1988年 · 第101卷第08期

This paper presents a group of 200 patients with repeated occurrence of ecchymosis on the extremities and/or menorrhagia occasionally associated with gum bleeding or epistaxis. 152 were female and 48 male, with age ranging from 16 to 42 years. The results of laboratory examinations such as blood platelet count, bleeding time, platelet morphology, platelet adhesiveness and platelet aggregation induced by ADP, epinephrine and ristocetin were all normal. Using SJAMP as a new platelet aggregating agent, 74 cases failed in platelet aggregation, the abnormality rate being 37%. SJAMP, a new anticoagulant isolation from Chinese sea-cucumbers, can induce a special aggregation tracing on normal platelet-rich plasma. Therefore, we consider that the patients with failure of SJAMP-induced aggregation may suffer from a new variant of platelet aggregation defect.

We designed a new trapezoid compression plate (TCP) system. Electric measurements and photoelastic models have demonstrated that the device or TCP conforms to the principle of identical strength, and that it not only provides rigid fixation at the fracture site but also is flexible at both ends. With the use of TCP, immediate active movement and early weight-bearing are possible postoperatively, and active exercise promotes fracture healing with adequate callus. Compared with thin plates of identical thickness (ICP-Tn) in animal experiments, 95% of the fractures fixed with TCP healed, whereas nonunion occurred in over half of the fractures fixed with ICP-Tn. Blood supply disturbance and bone structure changes following plate fixation disappeared after 12 weeks. 136 fractures of long bone of the extremities in 134 cases were treated with TCP from February 1982 to February 1987. Of these, 1/3 were multiple or comminuted fractures. All fractures were excellently healed after treatment. The function of 98% of the affected limbs was rated as excellent and good. Complications occur red in 6.5% of the cases.

Two cases of irritated seborrheic keratosis of the eyelid were studied clinicopathologically. One unusually large tumor was confirmed benign electron microscopically. Under light microscope, irritated seborrheic keratosis was diagnosed by the presence of its "stuck on" configuration, numerous horn cysts, and squamous eddies among the proliferated basaloid and squamoid cells. Ultrastructurally, both the basaloid cell and squamoid cell showed high differentiation and well-formed organelles in the cytoplasm. The nuclear chromatin was even and fine, and the nuclear membrane smooth and regular. Tonofilaments and desmosomes could be found. These ultrastructural findings were consistent with the concept that seborrheic keratosis develops on the basis of local arrest of keratocyte maturation.

It has been confirmed that two species of free-living amoebae of the genus Naegleria, i.e., N. fowleri and N. australiensis are intective to man and cause fatal meningoencephalitis known as primary amoebic meningoencephalitis. About 130 cases have been reported worldwide with two cases in China: one in Beijing caused by Naegleria fowleri, and the other in Shanghai with unknown causative agent. From a survey of pathogenic free-living amoebae in Shanghai, we found a strain WO42302 isolated from the cooling water of a power plant in Shanghai in April 1986. It could be fatal to the mouse. Culture of the brain tissue of the dead mice was positive for the amoeba. According to the morphology of trophozoites and their ability to transform into a temporary flagellate stage, the parasite belongs to the genus Naegleria. But the strain WO42302 was different from N. fowleri, by several ultrastructural characteristics, the protein and isoenzyme patterns of acid phosphatase, alkaline phosphatase and lactate dehydrogenase and its lower virulence. The results obtained in the present study infer that the pathogenic strain WO42302 may belong to the species N. australiensis, which is new to China.

A double bridge PAP method using antibodies to HBsAg was applied to formalin-fixed paraffin sections of 153 postmortem liver specimens collected during the past 30 years. Our preliminary observations support the following hypotheses: Membranous HBsAg may be associated with liver cell injury; membranous HBsAg in liver cells occurs before the necrotizing episode of acute hepatitis. We consider that perhaps cytoplasmic HBsAg may not be associated with liver cell injury but is only an expression pattern mainly found in the carriers.

Chediak-Higashi syndrome is a rare autosomal resessive disease. It was first reported by Cesar in 1943. Since then, similar cases were observed in North America, Latin America, Europe and Asia. Only three cases have been reported in our country. We report a case herein.

The protective effect of preopcrative high-dose insulin on ischemic myocardium was studied in dogs. Histochemical reaction, ultrastructure and water content of the heart muscle, hemodynamic condition before and after restoration of the circulation were observed. Dogs were divided into two groups and 5 mEq/L potassium cardioplegic solution was infused. In the insulin group, insulin 10 U/kg/h, glucose 1 g/kg/h and potassium chloride 0.25 mEq/kg/h were infused from the onset of anesthesia till aortic cross clamping. The control group received the same infusion but without insulin. All parameters suggested moderate damage of heart muscle after 90 minutes of ischemia in insulin group, which recovered to the preischemic level completely 30 minutes after restoration of circulation, while in the control group, the ischemic damage was severe after 90 minutes of cross-clamping, with delayed recovery even after 30 minutes of reperfusion of the heart. The difference between the two groups was statistically highly significanL The experiment indicates that myocardial protection is improved with high-dose insulin.

The prevalence and pattern of cardiovascular problems in Hong Kong are basically those of an ageing subtropical Chinese community, influenced by the impact of westernization and urbanization. Their trends over the past decades have been hall-marked by a decreasing prevalence of rheumatic and congenital heart disease, and a plunging incidence of rheumatic fever, associated with a rapidly increasing prevalence of ischemic and degenerative type of cardiovascular diseases. In the 1990s, rheumatic heart disease will be less prevalent but may still account for 10% of the problem. Ischemic heart disease and degenerative type of lesions will certainly be more commonly seen and account for 40% and 25% respectively, while the prevalence of hypertensive diseases and congenital heart disease may hope fully stays at 10% and 5% levels, respectively.

The changes of pituitary-adrenal function in diabetics and the reserving ability of pituitary ACTH-secreting cells were studied. 33 normal subjects served as controls. The diabetics were divided into two groups: insulin-dependent diabetes (IDD) group (20 cases) and noninsulin-dependent-diabetes (NIDD) group (31 cases). Aminoglutethimide (AG) test (0.25, q6h×2 days) was done in 13 normal controls, 15 IDD and 18 NIDD patients.

Since 1970, a cancer registration system has been in operation in Zhongshan City, Guangdong. From 1974 to 1983, 1 428 cases of nasopharyngeal carcinoma (NPC) were diagnosed and their courses of disease investigated. The prognostic factors for NPC were analysed by Cox model and compared with the conventional methods. The results showed that Cox model is more effective in fitting the survival data and is more sensible in analysing prognostic factors for NPC than the single variable methods.