环胞霉素A、亲合素和钙调磷酸酶复合物的结构特性与免疫抑制及其毒理作用机理

钙调磷酸酶（calcineurin，CN）是亲免素（immunophilin）-免疫抑制药物（immunosuppressant）复合物-环胞霉素A（cyclosporin A，CsA）、环胞霉素A亲合素（cyclophilin，CyP）和FK506结合蛋白（FK506-bindingprotein，FK BP-506）、FK506的共同靶目标。这些药物蛋白的复合物都能特异地抑制CN的生物活性，但是两种结构完全不同的亲免素-免疫抑制药物复合物为何能够作用同一靶目标目前仍不清楚。     

TOXINS AND ANTITOXINS--SNAKE VENOMS AND ANTIVENINS

A specific antivenin against crotalus venom can be prepared bv the immunization of goats. A specific antivenin against water moccasin venom can be produced by the immunization of goats with this venom, modified by hydrochloric acid. Immunization with the unmodified venom is very difficult. The toxicity of crotalus venom is diminished more than fifty percent. by passage through a Chamberland filter. There is a simple relation between the toxicity and the body weight for guinea-pigs weighing from 250 to 500 grams. Smaller guinea-pigs (125 grams) are comparatively less resistant. The toxicity is smaller by subcutaneous than by intraperitoneal injection (guinea-pigs), or by intravenous injection (rabbits). White rats are very resistant. The toxicity of cobra venom is not measurably diminished by filtration through a Chamberland filter. The relation between the amount of venom and the corresponding time of death is very regular, and can be expressed by a curve of asymptotic nature. Lecithin does not increase the toxicity. The tracings representing toxin-antitoxin neutralization for the three venoms (crotalus, cobra and moccasin) show deviation from the straight line. This deviation is most pronounced for the toxic quota of the venoms. The tracing representing crotalus venomantivenin neutralization, determined on guinea-pigs, can, within errors of experiment, be expressed by the equation: Free toxin · Free antitoxin = K · toxin-antitoxin. The corresponding tracing determined on rabbits is somewhat different, but both tracings are much more markedly curved than that for cobra venom-antivenin. The neutralization tracing of water moccasin venom shows the peculiarity, that small amounts of antivenin decrease the toxicity to a minimum, but the toxicity is again increased by further addition of antitoxin. The tracing representing neutralization of the haemolysins of the three venoms are different from the tracings of neutralization of the toxins, and approach very closely to a straight line. Still, in all instances, the determinations with great concentrations of antilysin show pronounced deviation, perhaps due to some dissociation of the toxin-antitoxin combination.     

HEPATITIS AND HIV: INTERRELATIONSHIP AND INTERACTIONS

SUMMARY Hepatitis in the context of HIV infection is commonplace, but the causative agent is not always readily identifiable. This review highlights the differential diagnosis of hepatitis in that context, examining the interrelationships and interactions between the four main hepatitis viruses and HIV.     

LEUCOPROTEASE AND ANTI-LEUCOPROTEASE OF MAMMALS AND OF BIRDS

The inhibiting action of the blood serum upon the enzyme of the polynuclear leucocytes, leucoprotease, is exerted by the albumin fraction of the serum. The albumin fraction contains no proteolytic enzymes. The globulin fraction of the serum contains no anti-enzyme for leucoprotease; it contains, on the contrary, an enzyme which digests proteids in a neutral or alkaline medium. This enzyme resembles leucoprotease which is present in the polynuclear leucocytes of an inflammatory exudate and in the bone marrow from which these cells are derived, and is doubtless identical with the similar enzyme occurring in smaller quantity in the spleen. This enzyme which is present in the blood serum is held in check by its anti-enzyme, but the latter is in such excess that the serum as a whole is capable of checking the action of leucoprotease when added in considerable quantity. Leucoprotease of one mammalian species is inhibited by sera of other mammalian species, but the anti-enzymotic activity of various sera differs; the anti-enzyme of the rabbit''s serum is stronger than that of dog''s serum, when tested either with dog''s or with rabbit''s leucoprotease. The co-existence in the rabbit of leucoprotease with feeble strength and anti-body of great activity may explain the absence in these animals of typical suppuration with liquefaction of tissues. The serum of birds which have been tested, namely, pigeon and hen, almost completely fails to inhibit mammalian leucoprotease (of dog). The polynuclear leucocytes, the bone marrow and the spleen of the hen do not contain an enzyme resembling leucoprotease of mammals. The absence of anti-enzyme in the serum is associated with absence of a corresponding enzyme in the leucocytes.     

CELL-MEDIATED IMMUNITY AGAINST BESNOITIA AND TOXOPLASMA IN SPECIFICALLY AND CROSS-IMMUNIZED HAMSTERS AND IN CULTURES

The capacity of hamster peritoneal cell populations to control viability and growth of Besnoitia and Toxoplasma organisms was assessed in vivo and in vitro. Immunized hamsters reduced the homologous organisms 100- to 10,000-fold over a 5-day period, but the heterologous infection increased 100- to 1,000-fold in numbers, similar as in the nonimmune controls. Passively administered antibody was ineffective although lytic cofactors were supplied by hamsters. In cultures, peritoneal cells from Besnoitia-immune hamsters delayed the growth of homologous parasites to an average of 38.5 h per division; however, in Toxoplasma-immune and nonimmune cells, Besnoitia divided every 12.8 h. Specificity of immunity was pronounced against both infections. With cross-infections, Toxoplasma-immune cultures did not effectively delay Besnoitia growth; however, Besnoitia-immune cultures reduced Toxoplasma growth by one-half. Co-cultivation experiments demonstrated that specifically committed lymphocytes could instruct macrophages to reduce the homologous organism 10-fold, whereas heterologous organisms were reduced only 2-fold. Lymphocyte supernatants initiated hypersensitivity as indicated by macrophage activation and giant cell formation in culture. However, these supernatants did not transfer infection immunity. Lymphokines could account for the hypersensitivity phenomena, but cell-mediated infection immunity in this model required close lymphocyte-macrophage proximity. These studies indicate that a number of distinct processes including delayed hypersensitivity, macrophage activation, and specific cellular immunity are acting simultaneously during latent Besnoitia infection of hamsters. All three processes are mediated by lymphoid cells and appear to be specifically induced. Although activated macrophages develop some heightened nonspecific capabilities, these were several orders of magnitude below the specific effects.     

HYPERVENTILATION AND DIZZINESS: CASE REPORTS AND MANAGEMENT

SUMMARY Dizziness is a common symptom in patients presenting to an otorhinolaryngologist. Hyperventilation accounts for up to 5% of cases with dizziness and is a contributory factor in a further 20% of cases. Six cases of dizziness due to hyperventilation are presented to illustrate the authors' simple management policy. A high index of suspicion in the absence of an organic cause of dizziness and a simple provocation test will identify these cases. Management is aimed at demonstrating resting hypocapnia, investigations to exclude organic causes of hyperventilation and rehabilitation in collaboration with a clinical psychologist ensures the appropriate treatment for the dizziness and can avoid the development of chronic somatisation behaviours.     

宫颈及盆腔解脲支原体、沙眼衣原体感染与输卵管性不孕

目的　探讨女性宫颈及盆腔解脲支原体 (UU)和沙眼衣原体 (CT)感染与输卵管性不孕的关系及其感染特点。方法　应用聚合酶链反应 (PCR)法对接受腹腔镜检查的 36例输卵管性不孕患者 (不孕组 )和 2 3例正常生育患者 (对照组 )进行宫颈分泌物和盆腔液体UU、CT检测 ;应用腹腔镜了解输卵管粘连及阻塞程度。结果　两组宫颈分泌物UU阳性率分别为 30 .6 %、8.7% ,两者相比有显著性差异 (P <0 .0 5 ) ;宫颈分泌物CT阳性率两者比较无显著性差异 ;两组盆腔液体UU、CT阳性率相比较无显著性差异 (P >0 .0 5 ) ;不孕组UU阳性患者输卵管周围轻度以下粘连占 5 0 % ,但输卵管阻塞率为 87.5 % ,同组UU阴性患者输卵管周围中、重度粘连占 79.2 % ,输卵管阻塞率为 6 4 .6 % ,两组粘连程度及阻塞率相比均有显著性差异 (P <0 .0 5 )。结论　女性生殖道UU感染与输卵管性不孕相关 ;UU、CT感染症状隐匿 ,但输卵管腔损害明显     

侧隐窝及腰椎旁注射强的松龙及来比林对腰椎间盘突出症患者血浆β—内啡肽与P物质的影响

目的 :检测腰椎间盘突出症疼痛患者血浆β 内啡肽及P物质水平的变化 ;观察侧隐窝及腰椎旁椎间孔注射强的松龙及来比林对腰椎间盘突出症的治疗效果。方法 :腰椎间盘突出症患者 4 8例 ,随机分为三组 ,采用不同药物及注射方法治疗。每次治疗前测定血浆 β 内啡肽与P物质含量。结果 :三组患者治疗前血浆 β 内啡肽含量均显著低于正常人 (P <0 .0 1) ,而P物质水平显著高于正常人 (P <0 .0 1)。治疗过程中 ,随疼痛症状改善 ,各指标逐渐趋向正常水平。结论 :β 内啡肽及P物质在腰椎间盘突出症引发的疼痛中可能起一定作用。     

PREPARATION AND PROPERTIES OF SHIGA TOXIN AND TOXOID

1. Shigella dysenteriae (Shiga) can, under the proper cultural conditions, produce a soluble toxin which is independent of the specific somatic polysaccharide antigen. A method is described for the rapid production of this toxin by an avirulent R variant of this organism. 2. The amount of bacterial protoplasm synthesized, and the yield of toxin produced, are very much increased when the culture is grown under conditions which favor aerobic metabolism and which do not permit accumulation of organic acids. 3. Although addition of an excess of inorganic iron to the medium does not interfere with the synthesis of bacterial protoplasm, maximal toxin production is obtained only in media which have been freed of the metal. 4. R Shiga bacilli grown under conditions of extreme aerobiosis at pH 7.0 in a simple medium free of inorganic iron and containing fumaric acid, glucose, meat extract, and peptone, give rise within 24 to 36 hours to cultures exhibiting a high degree of toxicity. The toxic principle rapidly becomes soluble as the cells die; it can be concentrated, purified, and freed of phosphorus by selective precipitation methods. 5. The toxin is fairly resistant to heat at pH 6.0 but rapidly denatured at pH 9.0. It is only slowly inactivated by trypsin. It filters readily and without loss of activity through anionic exchange resins but is precipitated and adsorbed by cationic resins which retain the nitrogen and toxic activity of the preparation. 6. The most active preparations of toxin available possess an LD₅₀ of 1 to 10 µg. for mice and rabbits. Young mice (up to 5 weeks of age) are more resistant than older animals. 7. The soluble toxin can be detoxified by treatment with 0.5 per cent formalin at pH 8.5; detoxification does not take place at lower pH whereas treatment at higher pH destroys specific antigenicity. Mice immunized with Shiga toxoid (in solution, or in the form of an alum precipitate) develop active immunity to the toxin.     

经尿道前列腺汽化电切术的并发症及其防治

目的：探讨经尿道前列腺汽化电切术(TUVP)的常见并发症及产生原因，提高TUVP治疗效果。方法：对420例有症状良性前列腺增生(BPH)患者行TUVP术。平均年龄62．9岁。术前及术后测定尿漉率，术后随访l～3个月。结果：该组无死亡率。发生尿道损伤2．1％。经尿道电切综合征(TURS)2．4％，包膜穿孔和尿外渗2．9％，出血4．5％，暂时性尿失禁2．8％，永久性尿失禁0．24％，尿道狭窄3．1％，膀胱颈挛缩l.9％．尿道感染及附睾炎、睾丸炎6．9％，阳萎6．4％，逆行射精11．4％。结论：TUVB术中保持清晰视野，规范操作．止血彻底，可防止前列腺包膜穿孔和切破静脉窦及术后出血和尿失禁发生，并且也可减少TURS的发生率。     

THE RECOGNITION AND COMPARISON OF PROLAN AND PROLAN-LIKE SUBSTANCES

The synergism phenomenon has made possible the recognition of substances, which we have called "prolan-like," in a wide variety of conditions. Indeed, it has been possible to demonstrate a prolan-like material in the urine of normal men. The method has shown a wide distribution of prolan-like substances in sera and urines of non-primates without demonstrating, however, significant difference in the reactions secured from pregnant as contrasted with non-pregnant states, or in males as contrasted with females. The synergism phenomenon with pregnancy prolan can also be shown in the increased development of the seminal vesicles of immature male rats. However, such males cannot be advantageously employed in the detection of prolan-like gonadotropic substances occurring in the blood and urine in conditions other than pregnancy, for the prolan-like substances usually do not effect appreciable development of the seminal vesicles.     

SEROLOGICAL RELATIONSHIPS AMONG AND BETWEEN THE STREPTOCOCCI AND PNEUMOCOCCI

Using the complement fixation reaction with whole bacterial solutions as antigens, it has been possible to confirm the existence, within the non-hemolytic streptococcus family, of two great groups. One of these groups, that which may be designated as of the left side, is related in an orderly way to the hemolytic streptococci; the other of the right side, is similarly related to the entire pneumococcus family. In addition, the hemolytic streptococcus family shows a reactive range which relates it, though less closely, to the non-hemolytic streptococci of the right side, and to the pneumococci. The existence of these cross-relationships is not associated with the precipitable substance of either family, but may tentatively be presumed to be dependent upon the properties of the protein or lipoid-protein fraction of the bacterial cell.     

COMPLEMENT AND COMPLEMENT-LIKE ACTIVITY IN LOWER VERTEBRATES AND INVERTEBRATES

A purified cobra venom factor with C-inhibiting activity also promotes lysis of erythrocytes in fresh mammalian serum. Lysis-inducing activity of purified cobra venom factor was found in sera of lower vertebrates including the cyclostome hagfish and in invertebrates. Lysis-inducing activity was most effective with frog serum. Frog serum was found to be more hemolytic for E^s in the presence of CVF than when cells were sensitized with hemolysin. The hemolysis induced by CVF with frog serum, as in the higher vertebrates, was inhibited when sera were pretreated with known C inhibitors including heat, chelators, endotoxin, immune complexes, and CVF itself. Complexes formed with CVF and either frog serum or invertebrate hemolymph promoted lysis of indicator cells in the presence of frog serum in EDTA. This lysis was most marked when the starfish-CVF complex was used and was C-dependent. Conversely, complex formed with frog serum and CVF promoted lysis of E in the presence of invertebrate hemolymph (Limulus) in EDTA. Hence, serum components were to some degree at least interchangeable between vertebrate sera and invertebrate hemolymph. Lysis-inducing activity of purified CVF occurs in a wide range of species, has revealed activities resembling those of terminal C-components in lower vertebrates and invertebrates, and provides one means for study of C and C-like activities in primitive species.     

荤素膳食与脑梗塞关系的相关性调查

通过对荤食组（离退体老干部）２５９５人和素食组（老和尚）７３２人的膳食与脑梗塞患病率关系的相关性调查,发现两组由于膳食结构的不同导致血脂水平及血液粘滞度的差异,由此导致两组脑梗塞患者率也有非常显著的差异ｐ＜０．００５,ＯＲ＝２５．２６。说明荤食与脑梗塞病率之间有着明显的相关性,提示早期限制荤 食的摄入可以降低脑梗塞的患病率。     

急慢性疼痛病人电针感觉阈和痛阈的调查分析

目的:了解急性和慢性疼痛病人的电针感觉阈和痛阈的特点,以便选用适宜的电针参数进行镇痛治疗。方法:测定正常人、急性疼痛病人和慢性疼痛病人三组人群的感觉阈和痛阈,并进行相互比较。结果:急性疼痛病人的感觉阈和痛阈均低于正常人(均P<0. 01),明显低于慢性疼痛病人(均P<0. 01)。结论:急、慢性疼痛病人有不同的电针感觉阈和痛阈基础,急性疼痛病人相对较低,慢性疼痛病人相对较高。电针镇痛治疗时,电针强度的运用应因人而异。