Correction of immunologic disorders in patients with burns

Addition of immunomodulating therapy with Thymalin, a thymus agent, to the multimodality therapy of burnt patients contributes to a rapid normalization of immunological parameters. The most marked immune response was observed 7-10 days after a therapy course initiated in the early periods of burn disease in patients with severely depressed T-system immunity and a high sensitivity to the drug. Inclusion of a donor blood leukomass transfusion course activates the cellular link of the immune system just after the treatment course, but fails to favour a stable normalization of thymus-dependent lymphocyte ratios.     

The detection rate and clinical and diagnostic values of L forms of the pathogen in patients with pulmonary or extrapulmonary tuberculosis

The detection rate and clinical and diagnostic values of L-forms of pathogens were determined in patients with pulmonary and extrapulmonary tuberculosis. Simultaneous culturing the specimens for typical and L forms of Mycobacterium tuberculosis (MBT) increased the number of positive results by isolating only L-forms by 10.3% in patients with pulmonary tuberculosis and by 27.7% in those with extrapulmonary tuberculosis. No bacterial isolation in tests only for typical forms of MBT is shown not to be true and a purposeful search for L-forms of MBT enhances the efficiency of a bacteriological test. This is of great significance in confirming the specific nature of the disease, its progression, in choosing a treatment policy, in evaluating is efficiency, in defining prognosis, and in correcting preventive measures in the focus of tuberculous infection. With extrapulmonary tuberculosis, the tuberculous nature of isolated L-forms has been evidenced by the polymerase chain reaction.     

Comparative analysis of hepatitis C virus core protein in the plasma and serum samples from HCV-infected blood donors and patients with hepatitis C

The aim of the study was to develop a sensitive and specific method for revealing the direct marker of hepatitis C virus (HCV)--core protein in the serum and to test it in the laboratory setting. Experiments were made on plasma and serum samples from asymptomatic HCV-seropositive blood donors (n=65), patients with acute (AHC) and chronic (CHC) hepatitis C (n=295), and HCV-seronegative blood donors (n=20). The processing protocol for serum included their concentration by means of polyethylene glycol and subsequent treatments of pellets to detect core protein in free virions, nonenveloped nucleocapsids, and immune complexes. This allowed an assay to be developed for the detection of core protein, by using a sandwich ELISA. Inclusion of a combination of three original monoclonal antibodies into the sandwich could reveal in the samples core proteins of at least 3 genotypes of HCV (1, 2, and 3) with a sensitivity of 20 pg/ml in the majority of HCV-infected subjects. The results of determination of core protein and HCV RNA correlated with a high degree of sensitivity. To detect HCV in the blood of patients with AHC, it was shown to be sufficient to find freely circulating virions whereas an analysis of immune complexes should be included in cases of CHC to achieve more sensitivity. The findings are a basis for developing a test system for the diagnosis of hepatitis C, including its early stages before seroconversion and for determining a viral load during interferon therapy. Introduction of the method into practice increases the reliability of the diagnosis of hepatitis C and virus-free safety of blood transfusions.     

肿瘤相关基因Cap43在胰腺癌中的表达及意义

目的研究肿瘤相关基因Cap43在胰腺癌组织中的表达情况,探讨其对胰腺癌的诊断价值。方法收集1999年4月～2002年8月长海医院外科手术切除胰腺癌标本和癌旁正常组织33例,诊断均由病理证实。男性22例,女性11例,年龄30～73岁,平均58．1岁。所有组织标本按肿瘤、癌旁(正常)配对。采用RT-PCR和Northern杂交方法研究Cap43 mRNA表达情况。结果 RT-PCR结果显示,Cap43在肿瘤组织中表达显著上调,其在肿瘤组织和癌旁正常组织的扫描值分别为4 033±1 986和2 244±1 145,有显著差异(P<0．001)。Northern杂交亦显示Cap43在肿瘤组织中表达显著上调,相同病例的RT-PCR结果与Northern杂交的结果有较好的一致性,经回归分析,没有显著性差异(P>0．1)。结论 Cap43在胰腺癌组织中呈显著高表达,其有可能成为胰腺癌早期诊断的重要标志物。     

Polymerase chain reaction and ligase chain reaction in the diagnosis of gynecological tuberculosis

The polymerase chain reaction (PCR) and the ligase chain reaction (LCR) were evaluated and compared on 55 gynecological samples collected from women with active gynecological tuberculosis (Group 1), gynecological diseases other than tuberculosis (Group 2), and active tuberculosis elsewhere in the body without evidence for gynecological tuberculosis (Group 3). Acid fast staining and culture of Mycobacteria appeared to be ineffective in all specimens. The sensitivity of both amplification methods was 94.7% (one of the 19 patients with non-tuberculosis). The LCx method showed a very high inhibition by specimens (64.1% of negative samples versus 16.7% for PCR and LCx could be useful tools in the diagnosis of gynecological tuberculosis.     

Range of combined treatment of locally advanced skin cancer

Due to combined use of surgery, chemo- and radiotherapy, 58.8% of patients with locally advanced squamous cell carcinoma survived for 5 years. More organ-saving operations could be performed as a result of administering cisplatin, bleomycin and 5-fluorouracil chemotherapy in conjunction with radiation and subsequent surgery. Greater extent of tumor excision and microsurgery involved lower incidence of relapse. Yet, the preliminary results of our combined treatment pointed to relatively high frequency of objective response matched by lower incidence of relapse which calls for further investigation.     

Invasive aspergillosis in immunocompromised patients

AIM: To analyse results of treatment of invasive aspergillesis in immunocompromised patients for 2000-2002. MATERIAL AND METHODS: The study was made of patients who, when treated with antibiotics, exhibited foci in the lungs typical for invasive aspergillesis. Aspergillas were detected in the sputum, bronchoalveolar lavage, bronchial wash-ups, aspergilla antigen (galactomannan) was detected in the blood. RESULTS: Invasive aspergillesis was diagnosed in 25 patients. 13 (52%) patients were treated with adjuvant glucocorticoids. 19 (76%) patients had neutropenia. All the patients had fever. Foci in the lungs were in 24 patients. Aspergillas were detected in 15 patients, a positive antigen galactomannan in 7 patients. A. Fumigatus, A flavus, A. Niger occurred in 67, 26.5 and 6.5% patients, respectively. All the patients received amphotericin B (median of the treatment reached 38 days, total dose 880-3500 mg). In 5 patients amphotericin B was replaced for liposomal amphotericin B because of high creatinine. 7 patients continued with itraconasol in a dose 400-600 mg/day. The foci were removed in 3 patients. The cure was achieved in 12 patients, 13 patients, 13 patients died (cause of death--respiratory insufficiency). CONCLUSION: Lethality in invasive aspergillesis in immunocompromised patients remains high--52%. Cultural detection of mycelial fungi was, as a rule, delayed. Early diagnosis of the disease requires monitoring of the aspergilla antigen in the blood and computer tomography of the chest especially in fever persisting in the treatment of wide-spectrum antibiotics.     

Long-term results of comprehensive treatment for cervical cancer with poor prognosis]

The data on a randomized treatment of 100 patients with locally advanced cervical carcinoma are discussed. Half of the patients received complex therapy while the rest--radiation alone (control). The modality also included immunotherapy with epithalamin 100 mg, intramuscularly, neoadjuvant intraarterial polychemotherapy with 5-fluorouracil 2 g/m2 and cisplatin 100 mg/m2, concurrent radiotherapy with an interval and 4-6 courses of adjuvant polychemotherapy. As a consequence, short-term results improved by 18.8% in cases tumor size under T3; end-results--by 14%. Improvement in survival was accounted for by causing tumor process to slow down considerably. The adjuvant polychemotherapy component was thought to be responsible for a 25.4% increase in one-year survival and 12.5%--in 3-year survival.     

Short-term and end-results of combined treatment of patients with stage-II cervical cancer]

The short-term and end-results of combined therapy of 109 patients with stage II epidermal carcinoma of cervix uteri are presented. Preoperative intracavitary large-fraction contact gamma therapy from the AGAT-B installation was followed by Wertheim's or simple hysterectomy, lymphadenectomy and distant gamma therapy. Postoperative mortality rate was 0.8%; five-year survival--81.8 +/- 4.4%. Early- and late-onset postoperative complication frequency was largely determined by extent of surgery rather than preoperative intracavitary irradiation.