1994年 · 第107卷第03期

Monoclonal antibody HMB-45 was previously thought to be melanoma specific antibody and was taken recently as a marker for melanocyte proliferation or activation. A single UV-irradiation system which may induce a functional activity change in melanocytes was used to test the irradiated epidermal melanocyte for expression of HMB-45. Melanocytes, in the epidermis of the biopsies taken 7 days after a single UV exposure, showed markedly stained HMB-45, accompanied by morphological changes such as enlarged size, rich cytoplasma and elongated dendrites. We conclude that since morphological changes in irradiated melanocytes may be interpreted as signs of functional activity changes, melanocytes are exposed to stimulatory factors induced by UV light and get into a functional activating state to produce melanosome and HMB-45 antigen. Besides, the presence of HMB-45 in a single UV exposed epidermal melanocyte may support the hypothesis that its expression is inducible and is closely related to the functional activity of melanocyte.

Hepatitis E virus antigen (HEVAg) has been identified in liver tissue of 6 out of 14 patients with hepatitis E using anti-HEV-IgG-horseradish peroxidase (HRP) and direct immunoperoxidase staining methods. HEVAg was found only in the cytoplasm of hepatocytes, but nor in the nuclei. The HEVAg positive hepatocytes were scattered singly, but in a few parts, where the liver damage was severe, the HEVAg positive cells were quite concentrated. We also observed the invasion of lymphocytes into the HEVAg positive hepatocytes. These phenomena suggest that the liver damage may be related to the immune reaction. No HEVAg was found in the liver tissues of stillborn fetus and neonate from woman patients with hepatitis E.

Drug absorptive function of the nasal mucosa has been a new and interesting subject of research in bridging rhinology and pharmacology. The authors applied a solution of gentamycin at a concentration of 40 mg/ml to 15 dogs at a dosage of 5 mg/kg for each through three routes of administration, ie, the intravenous, intramuscular and intranasal. The serum levels of gentamycin from 0 to 180 minutes after receiving the drug were determined with thin-layer scanning chromatographic method. It was found that if the bioavailability of the intravenous route was considered as 100%, the bioavailability of the intranasal route was 80.5%, and that of the intramuscular route was 42%. After giving drops of the drug into nasal cavity in above-mentioned dosage, the serum drug level reached a peak in 10 to 30 min ranging in 3.7 to 6.6 micrograms/ml. The half-life period of the drug given through this route was about three hours, indicating that the nasal mucosa is apt to be penetrated by gentamycin and allows the drug to be absorbed into the blood stream soon and maintained a long-acting level.

The clinical experience in the colon replacement of the esophagus in 240 cases is reported. The overall operative morbidity was 17.5%; the incidence of the anastomotic leaks was 10.4%; and the mortality was 2.80%. The points in surgical technique were: 1) utilizing the left colic artery as the supporting vessel if possible, based on the anatomy of the colon vessel; 2) using the colon segment in an isoperistaltic position, which has been proved much physiological; 3) single-layer anastomosis which is simple and reliable, with minimal inflammation and quick healing; and 4) choosing the channel of the colon transplant according to the disease condition, the age, and the function of the heart and the lung of the patients.

Fifty-two patients with unresectable hepatocellular carcinoma were divided into 2 groups. Group A (n=24) received lipiodolization with gelatin sponge and group B (n=28) lipiodolization alone. Angiography after hepatic arterial chemoembolization revealed a satisfactory accumulation of lipiodol and obliteration of the microvasculature in the tumors in both groups. However, prolonged obliteration of proximal hepatic arteries was noted in 70%-80% of patients in group A, in contrast to the patency of the arteries in group B. Collateral circulation was found more frequently in group A than in group B, in which recanalization of tumor vessels and phenomenon of iodized oil "wash-out" were seen. There were no significant differences in therapeutic effects in patients with low risk. In those with high risk, the response rates were 28.6% and 64.2%. The half-year survival rates were 28.5% and 62.8%, 1-year survival rates 7.1% and 27.5%, and 2-year survival rates 0% and 13.7% in group A and B respectively. The differences were significant (P<0.05). Serious complications occurred more frequently in group A than in group B. The therapeutic effects of lipiodolization without gelatin sponge for patients with high risk were significantly superior to those of lipiodolization with gelatin sponge. We conclude that the modality of hepatic arterial chemoembolization should be chosen according to the patient's clinical conditions.

We studied the relations of intracranial pressure (ICP), creatine kinase (CK) and brainstem auditory evoked potential (BAEP) in 44 patients with traumatic brain edema who were admitted to our hospital from June 1990 to February 1991. There were 30 males and 14 females, with age range from 9 to 67 years. The results showed that the abnormal BAEP could reflect the severity of cerebral edema in acute head injury and was related to ICP and serum CK levels. When ICP>30 mmHg (4kPa), the abnormality of BAEP was more obvious than that of the control group (P<0.05); the serum CK levels were also elevated markedly. In patients with ICP over and below 4kPa, the rate of abnormal BAEP was 38.46% and 77.78% respectively (P<0.05). The serum CK level in the normal group or in the group with moderate abnormality of BAEP was significantly different from that in the group with severe abnormality or lack of BAEP (274.8±98.24 U/L vs 705.3±364.27 U/L; P<0.001). After treatment, the ICP returned to normal, and the BAEP normalized too, but the serum CK level decreased. The results showed that BAEP may provide some indirect evidences for the relevant biochemical and biophysical changes after the occurrence of traumatic brain edema and an important clinical index for judging the severity of the edema.

Microencapsules for pituitary transplantation was successfully developed with sodium alginate and poly-L-lysine (average molecular weight MW 70,000). The permeability of the capsular membrane (CM) was tested. The results showed that 60% of growth hormone (GH), thyroid stimulating hormone (TSH), prolactin (PRL) have passed through the membrane within 3 hours, and reached equilibrium up to 6 hours, suggesting that pituitary hormones (MW 20,000) could pass through CM freely. Bovine serum albumin (MW 67,000) in 50% could also permeate the CM in 3 hours and reached equilibrium up to 24 hours. While immunoglobulin (Ig, MW>150,000) did not penetrate the CM completely. This study revealed that the microencapsular membrane we made effected immuno-isolation and could be used for pituitary transplantation.

Of the 25 cases of entrapment, or compression syndrome of the posterior interosseous nerve of the forearm reported, 23 were treated surgically. The compressing or entrapping factors found during the operations consisted of 14 sites in tendinous tissues, 12 in vessels, 6 in scar adhesions, and 3 unclear. Of 11 cases each had 2 or more compression sites. 19 patients underwent local decompression. And 4 cases had membranous and degenerated nerves resection and end-to-end anastomoses. Hypertrophy and inflammation appeared to be the main pathological changes in 10 cases. The causes and pathology are discussed and the early diagnosis and treatment emphasized.

The effect and mechanism of kappa opiate receptor agonist and high-frequency electrostimulation of acupoints in treating spinal spasticity were studied. The spinal spastic models were made by gradual mechanical compression on the cervical spinal cord of rabbits. 24 prepared rabbits were divided into 3 groups randomly, and each group with 8 rabbits was given intrathecally kappa-receptor agonist 66A-078, kappa-receptor antagonist +66A-078 and normal saline respectively. The degree of spasticity was quantified by both clinical score and electrophysiological examinations. The result showed that the spasticity was markedly inhibited by intrathecal injection of 66A-078 and that the kappa-receptor antagonist (naloxone) reversed this effect. We can infer that the antispastic effect of 66A-078 is mediated by kappa-receptors. This result is helpful in explaining the immediate antispastic mechanism of high-frequency electrostimulation of acupoints discussed in previous study.

Using the murine monoclonal antibodies against human gastric cancer cell antigens designated MG7 and MGd1, we developed a sandwich ELISA to detect the levels of antigen-specific immune complexes (IC) in human sera. By this assay, only 6.7%(6/90) of healthy blood donors and 9.2%(6/65) of patients with chronic gastritis had antigen-specific IC in sera exceeding the cut-off value. Whereas 21.4%(6/28) of patients with colorectal cancer, 18.2%(4/22) of patients with hepatocellular cancer, 11.4%(4/35) of patients with lung cancer and 9.5%(2/21) of patients with breast cancer had elevated levels of the antigen-specific IC. In contrast, 58.7%(54/92) of patients with gastric cancer and 53.3%(24/45) of patients with esophageal cancer were positive for this antigen-specific IC. Determination of levels of antigen-specific IC in sera may be useful in serologic diagnosis of patients with gastric and esophageal cancer.

Qigong as a part of the traditional Chinese medicine is similar to western "meditation", Indian "Yoga" or Japanese "Zen", which can all be included in the category of traditional psychotherapy. A series of physiological and psychological effects occur in the course of Qigong training, but inappropriate training can lead to physical and mental disturbances. Physiological effects include changes in EEG, EMG, respiratory movement, heart rate, skin potential, skin temperature and finger tip volume, sympathetic nerve function, function in stomach and intestine, metabolism, endocrine and immunity systems. Psychological effects are motor phenomena and perceptual changes: patients experienced warmness, chilliness, itching sensation in the skin, numbness, soreness, bloatedness, relaxation, tenseness, floating, dropping, enlargement or constriction of the body image, a sensation of rising to the sky, falling off, standing upside down, playing on the swing following respiration, circulation of the intrinsic Qi, electric shock, formication, during Qigong exercise. Some patients experienced dreamland illusions, unreality and pseudohallucination. These phenomena were transient and vanished as the exercise terminated. Qigong deviation syndrome has become a diagnostic term and is now used widely in China.