplasty is suggested to be a supplementary measure in treating end-stage heart failure.

In order to diagnose accurately the type of acid-base disturbance (ABD) in patients with post-traumatic multiple organ failure (PMOF), arterial blood gases and electrolytes were determined 645 times on 112 patients with PMOF and the data were analyzed with the pre-estimated compensatory formula of ABD and the calculations of anion gap, potential bicarbonate, and blood chlorides. Simple ABD was found in 381 times of determinations and double ABD in 239 when only the formula was used in the analysis, while 264 times of simple ABD, 260 times of double ABD and 96 times of triple ABD were found when the formula was employed in combination with the calculations of anion gap, potential bicarbonate and blood chloride. The mixed types of ABD were increased by 49% (117 times) from 239 to 356 times and triple ABD was increased from 0 to 96 times. The findings indicate that the employment of the combined formula and the calculations of anion gap, potential bicarbonate and blood chloride is of great significance to assess ABD especially its mixed and complicate types in patients with PMOF. It is emphasized that along with the monitoring of blood gases, the determination of blood electrolytes and the calculation of anion gap and potential bicarbonate should be performed to determine the correct type of ABD.

The macrophages mediated biodegradation of two biomaterials, collagen/hydroxylapatite (CHA) and beta-tricalcium phosphate ceramics (TCP), was studied in 24 male Kunming mice and 20 male C57BL/6 mice with histopathologic, histochemical and ultrastructural observation. It was demonstrated that macrophages infiltrated after CHA, TCP were implanted. The macrophages could be differentiated from fibroblasts and the other infiltrated cells for special cellular profile and strong acid phosphatase activity. Morphologically, monocyte-macrophages and infused multinuclear giant cell degraded CHA and TCP by phagocytosis and extracellular resorption. The carbonic anhydrase activity of macrophages was demonstrated by histochemical technique. It suggested that macrophages secreted H+ and accomplished the decalcification of calcium phosphate compound of CHA and TCP. We conclude that macrophages are the main mediating cells which degraded CHA and TCP intracellularly and extracellularly.

The effect of selenium (Se) supplement on pregnancy was studied in 52 pregnant women with high risk factors of pregnancy induced hypertension (PIH). They were given natural Se dietetic liquid (100 micrograms/d) for 6-8 weeks during late pregnancy, and 48 controls were given placebo. They received similar routine prenatal care. The results revealed that Se supplement on the pregnant women prevented and decreased the incidence of PIH and gestational edema, and elevated the mother's blood Se level by 0.1008±0.091 ppm in the treated group while decreased by 0.0402±0.046 ppm in the control group (P<0.01). The umbilical blood Se level was 0.2756±0.100 ppm in the treated group and 0.1544±0.051 ppm in the control (P<0.01). The differences of the neonatal birth weight and the amount of postpartum hemorrhage between the two groups were not significant.