1983年 · 第96卷第12期

Piperacillin is a new broad spectrum semi-synthetic penicillin. This paper reports the antibacterial activity, clinical pharmacology and clinical trials of piperacillin. The results of bacterial susceptibility testing of 387 clinical isolates reveal that piperacillin is active against various Gram positive and Gram negative organisms with especially marked activity against Gram negative organisms, the inhibition rates against Ps aeruginosa and E coli being 90% and 79%. Peak serum levels after IM and IV injections and IV drip of 1 gm piperacillin in normal volunteers were 25, 142.1 and 58 μg/ml. Pharmacokinetic parametcrs are calculated, based upon the specific therapeutic regimens used in treating various infections. Piperacillin is used in 148 cases of infect.ions including peritonitis, lung infections, septicemias etc, the total effective rate being 77.7%, the cure rate is 55.4%. Adverse reactions are rare, no renal, hepatic or hemopoietic toxicity were noted.

Neurofibroma is a benign slowly growing soft tissue tumor often present at birth. Most tumors are of small and medium size: only rarely do they grow rapidly ultimately reaching enormous size at puberty or during pregnancy for unknown reasons. Due to its great weight and bulk, a gigantic tumor though located on the trunk may interfere considerably with patient daily activity. Surgical removal is the only effective way of treatment though this may involve profuse bleeding which may be life-threatening and require great care. The case is more complicated if there is inadequate tumor skin available to cover the resulting wound. It is unwise to extend the already extensive wound area, and cause further bleeding by harvesting skin elsewhere, in critical cases, Therefore, a conservative operation aimed only at partial reduction of the tumor weight and bulk is justified rather than regarding the tumor as inoperable. 3 cases of gigantic neurofibroma of the back are reported in this paper.

85 patients with 99mTc phosphate scintigraphy to estimate femoral head viability following femoral neck fracture are presented. 68 are followed up, in whom 29 had scintigraphic examinations prior to X-ray diagnosis of avascular necrolsis. The prediction accuracy is 96.5% (28/29). Scintigraphic examination was performed simultaneously with or after X-rays in 39. The diagnosis accordance is 97% (38/39). It can be concluded that 99mTc pyrophosphate scintigraphy is an excellent method for early assessment of femoral head bone vitality. It may also be an important and reliable means of more accurate prognosis and aid the selection of an appropriate surgical procedure and elven tho most suitable preventive measures. It may also be a reliable method of observing the vascularity of the femoral head during treatment.

22 cases of intrahepatic cholestasis of pregnancy are reviewed. All had pruritus followed by icterus due to pregnancy occurring in the second or third trimester. Viral hepatitis was excluded serologically. The pruritus and icterus disappeared soon after parturition. 13 had spontaneous premature deliveries, 3 fetal deaths 1 stillbirth and 2 postpartum hemorrhages. The causes and mechanism of fetal death and still-birth are still unknown.

This study is conducted to obtain fuller knowledge of the pathologic changes and X-ray findings in suppurative arthritis, to provide the required basis for early diagnosis and prognosis. 13 joints of 7 animals are infected with suppurative arthritis and comparison is made of the roentgenologic and pathologic manifestations during the various stages of infection.

A reversed passive hemagglutination test (RPHA) has been established to determine human serum IgE levels Sheep erythrocytes stabilized by glut.araldehyde are coated with purified IgG fraction of horse anti-human. IgE serum with chromic chloride and tannic acid. Various factors were determined, including method of stabilization, coating pH, purification and heat-treatment of purified horse anti-human IgE serum and chromic chloride and tannic acid concentration yielding the best results. RPHA sensitivity was compared with that of the radioactive single radial diffusion test (RSRD) using a working standard coded '751' which was calibrated with the International Reference Standard 68/341, WHO. It was found that '751' IgE level is 2,100 units/ml by RSRD and the corresponding RPHA reproducible titer is usually around l:160. RPHA sensitivity is about 13.3 units/ml. The test specificity was confirmed by hemagglutination inhibition test (HAI). 196 serum samples were tested by both methods and showed definite correlation. If attention is paid to the conditions mentioned, RPHA can be used as a sensitive semiquantitative method for screening serum IgE levels in numerous samples.

An immunologic function study is made in in 220 schistosomiasis cases of various stages, IgG, IgA and IgM levels in all are elevated, while the lymphocyte transformation rates are markedly depressed as compared with controls. After treatment, elevated immunoglobulin levels of acute and chronic cases decline but not in advanced ones. In acute cases, IgA normalized and IgM decreased 2 months after treatment. Four to 7 months after medication, lymphocyte transformation rates in acute and chronic cases increase markedly but practically no change is found in advanced cases. The results suggest that acute schistosomiasis is accompanied by vigorous immune response and treatment with effective drugs helps promote and improve immune function.

The structures of the egg shell and oocyte of A lumbricoides are examined by SFM and the eggs fractured by DMSO freiezing cracking method. On the outer surface of protein layer there are numerous filament fibers arranged in a net-work-like structure between 2 projections and 2 eggs; the mammillated projections number 12-16 at 1 cross cracking surface in the egg middle portions. The chitinous shell consists of 3 layers, the outer limited membrane, middle chitinous zone and inner limited membrane. The lipoid layer, dissolved by alcohol, can not be seen by the freezing cracking technic. The oocyte is spherical or subspherical in shape and possesses continuous unit membrane. There are numerous granules such as dense granules and refringent bodies within the cytoplasm. Occasionally 1 or 2 first polar bodies extruding into the perivitelline space can be seem The oocyte is frequently surrounded by a layer of deutoplasm, which varies in amount.

A double antibody sandwich method is described for detecting serum IgD by enzyme-linked immunosorbent antibody (ELISA). The method is specific, rapid, convenient and inexpensive. Quantitative detection of serum IgD level by this method in normal fertile female and pregnant women in the first and third trimesters indicate that the mean values are 24.56±17.34, 28.94±16.07 and 55.10±9.04 μg/ml. The difference in IgD concentrations between normal fertile women and those in the third trimester is statistically significant (P<0.001). The significance of the findings is discussed and further study of IgD in reproductive immunology emphasized.

A case of thymic alymphoplasia with myelopoietic hypoplasia, so-called reticular dysgenesia is presented and compareld with the 7 cases reported in the world literature. This disease is the most severe and rarest form of combined immunodeficiency disease (SCID) caused by a hemopoietic stem cell defect in lymphopoiesis and myelopoiesis differentiation.