血液胆碱酯酶活力测定方法的进一步研究Ⅰ．红细胞／全血胆碱酯酶活力比例及红细胞计数校正酶活力值的研究

应用硫代乙酰胆碱－联硫代双硝基苯甲酸（ＡＳＣｈ－ＤＴＮＢ）比色测定法，测定了４０名健康者及５名贫血者血样的全血胆碱酯酶（ｂｌ－ＣｈＥ）活力值、红细胞胆碱酯酶（ｅ－ＣｈＥ）活力值及血浆胆碱酯酶（ｐ－ＣｈＥ）活力值，探讨它们之间的比例关系并用红细胞计数值（ＲＢＣ）校正酶活力。结果表明：ｅ－ＣｈＥ与ｂ１－ＣｈＥ之间关系密切（ｒ＝０．９４８，Ｐ＜０．００１），ｅ－ＣｈＥ稳定地占ｂｌ－ＣｈＥ的８４．９７％，在质和量两方面验证了以ｂｌ－ＣｈＥ值表示ｅ－ＣｈＥ值的可靠性和可信程度，血液胆碱酯酶（ｂ１ＣｈＥ）活力主要取决于ｅ－ＣｈＥ活力，ＲＢＣ值的离散对ｅ－ＣｈＥ值有极大影响，故用ＲＢＣ值校正ｅ－ＣｈＥ活力，这样可缩小人群测定值的变异度，得到较难确的群体均值；消除男女之间测定值的差异，建立更合理和通用的临界参比值，极大地方便了使用，使血液胆碱酯酶（ＣＨＥ）活力测定法在防治有机磷农药中毒中的应用，更为敏感和特异。     

In-vivo studies on Haemaccel-fibronectin interaction in man

An enzyme-linked immunoassay has been recently set up for direct measurement of the binding capacity of plasma fibronectin to gelatin. This binding capacity could be completely inhibited in vitro by an eight-fold excess of gelatin, of Haemaccel, but not of Geloplasma. On the contrary, the levels of immunoreactive fibronectin measured by laser nephelometry did not change, in presence of 10 to 1000 micrograms ml-1 of gelatin, of Haemaccel or of Geloplasma. When infused into normal volunteers, Haemaccel provoked a strong and immediate inhibition of the plasma fibronectin binding capacity to gelatin. This inhibition was dose-dependent and maximal after infusion of 500 ml of Haemaccel. Twenty-four hours after this infusion, there was a progressive recovery of the gelatin-binding capacity, which was almost completely achieved 96 h later. The formation of complexes between Haemaccel and fibronectin was demonstrated by gel filtration chromatography and by affinity chromatography. Immunoreactive plasma fibronectin levels remained unchanged up to 24 h after infusion of 500 ml of Haemaccel. A transient decline to 50% of its initial value then occurred the second day after the infusion. Therefore, a delay existed between the formation of fibronectin-Haemaccel complexes and their elimination from the bloodstream. This delay decreased when smaller volumes of Haemaccel were infused, which strongly suggests that plasma fibronectin is cleared by means of Haemaccel and does not seem to play a role of opsonin in these conditions.(ABSTRACT TRUNCATED AT 250 WORDS)     

Effects of zymosan-activated plasma and phorbol myristate acetate on isolated, perfused rabbit lungs

The effects of complement activation on pulmonary vascular permeability are disputed. In rabbit lungs perfused with autologous blood, zymosan activated plasma (ZAP) induced a moderate increase in pulmonary vascular resistance (PVR), but did not detectably change the vascular permeability within 2 h. The stronger neutrophil granulocyte (PMN) activator, phorbol myristate acetate (PMA), usually gave larger PVR increases and also increased pulmonary vascular permeability. Lungs from neutropenic animals, similarly perfused and given PMA, showed unchanged PVR reactions but had no apparent increase in vascular permeability. Lungs perfused with cell-free medium and given PMA displayed modest PVR increases, and no measurable permeability change. The lung preparatory procedure itself markedly influenced leukocyte circulation. Exsanguination of lung donors decreased the concentration of circulating PMN significantly, and they virtually disappeared from the perfusate within minutes after start of lung perfusion. PMN-mediated effects must therefore have been caused by cells already sequestered in the lungs. We conclude that ZAP does not induce an increased pulmonary vascular permeability in isolated, perfused rabbit lungs, in contrast to PMA. The permeability effects of PMA appear to be PMN dependent.     

Primary Aldosteronism

ABSTRACT A follow-up examination was performed one month to 20 years after adrenalectomy in 28 cases with surgically treated primary aldosteronism due to adrenal adenoma. The mean age at diagnosis was 45, and the mean duration of hypertension seven years. Severe hypertension with a diastolic blood pressure of 130 mmHg or more was observed in 35%. Postoperatively cerebrovascular catastrophe developed in two cases, both of which belonged to the group of patients with severe hypertension. Normalization of blood pressure was observed in 70% and in the remaining subjects the blood pressure was lower than at diagnosis. The blood pressure response to adrenalectomy appeared unpredictable in view of such parameters as the initial blood pressure, age at diagnosis, and duration of the hypertensive state. Toxicosis during pregnancy and metrorrhagia was observed with unexpectedly high frequency in this study population. Low ambulatory plasma renin activity was recorded at the follow-up in 15 out of 18 subjects studied in the absence of evidence of hyperaldosteronism.     

急性冠脉综合征中妊娠相关蛋白-A与斑块不稳定性

目的探讨妊娠相关蛋白-A(PAPP-A)在急性冠脉综合征(ACS)中的变化及其与斑块不稳定性的关系。方法26例冠脉正常者作为对照组,稳定性心绞痛(SA)组22例,ACS组40例,包括不稳定性心绞痛(UA)20例、急性心肌梗死(AMI)20例。定量检测外周血PAPP-A、C-反应蛋白(CRP)、肌酸激酶MB同工酶(CK-MB)。对所有冠脉造影显示狭窄≥30%的病变进行影像学分析。结果ACS中PAPP-A含量(13·19±4·04)mIU/L明显高于SA(5·47±3·00)mIU/L(P<0·01)及对照组(5·09±2·19)mIU/L(P<0·01);并且与CRP(r=0·62P<0·01)、复杂性狭窄的数量(r=0·45P<0·05)有显著的正相关。结论PAPP-A在ACS患者外周血中明显升高,可能与斑块的不稳定性有关,对ACS的危险度分层可能具有一定的价值。     

血浆成分分离治疗类风湿性关节炎21例

１９９２年１０月以来，对２１例类风湿性关节炎共进行了７１人次血浆成分分离治疗（ＰＦ），平均１－２周内进行３．６人次，并在治疗前后进行总体评估。结果示：疗程完成后，全部病例的体力活动和实验室指标均有不同程度改善，３例活动受限者治疗后均能自由行走。平均每次分离血浆５７３１±１２９ｍｌ，其中ＩＣ，ＩｇＧ，ＩｇＧ，ＩｇＡ，均有统计学意义的减少。血沉从８０．２１±３４．００ｍｍ／ｈ降到５１．４０±３１．２８ｍｍ／ｈ，８例类风湿因于阳性的患者中，５例阴转，作者认为ＰＦ正在成为一种实用的技术，并可能是治疗类风湿关节炎最好的方法之一。     

Orthogonal solid-phase synthesis of a monobiotinylated analog of Neuropeptide Y

Analogs of Neuropeptide Y (NPY) were synthesized with conventional Boc/benzyl protective group strategy. Instead of Asn⁷ in the native scquence, Boc-Lys(Alloc)-OH was incorporated. At the end of the synthesis the Alloc group was selectively removed by palladium-catalyzed hydrostannolysis and biotin coupled to the e-amino group of Lys⁷. After cleavage and characterization with plasma desorption mass spectrometry the N^e-7-biotinyl-[Lys⁷]-NPY and the nonbiotinylated analog [Lys⁷]-NPY were investigated as ligands to the NPY receptor from rat cerebral cortex. Both analogs were found to be high affinity ligands to the NPY receptor and bound with essentially the same affinity as unmodified NPY.     

妊娠相关血浆蛋白A水平与不稳定心绞痛患者冠状动脉狭窄病变形态的关系

[目的]探讨不稳定型心绞痛患者妊娠相关血浆蛋白(PAPP-A)水平与高敏C-反应蛋白(hs-CRP)及动脉粥样硬化斑块稳定性的关系.[方法]不稳定型心绞痛组患者42例,稳定型心绞痛组38例.冠状动脉造影前检测PAPP-A和hs-CRP,根据造影结果将冠状动脉病变分为复杂狭窄和光滑狭窄.[结果]稳定型心绞痛组有28例(74%)患者至少有1支血管狭窄≥70%,多于不稳定型心绞痛组的24例(57%),P＜0.05;不稳定型心绞痛组中33例(79%)有1处以上的复杂狭窄,多于稳定型心绞痛组(22例,58%,P＜0.05);PAPP-A与hs-CRP正相关(r=0.44,P＜0.001);不稳定型心绞痛组与稳定型心绞痛组相比,hs-CRP(4.40 mg/L±0.003 mg/L vs 0.48 mg/L±0.016mg/L,P＜0.001)和PAPP-A(18.40×10-3 U/L±0.002×10-3U/Lvs 7.79×10-3 U/L±0.001×10-3 U/L,P＜0.001),差异均有统计学意义;两组中有复杂狭窄者的PAPP-A和hs-CRP水平显著高于无复杂狭窄者.[结论]PAPP-A可作为评估冠状动脉斑块稳定性的血清学指标之一.     

Cyclic hormonal replacement therapy after the menopause: Transdermal versus oral treatment

Summary In an open, randomized, comparative, between-patient trial, 45 postmenopausal women were treated for 4 months with cyclical transdermal oestradiol 0.05 mg per day or oral conjugated equine oestrogens 0.625 mg per day, in both cases, plus, medroxyprogesterone acetate 10 mg per day on the last 8 days of each cycle. Similar relief from postmenopausal symptoms was obtained with both treatments. Post-treatment histological evaluation of the endometrium did not reveal neoplastic or hyperplastic change in any patient.Early follicular-phase plasma oestradiol levels were observed only after transdermal oestradiol. There was a significant reduction in serum total cholesterol and LDL cholesterol in both treatment groups, with no difference between treatments, whereas serum triglyceride levels were decreased only by transdermal oestradiol. Plasma calcium and phosphorus fell significantly and serum intact parathyroid hormone rose significantly, with no difference between the therapies. No significant changes were observed in clotting factors.Transdermal oestradiol appears to be an effective and safe hormonal replacement therapy, and this route of administration may be responsible for the more useful action of the drug on serum lipids and plasma oestradiol levels.     

The pitfalls of the dexamethasone suppression test: A biological marker of endogenous depression?

In the past few years there have been numerous publications which have stressed the value of the dexamethasone suppression test (DST) as a diagnostic marker of endogenous depression. Our own studies in 333 psychiatric inpatients and 121 healthy subjects did not reveal a differential diagnostic use for the DST. This result is in good agreement with other results in the literature. Our data demonstrate that intervening variables such as severity of illness, weight loss, sleep disturbances, situational stress, drug and alcohol withdrawal, and the pharmacokinetics of dexamethasone have an important influence on DST results, regardless of the diagnostic classification.