1995年 · 第108卷第07期

Introducing foreign gene(s) into vascular smooth muscle cells (VSMCs) and endothelial cells (ECs) is the pre-requirement of gene therapy for cardiovascular diseases. We have explored the use of adenoviral vectors (Adv-CMV/LacZ) to transfer LacZ gene into cultured VSMCs and ECs. Our results demonstrated that adenoviral vectors transferred foreign gene into VSMCs and ECs high-efficiently with dose-dependent response pattern. The frequencies of transfection reached 100% at the viral titer of 109 pfu/ml. Comparing the sensitivities of VSMCs and ECs to adenoviral vectors, we found that ECs were more sensitive than VSMCs, of which the frequencies of transfection in ECs reached 80% while in VSMCs only 40% for 8 hrs after transfection. In addition, the transfection of ECs and VSMCs with adenoviral vectors was partly blocked by monoclonal antibodies to Fiber and Core protein of the adenoviral capsid, but not by monoclonal antibody to Hexon protein. It is suggested transfection of ECs and VSMCs with adenovirus vectors is mediated by Fiber or Core protein of adenoviral capsid proteins.

To study the effects of nitinol alloy stent in the treatment of atherosclerotic arterial stenosis, eight miniature pigs were subject to abdominal aortic balloon denudation and high-fatty food. Then 8 nitinol alloy stents were implanted into each abdominal aortas of pigs. The pigs were equally divided into two groups. One group was given captopril (3 mg/kg/d). All animals were sacrified for pathological examination 6 to 10 months after stent implantation. The degree of arterial intima proliferation in the areas of stent implantation not significantly different from that of areas of balloon denudation alone; the atherosclerotic lesions were found at the arterial surface of stent implantation sites. The intima layer was rich in smooth muscle cells, with atherosclerotic plaque formed around the stent wire. On the other hand, significant decrease in arterial intima proliferation was found in group II with no atherosclerotic plaque. The arterial stenosis resulting from atherosclerotic lesion could not be prevented by implantation of intravascular stent, and on the contrary, the mechanical stress of stent wire might worsen the atherosclerosis. Captopril might impede the development of atherosclerotic stenosis after stent implantation.

The release kinetics of the cardiac specific troponin T (cTnT), measured by an immunosorbent assay, in 32 patients with acute myocardial infarction (AMI) was evaluated. In 8 AMI patients (25%), the release kinetics of serum cTnT showed biphasic serum concentration curves with a large peak at 10 to 18 hours after onset and the serum cTnT concentrations were up to 30 to 120 times of the normal upper limit-detected (0.2 μg/ml), and another samll cTnT peak at 70 to 100 hours after onset of pain. The serum cTnT measurements in the remaining 24 AMI patients (75%) gave only one large peak which was around 32 to 108 hours after onset of pain. cTnT appeared in serum as early as 3 to 4 hours and remained elevated until 240 hours after the infarctions. The results indicated that (1) cTnT was a sensitive and specific marker of AMI; (2) the biphasic curve of cTnT releae in general, the ratio of cTnT at around 14 to 32 (14/32)>1 in particular, may be a useful marker suggesting early reperfusion; (3) the continuous elevation of serum cTnT in AMI course might be a prognostic indicator for unfavorable outcomes.

We modified the examination and evaluation standard of impairment of hand function proposed by the International Federation of Societies for Surgery of the Hand (IFSSH). 1) The thumb adduction and opposition examination is changed from measuring distance alone to calculation of the ratio of thumb length to the distance of movement. 2) Sensation grading and two-point discrimination test are included in the sensory function evaluation. 3) In the estimation of anatomic loss of the hand, instead of measuring the length of the loss, calculation of the area of loss is proposed. 4) In the evaluation of joint movement, besides the angle of movement and position of the joint itself, influence of the defect distal to the joint thereon is also considered. 5) In the original evaluation standard, sensory disturb ances of the palmar and dorsal aspects of the hand as well as the anatomic loss of tissues through the palm are not taken into account. The present work pays special attention to this point. The software of the above mentioned work has been developed, approved by experts and adopted nation wide in China. The data of hand function examinations can be fed into the computer and the function loss in percentage can be displayed, or printed out. This software, using a graphic display, can also take care of the filling and retrieving of case history. At present the menu and instructions are in Chinese, which can be changed to suit other language. Our "Evaluation of Function Loss of the Hand" system and its software offer the doctors, patients and socially related parties (compensation cases, insurance and legal cases, etc) an objective and accurate way to evaluate the extent of hand function loss and the results of its management.

We evaluated the results of distal osteotomy of shortening the first metatarsal head with internal fixation of shape memory metal compression staple for hallux valgus in 26 feet of 17 women with a mean age of 41.0 years (30-65 years). The time for return to light work averaged 18.2 days, and to full work and normal walking 40.3 days after the operation. 16 patients (25 feet) had complete pain relief. Only in one foot, the pain was transferred under the 2nd metatarsal head. The appearance of the feet was markedly improved and the width of the forefeet was decreased by a mean of 0.92 cm after the operation. All of the patients were satisfied with the appearance of their feet. Radiographic analysis of feet showed that all osteotomies united, and the average angle of hallux valgus was improved from 30.1° to 16.0°, with the mean intermetatarsal angle of 11.2° -6.5°. No external fixation of plaster splintage was used and the distal fragment during healing of the osteotomy was stable. The time of bone healing was shortened and patients were allowed to bear weight at early stage.

Anti-HNK-1 monoclonal antibody (MAb) was reactive with non-cancerous and cancerous prostatic epithelia, as well as natural killer cells, myelinated nerves and cells from APUD systems. The expression of HNK-1 antigen on prostate cancer was investigated immunohistochemically by avidinbiotin-peroxidase complex (ABC) method with anti-HNK-1 MAb to clarify the relationship between anti-HNK-1 immunostaining of the cancerous tissue and the tumor differentiation, and that between the former and the survival rate of patients. Of 52 patients with prostate cancer, 49 were reactive with anti-HNK-1 MAb, the positive rate being 94%. The well differentiated cancer showed the highest percentage of positive cancer cells and the strongest staining, while the poorly differentiated cancer had the lowest percentage of positive cancer cells and the weakest staining. HNK-1 antigen was highly expressed on prostate cancer, and the better differentiated the cancer, the more HNK-1 antigen expressed. We also analyzed the total 5-year survival rate of the 52 patients, and the average 5-year survival rate and non-progression rate of 32 patients in stage D2 who had received only endocrinotherapy. Significantly higher survival rate and non-progression rate were observed in the group with more than two-thirds positive cancer cells as compared with the group with less than two-thirds positive cancer cells. The results suggest that the expression of HNK-1 antigen on prostate cancer may be a useful prognostic factor for patients with prostate cancer.

Two continuous cell lines derived from the neoplastic urothelium had been maintained in culture for more than two years. The first cell line derived from the urothelium of a fusion papillocarcinoma on the left lateral wall of the bladder was designated as TBC-1 and grown in vitro for more than 150 generations. The second cell line derived from the urothelium of a papillocarcinoma in the left renal pelvis was designated as TPC-1 and grown in vitro for more than 100 generations. Characterization studies made on both cell lines showed that the cells had a rapid doubling time, exhibited multilayering and produced tumors in sc of BALB/c. Tumor nodules that produced sc of BALB/c kept similar cellular and pathological features to those of the primary biopsy specimens under light and electron microscopes. TPC-1 cell line exhibited a three-dimensional structure of transitional epithelium on the nylon-mesh disk which was coated with a layer of rat tail collagen. Both TBC-1 and TPC-1 cell lines formed colonies in soft agar. Their forming rates were 35% and 28%, respectively. The chromosome number of TBC-1 cells ranged from 17 to 84, with a modal number of 54; whereas that of TPC-1 cells ranged from 28 to 139, with a modal number of 49. The TBC-1 cells showed mutant p53 and ras p21 protein expression and expressed weakly ABH blood group isoantigens. Analysis of lactic dehydrogenase (LDH) isozymes showed the highest levels of LDH isozyme 4 sonicated cell lysates of TBC-1 and TPC-1 respectively.

Sialographic follow-up studies of 36 cases of Sjogren's syndrome (SS) were performed with the duration of 5-72 months (mean 25 months). Three groups were divided according to the international criteria: secondary group, 14 cases (xerophthalmia, or/and xerostomia, and connective tissue diseases), primary group, 14 cases (xerostomia and xerophthalmia), and possible group, 8 cases (xerophthalmia or xerosptomia only). Sialographic findings at follow-up examination included (1) delayed evacuation, which may occur as early as 5 months later; (2) increased punctate sialectasis; (3) decreased punctate sialectasis with globular increase; (4) punctate, globular, and cavity sialectasis with radiolucent sialolith; and (5) centripetal atrophy. The cases with secondary and possible SS without xerostomia demonstrated little involvement of the parotid gland, without sialectasis. But sialodochitis was shown when radiolucent sialolith formed. The stimulated whole salivary flow rate (SWSFR) was closely related to sialographic appearance, i.e., the cases with lower value of SWSFR showed more siatectasis sialographically, but with higher SWSFR value, and less sialectasis. The relationship between the SS and pyogenic or candidal infection was discussed.

The characteristics of spinal cord-evoked potentials were investigated by using an in vitro spinal cord preparation. The spinal cord isolated from adult rats was immersed in a bathing chamber filled with oxygenated artificial cerebrospinal fluid (aCSF). The spinal cord-evoked potentials elicited by the stimulation of the spinal cord were recorded by using bipolar platinum electrodes. The potentials recorded consisted of early and late negative components (N1, N2). The inhibitory effect of lowered temperature on the N1 potential was clearly demonstrated. The oxygen deprivation of aCSF showed the higher sensitivity of N2 potential to hypoxia than that of N1. It was also possible to analyze the effects of potassium and magnesium ion concentration and pH on the evoked potentials. These results showed that the pure effects of various physiological and chemical factors on the spinal cord-evoked potentials can be analyzed by this experimental model.

On the basis of experimental study, we applied multiple subpial transection (MST) to treat 50 patients with intractable epilepsy in which epileptigenic lesion involved functional areas such as pericentral gyrus, postcentral gyrus, Broca's area, Wernicke's area, visual cortex, etc. They were followed up for 6 to 40 months. Complete control of seizures was obtained in 32 patients, significant reduction of seizure (more than 50%) in 13, reduction (less than 50%) in 3, and no effect in 2. The total effective rate was 96%. No functional defect was found in all patients. The mechanism of the disease and surgical technique were discussed in detail. We consider that MST could replace some standard excisional therapy for local epilepsy.

There are six large production institute of biologicals in China. The Kunming Institute of Medical Biology is the largest primate center, specializing in the production of live poliomyelitis vaccine and recently, of live poliomyelitis vaccine and recently, of live hepatitis vaccine as well.

A nation-wide survey of blood pressure (BP) and high BP was made in China in 1991, using standardized methods and covering 950,356 men and women aged 15 years and above, from 30 provinces, autonomous regions, and municipalities. The purpose of the study was to estimate the prevalence and the status of awareness, treatment, and control of hypertension. The overall prevalence rate of hypertension defined as systolic BP≥140 or diastolic BP≥90 mmHg or currently on antihypertensive medication was 13.6%, and was higher in urban (16.3%) than in rural (11.1%) setting. The rate was 6.6% if a BP cut-point of 160/95 mmHg was used. Rates were low in younger age-groups but rose sharply after age 45. The total number of hypertensives in 1990 was estimated to be close to 90 millions. Of all hypertensives, about 1/4 were aware of their high BP, half of these were on medication, and only 3% had their BP controlled. All the rates were higher if the BP cut-point was 160/95 mmHg. Higher rates were found in urban than rural setting and, to a lesser degree, for women than men. In conclusion, hypertension was found to be common in China, and the rates of awareness, drug treatment, and controlled BP were low, indicating an urgent need for developing a national program of treatment and prevention of high BP.