1989年 · 第102卷第05期

A polyglycosides of Tripterygium wilfodii hook F (TWH) preparation with a code name of T2 is used in the present double-blind, controlled, cross-over study on the treatment of 70 cases of theumatoid arthritis (RA). An impressive curative effect of T2 is confirmed much more convincingly by the present study than that by the previously reported clinical open trials. The adverse reactions and the probable pharmacological mechanism of T2 are also discussed.

CA 19-9 is a carbohydrate antigen isolated from human colon carcinoma cell line, and is reportedly a tumor marker for pancreatic carcinoma. In this study we determined serum CA 19-9 in 71 normal subjects, 103 patients with benign digestive diseases, 85 patients with periampullary cancers, and 160 patients with other digestive cancers. Serum CA 19-9 was elevated only in 2.3% of normals and benign digestive disease patients, whereas it was increased in 72.7%, 86.4%, and 89.5% of pancreatic, ampullary, and choledochal carcinoma patients, respectively. Of other digestive cancer patients, it was elevated in 23.8%. In addition, very high serum CA 19-9 (>120 u/m) was more of- ten observed in patients with pancreatic, ampullary, and biliary cancer patients than in GL cancer patients (54.1% vs 9.4%, p<0.001). In 18 normal subjects and 68 patients with benign and malignant diseases, it was found that CA 19-9 content in the pancreatic juice was significantly increased in pancreatic, ampullary, and choledochal cancer patients, whereas in chronic pancreatitis patients it was normal, indicating that it is a specific and valuable tumor marker in differential diagnosis of pancreatic cancer.

Of 143 patients with Budd-Chiari syndrome treated from December 1982 to August 1988, 100 had intractable ascites, 78 had esophageal varices and 39 had upper gastrointestinal bleeding. In these patients, 49 had membranous obstruction, 134 had occlusive lesions of the inferior vena cava (IVC) above the confluence of the hepatic veins including 50 membranous obstructions, and 9 had occlusion of the hepatic veins. According to the location and extent of lesions, we classified this disease into eight categories; the severity of the disease and corresponding operative risk were used to divide the disease into four grades. One hundred and four patients (73%) were operated upon. There was no death in Stage I and II patients, but in Stage III and IV patients the mortality was 9% and 21% respectively. The overall operative mortality was 9.6%. Follow-up for 1 to 66 months revealed that 73% (76/104) had good results except 4 who died from other causes. Among 39 patients receiving conservative treatment, 13 (33.3%) died of late complications. They all belonged to Stage IV patients. We conclude that the earlier the treatment the better the results, and the operative procedure must be tailored to the etiology and underlying pathology.

Pathological observation was made in 100 surgically resected lung cancers of Yunnan tin miners: peripbcral type 44 including 9 scar cancers; central type 56, 27 of whom were early lung cancer, with limited initial loci in a well defined area. On the basis of dust retention in original sites of lung cancer and results of X-ray microanalysis, a scheme for calculating the relative probability of causation is formulated. The result of calculation shows that the contribution of exposure to radon daughters is about 7 times that of ore dust retention in the etiology of Yunnan tin miner's lung cancer.

Urine and serum ferritin levels were measured by a double-antibody radio-immunoassay in 96 normal adults and 57 patients with urologic malignancies. In the 96 adults, the urine ferritin level ranged from O to 28ng/ml. Elevated urine ferritin levels were observed in all 7 patients with renal pelvic carcinoma, 4 of 13 patients with renal carcinoma, 1 of 13 patients with well-differentiated (Grade I) bladder carcinoma, 8 of 19 patients with mcdian-differentiated (Grade Ⅱ) bladder carcinoma, and all 5 patients with poorly-differentiated (Grades III, IV) bladder carcinoma. These results indicated that urine ferritin assay was helpful in discriminating well-differentiated bladder carcinoma from the poorly-differentiated (P<0.01) in addition to differentiating renal pelvic carcinoma from renal carcinoma (P<0.05).

This is a study of the correlation between the age of animals and the osteogenic potential of free periosteal autograft. The tibial periosteum of 27 rabbits, ranging in age from 4-104 weeks, was stripped and implanted into the quadriceps. Radiographic and histologic examination demonstrated that new bone was formed in both the young and adult rabbits. The morphologic basis and mechanism of bone formation of periosteum are discussed. Maintenance of integrity of the cambium layer of the periosteal graft is emphasized. Free periosteal graft of adult rabbits in the "resting" state can retain its osteogenic potential and produce new bone.

A rare type of annular pancreas, in which the tail of the annular duct is fused with the dorsal pancreatic duct to form the main duct, and its diagnostic imagings of endoscopic retrograde cholangiopancreatography, hypotonic duodcnography, computed tomography and ultrasound are described. Annular pancreas is an anomaly embryologically formed by the ventral anlage of the pancreas as the duodenum rotates, mainly due to hypertrophy of the left ventral bud. According to the fusion pattern of the ventral and dorsal pancreatic ducts, annular pancreas can be divided into three types: type I, divisional annular pancreas; type II, branch annular pancreas; and type III, main duct annular pancreas. Endoscopic retrograde cholangiopancreatography, hypotonic duodenography, computed tomography and ultrasound can show the imagings of annular pancreas from different aspects, but the final diagnosis must be based on the evidence of endoscopic retrograde cholangiopancreatography or hypotonic duodenography combined with computed tomography or ultrasound.

Five patients from 3 families with Becker muscular dystrophy (BMD) were reported. The main clinical and laboratory findings were in common. Pairs of affected brothers are quite resembled each other. However, there are also some variations among different families. The disease occurred later in the first pair of brothers and was accompanied by macroglossia and red-green color blindness, while the second pair got the disease earlier, which was accompanied by heart impairment. It is interesting that both myogenic and neurogenic changes of EMG can be found in the same patient with BMD in our series.

We found binucleated neurons in 8 autopsied brains and one surgical specimen with the numbers varying from one to several. All were found in the brain stem, mostly in the pons, next in the thalamus, and the least in the mid-brain and medulla. None was found in the cerebrum and cerebellum. The ages of the patients varied from 24 days postpartum to 74 years. More binucleated neurons were found in new born babies. The patients suffered from various disease which might be related to ischemic state of the brain. The binucleated neurons might be an abortive hyperplasia of the nerve cells reacting to unfavorable circumstances. According to our observations, binuclcated neurons are not very rare.

In China, progress in researches of cardiovascular diseases is relatively rapid. In the present overview an attempt is made to include the main advances of the last 5 years.