1997年 · 第110卷第10期

OBJECTIVE To verify from the aspects of immune senescence and free radical metabolism that "removing blood stasis as well as tonifying kidney is an ideal way to delay aging" and further investigate the anti-aging mechanism of this therapy. METHODS In the first period, the old mice were separately fed with the herbal decoction of the recipe of tonifying kidney, or of removing blood stasis, or of tonifying kidney and removing blood stasis for four weeks, and then IL-2 production of splenic lymphocytes, IL-1 production of peritoneal macrophages, SOD, CAT and GSH-Px activity in erythrocytes, and LPO contents in liver and brain were compared between the young control group and the old control group, or the old control group and each of the old medication groups. In the second period, the adult mice inhaled ozone or the splenic lymphocytes from adult mice were cultured in the medium containing peroxide hydrogen. The effects of free radicals on immune system and the reversion of the herbal decoction of the recipe of removing blood stasis as well as tonifying kidney were observed. RESULTS The activities of IL-1, IL-2, SOD, CAT and GSH-PX in old mice were significantly lower than those in young mice, and LPO contents were higher. The three herbal decoctions all have reversing effects on each of these parameters except that the decoction of removing blood stasis has inhibitory effects on IL-1 and IL-2 production. The effect of the decoction of removing blood stasis as well as tonifying kidney was the best among the three decoctions, and it can also reverse the impaired production of IL-2 by ozone in vivo and peroxide hydrogen in vitro. CONCLUSIONS The therapeutic method of removing blood stasis as well as tonifying kidney is an ideal way to delay aging, and its effects to improve immune senescence is correlated with the decrease of free radical damages.

OBJECTIVE To observe the changes of proto-oncogene c-fos/c-myc expression and its relation to specific transcription factors in human senescent fibroblast after epidermal growth factor (EGF) addition. METHODS The c-fos/c-myc expression were analysed by Northern blot. Transcription factors were analysed by Southwestern blot. RESULTS (1) The expression of c-fos/c-myc was less susceptible to induction by EGF as the cells aged. (2) EGF increased the binding of protein P91 to c-fos with regulatory sequence and P80 to c-myc with regulatory sequence, but the increased levels of both proteins were significantly reduced in senescent cells. CONCLUSIONS Inability of c-fos/c-myc gene induction by EGF in senescent cells might be correlated with some DNA-binding proteins.

OBJECTIVE To investigate the cytokines responsible for pathophysiology of asthma. METHODS In vitro effects of recombinant interleukin-4 (rIL-4) and interferon-γ (IFN-γ) on synthesis of immunoglobulin E (IgE) by peripheral blood mononuclear cells (PBMC) were studied in 30 asthmatic patients and 25 normal controls. RESULTS Spontaneous IgE synthesis by PBMC significantly increased in patients with asthma compared with the controls (t=4.471, P<0.001). Although the maximum amounts of IgE synthesis using PBMC after stimulation with rIL-4 were almost the same in the patients with asthma and in the controls (P>0.05), the enhancement rate of rIL-4-induced IgE synthesis was lower in the asthma patients than in the controls (t=4.6719, P>0.005). IFN-γ suppressed both spontaneous and rIL-4-induced IgE synthesis by PBMC in the asthma patients. The suppressive effect on IgE synthesis was more prominent in the patients with asthma than in the controls (t=7.1833, P<0.001). CONCLUSIONS Asthma attacks are related to IgE-dependent trigger mechanism. The imbalance of IL-4 and IFN-γ in vivo is the cause of elevated IgE than can produce mediators release and asthma attacks. IFN-γ can inhibit IgE synthesis, so IFN-γ may be a new approach to the treatment of asthma.

OBJECTIVE To sequence partial nonstructural 5 (NS5) gene of hepatitis G virus (HGV) in the sera of Chinese patients with chronic non-A-E hepatitis or hepatitis B virus (HBV) infection. METHODS Total nucleic acid was extracted from the sera of 35 patients with chronic non-A-E hepatitis and 20 patients with HBV infection, then it was subjected to reverse transcriptase-nested-polymerase chain reaction (RT-nested-PCR) with primers derived from the putative nonstructural gene 5 (NS5) region of HGV. The positive PCR products (994 bp in length) were directly sequenced using the Sang's method after purification. RESULTS HGV RNA was detected in 1 of the 35 patients (2.9%) with chronic non-A-E hepatitis and 5 of the 20 patients (25%) with HBV infection. All the 6 positive samples were sequenced. These 6 Chinese isolates exhibited 87.21% to 93.92% nucleotide sequence identities with 3 reported isolates (GBV-C, PNF2161, R10292) over the 994 nucleotides examined, while the nucleotide homologies among the 6 isolates were 90.09% to 93.82%. And 93.61% to 98.72% homologies were found at the deduced amino acid level in comparing the 6 isolates with 3 reported ones, while 93.61% to 98.40% amino acid identities were found among the 6 isolates. In the region sequenced, there existed 16 conserved proline residues and 8 conserved cysteine residues. CONCLUSIONS Six isolates of HGV were obtained from different Chinese patients in this study. The partial nucleotide sequences, as well as amino acid sequences, of the putative NS5 region of HGV in Chinese patients are relatively conserved. The overall degree of nucleotide conservation (90.09% to 93.82%) among Chinese isolates may make this region of the genome suitable for the development of diagnosis reagents.

OBJECTIVE To determine the antoantibodies and anti-interferon antibody in chronic viral hepatitis patients treated with interferon and the relation of the antibodies to the curative effect of interferon. METHODS Forty chronic viral hepatitis patients (twenty cases for hepatitis B; twenty patients for hepatitis C) were studied. Indirect immunofluorescence assay (IFA) was used to measure the autoantibodies. Enzyme immunoassay (EIA) was used to measure the anti-interferon total antibody. RESULTS Compared with normal groups, the autoantibodies in patients increased significantly (P<0.01), and the anti-interferon antibody in chronic hepatitis B and hepatitis C patients had an obvious difference (P<0.05). As for the curative effect, the presence or absence of autoantibodies did not have a distinct significance in patients treated with alpha-interferon, but the patients with anti-interferon antibody before or after therapy might have a different response to alpha-interferon. CONCLUSIONS It was suggested that the presence of autoantibodies was not a contraindication to the use of interferon in patients with chronic viral hepatitis; the clinical significance of anti-interferon antibody should be further studied.

OBJECTIVE To select advanced points from differently treated muscle grafts and explore a new conduit to bridge nerve defects. METHODS A total of 70 Sprague-Dawley rats were employed in this experiment. We applied a frozen probe to freeze the muscle in situ to disrupt any cellular elements of the local muscle grafts, but blood vessels to the muscle were carefully preserved. Radioactive microsphere technique was employed to visualize the blood supply to the muscle grafts. Immunohistochemical staining and ultrastructural observation were also carried out to assess the RESULTS of nerve regeneration. RESULTS The in-situ frozen muscle grafts were revascularized within the first 3 days, which led to fast migration of macrophages and Schwann cells. That was really reflected in the final results: the early incursion of regenerating axons, more regenerating axons at the early stage both in the grafts and distal stumps, and thicker myelin sheath of regenerating axons. CONCLUSIONS The in-situ frozen autogenous muscle graft is useful in the repair of sciatic nerve of rats. In the thicker and longer grafts the benefits will be more remarkable. It will be the most useful technique for nerve repair, especially in the repair of a large nerve gap in a poor recipient bed.

OBJECTIVE To evaluate a new scanning method designed for the diagnosis of early transtentorial hernia as compared with the routine scanning method (parallel to orbitomeatal line). METHODS 102 patients with unilateral high intracranial pressure and 100 volunteers without any cranial symptoms and signs were scanned on (1) the plane perpendicular to the plane of clivus and (2) the plane parallel to orbitomeatal line, a line joining the apex of the dorsum sellae and the lowest point of the clivus. RESULTS Vertical-to-clivus scanning method directly demonstrated the temporal transtentorial hernia in 48 of 102 patients with unilateral high intracranial pressure, but the orbitomeatal line scanning method was not able to show this direct finding. The projected tissue of the temporal lobe could be obviously shown and the degree of the hernia could be judged directly on the CT imaging with the vertical-to-clivus scanning method. Therefore, the CT diagnosis criterion of the hernia was suggested as follows: the hernia would be determined if the downward shift of the temporal lobe was more than 3 mm and suspected if less than 3 mm with ipsilateral high intracranial pressure. CONCLUSIONS This new method presented a superiority in showing the temporal transtentorial hernia for the patients with a cranial emergency.

OBJECTIVE A human promyelocytic leukemia (APL) cell line NB4 was used to demonstrate the synergistic effects between all-trans retinoic acid (ATRA) and prostaglandin E2 (PGE2) on growth inhibition and cytodifferentiation induction. METHODS NB4 cells were cultured in the presence of either ATRA or PGE2 as a single agent or in combinations at various ratio. Cell growth was measured and myeloid differentiation was tested on consecutive days over the whole course of culture. RESULTS PGE2 and ATRA synergistically induced the myeloid differentiation of NB4 cells. In comparison with ATRA alone, the combination of PGE2 with ATRA caused an almost 20-fold decrease of effective concentration of ATRA. CONCLUSIONS The combination of ATRA and PGE2 at an appropriate ratio may provide a convenient oral regimen of combined differentiation therapy for a better clinical outcome in APL patients.

OBJECTIVE To summarize the clinical features of 201 cases with Duane's retraction syndrome (DRS) and discuss its differential diagnosis. METHODS We retrospectively summarized the 201 cases from 1979 to 1996. The clinical features including chief complaints, sexual distribution, age at first visit, laterality, type of presentation, ocular deviation in the primary position, refractive errors, amblyopia, globe retraction, change of the palpebral fissure, upshoot and downshoot in adduction, binocular single vision, and its associated ocular and non-ocular anomalies were analysed. RESULTS There were 99 males and 102 females with a female-to-male ratio 1:1. The 65.88% of DRS cases had left eye involvement with two-to-one predilection for the left eye. The most common form of the syndrome was type I (184 patients, 91.54%). Exotropia was the most common deviation in the primary gaze (72 patients, 35.8%). Among 118 patients, most had abduction deficits, globe retraction in adduction, and faceturn as to maintaining single binocular vision. Crocodial tears (26 patients, 11.93%) was the most frequently encounted ocular abnormalities. CONCLUSIONS Diagnosis of DRS in a typical case is not difficult, however, children with bilateral abduction deficits which may mimic DRS must be differentiated from the following four motility disorders, namely, abducens nerve palsy, Moebius syndrome, congenital oculomotor apraxia, and congenital or infantile esotropia.

OBJECTIVE To obtain information on prescription pattern of antipsychotic drugs for schizophrenic in-patients treated in public hospitals in Hong Kong. Four main areas of antipsychotic treatment are reported in this paper: (1) doses of antipsychotic drugs, (2) the practice of giving multiple antipsychotic agents simultaneously, (3) use of antipsychotics in divided daily doses and (4) co-administration of antipsychotic and antiparkinson drugs. METHODS A cross-sectional survey of prescriptions of antipsychotic medication for a representative sample of 957 schizophrenic in-patients was conducted on a randomly chosen census day. Questionnaire items included basic demographic and clinical data, as well as inventory for all medications received by patients on census day. RESULTS The mean antipsychotic dose was 854±759 (median: 600; range) 0-4450) mg CPZeq. Over two-third of the patients were given more than drug concurrently while less than 20% received the medication in multiple divided doses. Antiparkinson drugs were prescribed with antipsychotic medication in 69.61%, of the subjects. There were few differences between acute and chronic patients with respect to their respective prescription patterns. CONCLUSIONS Antipsychotic treatment of schizophrenic inpatients in Hong Kong is largely in accord with international standards. Problematic areas identified for closer scrutiny include the concurrent use of more than one antipsychotic drug for both acute and chronic patients, and the higher than recommended doses for antipsychotic drugs and frequent use of antiparkinson medication for chronic patients. Dissemination of these results, accompanied by continuing medical education about psychopharmacology, are planned to further improve the quality of treatment for schizophrenic patients.