1989年 · 第102卷第03期

The morphologic classification and clinical spectrum of 1 001 cases of primary glomerulonephritis (GN) in Jinling Hospital during 1980-1988 were analysed. It was found that the incidence of mesangial type lesion including mesangial proliferative GN, IgA nephropathy and IgM nephropathy ranks first (21.5%, 32.1% and 10.1% respectively), which is not only the commonest cause of patients clinically manifesting nephrotic syndrome and gross hematuria but also the predominant type of nephritis causing uremia and hypertension.

Twenty patients underwent endourethral urethroplasty with free prepuce graft in combination with transurethral resection of scar for posterior urethral stricture. Two-year follow-up showed that they had good continent and free voiding results. Problems about surgical technique were detailed. We conclude that a free full-thickness prepuce evenly patched by means of the tube balloon to the freshly prepared wound derived from the stricture is the key to surgical success.

For the reseach on the structure and function of the HDL apoproteins, we have successfully constructed a complete genomic library, in self-prepared EMBL3 λ vector and the packaging extracts of lysogenic strains BHB2688, BHB2690, from a Chinese fetal liver, which will be widely used in the research on the structure and function of apoproteins. In this study, a DNA sequence polymorphism, revealed by digestion of human DNA with the restriction endonuclease Sst1 and hybridization with an apoprotein AI cDNA probe, has been shown to be located at apoAI/CIII gene-loci. Three gene related fragments (5.7Kb, 4.0Kb and 3.0Kb) were detected. The 5.7Kb fragment is common and the polymorphism is demonstrated by the presence of either a 4.0Kb fragment (S1 allele) or the 3.0Kb fragment (S2 allele); Individuals were genotyped S1S1 or S1S2. Our result showed that the frequency of genotype S1S2 was higher in hypertriglyceridemic subjects than that in normol-ipidemic subjects.

The in vitro induced differentiation of a number of human leukemia cell lines by chemical inducers not only provides a valuable model system for the study on the mechanism of hematopoietic cell proliferation and differentiation at both cellular and molecular levels, but also reveals a new prospect in the treatment of leukemia. In order to find out the possibility of applying inducing agents to the patients with various types of leukemia, the bone marrow cells in primary culture from 50 patients with leukemia were tested for their inducibility in response to the inducers. Only M3 leukemia bone marrow cells can be markedly induced by retinoic acid to the myeloid terminal cells with positive NBT reduction while the cells of other types respond with uncertainty. TPA is able to cause a macrophage-like differentiation in bone marrow cells of all types of leukemia except M1. However, the lukemic cells of chronic myelogenous leukemia in lymphocytic blast crisis will lose response to TPA. The cultured bone marrow cells of acute lymphocytic leukemia respond neither to retinoic acid nor to TPA. Homoharringtonine, a chemotherapeutic drug used in the so-called HOAP regimen for acute nonlymphocytic leukemia, seems to possess the capability of inducing HL-60, the promyelocytic leukemia cell line, to NBT positive myeloid terminal cells, although the inducing effect is weaker than retinoic acid.

Serum ribounclease (RNase) activity and its isoenzymes were determined by biochemical and PAGE electrophoretic separation technique in 20 patients with pancreatic cancer, in 27 with other gastroenterologic malignant tumors, 8 with acute pancreatitis, 7 with chronic pancreatitis, 5 with leukemia, 3 with chronic uremia of glomerulonephritis, and in 30 adult normal controls. Serum A1AT rocket immunoelectrophoresis and carcinoembryonic antigen (CEA) radioimmunoassay were also carried out simultaneously.

Using perinatal monitoring, we evaluated retrospectively 793 late pregnancies with regard to the overnight 12-hour urine estriol/creatinine ratio (E3/C) and fetal heart rate (FHR). The results revealed that l) FHR corrected the false positive rate of E3/C by 13.7% (93/677); 2) E3/C gave reliable results in perinatal prediction in 81 of the 116 suspicious FHR cases (70%, 81/116); 3) When both tests were abnormal the incidence of poor perinatal results increased by 83.7% (36/43), and the perinatal mortality (7%, 3/43) in patients with abnormal values in both methods was 35 times higher than that in patients with normal results in both tests (0.2%, 1/462); 4) Both negative FHR test and normal E3/C could be reassured, as the risk of death in uterus within a week of both normal tests was only 0.13% (1/793). It is suggested that the E3/C may be used as a first line test for perinatal monitoring, where E3/C value is lower than normal, FHR test is added to increase the reliability of perinatal diagnosis, especially in the moderate and severe hypertensive disorders of pregnancy.

The functions of glucagon were studied experimentally and clinically. It was found that glucagon (2×l0-6g/ml) could not induce any demonstrable changes in the longitudinal contraction and tonicity of the isolated muscle of the lower esophageal body in 4 rats, nor could cause (0.2 mg iv) significant changes in swallow motility of the esophagus and lower esophageal sphincter (LES) (the esophageal barium transit time, the largest esophageal caliber, the angle of esophageal contraction, the largest LES caliber, and the amount of barium retenOon at LES) in 6 volunteers under serial-radiography but it (0.2 mg iv) could cause hypomotility of the stomach and duodenum in 19 volunteers. No obvious side-effects were found in 20 volunteers. The recent experimental evidences have suggested that the inhibitory effect of glucagon on the motility of the smooth muscle of the alimentary tract may not be due to its direct action on the receptor, but to its interference with intramural cholinergic neuronal transmission.

A double blind clinical trial on prostaglandin for cervix ripening prior to vacuum aspiration for termination of early pregnancy in primigravidae was carried out in 68 patients with 6-11 week's, gestation. The patients were randomly treated with either l.0 mg of 15-methyl-prostaglandin F2α methyl ester vaginal suppository or a placebo suppository. A mean cervical dilation to 6.6 mm was achieved with minimal side effects in the prostaglandin group as against 4.3 mm in the placebo group. The 15-methyl-prostaglandin F2α methyl ester suppository technique seems to be effective, safe and simple in ripening the cervix for termination of early pregnancy in primigravidae.

Intracellular accumulation of sorbitol, resulting from the increased glucose flux through polyol pathway with the action of aldose rednctasc, has been found pathogenic to chronic diabetic complications. It has been reported that baicalin and Glycyrrhiza uralensis Fisch can inhibit rat lens aldose reductase in vitro. In order to determine whether the said medicinal herbs give the inhibitive effect in vivo, 10 streptozotocin induced diabetic rats were treated with baicalin 150 mg/kg.d and liquid extract of licorice (LEL) 7.5 ml/kg.d for a week. RBC sorbitol was determined by a fluorometric assay before and after the treatment, as well as one week afterwards. It was found that oral baicalin and licorice dramatically reduced sorbitol levels in RBC without sffecting blood glucose levels. The sorbitol levels was restored to its original values one week after discontinuing the treatment. The present study has demonstrated the effectiveness of baicalin and licorice in reducing RBC sorbitol levels in diabetic rats. Its mechanism is presumably through inhibition of aldose reductase. The feasibility of its clinical application for the control of diabetic complications is under investigation.

Intra-articular fractures involving the subchondral bone were produced surgically in both left and right medial femoral condyles of twenty rabbits. The edges of the fractures on the left side were well approximated, while those on the right side maintained with a gap of 2 mm. Transmission electron microscopic study of the nearby articular cartilages conducted l, 2, 3, 4 and 5 months after the fracture revealed the following results: l) The neighbouring articular chondrocytes tended once to assume the configuration of fibroblasts; 2) Those remote from the fracture showed both degeneration and hyperplasia to form clones; 3) Even after the intra-articular fractures were well-healed, degeneration and hyperplasia of the articular chondrocytes nearby the fracture would persist for some time.