多重抗药性突变株中α－淀粉酶高产菌株选育

以解淀粉芽孢杆菌（Ｂａｃｉｌｌｕｓａｍｙｌｏｌｉｑｅｆａｃｉｅｎｓ）Ａ－４为出发菌株，经诱变处理，选育多重抗药性突变株。研究结果表明，抗药性突变株α－淀粉酶产量提高的正变率和正变幅度明显大于非抗药性突变株，负变率和负变幅度也较高。经ＮＴＧ和ＮＴＧ－ＵＶ诱变处理，获得一株林可霉素、Ｄ－环丝氨酸和万古霉素多重抗性突变株ＬＣＶ＿５（Ｌｉｎ￣ｒ，Ｃｓ￣ｒ，Ｖｍ￣ｒ），其α－淀粉酶活力比出发菌株Ａ－４提高３２．５％，发酵周期短，摇瓶为４０ｈ，酶活力达４６１ｕ／ｍｌ．     

阿舒假囊酵母过量合成核黄素性能的改良

以６０Ｃｏ的ｒ射线为诱变剂，核黄素合成途径的中间产物的结构类似物为“筛子”，筛选了阿舒假囊酵母（Ｅｒｅｍｏｔｈｅｃｉｕｍａｓｈｂｙｉ）的四种抗性突变株：杀结核菌素抗性突变株（Ｔｕｂｒ）、２－脱氧葡萄糖抗性突变株（２－ＤＧｒ）、８－氮杂鸟嘌呤（８－ＡＧｒ）和抗残液突变株。杀结核菌素抗性突变株Ｔ３０的摇瓶核黄素产量由出发菌的２．５～２．８ｍｇ／Ｌ提高并稳定在３．５ｍｇ／Ｌ以上，经初步优化（培养基配方）后，稳定在５．４ｇ／Ｌ以上。     

普外科住院患者乙肝病毒感染的血清流行病学调查（附5297…

对１９９０￣１９９３年住我院普外科患者５２９７例进行乙型肝炎病毒（ＨＢＶ）感染的血清流行病学统计调查。结果：ＨＢＶ感染者３７３６例，总感染率７０．５％，ＨＢｓＡｇ，抗－ＨＢｓ及抗－ＨＢｓ的阳性率分别为１９．４％、３５．９％和４１．１％，明显高于一般人群。而肝胆胰系统疾病患者的ＨＢＶ总感染率、ＨＢｓＡｇ及抗－ＨＢｃ的阳性率分别为８０．３％、３４．２％和５６．１％，亦明显高于外科其它系统疾病患者。因此     

几种激素对茶愈伤组织合成茶氨酸的影响

根据生长素（ＩＡＡ），吲哚丁酸（ＩＢＡ），萘乙酸（ＮＡＡ），以及２，４－二氯苯氧乙酸（２，４－Ｄ）和６－卞艹基腺嘌呤（６－ＢＡ），激动素（ＫＴ），玉米素（ＺＴ）及三十烷醇（ＴＡ）等的不同浓度和不同组合，测定茶愈伤组织生长和茶氨酸的积累情况，以求得茶愈伤组织生长和茶氨酸积累的较佳培养条件。试验证明，以４ｍｇ／Ｌ６－ＢＡ＋２ｍｇ／ＬＩＡＡ或３ｍｇ／Ｌ６－ＢＡ＋１．５ｍｇ／ＬＩＡＡ＋２ｍｇ／ＬＴＡ的组合，添加于ＭＳ培养基上，茶愈伤组织生长和茶氨酸积累均良好，茶氨酸含量最高可达１７０ｍｇ／ｇ．     

羟基脂肪酸聚酯产生菌选育

以特定方法筛得羟基脂肪酸聚酯（ＰＨＡＳ）产生株ＡＭＢ－００１，初步鉴定为产碱菌（Ａｌｃａｌｉｇｅｎｅｓ）属。经紫外线与亚硝基胍诱变，变异株ＡＵＮ－３９产聚羟丁酸（ＰＨＢ）和聚羟丁戊酸共聚物（ＰＨＢＶ）的产率分别为细胞干重的３５％和４７．５％．透射电镜观察表明ＡＵＮ－３９胞内积累的ＰＨＢ粒子可充满胞内空间。     

L－脯氨酸产生菌的选育

以嗜乙酰乙酸棒杆菌ＡＴＣＣｌ３８７０为出发菌株，经硫酸二乙酯（ＤＥＳ）和亚硝基胍（ＮＴＧ）逐级诱变处理，结构类似物定向选育，获得一株Ｌ－脯氨酸高产菌ＺＱ－３（ＳＧｒ、Ｓｕｃｇ、ＤＨＰｒ）。在含１６％葡萄糖的培养基中，摇瓶发酵７２ｈ，产酸率为５．３％～５．５％。     

肝细胞肝与乙,丙及庚型肝炎病毒感染相关的组织学证据

目的 探讨肝细胞肝癌（ＨＣＣ）与乙、丙及庚型肝炎病毒（ＨＢＶ、ＨＣＶ，ＨＧＶ）感染的相关性。方法 采用免疫组化方法检测ＨＣＣ患者癌及癌直组织中ＨＢＶ，ＨＣＶ表达状况。结果 ６５例ＨＣＣ患者中，共计５２例（８０．％）检出以上三种肝类病毒抗原，其中乙型肝炎表面抗原（ＨＢｓＡｇ０，ＨＣＶＮＳ５和ＨＧＶＮＳ５怕阳性者分别为４７（７２．３％），３０（４６．２％）和１０（１５．４％）例。５２例病毒标志阳性者中     

补体在重度烧伤病人PMN吞杀绿脓杆菌力中的作用

采集了７０例烧伤病人１２９份外周血中性粒细胞（ＰＭＮ），以Ｏ~２￣－、特殊颗粒（ＳＧ）和胞内杀菌力（ＩＣＢＡ）为指标动态观测了深度烧伤后病人的ＰＭＮ水平变化；分析了病人血浆对正常人ＰＭＮ胞内指标的有害作用，及抗人Ｃ~３、Ｃ~５血清（ＡＨＣ~３Ｃ~５Ｓ）对上述有害作用的特异阻断效能。结果表明：①重、中度烧伤病人的各指标值均显著低于正常水平（Ｐ＜０．０５）；当ＢＳＤ（深度烧伤面积）≥４５％和病程在１～６天时，ＩＣＢＡ最低。②ＩＣＢＡ与ＳＧ和Ｏ~２￣－的动态相关显著（Ｐ＜０．０５）。③病人血浆能显著削减正常人ＰＭＮ胞内ＩＣＢＡ、ＳＧ和Ｏ~２￣－的储存，而ＡＨＣ~３Ｃ~５Ｓ能减轻这些储存的丢失，效能由保护率表示：ＩＣＢＡ（６７．３３％）＞ＳＧ（５１．６０％）＞Ｏ~２￣－（４６．６８％）。结果提示：ＰＭＮ杀菌力的高低与ＢＳＤ和病程早晚呈负相关，Ｃ~３、Ｃ~５碎片是ＰＭＮ胞内ＩＣＢＡ下降的重要直接因素。     

国产人α_1型基因工程干扰素治疗小儿乙型肝炎病毒相关性肾炎（HBV－GN）的初步观察

我们报道应用国产重组人α１干扰素治疗小儿乙肝病毒相关性肾炎（ＨＢＶ－ＧＮ）三例患者临床表现均为肾病综合征，结合临床特征，病理检查及肾组织中ＨＢＶＤＮＡ的提取均符合ＨＢＶ－ＧＮ的诊断标准。应用α１干扰素的剂量为３００万ｕ／ｍ￣２体表面积，疗程４个月，发现一例血清ＨＢＡｇ较快转阴，尿蛋白减少，血ＣＤ＿４／ＣＤ＿８恢复正常，另一例血清ＨＢＡｇ始终阳性，血ＣＤ＿３上升，尿蛋白消失。提示该药有抑制ＨＢＶ病毒在被感染细胞内复制及增殖作用，并可调节、改善机体的免疫功能。     

阿法D3防治绝经后骨质疏松症的临床研究

应用阿法Ｄ３防治绝经后骨质疏松症２４例。年龄６０．５３±６．６岁，绝经年龄４８．６±１０．９岁。阿法Ｄ３０．２５μｇＢｉｄ，钙剂（乳酸钙）日５００ｍｇ元素钙，疗程半年。结果：血ＡＬＰ、尿ＨＹＰ／Ｃｒ，尿Ｃａ／Ｃｒ，尿Ｃａ／Ｃｒ用药后明显下降。Ｌ２－４ＢＭＤ轻度增高。骨痛改善率５９．３％。以上骨癌症状消失，Ｌ２－４ＢＭＤ改善的总疗效为９０．５％。其中６例手足肌肉痉挛者５例症状消失，１例明显减轻。全组血尿常规，肝肾功能，肾脏Ｂ超于用药后均未见异常。未出现高血钙，不良反应轻微。表明阿法Ｄ３是防治绝经后骨质疏松症安全有效的药物。     

Vasopressor hormone response following mesenteric traction during major abdominal surgery

Background : We investigated the vasopressor hormone response following mesenteric traction (MT) with hypotension due to prostacyclin (PGI₂) release in patients undergoing abdominal surgery with a combined general and epidural anesthesia. Methods : In a prospective, randomized, placebo-controlled study we administered 400 mg ibuprofen (i.v.) in 42 patients scheduled for abdominal surgery. General anesthesia was combined with epidural anesthesia (T4-L1). Before as well as 5, 15, 30, 45, and 90 min after MT we recorded plasma osmolality, hemodynamics and measured 6-keto-PGFlα (stabile metabolite of PGI₂), TXB₂ (stabile metabolite of thromboxane A₂) active renin, and arginine vasopressin (AVP) plasma concentrations by radioimmunoassay. Catecholamine levels were assessed by high-pressure liquid chromatography (HPLC) with electrochemical detection. Results : Following MT, arterial hypotension occurred along with a substantial PGI₂ release. This was completely abolished by ibuprofen administration. Although plasma levels of 6-keto-PGF_1α (1133 (708) vs. 60 (3) ng/L, median (median absolute deviation), P=0.0001, placebo vs. ibuprofen) remained significantly elevated, blood pressure was restored within 30 min after MT in the placebo group. At the same point in time plasma concentrations of TXB² (164 (87) vs. 58 (1) ng/L, P=0.0001), epinephrine (46 (33) vs. 14 (6) ng/L, P=0.001), AVP (41 ± (18) vs. 12 (7) ng/L, P=0.0004), and active renin (27 (12) vs. 12 (4) ng/L, P = 0.001) were significantly higher in placebo-treated patients. Conclusion : Under combined general and epidural anesthesia arterial hypotension following MT due to endogenous PGI₂ release is associated with enhanced release of AVP, active renin, epinephrine and thromboxane A₂, presumably contributing to hemodynamic stability within 30 min after MT.     

A comparison of the inhibitory effects of four volatile anaesthetics on the metabolism of chlorzoxazone, a substrate for CYP2E1, in rabbits

Background: Halothane inhibits in vitro and in vivo activity of cytochrome P-450 (CYP) 2E1. There are several fluorinated volatile anaesthetics besides halothane, and most of them are defluorinated by CYP2E1. It is unclear whether other fluorinated anaesthetics inhibit the in vivo activity of CYP2E1.
Methods: We compared the inhibitory effects of therapeutic concentrations of four inhalational anaesthetics, halothane, enflurane, isoflurane, and sevoflurane, on chlorzoxazone metabolism in rabbits receiving artificial ventilation.
Results: All four inhalational anaesthetics decreased arterial blood pressure and increased plasma chlorzoxazone concentration. However, no significant differences in the plasma chlorzoxazone concentration were found between the four anaesthetics. The estimated chlorzoxazone clearance increased after beginning inhalation with all four agents, but no significant difference in clearance was noted between agents.
Conclusions: At therapeutic concentrations, the in vivo inhibitory effect on chlorzoxazone metabolism was similar for all four inhalational anaesthetics examined, even though their chemical characteristics and extent of hepatic metabolism differ considerably.     

A Teaspoon Pump for Pumping Blood with High Hydraulic Efficiency and Low Hemolysis Potential

Abstract: Virtually all blood pumps contain some kind of rubbing, sliding, closely moving machinery surfaces that are exposed to the blood being pumped. These valves, internal bearings, magnetic bearing position sensors, and shaft seals cause most of the problems with blood pumps. The original teaspoon pump design prevented the rubbing, sliding machinery surfaces from contacting the blood. However, the hydraulic efficiency was low because the blood was able to "slip around" the rotating impeller so that the blood itself never rotated fast enough to develop adequate pressure. An improved teaspoon blood pump has been designed and tested and has shown acceptable hydraulic performance and low hemolysis potential. The new pump uses a nonrotating "swinging" hose as the pump impeller. The fluid enters the pump through the center of the swinging hose; therefore, there can be no fluid slip between the revolving blood and the revolving impeller. The new pump uses an impeller that is comparable to a flexible garden hose. If the free end of the hose were swung around in a circle like half of a jump rope, the fluid inside the hose would rotate and develop pressure even though the hose impeller itself did not "rotate"; therefore, no rotating shaft seal or internal bearings are required.     

Microspheres Based Detoxification System: A New Method in Convective Blood Purification

Abstract: A variety of protein-bound or hydrophobic substances, accumulating as a result of pathologic conditions such as exogenous or endogenous intoxications, are removed poorly by conventional detoxification methods because of low accessibility (hemodialysis), insufficient adsorption capabilities (hemosorption), low efficiency (peritoneal dialysis), or economic limitations (high-volume plasmapheresis). Combining advantages of existing methods with microspheric technology, a module-based system was designed. Major operating parameters of the latter can be modified to allow for adjustment to individual clinical situations. An extracorporeal blood circuit including a plasmafilter is combined with a secondary high-velocity plasma circuit driven by a centrifugal pump. Different microspheric adsorbers can be combined in one circuit or applied in sequence. Thus, a prolonged treatment can be tailored using specially designed selective adsorber materials. Comparing this system with existing methods (high-flux hemodialysis, molecular adsorbent recycling system), results from our in vitro studies and animal experiments demonstrate the superior efficiency of substance removal.     

Is the recovery profile of mivacurium independent of the rate of decay of its plasma concentration in patients with normal plasma cholinesterase activity?

Background: The duration of action of muscle relaxants is poorly correlated to the rate of decay of their plasma concentration. The plasma concentration of mivacurium may rapidly decrease below its active concentration because of the extensive hydrolysis of mivacurium. By inflating a tourniquet on one upper limb for 3 min after the administration of atracurium, mivacurium or vecuronium, we studied the influence of the initial decline of their plasma concentration on their effect. Methods: In 50 patients anaesthetised with thiopental, isoflurane and fentanyl, the effect of bolus doses of 0.15 or 0.25 mg . kg^?1 mivacurium (MIV 15, MIV 25), 0.3 or 0.5 mg . kg^?1 atracurium (ATR 30, ATR 50) and 0.06 or 0.1 mg . kg^?1 vecuronium (VEC 06, VEC 10) were measured on both arms (evoked response of the adductor pollicis to train-of-four stimulation every 12 s), a tourniquet being applied on one arm just before and during 3 min after the muscle relaxant bolus. Results: Tourniquet inflation of 3 min almost abolished the neuromuscular effect of mivacurium. In the vecuronium groups and in the ATR 50 group, tourniquet inflation did not modify the maximum degree of depression of the twitch response. Also, the duration of action of vecuronium was unaffected by the tourniquet. In the ATR 30 group, times to return of the twitch response to 25% (duration 25%) and 75% (duration 75%) of control response were significantly shorter in the cuffed arm, 23 min vs 27 min, and 41 min vs 45 min, respectively. In the ATR 50 group, only duration 25% was significantly shorter in the cuffed arm (41 min vs 45 min). Conclusion: The results suggest that the rate of decline of the plasma concentration of mivacurium is so rapid, that a very low and almost clinically ineffective concentration is present as soon as 3 min after its administration. The results also indicate that the recovery from a mivacurium-induced neuromuscular blockade is not influenced by the rate of decay of its plasma concentration in patients with genotypically normal plasma cholinesterase.     

Membranes in Artificial Organs

Abstract: Membrane processes play a pivotal and enabling role in modern replacement therapy for acute and chronic organ failure and in the management of immunologic diseases. In fact, virtually all contemporary extracorporeal blood purification methods employ membrane devices, and the next generation of artificial organs and tissue engineering therapies are almost certain to be similarly grounded in membrane technology. In this short essay, we comment on the similarities and differences among synthetic membranes and their natural counterparts and also provide a critical overview of the demographics and technology of hemodialysis, hemofiltration, apheresis, oxygenation, and emerging membrane technologies and applications.     

Tissue perfusion in relation to cardiac output during continuous positive-pressure ventilation and administration of propranolol or verapamil

Background : Our objective was to determine whether administration of propranolol or verapamil modifies the hemodynamic adaptation to continuous positive-pressure ventilation (CPPV), in particular the regional distribution of cardiac output (CO).
Methods : General hemodynamics and regional blood flows assessed by microsphere technique (15 (μm) were recorded in 16 anesthetized pigs during spontaneous breathing (SB) and CPPV with 8 cm H₂O end-expiratory pressure (CPPV8) before and after intravenous administration of propranolol (0.3 mg · kg⁻¹ followed by 0.15 mg · kg⁻¹ · h⁻¹, n=8) or verapamil (0.1 mg · kg⁻¹ followed by 0.3 mg · kg⁻¹ · h⁻¹, n=8).
Results : CPPV8 depressed CO by 25% without shifts in its relative distribution with the exception of a noteworthy increase in adrenal perfusion. Propranolol increased arterial blood pressure, and due to a fall in heart rate, CO dropped by 25%. The kidneys and, to a lesser extent, the splanchic region and central nervous system received increased fractions of the remaining CO at the expense of skeletal muscle flow. Similar patterns were seen during SB and CPPV8 such that the combination of propranolol and CPPV8 depressed CO by 50%. The circulatory effects of verapamil were less evident but myocardial perfusion tended to increase.
Conclusions : The combination of propranolol or verapamil with CPPV does not result in any specific hemodynamic interaction in anesthetized pigs, except that the combined effect of propranolol and CPPV may severely reduce CO.     

Volatile anaesthetics reduce adhesion of blood platelets under low-flow conditions in the coronary system of isolated guinea pig hearts

Background : Inhibitory effects of volatile anaesthetics on platelet aggregation have been demonstrated in several studies. However, the influence of volatile anaesthetics on intracoronary platelet adhesion has not been elucidated so far.
Methods : Isolated hearts of guinea pigs were perfused with buffer in the absence or presence of volatile anaesthetics (0.5 and 1 MAC) at constant coronary flow rates of 5 ml/min for 25 min, then 1 ml/min for 30 min and again 5 ml/min for 10 min. Before, during and after low-flow perfusion, a bolus of human platelets was applied into the coronary system. To simulate thrombogenic conditions, 0.3 U/ml human thrombin was infused during low-flow perfusion and reperfusion. The number of platelets sequestered to the endothelium was calculated from the difference between coronary in- and output of platelets. The myocardial production of lactate and consumption of pyruvate and coronary perfusion pressure were also determined.
Results : At a flow rate of 5 ml/min only about 3% of the applied platelets did not emerge from the coronary system, in any group. In contrast, 13.1±1.2% (mean±SEM) of infused platelets became adherent in low-flow perfusion in the control group without anaesthetic. The adherence was reduced with each 1 MAC isoflurane (to 6.2±1.2%), sevoflurane (to 4.4±0.9%) or halothane (to 3.2±1.5%) (each P <0.05 vs. control). Volatile anaesthetic, 0.5 MAC, did not inhibit platelet adhesion to a statistically significant extent in any case. Perfusion pressure and metabolic parameters were not statistically different between the control and the hearts exposed to anaesthetics.
Conclusion : Volatile anaesthetics in a concentration of 1 MAC can reduce the adhesion of platelets in the coronary system under reduced flow conditions. This action does not arise from vasodilation or inhibition of ischaemic stress.     

Bariatric Surgery in Some "Central and East-European (former Eastern bloc)"Countries - Current Status and Prediction for the Next Millennium

Background: Obesity is increasing globallly, including in the formerly "Eastern Bloc" countries. Methods: A survey was made of obesity and bariatric surgery. Results: In the 8 East and Central European countries studied, with total population 300 million, roughly 43% of the population was overweight (BMI 25-30), 23% obese (BMI > 30), with about 15 million people morbidly obese (BMI > 40). From 0-10 morbidly obese individuals/100,000/year undergo bariatric surgery. Conclusion: Most countries were found to provide inadequate treatment for obesity.The majority of the morbidly obese are not treated effectively. However, health-care awareness of obesity and bariatric surgeons are slowly increasing.     

Dilemma of Membrane Biocompatibility and Reuse

Abstract: Numerous articles have been published on the multiple use of dialyzers and on the effect of different reprocessing chemicals and techniques on the dialyzer biocompatibility and performance. The results often appear contradictory, especially those comparing standard biocompatibility parameters. Despite this confusion, a discerning review of the published works allows certain limited conclusions to be drawn. Reprocessing of used hemodialyzers changes the biocompatibility profile of a dialyzer as defined by the parameters complement activation. leukopenia, and cytokine release. The effect of reprocessing depends on the chemicals and reprocessing technique applied and also on the type of membrane polymer being subjected to the reprocessing procedure. Reports of pyrogenic reactions indicate that the flux of the membrane also influences how suitable it is for safe reuse. An increased risk of allergic and pyrogenic reactions appears to be associated with dialyzer reuse. Furthermore, there has been a lack of investigations into the immunologic effect of the layer of adsorbed and chemically altered proteins that remains on the inner surface of reprocessed dialyzers. We conclude that the clinical benefit of dialyzer reuse cannot be generally accepted from a biocompatibility point of view.