1990年 · 第103卷第05期

Twenty-one patients, under 6 years of age, with root avulsion of the brachial plexus were treated from 1975 to 1987. Among them, 9 had root avulsion of the upper trunk, 2 root avulsion of the lower trunk with middle trunk broken, and 10 root avulsion of the whole brachial plexus. Follow-up of 16 patients showed excellent results in 2 patients, good in 11, fair in 1 and poor in 2. It is suggested that good results can be obtained if multi-paired nerve transfer is adopted in treatment. We conclude that owing to anatomical and physiological characteristics of the respiratory system in children, it is harmful to perform phrenic nerve transfer concomitantly with intercostal nerve transfer. Advisably, two-stage operation is required, otherwise dyspnea and pneumonia are liable to occur. In addition, the time of the operation could be extended to 4-5 years after injury in children, but best results are obtained if the operation is performed within 1 year.

To develop a specific and sensitive method for the identification of Leishmania species and strains in China, Kinetoplast DNA (kDNAs) from 10 different isolates of Leishmania donovani and other species were analyzed by Southern and Dot hybridization. Our results showed significant diversities within different species and strains of Leishmania, which may be a useful criterion for taxonomic analysis. By Southern blot under different stringency conditions, we estimated that there is greater sequence heterogeneity between L. donovani isolated from dog and from human being in the same endemic focus than within the same isolate. Our Dot blotting assay with kDNA probe labelled by photobiotin differentiated species and isolates of Leishmania with as little as 104 parasites; so it is useful for field identification. The heterogeneity between isolates of L. donovani from patients in hilly and plain areas may have practical implications for disclosing the difference in endemicity. For the purpose of obtaining a large quantity of homogeneous minicircle, it was cloned and produced by recombinant pUC18.

Sister chromatid exchange (SCE) and chromosome aberration have been used to examine the peripheral lymphocytes of 20 epileptic children on 6-52 months monotherapy with valproic acid (VPA), and two matched control groups were set for comparison. The frequency of SCE in the VPA treated group is significantly higher than two control groups (P less than 0.01). It seems that the increase in SCE frequency is not related to epilepsy. SCE was also examined in 10 epileptic children before and after intake of only sodium valroat for 6-7 months, there was statistically significant change of SCE following VPA. 9 normal children's lymphocytes were exposed in vitro to sodium valproate (5-20 μg/ml), all showed a significant increase in SCE. These results suggested that VPA and its derivatives could damage the DNA of child users; however slightly higher rates of chromosome aberration were not significantly different from two control groups.

The system of blood supply of the optic chiasma was studied on 85 human fresh bodies by several methods. The optic chiasma is supplied by the Willis' circle, arterioles from which, after forming anastomosis at two levels, enter the chiasma and break into capillaries. The authors found that the median portion of chiasma is a weak point of microcirculation, as demonstrated by rarefied and transverse capillaries. When the blood supply of chiasma is compromised by lesions near the sella turcica, this weak point of microcirculation is apt to be disturbed first and becomes ischemic, causing disorders of the crossing optic nerve fibers in the median portion of chiasma, and the characteristic bitemporal visual field defects appear.

Fourty-five patients with Budd-Chiari syndrome were treated surgically from December 1985 to May 1988. The procedures consisted of cavoatrial shunt, mesoatrial shunt, transcardiac membranotomy, splenopneumopexy, portal vein-systemic vein shunt and re-opened umbilical vein-right auricle shunt, etc. Two of the patients died postoperatively. Others showed improvement after follow-up for 3-24 months. Recurrent hemorrhage from varices did not occur after operation in all patients. The diagnosis, surgical indications, and various methods of surgery for Budd-Chiari syndrome were discussed.

The effect on the stability of the lumbar motion segment, as affected by partial discectomy, was investigated using three-dimensional motion measurement technique. Eight functional spinal units from fresh cadaver lumbar spines were potted and clinically relevant loads applied through a special loading frame attached rigidly to the top vertebra of the specimen. Partial discectomy was performed on the right side of the specimen. The three-dimensional motions of each lumbar motion segment, before and after partial discectomy, were recorded. The results showed that partial discectomy significantly affects the stability of lumbar spinal motion segments. The clinical relevance of this finding is discussed.

To understand the mechanism of hemorrhage, coagulation and fibrinolysis in epidemic hemorrhagic fever (EHF), thrombin time (TT), prothrombin time (PT), fibrinogen (FIG), the platelet count (PLAT), plasminogen (PLG), antithrombin-III (AT-III), fibrin-fibrinogen degraded products (FDP) and platelet functions of aggregation and release were studied dynamically with advanced methods in 134 EHF patients. TT and PT were prolonged, FIG, AT-III and PLG were decreased and FDP was increased. Besides, the decrease of PLAT, the platelet functions of aggregation and release were below the normal level. The results showed that the balance of blood coagulation and fibrinolysis was lost from the early stage of the disease.

A CD10 monoclonal antibody 55 (McAb55) was intended for purging residual common acute lymphoblastic leukemia antigen (CALLA) positive leukemic cells from autotransplants of common acute lymphoblastic leukemia (C-ALL) patients. It was found that after two rounds of McAb55 and complement treatment, 4-5 logs of CALLA+ cells were removed from bone marrow detected by clonogenic assay. The standardization of separation, purgation and preservation of bone marrow for C-ALL patients' autotransplants was then set as follows: Following the carboxymethyl starch sedimentation and Ficoll-Hypaque gradient separation, the isolated mononuclear cells (MNCs) were treated with McAb55 and complement twice and kept in room temperature for 48-72 hours prior to infusion. This procedure resulted in the removal of more than 99% of CALLA+ cells, recovery of 10-30% MNCs, and leaving the hematopoiesis stem cells intact. After the intensive cytoreductive therapy, 4 patients with C-ALL received the purged autotransplants giving timely recovery of the hematopoietic function. The patients were all remaining in remission status for more than 40-250 days so far.

A study of the relationships between serum TC, TG and HDL.C and selective coronary arteriography was carried out on 117 patients who were divided into groups according to the extent of artery stenosis. Normal control group consisted of 153 healthy subjects. There were no statistical differences in TC, TG, HDL.C, LDL.C, TC/HDL.C, LDL.C/HDL.C and TC-HDL.C/HDL.C between normal control group and the group with normal coronary arteriogram. LDL.C, TC/HDL.C, LDL.C/HDL.C, TC HDL.C/HDL.C rose and HDL.C decreased as the degree of coronary artery stenosis and the extent of stenosis increased, besides the medium and severe stenosis group. Analyses based on the correlation coefficients indicate that 3 compound indexes (TC-HDL.C/HDL.C, TC-HDL.C, LDL.C/HDL.C) are better in assessing CAD than single index such as LDL.C, HDL.C and TC. The results of our study showed that the 3 compound indexes might be regarded as important risk factors for CAD.

Several chemotherapeutic drugs including methotrexate, daunomycin, mitomycin C and toxin such as ricin, A chain of ricin were chosen to conjugate with murine monoclonal antibodies MGb2 and MG11. The drugs were linked to antibody directly or through human serum albumin as intermediary. The ELISA results showed that the antibody retained well the antigen-binding capacity during conjugation. These conjugates showed highly selective cytotoxic effect on target cells. In chronic cytotoxicity tests, the cytotoxic effect of these conjugates on human gastric cancer cells KATOIII was quite similar to that of free drugs or ricin, but greater than that of irrelevant conjugates, while they had a little effect on non-target cells, suggesting that the selective cytotoxicity on target cells of the conjugates be mediated by antibodies.

Xanthomonas campestris isolated from the blood of a patient with a fever was first reported. Xanthomonas campestris is a bacterium that can cause black rot of some vegetables, such as rape. Chinese cabbage, etc. Human infection due to X. campestris has not been reported so far. The characteristics of this organism, including morphology, staining, physiology and biochemistry were studied. We believe that X. campestris is also one of the opportunistic pathogens, which can infect compromised host.